Child’s Play: Examining the Association Between Time Spent Playing and Child Mental Health


It is theorised that adventurous play offers learning opportunities that help to prevent mental health problems in children. In this study, data from two samples is used to examine associations between the time that children aged 5–11 years spent playing adventurously and their mental health. For comparison, time spent playing unadventurously and time spent playing outdoors are also examined. Study 1 includes a sample of 417 parents, Study 2 includes data from a nationally representative sample of 1919 parents. Small, significant associations between adventurous play and internalising problems, as well as positive affect during the first UK-wide Covid-19 lockdown, were found; children who spend more time playing adventurously had fewer internalising problems and more positive affect during the Covid-19 lockdown. Study 2 showed that these associations were stronger for children from lower income families than for children from higher income families. The results align with theoretical hypotheses about adventurous play.


Recent research estimates that, outside of school, children in Britain spend just over three hours a day playing [1]. Play is intrinsically rewarding for children, provides a way for them to interact with the world, express themselves, and make sense of the world around them. Despite this, there has been growing concern that children’s play, particularly their outdoor, independent, adventurous play has been declining over recent decades. For example, Clements [2] found that whilst 70% of mothers surveyed in the United States reported that they played outdoors daily as children, only 31% of their children were reported to do so. Moreover, findings from the UK suggest that whilst parents reported spending approximately 40% of their time playing as children in natural spaces, only 10% of their children’s play was reported to happen in these spaces [3]. Furthermore, there is robust evidence of increasing restrictions over the past 50 years on children’s independent mobility, defined as the age at which children are allowed out alone and how far they allowed to travel [14]. Alongside these declines in outdoor play and independence, rates of emotional disorders in UK children aged 5–16 years increased by 49% between 1994 and 2017 [5] and recent data show further increases, with an estimated one in six UK children having a probable mental health problem in July 2020 [6]. It has been proposed that reductions in children’s outdoor, risky play, may have negative consequences for children’s mental health, and may be contributing in part to the increase in children’s mental health problems [7,8,9]. To date though, no empirical research has directly examined this association [10].

Adventurous play, or risky play, is defined as child-led play where children experience subjective feelings of excitement, thrill and fear; often in the context of age-appropriate risk-taking. Several theoretical articles have hypothesised links between adventurous play and children’s mental health, particularly internalising problems such as anxiety and phobias. For example, Sandseter and Kennair [9] propose that children have a natural drive to engage in risky play, which evolved because it has anti-phobic effects, naturally exposing children to stimuli that may otherwise be feared such as heights and water. In keeping with this, Gray [7] theorises that the decline in play over the last generation is associated with increasing rates of mental health problems in children. A recent conceptual model drew on the extensive literature related to the development of anxiety in children to argue that sufficient adventurous play experiences during childhood may help to prevent anxiety in children [8]. Specifically, Dodd and Lester describe the role of intolerance of uncertainty [11], coping [1213], anxiety sensitivity [14] and avoidance [1516] in child anxiety and propose that adventurous play provides a motivating, positive context for exposures to, and subsequent healthy learning about, uncertainty, coping and physiological arousal. They argue that through these learning experiences children’s ability to cope adaptively in the face of uncertainty and arousal increases and their risk for problematic anxiety decreases.

Despite this theoretical work, research examining the association between adventurous play and children’s anxiety, or mental health more broadly defined, is scarce. Qualitative evaluations of school-based interventions to increase levels of adventurous play report positive outcomes of adventurous play, including increases in resilience [17] and improvements in children’s happiness at school [18]. There is also evidence that play, in general, is good for children’s wellbeing and mental health; children admitted to hospital show lower levels of anxiety and fewer negative emotions when they take part in a play intervention [19] and, when given time for free play, hospitalised children show reductions in stress [20]. Outdoor play and being in nature, which facilitate adventurous play, also have a positive effect on children’s wellbeing [21,22,23], but the direct link between adventurous play and children’s anxiety has yet to be examined.

Although the theoretical links between play and internalising symptoms have been described in previous work, to our knowledge adventurous play has not been explicitly linked to externalising problems such as Attention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder within psychological theory. There are some findings that would be consistent with adventurous play offering benefits for externalising problems. For example, schools taking part in an intervention to prioritise risk and challenge in the playground reported less bullying and conflicts on the playground post-intervention [18]. Further, children with ADHD who played regularly in green play settings were reported to have milder symptoms than children who played in built outdoor or indoor play settings [24]. It is not clear though that adventurous play has a specific role in these positive effects and, again, there is a lack of research directly evaluating the link.

In this paper we present two studies which examine the association between parent-report of children’s time spent playing and child mental health. Study 1 and Study 2 use the same measures of play and mental health; Study 1 uses an opportunity sample of parents living in Northern Ireland and Study 2 examines the extent to which the findings hold using a large nationally representative sample of parents living in Great Britain. To capture mental health broadly, in both studies we evaluate long term symptoms of internalizing and externalizing problems as well as shorter term positive and negative affect, which were assessed during the first weeks of the Covid-19 lockdown. Internalising problems include symptoms of anxiety and depression whereas externalising problems refer to difficulties with behaviour and attention. Positive and negative affect refer to more transient mood states. Time spent playing adventurously, time spent playing unadventurously and time spent playing outdoors are estimated using the Children’s Play Scale (CPS; 25) in both studies.

Our primary hypothesis follows relevant conceptual models: that children who spend more time playing adventurously will have fewer internalizing symptoms. In addition, we hypothesise that children who typically spend more time playing adventurously will have less negative affect and more positive affect during the Covid-19 lockdown, which we conceptualise as indicating better coping under uncertainty. To evaluate the specificity of these associations, we also examine associations between adventurous play and externalizing symptoms, as well as associations between mental health and both time spent playing unadventurously and time spent playing outdoors.


A number of theories indicate a role for adventurous or risky play in anxiety prevention. In this paper for the first time, the association between children’s time spent playing adventurously and their mental health is examined. More adventurous play was associated with lower internalising symptoms and more positive affect. The results suggest that giving children more opportunity to play in an adventurous way when they are in and out of school may offer benefits in terms of children’s mood and longer term mental health. To support children’s mental health, they need opportunity to play outdoors and adventurously, planning policy must consider children’s needs to ensure that every child, particularly those growing up in lower income families, has free access to safe space for adventurous outdoor play close to home. Longitudinal and experimental work is required to tease apart direction of effect in future research.

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Nature Play WA acknowledges the Whadjuk people of the Noongar Nation, as the custodians of the land where our team lives and works. We also acknowledge the traditional custodians throughout Western Australia and recognise the continuing connection of Indigenous people to their land, waters, sky, culture and community. We pay our respect to all Indigenous people of this land; ancestors, elders and young ones.