Participation in everyday activities is beneficial for mental health. However, little is known about the extent to which changes in children’s participation are associated with later mental health.
Objectives:
To investigate the association between changes in the frequency and involvement in home, school, and community activities and subsequent mental health problems in children. Methodology: We recruited 242 school-aged children. Their parents completed the Participation and Environment Measure for Children and Youth twice, and after 2 years, they completed the Strengths and Difficulties Questionnaire.
Results:
After controlling for demographic factors, hierarchical regression analysis revealed that reductions in children’s involvement in home and community activities were significantly associated with elevated levels of externalizing and internalizing problems. Furthermore, an increase in children’s involvement in school activities showed significant relationships with better mental health outcomes.
Conclusion:
These findings inform participation-based interventions for occupational therapists aimed at mitigating children’s future mental health problems.
Plain Language Summary
The Impact of Home, School, and Community Activities on Children’s Mental Health
This study examined how changes in children’s participation in activities at home, school, and in the community are related to their later mental health. Over a two-year period, 242 school-aged children, including 48 with disabilities and 194 without disabilities, took part in the research. Parents completed questionnaires to assess activity participation and mental health problems. The results showed that a decrease in children’s involvement in home and community activities was significantly associated with an increase in internalizing and externalizing problems. An increase in children’s involvement in school activities was significantly related to better mental health outcomes. Disabilities and the availability of environmental support consistently predicted children’s mental health problems. This study emphasizes the importance of children’s activity involvement, considering disability status and environmental support, for promoting their mental health. The findings inform occupational therapy interventions focused on participation to reduce future mental health problems in children.
AldertonA.VillanuevaK.O’ConnorM.BoulangéC.BadlandH. (2019). Reducing inequities in early childhood mental health: How might the neighborhood built environment help close the gap? A systematic search and critical review. International Journal of Environmental Research and Public Health, 16(9), 1516. https://doi.org/10.3390/ijerph16091516
2.
AnabyD. R.LawM.CosterW.BedellG.KhetaniM.AveryL.TeplickyR. (2014). The mediating role of the environment in explaining participation of children and youth with and without disabilities across home, school, and community. Archives of Physical Medicine and Rehabilitation, 95(5), 908–917. https://doi.org/10.1016/j.apmr.2014.01.005
3.
AnabyD. R.LawM.FeldmanD.MajnemerA.AveryL. (2018). The effectiveness of the Pathways and Resources for Engagement and Participation (PREP) intervention: Improving participation of adolescents with physical disabilities. Developmental Medicine and Child Neurology, 60(5), 513–519. https://doi.org/10.1111/dmcn.13682
4.
AugustineL.LygnegårdF.GranlundM. (2022). Trajectories of participation, mental health, and mental health problems in adolescents with self-reported neurodevelopmental disorders. Disability and Rehabilitation, 44(9), 1595–1608. https://doi.org/10.1080/09638288.2021.1955304
5.
BasuS.BanerjeeB. (2020). Impact of environmental factors on mental health of children and adolescents: A systematic review. Children and Youth Services Review, 119, 105515. https://doi.org/10.1016/j.childyouth.2020.105515
6.
BattistichV.SolomonD.WatsonM.SolomonJ.SchapsE. (1989). Effects of an elementary school program to enhance prosocial behavior on children’s cognitive-social problem-solving skills and strategies. Journal of Applied Developmental Psychology, 10(2), 147–169. https://doi.org/10.1016/0193-3973(89)90002-6
7.
BedellG. M.KhetaniM. A.CousinsM. A.CosterW. J.LawM. C. (2011). Parent perspectives to inform development of measures of children’s participation and environment. Archives of Physical Medicine and Rehabilitation, 92(5), 765–773. https://doi.org/10.1016/j.apmr.2010.12.029
8.
BiddleS. J.AsareM. (2011). Physical activity and mental health in children and adolescents: A review of reviews. British Journal of Sports Medicine, 45(11), 886–895. https://doi.org/10.1136/bjsports-2011-090185
9.
ChienC. W. (2022). Effects of the change in activity participation during the COVID-19 pandemic on children’s mental health. American Journal of Occupational Therapy, 76(2), 7602345010. https://doi.org/10.5014/ajot.2022.047118
10.
ChienC. W.LinC. Y. (2021). Community participation of school-age children: Who is at risk of restricted participation?Physical and Occupational Therapy in Pediatrics, 41(5), 447–463. https://doi.org/10.1080/01942638.2021.1900489
11.
