The Relationship Between Children’s Screen Time and the Time They Spend Engaging in Play: An Exploratory Study

ABSTRACT

Introduction

Play is a critical daily occupation that facilitates children’s learning of essential life skills. However, with the growing use of, and accessibility to, online-linked devices, children are engaging more and more in screen-time linked activities and less time in non-technology play. Therefore, it is crucial to understand the influence of children’s screen-time use on their play patterns. This study aims to explore the relationship between school-age children’s screen time and their engagement and participation in play occupations.

Methods

Twenty-six pairs of parents and children were recruited to complete the Children’s Play Scale (CPS), parent and child versions of the Children’s Screen Time Use Report (CSTUR), and the Children’s Perceptions of Their Play (CPTP). Data were analyzed using Spearman’s rho correlations and linear regressions with bootstrapping.

Results

Two regression models found that weekday social screen time accounted for 30.7% of the total variance (p = .002) of social play while weekend educational screen time, weekday interactive screen time, and weekday passive screen time together accounted for 55.6% of the total variance (p < .001) of active play.

Conclusion

The study findings provide evidence that a relationship exists between school-aged children’s screen time and play engagement and participation. Further research is recommended on this topic.

KEYWORDS:

• Play
• screen time
• children
• video games

Introduction

Play

Play is intrinsically motivated, fun, and meaningful and is one of the most important occupations for children (Lynch & Moore, 2016). Children can explore, experiment, and express themselves creatively in play in an unrestricted, free, and voluntary way while also learning life skills like problem-solving, teamwork, and communication (Ginsburg & Committee on Psychosocial Aspects of Child and Family Health, 2007). As a result, play is an occupation that is crucial for children’s cognitive, emotional, social, and physical growth and development (Ginsburg & Committee on Psychosocial Aspects of Child and Family Health, 2007).

Types of Play

According to Parten (1932), children move through six stages of play in their early childhood, from simple solo activities to more complex group activities. From birth to the age of four, children participate in unoccupied play, followed by solitary play and onlooker play, parallel play, associative play, and cooperative play, according to children’s developmental milestones (Parten, 1932). Previous studies also indicated the importance of pretend play in early childhood (Slot et al., 2017, Weisberg, 2015). Pretend play is a type of playful behavior that incorporates nonliteral action, and was found to be helpful for children to develop their social, affective, and cognitive abilities like self-regulation, symbolic thinking, creativity, and counterfactual reasoning (Slot et al., 2017, Weisberg, 2015). Slutsky and DeShetler’s (2017) classified play into three main types: (i) technology play, including technology-based activities, such as playing video games; (ii) non-technology play, including activities that do not involve technological devices in indoor areas, such as playing with toys; and (iii) outdoor play, referring to activities done outdoors, including free play and ride-on toys (Slutsky & DeShetler, 2017).

Children’s Perceptions of Play

Understanding play from children’s perspective is crucial as they may perceive play occupations differently from adults. Glenn et al. (2013) study found that children perceived almost anything as play if it was experienced as fun. Similar to Lee et al. (2015) study conducted in Japan, children thought that anything that was fun could be play. They further categorized the characteristics of play into four themes: (1) socializing; (2) achievement; (3) emotions; and (4) freedom. Veitch et al. (2010) ascertained that children who had a social network in their neighborhoods were more than 2.5 times as likely to play outside than those who did not have many friends. Brockman et al. (2011) study provided further evidence that children were motivated to play because of socializing and a sense of freedom. They perceived almost anyone to be their playmates, especially those who were nice and friendly, though siblings and friends were most preferred most often (Lee et al., 2015).

Play As Human Occupation

According to Lynch and Moore (2016), play “is a subjective experience of joy and fun, that comes from engaging in freely chosen, intrinsically motivated, self-directed meaningful occupations; play transactions take place between the child and the environment (including the virtual)” (p. 519) and focuses on the manner of engagement instead of the end product. Moreover, Bundy and Du Toit (2018) defined play as “transaction characterized by relative intrinsic motivation, relative internal control, and suspension of reality that is framed in such a way as to separate it from ‘real life’” (p. 808). In the Occupational Therapy Practice Framework − 4th edition (OTPF-4), play is specifically delineated as part of it (American Occupational Therapy Association, 2020). In the OTPF-4, play is defined as “active engagement in an activity that is intrinsically motivated, internally controlled, and freely chosen and that may include the suspension of reality … [and] participation in … exploration, humor, fantasy, risk, contest, and celebrations” (p. 81). The OTPF-4 mentions play exploration that involves identifying “play activities, including exploration play, practice play, pretend play, games with rules, constructive play, and symbolic play” (p. 34), and play participation that involves taking part “in play; maintaining a balance of play with other occupations; obtaining, using, and maintaining toys, equipment, and supplies” (p. 34).

