Preschool Environmental Influences on Physical Activity in Children with Disabilities

Med Sci Sports Exerc. 2020 Dec;52(12):2682-2689. doi: 10.1249/MSS.0000000000002401.


Purpose: The purpose of this study was to describe associations between physical and social environmental features of preschools and physical activity behaviors of young children with developmental disabilities.

Methods: A sample of 34 preschool-age children (mean age, 4.28 ± 1.07; male, 64.7%) with developmental disabilities participated in this study. Physical activity and preschool environmental factors were measured through direct observation using the Observational System for Recording Physical Activity in Children-Developmental Disabilities version. Children were observed approximately eight times over the course of a week, yielding a total of 11, 310 observation intervals. The number of intervals and percentage of time spent in physical activity across environmental contexts were calculated. Logistic regression analyses were conducted to determine associations between time spent in physical activity and features of the physical and social environment.

Results: Children with disabilities were sedentary for most of the observed intervals (81.5%). Children were 4.8 times (confidence interval (CI), 4.25-5.50) more likely to be physically active while outdoors compared with indoors. Physical activity was more likely to occur in open spaces (odds ratio [OR], 3.3; CI, 2.59-4.19) and when using portable play equipment (OR, 2.7; CI, 1.31-5.64) compared with fixed playground equipment. While indoors, children in this study were 5.6 times (CI, 3.78-8.03) more likely to be active when in therapy compared with group time activities. Physical activity was more likely to occur when in solitary (OR, 3.4; CI, 2.87-4.10) or one-on-one group contexts (OR, 1.7-2.9) compared with in groups with an adult present.

Conclusions: Certain features of the preschool setting, such as location and social group composition, were more conducive to physical activity than others. Children with disabilities would benefit from more time outdoors and in smaller group settings during preschool.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child, Preschool
  • Disabled Children / statistics & numerical data*
  • Exercise*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Play and Playthings
  • Sedentary Behavior*
  • Social Environment*
  • Social Participation
  • Time Factors