The research, conducted by Anika Stoffel, Johanna Linimayr, and Christina Schulze of the Zurich University of Applied Sciences, surveyed 35 parents of children aged 4 to 7 with a confirmed diagnosis of developmental coordination disorder, commonly abbreviated as DCD. Families lived across eight regions of German-speaking Switzerland and Liechtenstein, and each parent evaluated the playground their child used most frequently. The children, whose average age was 6.0 years, were predominantly boys, and more than half showed impairments in gross motor function. Eight parents reported common comorbidities, including attention deficit hyperactivity disorder, learning disability, Tourette syndrome, and vestibular disorder, reflecting the broader clinical reality that DCD rarely appears in isolation.

The study’s conceptual backbone is a framework of occupational wellbeing developed by Saraswati and colleagues, which breaks a child’s experience of meaningful activity into five domains: competence, autonomy, contentment and pleasure, identity, and belonging. In playground terms, competence means mastering the climb up a lookout tower or balancing across a beam; autonomy means freely choosing what and with whom to play; contentment describes the deep immersion of uninterrupted play; identity reflects a child’s sense of self built on strengths and interests; and belonging captures the experience of connecting with peers. The researchers paired this wellbeing framework with the concept of usability, defined as the ability to navigate and interact with an environment on comparable terms with others, always from the user’s own perspective rather than against official design standards.

Because no existing German-language instrument could capture both constructs, the team built a custom questionnaire, refining it through panels of researchers, occupational therapists, and mothers of young children. Parents rated statements on five-point Likert scales covering everything from sensory stimulation to equipment accessibility, and they added open-ended comments at the end. The data were analyzed descriptively using SPSS, an approach the authors acknowledge was appropriate given the small, exploratory sample. Recruitment ran through 120 pediatric occupational therapy practices, of which 23 agreed to distribute survey materials, with an extension through a Swiss parent counseling organization’s social media channels after the initial four-week window produced too few responses.

The headline finding is unambiguous: parents overwhelmingly value playgrounds. Ninety-four percent agreed or strongly agreed that the playground is an important and valuable play area for their child, and 88 percent endorsed the idea that playgrounds should stimulate multiple senses. Eighty-three percent agreed that diverse children can play according to their own abilities, and 80 percent said versatile equipment that can be used in many ways helps their child. Most families lived within a kilometer of their favorite playground, children spent an average of 72 minutes per visit, and 77 percent of the playgrounds were rated attractive or very attractive. On the surface, the person-environment fit appears remarkably good.

Beneath that positive surface, however, the wellbeing data tell a more complicated story. While autonomy scored high, with a median of 4.5, and contentment and pleasure reached a median of 4, with 89 percent of parents reporting their child has fun almost always or often, the domain of competence exposed the sharpest limitations. Only 34 percent of parents said their child frequently seeks out motor challenges, and exactly half reported that their child could not consistently master playground risks without help. The activities children most wanted to do, climbing (66 percent) and swinging (54 percent), were precisely the activities most often restricted: 54 percent of parents said balancing was difficult, 42 percent flagged climbing, 38 percent monkey bars, and 32 percent swinging. In other words, the very equipment that draws children to playgrounds is where children with DCD hit a wall.

This contradiction between desire and capability carries real clinical weight. Children with DCD are already at elevated risk of anxiety, depression, low self-efficacy, and poor quality of life, and repeated experiences of failure in a public, peer-visible setting can reinforce motor anxiety and learned helplessness. At the same time, risky play is a documented motivator for physical activity and health. The authors argue that playgrounds must therefore strike a delicate balance: offering graduated challenges that invite children to take the next step in mastering motor skills at different levels, without excluding those who are not yet ready. Equipment with multiple difficulty levels, generous handrails, wide platforms, and surfaces that remain safe in all weather emerged from parents’ comments as concrete design priorities.

The domain of belonging showed similarly mixed results. Seventy-one percent of parents said their child could play easily with other children, and the overall belonging score reached a median of 4. Yet responses about positive affirmation from peers spanned the full range from 1 to 5, and among the five children who faced social difficulties, outright social isolation was reported in two cases. Qualitative comments emphasized that keeping up with peers was the key to inclusion in parents’ eyes. The authors note this is more optimistic than earlier studies describing solitary play tendencies in DCD, but they caution that subtle peer dynamics may still reinforce isolation in children already vulnerable to negative self-appraisal. They also raise an intriguing possibility: children may be quietly adapting their own play styles and creating their own places on the playground in ways parents cannot observe, meaning some of the apparent fit may reflect children’s hidden agency rather than genuinely inclusive design.