ChienC. W.Li-TsangC. W. P.CheungP. P. P.LeungK. Y.LinC. Y. (2020). Development and psychometric evaluation of the Chinese version of the Participation and Environment Measure for Children and Youth. Disability and Rehabilitation, 42(15), 2204–2214. https://doi.org/10.1080/09638288.2018.1553210
12.
ChristensenD.FaheyM. T.GialloR.HancockK. J. (2017). Longitudinal trajectories of mental health in Australian children aged 4-5 to 14-15 years. PLOS ONE, 12(11), Article e0187974. https://doi.org/10.1371/journal.pone.0187974
13.
CosterW.BedellG.LawM.KhetaniM. A.TeplickyR.LiljenquistK.GleasonK.KaoY. C. (2011). Psychometric evaluation of the Participation and Environment Measure for Children and Youth. Developmental Medicine and Child Neurology, 53(11), 1030–1037. https://doi.org/10.1111/j.1469-8749.2011.04094.x
14.
CosterW.KhetaniM. A. (2008). Measuring participation of children with disabilities: Issues and challenges. Disability and Rehabilitation, 30(8), 639–648. https://doi.org/10.1080/09638280701400375
15.
CucchiaroG.DalgalarrondoP. (2007). Mental health and quality of life in pre- and early adolescents: A school-based study in two contrasting urban areas. Brazilian Journal of Psychiatry, 29(3), 213–221. https://doi.org/10.1590/s1516-44462007000300005
16.
DemarayM. K.JenkinsL. N. (2011). Relations among academic enablers and academic achievement in children with and without high levels of parent-rated symptoms of inattention, impulsivity, and hyperactivity. Psychology in the Schools, 48(6), 573–586. https://doi.org/10.1002/pits.20578
17.
DeyM.LandoltM. A.Mohler-KuoM. (2012). Health-related quality of life among children with mental disorders: A systematic review. Quality of Life Research, 21(10), 1797–1814. https://doi.org/10.1007/s11136-012-0109-7
18.
DilleggiE. S.dos SantosP. L.Scorsolini-CominF. (2022). Associations between family environment resources and mental health problems in children. Journal Brasileiro de Psiquiatria, 71(1), 32–39. https://doi.org/10.1590/0047-2085000000359
19.
DownsJ.BlackmoreA. M.EpsteinA.SkossR.LangdonK.JacobyP.WhitehouseA. J. O.LeonardH.RoweP. W.GlassonE. J. (2018). The prevalence of mental health disorders and symptoms in children and adolescents with cerebral palsy: A systematic review and meta-analysis. Developmental Medicine and Child Neurology, 60(1), 30–38. https://doi.org/10.1111/dmcn.13555
20.
DunstC. J.BruderM. B.TrivetteC. M.HambyD.RaabM.McleanM. (2001). Characteristics and consequences of everyday natural learning opportunities. Topics in Early Childhood Special Education, 21(2), 68–92. https://doi.org/10.1177/0271121401021002
21.
EmersonE. (2003). Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability. Journal of Intellectual Disability Research, 47(Pt. 1), 51–58. https://doi.org/10.1046/j.1365-2788.2003.00464.x
22.
FowlerP. J.TompsettC. J.BraciszewskiJ. M.Jacques-TiuraA. J.BaltesB. B. (2009). Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Development and Psychopathology, 21(1), 227–259. https://doi.org/10.1017/S0954579409000145
23.
GarvikM.IdsoeT.BruE. (2014). Depression and school engagement among Norwegian secondary vocational school students. Scandinavian Journal of Educational Research, 58(5), 592–608. https://doi.org/10.1080/00313831.2013.798835
24.
GhandourR. M.ShermanL. J.VladutiuC. J.AliM. M.LynchS. E.BitskoR. H.BlumbergS. J. (2019). Prevalence and treatment of depression, anxiety, and conduct problems in US children. Journal of Pediatrics, 206, 256–267.e253. https://doi.org/10.1016/j.jpeds.2018.09.021
25.
GiovagnoliG.PostorinoV.FattaL. M.SangesV.De PeppoL.VassenaL.RoseP. D.VicariS.MazzoneL. (2015). Behavioral and emotional profile and parental stress in preschool children with autism spectrum disorder. Research in Developmental Disabilities, 45–46, 411–421. https://doi.org/10.1016/j.ridd.2015.08.006
26.