The Canadian Model of Occupational Performance and Engagement (CMOPE) mention three specific subtypes of human occupation which are self-care, productivity, and leisure (Townsend & Polatajko, 2007). Play can be included under both the occupational categories of productivity where children learning through play, and leisure where children play for the sake of enjoyment, fun, creativity, and losing themselves in a play occupation of their choosing (Brown & Lynch, 2023). In play participation includes several attributes of “participation” including “to take part, to feel included, to have choice over what to take part in and to achieve a meaningful goal” (Lynch & Moore, 2016, p. 519). In sum, play as human occupation is a key activity that all children participate in and is essential to facilitate their learning, development, and adaption.

Screen Time

Types of Screen Time

Sanders et al. (2019) classified screen time into four categories: (i) educational, using a screen for school-related, learning, tutoring, or studying activities; (ii) social, using a screen for socializing and interacting with others; (iii) interactive, activities done in front of a screen when people take action to alter what is displayed there; and (iv) passive, activities done in front of the screen where people are watching without altering what is happening on the screen. Both Slutsky and DeShetler’s (2017) study that included 33 preschoolers from the United States and Konca’s (2022) study that involved 537 kindergarten children in Turkey, found that watching television was the most popular type of screen time amongst children, followed by tablets. Oswald et al. (2020) conducted a systematic scoping review that included 186 studies regarding children’s and adolescents’ screen time and green time (exposure to or time spent in nature), with results also indicating that television contributed to their screen time the most.

Factors Influencing Screen Time

Co-participation, which refers to parents/caregivers using electronic devices together with their children, has been found to play an important role in children’s screen time (Konca, 2022, Martin et al., 2022). Both Konca (2022) and Slutsky and DeShetler (2017) found that half of the parents surveyed used devices alongside their children or supervised their use. Parents’ own screen time was found to be associated with children’s screen time, as children tended to imitate their parents’ screen-time use behaviors (Garcia et al., 2016, Konca, 2022).

The environment was determined to have significant impacts on children’s screen-time use in different ways (Konca, 2022, Sanders et al., 2019). Shawcroft et al. (2022) completed an observational study of 150 children who attended a children’s play museum where personal electronic devices were absent to examine the potential impact that media had on the children’s play processes. It was found that children who attended the museum setting did not use personal media devices, their social and emotional play experiences may have been impacted by presence of media, and their “positive interactions decreased after playing in an exhibit with a screen” (Shawcroft et al., 2022, p. 1). This in part demonstrates that the presence and accessibility of electronic devices can contribute to the amount of time that children spend accessing screens. According to a cross-sectional study involving 7725 participants aged 12 to 17 years in Canada, teens who exceeded two hours of screen time each day were 30% more likely to have sub-optimal self-rated health and 30 to 50% more likely to have sub-optimal self-rated mental health (Herman et al., 2015). This shows that excess screen time could potentially affect children’s physical and mental well-being.

While several negative impacts of children’s increased participation in screen time-related activities, there are some positive outcomes depending on how it is used and applied as well (Ponti, 2023). For example, using electronic devices can enhance visual intelligence, fine motor skills, problem-solving, creative abilities, school readiness, critical thinking, psychosocial functioning, and communication skills in children (Ponti et al., 2017, Przybylski et al., 2019, Sanders et al., 2024). Types of screen time activities that promotion children’s abilities include taking photos, creative videos on topics being studied, using online maps, and participation in online games or apps that involve cooperation, problem solving and exchange of ideas. However, ongoing research is indicating that excessive screen time by young children, school age children and adolescents can have many long-term negative impacts on children’s health, development, and wellbeing (Guellai et al., 2022; Stiglic & Viner, 2019).

Association Between Play and Screen Time

Numerous studies have investigated the relationship between screen time and other factors, such as leisure preferences, physical activity (PA), and health outcomes (Bertuol et al., 2019, Dadson et al., 2020, Harrington et al., 2016, Larson et al., 2019, Pedersen et al., 2022). It has been hypothesized that screen time reduces the amount of time children engage in free and active play and taints social relationships with family and friends (Kerai et al., 2022, Kostyrka-Allchorne et al., 2017, Sigman, 2012). Putnick et al. (2023) also found that early childhood screen time displaced reported peer play time. Bertuol et al. (2019) study in Brazil found that adolescents’ preference for PA and cultural activities decreased, while their engagement with digital media increased significantly from 2001 to 2011. Pedersen et al. (2022) found a negative relationship between screen time and non-sedentary leisure activities. Dadson et al. (2020) suggested that excessive screen time may decrease children’s opportunities for social interaction and negatively impact their enjoyment of play and creative narratives.

Implication and Research Gap

The change in play and screen-time engagement and participation may impact children’s development in different aspects. As an important human occupation, play has a significant role in occupational therapy pediatric practice. As such, understanding more about school-age children’s play patterns and their screen-time use is vital to inform better occupational therapy goal-setting and intervention planning (Lynch et al., 2018).