The study has clear limitations. The self-developed questionnaire was not statistically validated, the sample of 35 is small and purposively recruited, potentially overrepresenting highly engaged parents, and there was no comparison group of typically developing children. Crucially, the children’s own voices are absent; parents served as proxy informants, and prior research suggests adult perceptions of children’s play choices may diverge from children’s lived experiences. The authors call for future work incorporating direct child reports, observational data, and universal design principles to build playgrounds that work for all children from the outset.

Even so, the implications are immediate. For occupational therapists, parents are valuable informants when evaluating a child’s competence and wellbeing in natural settings, and the five-domain framework offers a structured lens for tailoring interventions to playground participation. For planners and communities, the message is that accessibility is not just about ramps for wheelchairs; it is about whether a child with coordination difficulties can climb, swing, and balance alongside friends without help. Playgrounds, the study concludes, are genuinely important places where children with DCD experience autonomy, joy, and connection, but realizing their full inclusive potential will require design that treats the full spectrum of motor ability as a core requirement rather than an afterthought.

Subject of Research: Playground usability and occupational wellbeing in children with developmental coordination disorder

Article Title: Occupational wellbeing on playgrounds: Parents’ views on children with coordination disorder

Article References: Stoffel, A., Linimayr, J., & Schulze, C. (2025). Occupational wellbeing on playgrounds: Parents’ views on children with coordination disorder. Scandinavian Journal of Occupational Therapy, 32(1), Article 2526417. https://doi.org/10.1080/11038128.2025.2526417

Image Credits: AI Generated

DOI: 10.1080/11038128.2025.2526417

Keywords: developmental coordination disorder, playgrounds, occupational wellbeing, inclusive design, parent perspectives, child development, motor skills, occupational therapy, usability, social participation, Switzerland, pediatric health

The research, led by Henna Launistola of the Folkhälsan Research Center and the University of Helsinki, drew on data from 673 Finnish families with children aged three to six years. The families were participating in the DAGIS intervention study, a clustered randomized controlled trial based in two municipalities in southern Finland that aims to promote healthy eating, physical activity, self-regulation skills and lower screen use among preschoolers. Parents completed a survey asking how often during the previous month their child had visited nature or forest, their own yard, and a park or playground together with at least one adult in the family. Crucially, parents also kept a seven-day screen time diary, recording every stretch of ten minutes or more that their child spent watching television or videos or using tablets, smartphones, computers or game consoles outside early childhood education hours.

The diary approach is one of the study’s technical strengths. Rather than relying on a single retrospective question, which is vulnerable to recall bias, parents logged screen activities day by day, and the researchers calculated average weekday, weekend day and weighted whole-week screen time in minutes. A child’s data were included only if the diary covered at least three weekdays and one weekend day. On average, the preschoolers accumulated 70 minutes of screen time per weekday, 125 minutes per weekend day, and 86 minutes per day across the whole week. That weekend figure, more than an hour higher than the weekday average, immediately signals that weekends are where the battle against excessive screen use is most likely to be lost or won.

The outdoor visit data revealed a striking pattern in their own right. Forty-four percent of families reported visiting their own yard daily, making it by far the most frequented outdoor space. Nature and playgrounds were far less central to family routines: 37 percent of families visited nature only one to three times a month, 35 percent visited playgrounds at that low frequency, and 17 percent had not taken their child to a park or playground at all during the entire month. These frequencies were recoded into continuous weekly values and analyzed using multiple multivariate linear regression, with screen time as the dependent variable and visit frequencies as independent variables, adjusted in successive models for the child’s age and sex, then additionally for parental education, relative household income and season.

The fully adjusted results told a nuanced story. On weekdays, more frequent visits to the family’s own yard were associated with lower child screen time, with each step up in visit frequency corresponding to roughly two fewer minutes per day. Nature visits showed a similar weekday effect, at about 2.3 minutes less screen time per frequency increment. Playgrounds, however, lost their weekday significance once socioeconomic factors and season were accounted for. On weekends the pattern flipped: playground visit frequency was the only context-specific measure that remained significantly associated with lower weekend screen time, at nearly 3.7 minutes less per increment, while yard and nature visits showed no weekend effect. Across the entire week, all three outdoor spaces and the total visit frequency were linked to less screen time, with total outdoor visits showing consistent negative associations on weekdays, weekends and the whole week alike.

