Herminia Vega-Perona1,2†
Nataliya Filenko1,2†
Felipe Gertrúdix-Barrio3
José Manuel Azorín-Delegido4Daniel A. Martínez-Bello5
María del Mar Bernabé-Villodre1,2
Vladimir E. Martínez-Bello1,2*- 1Faculty of Teaching, University of Valencia, Valencia, Spain
- 2COS Research Group, Body, Movement, Music and Curricular Practices, University of Valencia, Valencia, Spain
- 3Faculty of Teaching, Castilla-La Mancha University, Toledo, Spain
- 4Catholic University of Murcia, Murcia, Spain
- 5Programa de Bacteriología y Laboratorio Clínico, Facultad de Ciencias Médicas y de la Salud, Universidad de Santander, Bucaramanga, Colombia
Objectives: This study was designed with three primary objectives: (a) to evaluate the levels of physical activity (PA) and sedentary behavior (SB) in toddlers during the school day at ECEC institutions in Spain; (b) to establish the rate of adherence to specific recommendations for total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), sleep, and screen time; and (c) to characterize the relationship between individual and socioenvironmental correlates and toddlers’ TPA, light physical activity (LPA), MVPA, and SB during the school day.
Methods: This study recruited 264 toddlers (14–23 months) via convenience sampling from public ECEC institutions across three cities. PA was quantified using ActiGraph accelerometry. Sleep behavior was evaluated using the Spanish version of the Brief Infant Sleep Questionnaire (BISQ-E), which was completed by parents. Parents reported their toddler’s average screen time.
Results: (a) ECEC settings significantly contribute to young children achieving daily TPA recommendations (72%), despite high sedentary time (69%) during school hours. (b) Age positively correlated with LPA (β = 0.003, 95% confidence interval (CI) [CI 0.001, 0.005], p < 0.006), MVPA (β = 0.002, 95% CI [0.000, 0.003], p = 0.004]), and TPA (β = −0.005, 95% CI [0.002, 0.008], p = 0.001) and inversely with SB (β = −0.005, 95% CI [0.0082, 0.002], p = 0.001). (c) No associations were found for gender, BMI, or other personal and social factors with any PA/SB variables. (d) Most young children (64%) exceeded screen time recommendations, while sleep guidelines were largely met (81% adherence); however, no association was between these variables and PA and SB were found. (e) After ECEC hours, unstructured outdoor recreation was strongly preferred over structured activities, and visiting a park at least three times per week was associated with MVPA (β = −0.007, 95% CI [−0.015, 0.001], p = 0.05).
Conclusion: Parents need to be aware of their influence on children’s media habits, and ECEC settings should develop strategies to reduce excessive screen time. A balanced approach to PA, reduced sedentary time, and limited screen exposure—alongside healthy sleep habits supported by such routines—is consistently linked in emerging evidence to better early childhood wellbeing.
1 Introduction
Between the ages of one and three, children experience rapid and significant development across physical, cognitive, social, and emotional areas (Jeong et al., 2021), which can be promoted through the achievement targets for daily physical activity (PA) (Feng et al., 2021). Children aged 1–2 years old should get 180 min of total physical activity (TPA) every day, including light (LPA), moderate, and vigorous physical activity (MVPA), with zero exposure to screens, along with 9–11 h of sleep. Children should be engaging in a minimum of 60 min of MVPA daily by the time they reach 5 years of age (Ministry of Health, 2022; World Health Organization [WHO], 2019). Research across various countries reveals a consistent pattern of toddlers struggling to meet comprehensive movement guidelines, despite high adherence in specific areas (Santos et al., 2017; Meredith-Jones et al., 2019; Lee et al., 2017; Quah et al., 2024). For instance, Canadian studies showed that while most 2-year-olds met sleep and PA recommendations, the majority failed to meet screen time guidelines (Lee et al., 2017; Meredith-Jones et al., 2019). Similarly, in Australia, fewer than 9% of toddlers met all guidelines, with particularly low adherence (11.4%) to sedentary behavior (SB) recommendations (Santos et al., 2017). Conversely, recent data from Singapore indicated high sleep guideline adherence (82%), but significantly lower adherence to both screen time (38.8%) and PA (50.1%) recommendations (Quah et al., 2024). Furthermore, research across various countries shows adherence to some individual movement guidelines at certain ages throughout early childhood was associated with improved mental health and wellbeing at 5 years of age (Taylor et al., 2021). For instance, Australian studies showed that meeting the recreational screen time plus physical activity guidelines has the strongest positive association with children health-related quality of life indicators and supporting preschool children to meet all guidelines or more guidelines, particularly the sleep and screen time guidelines, may be beneficial for their social-cognitive development, respectively (Cliff et al., 2017; Xiong et al., 2022). Collectively, these findings underscore the importance of studying the interplay between PA, SB, and sleep on child health outcomes (Kuzik et al., 2017).