There are different studies exploring play and screen-time participation in children respectively, but there are not many studies that focus on the relationship between school-age children’s screen time and play (Garcia et al., 2016, Mutz et al., 2019). Also, the pattern of children’s participation in play and screen time continues to change at a swift pace due to rapid advancements in technology (Sung et al. 2016). Hence, it is essential to keep evidence current to understand the real-life situation of children. Moreover, many of the studies that have investigated the link between children’s play and screen time were from parent/caregiver perspectives since they mainly used parent/caregiver reports as data sources. Therefore, it is important to understand the relationship between children’s screen-time and play engagement and participation from children’s perspective themselves.

To address the current knowledge gap, the research aim of this study is to explore the relationship between school-age children’s screen time and their play. The related research questions are: (i) what is the association between children’s self-reported screen time and their perceptions of play?; and (ii) what is the association between parent-reported screen time of their children and their children’s play engagement and participation?

Materials and Methods

Design

A cross-sectional, non-experimental study approach was adopted to explore the relationship between children’s screen time and play. The study was approved by the Monash University Research Ethics Committee (project ID: 35878) and the Victorian Department of Education and Training (application number: 2022_004670).

Participant Recruitment

Convenience and snowball sampling were used to recruit participants from two state public schools in Frankston, a suburb in Melbourne, Victoria, Australia and the researchers’ networks (Fowler, 2014). Approval was obtained from the principals of the two schools prior to the participant recruitment and data collection processes. An information package, including a letter explaining the purpose and procedures in this study, consent forms for participation, and a demographic questionnaire were distributed to children at the schools. Parents/caregivers and children who agreed to participate signed the consent forms, completed the demographic questionnaire, and returned the forms to the school office in a sealed envelope. Digital information packages with a link to an online demographic questionnaire were sent via e-mail to parents/caregivers from the researchers’ networks who showed an interest in this study. They were asked to sign the consent forms, return the forms to the researchers, and complete the online demographic questionnaire.

Child participants had to meet the following criteria to participate in this study: (1) be aged 8 to 12 inclusive; (2) be able to read and comprehend English sufficiently to read instructions and complete the self-report instruments; (3) not have any known diagnoses or developmental delays (based on parental/caregiver report); and (4) provided written and verbal consent to participate in the study. For parent/caregiver participants, they had to: (1) be able to read and comprehend English sufficiently to read a daily newspaper; (2) be familiar with their children’s play and screen-time use behaviors; and (3) provide written consent to participate in this study. Parents/caregivers or children who did not meet the above criteria were excluded from the study.

Instrumentation

Four assessments were used to collect data from parent/caregiver and child participants. Parents/caregivers completed the demographic questionnaire, the Children’s Play Scale (CPS), and the Children’s Screen Time Use Report (CSTUR). Children completed the CSTUR and the Children’s Perceptions of Their Play (CPTP).

Demographic Questionnaire

The demographic questionnaire was developed to obtain child participants’ demographic information and determine if they were eligible to participate in this study. It included questions about the child’s gender identity, age, and grade level. The demographic questionnaire was reviewed by two researchers who were familiar with survey research and two parents of school-age children. They all indicated that the demographic questionnaire had reasonable face and content validity.

Children’s Play Scale (CPS)

The CPS is a parent-report survey developed by Dodd et al. (2021) to explore school-age children’s time spent playing in various locations and their participation in adventurous play. There are three subscales rating children’s frequency, duration, and level of participation in adventure of play. The first subscale measures children’s play frequency in different locations with a 7-point scale from “everyday” to “never.” The second subscale measures the duration children played in different locations on a 4-point scale from “less than an hour” to “4 hours+.” The third subscale measures children’s level of adventurous play in different locations on a 5-point scale from “very low levels of adventure” to “maximum levels of adventure.” Four scores (total hours spent playing, total hours spent playing outdoors, total hours spent playing in nature, and total hours spent playing in adventurous places) are calculated by multiplying the frequency and duration children spend playing in different locations (Dodd et al., 2021).

The CPS has good content validity and practical utility as it was reviewed by experts from the Children’s Play Policy Forum and Play Safety Forum in the United Kingdom (Dodd et al., 2021). For the time spent playing variable, test-retest reliability for mothers varied from 0.67 to 0.76 and for fathers from 0.39 to 0.63 (Dodd et al., 2021). The average test-retest reliability for both parents for the level of adventurous play variable was 0.46 (Dodd et al., 2021).

Children’s Screen Time Use Report (CSTUR)

The CSTUR captures the screen time of children on an ordinary weekday and a weekend day from both child and parent/caregiver perspectives on four different types of screen time: educational, social, interactive, and passive. The tool’s contents incorporated screen categories that had previously been reported in the pediatric research literature (Sanders et al., 2019). Children are asked to record the number of minutes they spent in each screen-time group. The CSTUR is also completed by parents/caregivers based on their perceptions of the number of minutes their child spends on-screen during a typical week and weekend day. No formal reliability or construct validity evidence has been reported about the CSTUR other than favorable face validity and content validity (Ye et al., 2023). The CSTUR has been used in several previously published studies including (Nguyen et al., 2023, Ye et al., 2023).

