Relationship Between School Environment and Occupations of Play, Leisure, and Sleep in Children During the COVID-19 Pandemic

As schools transitioned between virtual and in-person settings during the COVID-19 pandemic, there were likely changes in how children engaged in their occupations. Understanding the connection between change in schooling and occupational engagement would help to identify how school closures related to the pandemic have uniquely affected the development of children and youth. Therefore, the purpose of this study was to evaluate the relationship between school environment and the occupations of play, sleep, and leisure in school-age children. We hypothesized that children who remained in an online or virtual instruction format during the pandemic would have reduced engagement in occupations compared to children who had some level of in-person instruction. The timeliness of this information for a post-COVID society may inform future interventions for school-age children that address changes in occupations experienced during the pandemic. We used a cross-sectional quantitative survey design of parents during the pandemic (October-November, 2020). Subjects were excluded from analysis if they did not complete at least 75% of the survey. Parent participants were English-speaking adults ages 18 years or older who 1) were the parent or legal guardian of, and 2) who have lived with at least one school-age (4-18 years old) child for six months prior to start of the pandemic. A strategic convenience sample was recruited in the United States using social media postings (on Facebook, Twitter, etc.), recruitment emails, flyers in healthcare settings, referrals from colleagues. Through parent proxies, we collected data from 225 school-aged children (4-18 years old) to examine how the pandemic affected children as they began a new academic school year. The survey was developed and implemented using QualtricsXM (Qualtrics Inc. Provo, UT). We asked about the frequency of children’s indoor and outdoor play and participation in organized physical activities (e.g. sports teams), leisure or recreational activities and leisure electronic device usage, and sleep duration. Data were analyzed with chi-square tests to compare instruction type (in-person/ hybrid vs. online only) to the frequency responses for each question. There was a statistically significant relationship between instruction type and indoor play (χ² = 11.482, p = 0.009), outdoor play (χ² = 19.657, p < 0.001), organized physical activities (χ² = 17.512, p = 0.001), and organized recreational activities (χ² = 9.402, p = 0.024). Overall, children who remained in online school engaged in less play and leisure recreational activities. There were nonsignificant relationships between instruction type and leisure usage of electronics (computer and iPad, p = 0.458; TV, p = 0.135; cell phone, p = 0.791), and sleep duration (p = 0.892). This preliminary research explores the impact of the COVID-19 pandemic on school-age children and focused on changes in school environment and occupational engagement. Our hypothesis that children who remained in virtual school environments would experience lower occupational engagement was partially supported by the data but may not reflect the general population due to the relatively small and homogenous sample.

IMPACT STATEMENT: The potential negative consequences of virtual schooling on occupations were shown in our survey data. Continued evaluation of the potential developmental changes resulting from isolation experienced during the pandemic is needed to support any future implementation of occupation-based interventions in the school and community settings.

References

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