Children experience steady growth in height and weight, provided that all necessary factors, including nutrition, are adequately met. On average, they gain about 5-7 pounds and grow 2-3 inches in height each year. Besides nutritional and all other factors required for normal child growth, physical activity plays a key role in child growth and development ( Physiother, Ther et al. 2022). Physical activities become more coordinated as children gain strength and balance ( Physiother, Ther et al. 2022). Playing outside allows children to develop more advanced motor skills than children who spend most of their time indoors, including agility, balance, and coordination. Playing outside tends to move in ways that push their muscles, bones, and stamina. They run, jump, climb, and take part in sports, building strength, coordination, and confidence as they grow. Their hand-eye coordination improves, allowing them to perform tasks such as writing and drawing more precisely ( Boxberger and Reimers 2019, Ne’matullah, Abd Talib et al. 2022). Children begin to realize why health and nutrition matter and may take an interest in physical fitness, recognizing how the choices they make affect their bodies. Children who play outside more often tend to be more energetic than their sedentary counterparts, which means they are less likely to become obese ( Moore, Sharma et al. 2021). Instead of sitting idly in front of a television or computer for hours, a phenomenon informally known as couch potato, they are outside, being active and burning off calories. In preschool-age children, a direct correlation exists between a child’s body mass index (BMI) and the time spent engaging in outdoor activities. Parents who allowed their children to play outside longer generally had children with lower BMI than parents who limited their children’s playtime. Obese children are more likely to develop health issues like diabetes and cardiovascular disease. In addition to the benefits of physical activity, exposure to sunlight while outdoors can enhance children’s mood, bolster their immune system, and boost their vitamin D intake. Children who have Attention Deficit Hyperactivity Disorder (ADHD) can also benefit from outdoor play, as it provides a safe way for them to release pent-up energy that can create problems in indoor settings ( Whitebread, Neale et al. 2017; Sandseter, Cordovil et al. 2020; Moore, Sharma et al. 2021). 1.

Cognitive and emotional development associated with outdoor play

According to Jean Piaget’s stages of cognitive development, children aged 6-12 are typically in the concrete operational stage ( Mcleod 2009, Shukla 2020, Malik and Marwaha 2025). They begin to think logically about concrete events, understand the concept of conservation (the idea that quantity remains constant even when its shape changes), and categorically order and classify objects. Vocabulary expands significantly, and reading and writing skills become more sophisticated ( Wilks, Gerber et al. 2010, Newcombe 2013). Children can engage in more complex conversations, express abstract ideas, and understand figurative language. Children develop better problem-solving abilities and can approach tasks with planning and strategy, rather than relying on trial and error. They begin to engage in more complex thinking, such as understanding cause and effect ( Mcleod 2009).

Emotional development allows children to empathize with others and understand different perspectives ( Wilks, Gerber et al. 2010). They learn to recognize and respond to the feelings of their peers. Social interaction becomes increasingly important. Children develop friendships that are often based on mutual interests and shared activities, leading to a greater emphasis on peer approval and the dynamics of social groups ( Whitebread, Neale et al. 2017; Sandseter, Cordovil et al. 2020). As children assume roles in group activities, they learn the importance of teamwork, cooperation, and practical communication skills. They become adept at negotiating and resolving conflicts with peers. During this stage, children start to understand societal rules and expectations. They develop a sense of right and wrong and begin to internalize moral values, often guided by parents and teachers ( Mcleod 2009, Sandseter, Cordovil et al. 2020), as shown in Table 1.

Despite the awareness of children’s right to play and the proven benefits of outdoor play, children’s time spent outdoors has decreased ( Larson, Green et al. 2011). Over time, young children’s “screen time” has increased as they frequently sit in front of computers and play electronic games ( Fjørtoft 2001; White 2013). However, various challenges and barriers can limit children’s opportunities to engage in outdoor play.

Technology and screens top the list of barriers to outdoor play. The prevalence of screens (TV, video games, smartphones) and social media is all addictive, especially for children. The American Academy of Pediatrics (AAP) recommends zero screen time for children under two years old and limited screen time for children aged 2 to 5 years old. When screen time is limited, it will provide more opportunities for outdoor activities. Academic pressure on our children adds to the stress, and the availability of unstructured activities, such as homework, after long school days, and other activities, is draining, and families may prioritize indoor study or tutoring over outdoor play ( Brussoni, Gibbons et al. 2015, Sandseter, Cordovil et al. 2020). As a result, children are left with little time or desire to be outside. Most families live in urban areas with limited outdoor spaces, parks, playgrounds, and other green areas. Oftentimes, they have rules of what can and cannot be done, leaving children with minimal options for unstructured and safe outdoor play. If children are fortunate enough to find parks with green space, it is mostly lawns with very little room for exploration. In a similar sense, playgrounds are often outdated, too small, or inaccessible to children with special needs. Also, families without reliable transportation may struggle to access outdoor spaces. Extreme weather, like hot summers, cold winters, rainy weather, and disease outbreaks ( Bilton 2019, Ebbeck, Yim et al. 2019), can limit outdoor playtime as they are risky for children, resulting in sunburn, pneumonia ( Bilton 2019, Ebbeck, Yim et al. 2019). Poor air quality due to pollution or allergens can make outdoor play unsafe for children, especially those with respiratory issues such as asthma. Safety concerns are another barrier to outdoor play for children, as parents are worried about strangers and busy roads, lack of safe pathways, and potential environmental dangers, which can discourage outdoor activities ( Bilton 2019, Lafave, Webster et al. 2021). Some parents may be overly cautious and choose to keep their children indoors due to perceived risks associated with outdoor play. In contrast, parents who are not actively involved in outdoor activities may not encourage their children to engage in outdoor play. Inadequate public facilities, such as benches and restrooms, can deter families from utilizing outdoor spaces ( Brussoni, Gibbons et al. 2015).