Children’s Perceptions of Their Play (CPTP)

The CPTP is a child self-report scale developed by Barnett (2013) with the aim of gaining an understanding of children’s perspectives regarding what they think play is and what play consists of. It uses a Likert 4-point scale (e.g., “definitely yes,” “probably yes,” “probably no,” and “definitely no”) and comprises 25 items that measure six aspects of play regarding children’s choice, social play, planned activities, engagement, active play, and free play (Barnett, 2013). It was found to have high internal consistency with Cronbach’s alpha coefficients ranging from .79 to .91, and good test-retest reliability with coefficient w = 0.78 (Barnett, 2013). It also has significant construct, discriminant, and content validity, with a content validity ratio (CVR) of − 0.803 (Barnett, 2013).

Data Analysis

All data were analyzed using the Statistical Package of the Social Sciences [SPSS] version 27.0 (IBM Corp, 2020). Descriptive statistics (mean, interquartile, standard deviation, and range) were calculated for the demographic information and each of the CPS, CSTUR, and CPTP subscales. Spearman’s rho correlation analyses with bootstrapping were used to explore if there were any statistically significant correlations between the variables. Regression analyses with bootstrapping were used to determine if children’s screen time was predictive of children’s play participation and their perceptions of play. They were completed when the correlation between independent and dependent variables were significant (p ≤0.05). Bootstrapping is a statistical procedure that can be used to increase the representativeness of a sample under study and to calculate estimates of the parameters when the sample size is too small to adequately generalize the study results to the target population (Choi, 2016). The bootstrapped sample size was 1000 participants.

Procedure

A total of 160 information packages were distributed to parents and children from the two primary schools, with 19 of them returning their consent forms and demographic questionnaires, and 16 being included in the study after reviewing the forms to determine which children met the inclusion criteria. The response rate in primary schools was 11.8%. Eleven digital information packages were sent to parents and children recruited from the researchers’ network. All of them returned the consent forms and 10 of them were included in the study after reviewing screening eligibility criteria.

Child Participants Recruited from the Two Primary Schools

Eligible children who signed the consent forms were invited to complete their questionnaires (CSTUR and CPTP) in a group setting at their schools. Verbal consent was obtained from child participants before the start of the process. The researchers were present to answer questions and check if the instruments were all completed before the children returned them. The data collection process was held at a time when students were not engaged in core school academic learning (e.g., language arts, mathematics, etc.).

Confirmation e-mails were sent to the eligible parents/caregivers of the children who signed the consent forms. Parent-completed questionnaires (CPS and CSTUR) were completed online using Qualtrics software, and the links to the online questionnaires were attached to the confirmation e-mail. Follow-up e-mails were sent every fortnight to parents/caregivers to remind them to fill in the online questionnaires.

Child Participants Recruited from Personal Networks

E-mail invitations, with the explanatory statements and consent forms attached, were sent to child and parent/caregiver participants recruited from personal networks. Once the parents returned the consent forms to the researchers, the links to the parent-completed questionnaires (CPS and CSTUR) and the child-completed questionnaires (CSTUR and CPTP) were sent to them via e-mail. All questionnaires were completed online via Qualtrics software and follow-up e-mails were sent every fortnight to parents/caregivers to remind them to fill in the online questionnaires.

Results

Participants

A total of 26 children and their parents participated in this study (see Table 1). Of the child participants, 11 were male (42.3%) and 15 were female (57.7%). The most frequent grade level was grade 4 (30.8%), followed by grade 7 (26.9%), grade 5 (19.2%), and grades 6 and 7 (11.5%), respectively. Nineteen of the parent/caregiver participants were the mother (69.2%) and seven were the father (30.8%). The majority of child participants had their own personal electronic device (69.2%).

Table 1. Child participants’ demographic information (n = 26).

Demographic variable	Frequency	(%)
Gender identity
Male	11	42.3
Female	15	57.7
Grade level attended
Grade 3 (8 to 9 years of age)	7	26.9
Grade 4 (9 to 10 years of age)	8	30.8
Grade 5 (10 to 11 years of age)	5	19.2
Grade 6 (11 to 12 years of age)	3	11.5
Grade 7 (12 to 13 years of age) *	3	11.5
Parent participant’s relationship to the child
Father	7	26.9
Mother	19	73.1
Child’s personal electronic device
Yes	18	69.2
No	8	30.8

Note. SD = standard deviation.

*only 12 year olds who attended Grade 7 were recruited into the study.

Participant Instrument Scores

The mean, median, standard deviation, range, and interquartile ranges of the scores of the parent- and child-reported CSTUR, CPTP, and CPS subscales are presented in Table 2.

Table 2. Descriptive statistics of subscales of children’s perceptions of their play (CPTP), parent and child versions of the children’s screen time use report (CSTUR), and children’s play scale (CPS) (n = 26).