Why would the yard and the forest matter on Tuesdays but the playground matter on Saturdays? The authors offer several plausible mechanisms. The own yard is close to home, private, safe and familiar, which may ease the parental safety concerns that are a well-documented barrier to young children’s outdoor play. In Finland, most houses and condominiums have their own yard, often equipped with swings and climbing apparatus, making it a feasible destination even during the compressed routines of a working weekday. Nature, meanwhile, is remarkably accessible in Finland: half of the population lives only 300 meters from the nearest forest, and the traditional right of everyman allows access to natural areas without the landowner’s permission. Both spaces, the researchers suggest, may simply compete more directly with screens during the busy weekday hours between daycare and bedtime.

Weekends, by contrast, offer families abundant unstructured leisure time, and children typically spend more of it in front of screens. The finding that playground visits were linked to lower weekend screen time echoes an earlier American study of low-income families, in which more frequent weekend park visits were associated with less television viewing among two- to four-year-olds. The Finnish authors also note a measurement caveat: in the Finnish language, the terms for park and playground overlap considerably, and the questionnaire item combined them, which may have led to varied interpretations among respondents. They further acknowledge that playgrounds were visited relatively seldom in their sample, and that access may have been uneven because the data were collected in communities that include rural areas where public playground density is lower than in cities.

The study’s authors are careful about what the data cannot show. As a cross-sectional analysis, it captures associations at a single point in time and cannot establish whether outdoor visits reduce screen time or whether screen-heavy families simply venture out less. The data are parent-reported, opening the door to social desirability bias, and the screen time diary, while reducing recall bias, may have produced some overreporting because device-specific times were summed. The data were also collected in autumn 2017, seven to eight years before publication, and children’s screen habits have likely shifted since. The effect sizes, the authors concede, are modest, and factors not controlled in the analysis, such as parental screen use, household screen rules and perceived barriers to outdoor play, may exert a larger influence on children’s screen time than outdoor visits do. Still, from a public health perspective, even small associations contribute to the overall picture of what shapes young children’s behavior.

What elevates this study above much of the existing literature is its context-specific design. Previous research has yielded mixed results: a Canadian study found no association between outdoor time and screen time in three- to six-year-olds, and two other studies reported no link between preschoolers’ outdoor play and television viewing, while an Indian study of children aged three to fifteen found that a lack of outdoor play was associated with excessive screen use exceeding two hours per day. Longitudinal work has been more encouraging, with early childhood outdoor play predicting less computer use and gaming later in childhood, and high screen time at ages three to four predicting less outdoor play at ages ten to eleven. By measuring actual visits to distinct outdoor settings rather than merely the availability of green space, and by separating weekdays from weekends, the Finnish team has added a layer of granularity that earlier studies lacked.

The practical implications reach well beyond individual households. The authors argue that municipalities should ensure a variety of outdoor spaces, both built and unbuilt, public and private, are available within feasible distance of residential neighborhoods, so that families from all socioeconomic backgrounds have genuine alternatives to screens. For parents, the message is to make frequent visits to whichever outdoor spaces they prefer, since total visit frequency was consistently associated with lower screen time throughout the week. For urban planners and policymakers grappling with rising urbanization, the findings suggest that preserving yards, forests and playgrounds within walking distance of homes is not merely an aesthetic luxury but a measurable component of children’s healthy development. Future longitudinal and intervention studies, the researchers emphasize, will be needed to establish whether the relationship is causal, and more detailed measurement of visit duration, timing and activity type could clarify exactly which kinds of outdoor excursions best compete with the glowing rectangles that increasingly fill young children’s days.

Subject of Research: Associations between parent-child outdoor visits to nature, own yards and playgrounds and screen time in preschool-aged children

Article Title: Associations between parent–child outdoor visits and preschool-aged children’s screen time: a cross-sectional study

Article References: Launistola, H., Lehto, R., Engberg, E., Björkqvist, J., Rahkola, J., Simonsen, N., Wackström, N., Tilli, E., Roos, E., & Ray, C. (2025). Associations between parent–child outdoor visits and preschool-aged children’s screen time: a cross-sectional study. Journal of Activity, Sedentary and Sleep Behaviors, 4(1), Article 18. https://doi.org/10.1186/s44167-025-00089-5

Image Credits: AI Generated

DOI: 10.1186/s44167-025-00089-5

Keywords: preschool children, screen time, outdoor play, nature visits, playgrounds, own yard, parent-child activities, sedentary behavior, child health, Finland, DAGIS study, urban planning