GoodmanR. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child & Adolescent Psychiatry, 40(11), 1337–1345. https://doi.org/10.1097/00004583-200111000-00015
27.
GrahamF.RodgerS.ZivianiJ. (2009). Coaching parents to enable children’s participation: An approach for working with parents and their children. Australian Occupational Therapy Journal, 56(1), 16–23. https://doi.org/10.1111/j.1440-1630.2008.00736.x
28.
GranlundM.ImmsC.KingG.AnderssonA. K.AugustineL.BrooksR.DanielssonH.GothilanderJ.IvarssonM.LundqvistL. O.LygnegårdF.AlmqvistL. (2021). Definitions and operationalization of mental health problems, wellbeing and participation constructs in children with NDD: Distinctions and clarifications. International Journal of Environmental Research and Public Health, 18(4), 1656. https://doi.org/10.3390/ijerph18041656
29.
GustafssonJ.WestlingM. A.ÅkermanB. A.ErikssonC.ErikssonL.FischbeinS.GranlundM.GustafssonP. A.LjungdahlS.OgdenT.PerssonR. (2010). School, learning and mental health: A systematic review. Health Committee of the Royal Swedish Academy of Sciences.
30.
HeahT.CaseT.McGuireB.LawM. (2007). Successful participation: The lived experience among children with disabilities. Canadian Journal of Occupational Therapy, 74(1), 38–47. https://doi.org/10.2182/cjot.06.10
31.
HoogsteenL.WoodgateR. L. (2010). Can I play? A concept analysis of participation in children with disabilities. Physical and Occupational Therapy in Pediatrics, 30(4), 325–339. https://doi.org/10.3109/01942638.2010.481661
32.
HuiB. P. H.NgJ. C. K.BerzaghiE.Cunningham-AmosL. A.KoganA. (2020). Rewards of kindness? A meta-analysis of the link between prosociality and well-being. Psychological Bulletin, 146(12), 1084–1116. https://doi.org/10.1037/bul0000298
33.
HwangA. W.ChangC. H.GranlundM.ImmsC.ChenC. L.KangL. J. (2020). Longitudinal trends of participation in relation to mental health in children with and without physical difficulties. International Journal of Environmental Research and Public Health, 17(22), 8551. https://doi.org/10.3390/ijerph17228551
34.
ImmsC.GranlundM.WilsonP. H.SteenbergenB.RosenbaumP. L.GordonA. M. (2017). Participation, both a means and an end: A conceptual analysis of processes and outcomes in childhood disability. Developmental Medicine and Child Neurology, 59(1), 16–25. https://doi.org/10.1111/dmcn.13237
35.
ImmsC.MathewsS.RichmondK. N.LawM.UllenhagA. (2016). Optimising leisure participation: A pilot intervention study for adolescents with physical impairments. Disability and Rehabilitation, 38(10), 963–971. https://doi.org/10.3109/09638288.2015.1068876
36.
IshiiK.ShibataA.AdachiM.OkaK. (2016). Association of physical activity and sedentary behavior with psychological well-being among Japanese children: A two-year longitudinal study. Perceptual and Motor Skills, 123(2), 445–459. https://doi.org/10.1177/0031512516662645
37.
KoningN. R.BüchnerF. L.VerbiestM. E. A.VermeirenR.NumansM. E.CroneM. R. (2019). Factors associated with the identification of child mental health problems in primary care—a systematic review. European Journal of General Practice, 25(3), 116–127. https://doi.org/10.1080/13814788.2019.1623199
38.
LaiK. Y.LukE. S.LeungP. W.WongA. S.LawL.HoK. (2010). Validation of the Chinese version of the strengths and difficulties questionnaire in Hong Kong. Social Psychiatry and Psychiatric Epidemiology, 45(12), 1179–1186. https://doi.org/10.1007/s00127-009-0152-z
39.
LarsonK.RussS. A.KahnR. S.HalfonN. (2011). Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics, 127(3), 462–470. https://doi.org/10.1542/peds.2010-0165
40.
LiuJ.SekineM.TatsuseT.FujimuraY.HamanishiS.ZhengX. (2015). Association among number, order and type of siblings and adolescent mental health at age 12. Pediatrics International, 57(5), 849–855. https://doi.org/10.1111/ped.12629
41.
LiuaY.MerrittD. H. (2021). Family routines and child problem behaviors in fragile families: The role of social demographic and contextual factors. Children and Youth Services Review, 129, 106187. https://doi.org/10.1016/j.childyouth.2021.106187
42.