					Percentiles
	Mean	Median (50 Q2)	SD	Range	25 (Q1)	75 (Q3)
Parent-reported CSTUR subscales (minutes)
Weekday Educational Screen Time	50.20	30.00	54.97	180.00	7.50	67.50
Weekend Educational Screen Time	15.00	0	51.23	255.00	0	0
Weekday Social Screen Time	35.50	30.00	40.08	150.00	0	60.00
Weekend Social Screen Time	52.20	30.00	67.98	255.00	0	77.50
Weekday Interactive Screen Time	52.90	50.00	76.20	375.00	0	60.00
Weekend Interactive Screen Time	96.00	90.00	72.33	360.00	60.00	120.00
Weekday Passive Screen Time	73.40	60.00	61.74	300.00	37.50	60.00
Weekend Passive Screen Time	134.28	120.00	72.08	288.00	75.00	180.00
Child-reported CSTUR subscales (minutes)
Weekday Educational Screen Time	99.89	61.00	85.40	300.00	30.00	153.75
Weekend Educational Screen Time	30.87	1.25	75.42	300.00	0	22.50
Weekday Social Screen Time	2.31	1.00	2.99	10.00	0	4.25
Weekend Social Screen Time	65.37	40.00	81.47	270.00	1.63	120.00
Weekday Interactive Screen Time	48.35	42.20	45.68	150.00	11.88	60.00
Weekend Interactive Screen Time	113.08	90.00	111.37	450.00	30.00	123.75
Weekday Passive Screen Time	78.75	60.00	66.10	300.00	28.75	120.00
Weekend Passive Screen Time	159.81	120.00	131.31	600.00	71.25	210.00
CPTP subscales
Child’s Choice	16.31	16.50	2.13	10.00	15.00	18.00
Social Play	12.65	13.00	1.83	7.00	11.00	14.00
Planned Activity	13.77	14.00	2.72	11.00	11.75	15.25
Engagement	12.12	12.00	1.86	8.00	11.00	14.00
Active Play	7.88	8.00	1.77	8.00	7.00	9.00
Free Time	10.19	11.00	2.04	7.00	8.75	12.00
CPS subscales (hours)
Total Hours Spent Playing	1194.87	1121.00	626.70	2347.50	708.75	1589.78
Total Hours Spent Playing Outdoors	664.36	630.00	459.18	1464.30	189.75	1075.06
Total Hours Spent Playing in Nature	227.23	195.25	218.00	715.50	28.50	411.00
Total Hours Spent Playing in Adventurous Places	360.33	269.75	303.14	1000.00	164.38	546.75

Note. CPTP = Children’s Perceptions of Their Play; CSTUR = Children’s Screen Time Use Report; CPS = Children’s Play Scale.

SD = standard deviation.

Correlation Results

Spearman’s rho correlation analyses with bootstrapping were completed between the child-reported CSTUR and CPTP subscales, and the parent-reported CSTUR and CPS subscales.

Correlations Between Child-Reported CSTUR and CPTP Subscale Scores

As shown in Table 3, statistically significant correlations were found between the child-reported CSTUR weekday social screen time and the CPTP social play subscales (rho = −6.77, p < 0.01); the child-reported CSTUR weekday social screen time and the CPTP engagement subscales (rho = −.517, p = .007); the child-reported CSUTR weekend educational screen time and the CPTP active play subscales (rho = .504, p = .009); the child-reported CSTUR weekday interactive screen time and CPTP active play subscales (rho = −.484, p = .012); and the child-reported CSTUR weekday passive screen time and the CPTP active play subscales (rho = −.458, p = .019).

Table 3. Spearman’s rho correlation coefficients of subscales of children’s perceptions of their play (CPTP), parent-reported children’s screen time use report (CSTUR), child-reported children’s screen time use report (CSTUR), and children’s play scale (CPS) (n = 26).

		Weekday educational	Weekend educational	Weekday social	Weekend social	Weekday interactive	Weekend interactive	Weekday passive	Weekend passive
Child-reported CSTUR Subscales
CPTP Subscales	Child’s Choice	.102	−.059	−.161	−.181	−.090	−.068	.196	.119
	Social Play	−.028	−.062	−.677**	−.102	.033	−.037	.121	.229
	Planned Activity	−.133	.019	−.243	−.199	.199	.281	−.005	−.221
	Engagement	.054	.101	−.517**	−.231	.037	.166	−.207	−.091
	Active Play	−.191	.504**	.182	.015	−.484*	−.138	−.458*	−.213
	Free Time	.326	−.144	−.010	.037	.338	.368	.054	−.016
Parent-reported CSTUR Subscales
CPS Subscales	Total Hours Spent Playing	−.197	−.137	−.029	−.0.16	.179	.149	−.065	.293
	Total Hours Spent Playing Outdoors	−.057	−.164	−.011	−.030	.290	.254	−.193	−.015
	Total Hours Spent Playing in Nature	−.006	−.116	.244	.223	.242	.320	−.281	−.288
	Total Hours Spent Playing in Adventurous Places	−.056	.060	.338	.321	.324	.421*	−.222	−.213

Note. * = correlation is significant at the 0.05 level (2-tailed); ** = correlation is significant at the 0.01 level (2-tailed).