MoeijesJ.van BusschbachJ. T.BosscherR. J.TwiskJ. W. R. (2019). Sports participation and health-related quality of life: A longitudinal observational study in children. Quality of Life Research, 28(9), 2453–2469. https://doi.org/10.1007/s11136-019-02219-4
43.
OlivierE.ArchambaultI. (2017). Hyperactivity, inattention, and student engagement: The protective role of relationships with teachers and peers. Learning and Individual Differences, 59, 86–95. https://doi.org/10.1016/j.lindif.2017.09.007
44.
PalisanoR. J.ChiarelloL. A.KingG. A.NovakI.StonerT.FissA. (2012). Participation-based therapy for children with physical disabilities. Disability and Rehabilitation, 34(12), 1041–1052. https://doi.org/10.3109/09638288.2011.628740
45.
PillerA.PfeifferB. (2016). The sensory environment and participation of preschool children with autism spectrum disorder. OTJR: Occupation, Participation and Health, 36(3), 103–111. https://doi.org/10.1177/1539449216665116
46.
PolanczykG. V.SalumG. A.SugayaL. S.CayeA.RohdeL. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345–365. https://doi.org/10.1111/jcpp.12381
47.
ŞahinS.KayaK. O.KöseB.KaraK. (2020). Investigation on participation, supports and barriers of children with specific learning disabilities. Research in Developmental Disabilities, 101, 103639. https://doi.org/10.1016/j.ridd.2020.103639
48.
SalerniN.CaprinC. (2022). Prosocial behavior in preschoolers: Effects of early socialization experiences with peers. Frontiers in Psychology, 13, Article 840080. https://doi.org/10.3389/fpsyg.2022.840080
49.
SanmartínR.InglésC. J.VicentM.GonzálvezC.Díaz-HerreroA.García-FernándezJ. M. (2018). Positive and negative affect as predictors of social functioning in Spanish children. PLOS ONE, 13(8), Article e0201698. https://doi.org/10.1371/journal.pone.0201698
50.
SantiagoC. D.KaltmanS.MirandaJ. (2013). Poverty and mental health: How do low-income adults and children fare in psychotherapy?Journal of Clinical Psychology, 69(2), 115–126. https://doi.org/10.1002/jclp.21951
51.
ScharteM.BolteG. (2013). Increased health risks of children with single mothers: The impact of socio-economic and environmental factors. European Journal of Public Health, 23(3), 469–475. https://doi.org/10.1093/eurpub/cks062
52.
Schulte-KörneG. (2016). Mental health problems in a school setting in children and adolescents. Deutsches Ärzteblatt International, 113(11), 183–190. https://doi.org/10.3238/arztebl.2016.0183
53.
SimonciniK.CaltabionoN. (2012). Young school-aged children’s behaviour and their participation in extra-curricular activities. Australasian Journal of Early Childhood, 37(3), 35–42. https://doi.org/10.1177/183693911203700306
54.
Tapia-FonllemC.Fraijo-SingB.Corral-VerdugoV.Garza-TeránG.Moreno-BarahonaM. (2020). School environments and elementary school children’s well-being in northwestern Mexico. Frontiers in Psychology, 11, Article 510. https://doi.org/10.3389/fpsyg.2020.00510
55.
ThompsonR.LindseyM. A.EnglishD. J.HawleyK. M.LambertS.BrowneD. C. (2007). The influence of family environment on mental health need and service use among vulnerable children. Child Welfare, 86(5), 57–74.
56.
VellaS. A.CliffD. P.MageeC. A.OkelyA. D. (2015). Associations between sports participation and psychological difficulties during childhood: A two-year follow up. Journal of Science and Medicine in Sport, 18(3), 304–309. https://doi.org/10.1016/j.jsams.2014.05.006
57.
WangM. T.PeckS. C. (2013). Adolescent educational success and mental health vary across school engagement profiles. Developmental Psychology, 49(7), 1266–1276. https://doi.org/10.1037/a0030028
58.
WilesN. J.JonesG. T.HaaseA. M.LawlorD. A.MacfarlaneG. J.LewisG. (2008). Physical activity and emotional problems amongst adolescents: A longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 43(10), 765–772. https://doi.org/10.1093/eurpub/ckaa182
59.
World Health Organization. (2001). International classification of functioning, disability, and health.
60.
World Health Organization. (2004). Promoting mental health: Concepts, emerging evidence, practice (summary report).