CPTP = Children’s Perceptions of Their Play; CSTUR = Children’s Screen Time Use Report; CPS = Children’s Play Scale.

Correlation Between Parent-Reported CSTUR and CPS Subscale Scores

A positive statistically significant correlation was also found between parent-reported CSUTR weekend interactive screen time and CPS total hours spent playing in adventurous places (rho = .421, p = .036).

Regression Results

Linear regression analyses with bootstrapping were completed to explore if child-reported CSUTR and parent-reported CSTUR subscale scores were predictive of CPTP and CPS subscale scores, respectively. Only independent variables that were significantly correlated with the dependent variables were included in the regression models. The results are presented in Table 4.

Table 4. Linear regression analysis results for the CPTP, CPS, and CSTUR subscales (n = 26) (based on bootstrapped 1000 samples).

	Before bootstrapping					After bootstrapping^b
Models	B	SE	β	t	p	Bias	SE	p	BCa95% CI lower	BCa95% CI upper
DV: Social Play Adjusted R^2: .307 p = .002
(Constant)	13.472	.381		35.401	<.001	.010	.375	<.001	12.807	14.179
Child-reported CSTUR Weekday Social Screen Time	−.354	.102	−.579	−3.475	.002	−.014	.101	.002	−.614	−.215
DV: Engagement Adjusted R^2: .077 p = .092
(Constant)	12.600	.446		28.222	<.001	.007	.472	.001	11.570	13.556
Child-reported CSTUR Weekday Social Screen Time	−.210	.120	−.337	−1.754	.092	−.020	.106	.051	−.454	−.061
DV: Active Play Adjusted R^2: .556 p = <.001
(Constant)	9.142	.425		21.525	<.001	.097	.387	.001	8.124	10.590
Child-reported CSTUR Weekend Educational Screen Time	.011	.003	.487	3.633	.001	−.001	.011	.002	−.010	.016
Child-reported CSTUR Weekday Interactive Screen Time	−.019	.005	−.479	−3.542	.002	.001	.005	.001	−.030	−.007
Child-reported CSTUR Weekday Passive Screen Time	−.009	.004	−.336	−2.472	.022	−.002	.006	.065	−.022	−.005
DV: Total Hours Spent Playing in Adventurous Places Adjusted R^2: .023 p = .218
(Constant)	283.442	84.578		3.351	.003	−4.984	79.068	.003	154.185	414.143
Parent-reported CSTUR Weekend Interactive Screen Time	.680	.538	.250	1.264	.218	.116	.698	.258	−.365	2.643

Note. DV = dependent variable; adjusted R² = adjusted R squared; B = unstandardized beta coefficient; SE = coefficients standard error; β = standardized coefficients beta; t = t test statistic; p = significance; BCa = bias-corrected and accelerated; CPTP = Children’s Perceptions of Their Play; CSTUR = Children’s Screen Time Use Report; CPS = Children’s Play Scale.

Predictors of the CPTP Social Play Subscale Score

The child-reported CSUTR weekday social screen time subscale was included in the regression analysis. The model accounted for 30.7% of total variance of the dependent variable (Adjusted R² = .307, p = .002). Child-reported CSTUR weekday social screen time made a statistically significant unique contribution to the overall predictive regression model (p = .002).

Predictors of the CPTP Engagement Subscale Score

The child-reported CSUTR weekday social screen time subscale was included in the regression analysis. The model accounted for 7.7% of total variance of the dependent variable (Adjusted R² = .077, p = .092). The regression result showed that there was no statistically significant predictive relationship between the CPTP engagement and child-reported CSUTR weekday social screen time subscales.

Predictors of the CPTP Active Play Subscale Score

Three independent variables (the child-reported CSUTR weekend educational screen time, weekday interactive screen time, and weekday passive screen time subscales) were included in the regression analysis. The model accounted for 55.6% of total variance of the dependent variable (Adjusted R² = .556, p < .001). Child-reported CSTUR weekend educational screen time (p = .002) and child-reported CSTUR weekday interactive screen time (p = .001) both made statistically significant unique contributions to the overall regression model (p = <. 001); their contributions to the model were 23.4% and 22.3%, respectively.

Predictors of CPS Total Hours Spent Playing in Adventurous Places Score

The parent-reported CSUTR weekend interactive screen time subscale was included in the regression analysis. The model accounted for 2.3% of total variance of the dependent variable (Adjusted R² = .023, p = .218). The regression result indicated that there was no statistically significant predictive relationship between the CPS Total Hours Spent Playing in Adventurous Places subscale score and parent-reported CSUTR weekend interactive screen time.

Discussion

Social Play

The child-reported CSTUR weekday social screen time subscale was found to be statistically significantly associated with the CPTP social play subscale. Weekday social screen time was calculated on the child-reported CSTUR by adding up the time spent on-screen involving socializing and interacting with people on weekdays (Ye et al., 2023). On the CPTP, social play was measured by four questions regarding children’s play interaction with friends (Barnett, 2013). The child-reported CSTUR weekday social screen time subscale accounted for 30.7% of the total variance of the CPTP social play subscale, indicating a predictive relationship between the two variables. This would be interpreted as the more time during the week that children spent engaged in social screen time, the less time they engaged in socially interacting with their friends in-person in play contexts.

The relationship may be due to the longer time spent with classmates at school on weekdays. Children tend to spend longer periods of time with peers on weekdays than weekends because they can see friends during school times. Therefore, they spend more time playing with friends face-to-face and less time socializing with others on-screen. This finding is in line with a previously reported mixed-method study by Garcia et al. (2016), involving 152 adolescents aged between 12 and 18 in the United States. The study found that adolescents preferred to stay with friends at school rather than be alone, and those who had active friends were more likely to be physically active and spend less time on-screen.

Active Play

Three child-reported CSTUR variables were found to be significantly associated with the CPTP active play subscale. The CPTP active play subscale was positively correlated with the child-reported CSTUR weekend educational screen time subscale, but was negatively correlated with both the child-reported CSTUR weekday interactive and weekday passive screen time subscales. Active play was measured by three questions regarding how physically active children were during play (Barnett, 2013). Child-reported CSTUR weekend educational screen time and child-reported CSTUR weekday interactive screen time both made statistically significant unique contributions to the overall regression model; their contributions to the model were 23.4% and 22.3%, respectively. This model could be interpreted as the more time children engaged in weekend educational screen time, the more time they engaged in physically active play. On the other hand, the model indicates that the more time children engaged in weekday interactive screen time, the less time they spent in physically active play activities.

A statistically significant predictive relationship was found between the CPTP active play and the CSTUR weekend educational screen time subscales. The child-reported CSTUR weekend educational screen time variable was calculated by adding up the time children spent on activities on-screen for school, learning, tutoring, or studying at weekends (Ye et al., 2023). The relationship between educational screen time and active play could potentially be linked with the parental involvement in children’s play engagement and participation. According to a qualitative study involving 15 families in the United States, some parents pointed out that they would allow their children to “go swimming club” and “play games” after they had finished their homework (Froiland, 2015). This, in part, could potentially be one contextual explanation for the positive relationship between the two variables. Similarly, Farrell and Danby (2015) interviewed 120 Australian children aged between four and eight years about their daily lives and routines. Some children reported that they did their homework under their parents’ supervision before moving on to other play activities, which also supports the current study’s finding.

The child-reported CSTUR weekday interactive screen time subscale was calculated by summing up children’s time spent altering the content of the screen on weekdays (Ye et al., 2023). A statistically significant predictive relationship was found between the CPTP active play and the CSTUR weekday interactive screen time subscales. Similar results were reported by Bertuol et al. (2019) who conducted a repeated cross-sectional study involving two samples of students regarding their leisure preferences in 2001 and 2011. The study revealed that students preferred to devote more time to video games and less time to physical and cultural activities. In another related study, Pedersen et al. (2022) conducted a parallel cluster randomized clinical trial involving 89 families with children aged six to 10 years. The study indicated that when recreational screen time was reduced, children would spend more time engaging in non-sedentary activities. These two studies support the findings of the current study.

The child-reported CSTUR weekday passive screen time subscale was calculated by adding up children’s time spent on-screen without altering the content of the screen on weekdays (Ye et al., 2023). A statistically significant negative correlation was found between the CPTP active play and CSTUR weekday passive screen time subscales, but the independent variable was found to be not predictive of the dependent variable after bootstrapping was applied. This finding could be due to a change in leisure preference among children as well (Bertuol et al., 2019). Besides computer and video games, their study also revealed the fact that more children preferred watching TV in their free time. Howie et al. (2017) conducted a subject laboratory trial that recruited 10 children aged between three to five years in Australia, which proved that the physical activity of children watching TV was lower than non-sedentary play. This also supports our research finding.

Play Engagement and Participation

Besides the CPTP social play subscale, the child-reported CSTUR weekday social screen time subscale was also found to be statistically significantly associated with the CPTP engagement subscale. The CPTP engagement subscale was measured by four questions regarding children’s involvement and absorption in play (Barnett, 2013). It accounted for 7.7% of the total variance of the dependent variable; however, there was no statistically significant predictive relationship between the two variables.

Firstly, when children spend more time on-screen communicating with others, the time they allocate to play activities will decrease, impacting their involvement and engagement and participation in play (Pedersen et al., 2022). According to Uhls et al. (2014), face-to-face interactions involve the exchange of social information through non-verbal cues, such as eye contact and facial expression. Therefore, children can learn how to read social cues through face-to-face interactions, which is beneficial for their development of social and interactive skills. However, Konca’s (2022) found that children usually texted or made video calls at home, which inhibited them from learning social cues through real-life interactions. This could potentially reduce their capacity to engage with peers during social play in real life as they lack the opportunities to practice reading non-verbal cues (Konca, 2022). Therefore, children might feel less involved in social play, leading to a decrease in play participation. Shawcroft et al.’s (2022) observational study involving 150 children also indicated that children’s positive interactions decreased after playing with a screen, supporting the above explanation.

Adventurous Play

The parent-reported CSTUR weekend interactive screen time subscale was found to be significantly correlated to the CPS total hours spent playing in adventurous places subscale score. The CSTUR weekend interactive screen time was calculated by summing up the time children spent on-screen socializing and interacting with people at weekends (Ye et al., 2023). The CPS total hours spent playing in adventurous places subscale score was calculated by adding up the total hours that children spent playing in adventurous places (Dodd et al., 2021). No statistically significant predictive relationship between the two variables was found.

This finding may be due to an increase in risk-taking behaviors influenced by video games in children. Many of the most widely played video games highlight negative themes, such as promoting killing and criminal activities (Gilbert et al., 2018). Previous studies found that children and adolescents who played video games with negative themes (such as excessive violence) were more likely to engage in risk-taking behaviors (Gilbert et al., 2018). Play activities in adventurous places are usually fascinating and exciting, but also potentially dangerous and risky for children (Dodd et al., 2021). Children who were more willing to take risks were more likely to engage in play in adventurous places, which supports our finding.

Implications for Practice

In terms of general implications, it is important to note that this study only recruited children who were typically developing/neurotypical. The implications for practice are therefore only applicable to pediatric groups with similar demographic traits. This study indicates a negative relationship between children’s interactive and passive screen time and their engagement and participation in active play. Occupational therapists working with children should work on facilitating children’s participation and engagement in active play since it is crucial for their physical and mental health. Occupational therapists should have a good understanding of their pediatric clients’ interactive and passive screen-time use and how it affects their play engagement and participation to inform interventions aimed at reducing children’s screen time and encouraging more active play-related activities. Furthermore, it will be beneficial for therapists to educate their clients and the parents about the value of striking a balance between screen time and active play for overall health and well-being.

Additionally, results showed a negative relationship between social screen time and social play. Socializing through in-person play helps children develop and practice social skills and problem-solving abilities rather than online social activities or electronic games. Therefore, occupational therapists should try to promote children’s engagement and participation in social play, especially in school settings where children have a higher chance to socialize with peers and on weekends during informal social activities and gatherings.

Limitations

This study investigated the relationship between children’s screen time and play engagement and participation; however, several limitations are acknowledged. Firstly, the sample size was small (n = 26) and a convenience sampling method was used, which might contribute to sampling bias. Secondly, self-report questionnaires were completed by parent/caregiver and child respondents and the use of any type of self-report scale has the potential for participant response and social desirability bias. Thirdly, as the participants for the study were recruited from one specific geographical region, this may have contributed to geographical bias in the results. Fourthly, one of the data collection tools referred to as the Children’s Screen Time Use Report has been previously used in two published studies but does not have reliability or construct validity reported about it. This is another acknowledged limitation. Finally, it should be noted that this study only involved neurotypical/healthy children, therefore the results are only applicable to similar participant groups. There are some pediatric groups that technology can have definite benefits to their socialization, education, and quality of life.

Future Research

Future investigation of school-age children’s screen time and play engagement and participation using a larger sample size that is randomly recruited is recommended to produce more generalizable results. Exploration of the relationships between specific types of screen time and specific types of play are also warranted, as are qualitative studies that investigate children’s perceptions of the relationship between their play engagement and participation and amount of screen time. These studies would add further findings to the evidence base and body of knowledge.

Conclusion

This study investigated the relationship between children’s screen time and play engagement and participation. The results provide insights into the connection between children’s engagement and participation in social, interactive, and educational screen time and their engagement and participation in social and active play. To promote play engagement and participation in school-aged children, occupational therapists are encouraged to design interventions that promote engagement and participation in social and active play and moderate children’s levels of screen-time use. Future research on this topic is recommended.

Authors’ declaration

All authors contributed to conceptualization, methodology, data analysis, review, editing, and approval of the final submitted version. The first author was also responsible for data collection and writing the initial draft of the manuscript.

Declaration if generative aI and aI-assisted technologies used in the writing process

During the preparation and writing of this manuscript, the authors did not use any generative AI and AI-assisted tools, software, or services.

Acknowledgements

The authors acknowledge the contribution of Overport Primary School, Frankston Primary School, and all the participants who completed the Children’s Play Scale, Children’s Screen Time Use Report, and Children’s Perceptions of Their Play.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data for this study is not available to be released to prospective readers due to ethics committee restrictions. Given the small sample size it is possible that individual participants would be identified. Consent from participants was not received to make the dataset for this study publicly accessible.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.