Different correlates of PA abound in early childhood and have been characterized in the literature through ecological models of health behaviors (Sallis and Owen, 2008). However, the research on this topic is concentrated in older toddlers (over 2 years of age) (Wijtzes et al., 2013; Johansson et al., 2015), with limited data in children aged 1–2 years (Hager et al., 2016; Carson and Kuzik, 2017; Prioreschi et al., 2017; Bruijns et al., 2020) and even less in early childhood education and care (ECEC) settings. At the individual level, evidence from diverse settings consistently rules out any significant association between body mass index (BMI) and PA intensity or sedentary behavior (Johansson et al., 2015; Prioreschi et al., 2017; Kelly et al., 2022). Conversely, older age is strongly associated with increased PA and reduced sedentary time (Wijtzes et al., 2013; Hager et al., 2016; Prioreschi et al., 2017). Regarding the impact of gender, there are inconsistent findings: most studies have not found gender differences in MVPA (Hnatiuk et al., 2012; Kwon et al., 2019), but some have observed higher total TPA in boys (Prioreschi et al., 2017; Kwon et al., 2019) or more SB and lower MVPA in girls (Carson and Kuzik, 2017).
At the social level, parental practices—including role modeling, support, monitoring, and active play—positively correlate with young children’s PA (Kwon et al., 2019; Arts et al., 2023). Conversely, excessive screen time is a widespread concern: studies report high media exposure across diverse contexts, including in Germany (Paulus et al., 2024), the USA (Kwon et al., 2019), and Turkey (Konca, 2022). Screen use increases significantly with age (Carson and Kuzik, 2017; Paulus et al., 2024) and is linked to diminished cognitive stimulation at home (Duch et al., 2013). Compliance with screen-time guidelines is low; for example, less than 26% of Canadian toddlers under age 2 met recommendations (Luukkainen et al., 2024). In addition, Janssen et al. (2020) found in their systematic review that increased screen time is associated with poorer sleep outcomes, including shorter total sleep duration, in infants and toddlers (Janssen et al., 2020). Conversely, higher levels of total PA and MVPA were associated with longer sleep duration, improved sleep quality, and greater sleep stability in toddlers. These trends underscore the need for parental awareness and ECEC-based strategies to reduce screen exposure in early childhood (Daly-Smith et al., 2020). Toddler PA can be effectively promoted in ECEC institutions (Coyle-Asbil et al., 2024). Furthermore, ECEC institutions are considered ideal contexts for establishing healthy lifestyles, with beneficial impacts in the present (Toussaint et al., 2019; Carson et al., 2023) as well as throughout childhood and in later life (Luukkainen et al., 2024). Considering toddlers’ unique needs, specialized training and sensitivity are essential for implementing appropriate curricular practices (Gilken et al., 2023) optimizing their impact on movement behaviors (Coyle-Asbil et al., 2024). However, significant gaps persist in understanding the PA correlates in children aged 1–2 years old specifically in ECEC settings. Therefore, this study aimed to: (a) assess PA and SB in toddlers during the school day at ECEC institutions in three Spanish cities; (b) establish the rate of adherence to specific recommendations for TPA, MVPA, sleep, and screen time; and (c) characterize the relationship between individual and socioenvironmental correlates and toddlers’ TPA, LPA, MVPA, and SB during the school day.
2 Materials and methods
2.1 Design and participants
Employing a cross-sectional, correlational design within the MOVIMUSI project (Register: Study Protocol - Trial registration number NCT06381687, date registered: April 23, 2024).), this study recruited 264 Spanish toddlers (14–23 months) via convenience sampling from public ECEC institutions across three cities: Valencia, Murcia, and Toledo. This study reports the baseline results from the first year of the project (Bernabé-Villodre et al., 2024). Inclusion criteria were: (a) aged 14–23 months; (b) able to walk independently; and (c) attending ECEC ≥ 3 days/week. Further eligibility requirements were parental consent, ECEC enrollment, and typical developmental status. Final analyses excluded children failing to complete five consecutive days of data collection (e.g., due to illness or early departure during measurements).
The sample size calculation took into account the results of a previous study, which objectively measured PA using accelerometry with young toddlers (Vega-Perona et al., 2022a). According to that study, toddlers engage in an average of about 40 min [standard deviation (SD) 15.8] of MVPA during ECEC. For an (alpha) significance level of 5%, a statistical power of 90%, an expected SD of 7 min, and a minimum mean difference of 8 min considered practically significant, the initial calculation indicated a requirement of X individuals per city. However, as the data are naturally clustered by city, the design effect was incorporated to adjust for between-city variance. Assuming an average cluster size of 13 (the mean number of children per ECEC class) and an intraclass correlation coefficient (ICC) of 0.35, the design effect was calculated. This adjustment yielded a final sample size requirement of 21 ECEC institutions, encompassing an estimated total of 264 young children. This approach, adapted from methodologies for clustered comparisons (Campbell and Walters, 2014).
After applying these criteria, the final sample comprised 213 toddlers (mean age 21.2 months, SD 2.5; 49% girls; Table 1). The parents or guardians of all participating children provided informed consent before the study began. The protocol for this research was approved by the Human Research Ethics Committee of the corresponding author’s university (ethical approval code: UV-2023-3118978). Data were gathered between December 2023 and June 2024.
Table 1. Child, family, and social participant characteristics.
2.2 Parental and toddler characteristics
Concurrent with the PA assessment, parents completed a demographic questionnaire capturing data on toddler gender, age, ECEC enrollment, and family variables. Children underwent standardized anthropometric assessments: weight was measured without shoes or heavy clothing, and height was determined using a portable calibrated stadiometer. All data collection occurred after informed consent was obtained. BMI values were calculated and categorized according to established age- and gender-specific reference standards, defining the groups as underweight, healthy weight, overweight, or obese (Cole and Lobstein, 2012). The age of the toddlers, in months, was determined by calculating the difference between their date of birth and the date of data collection. The number of siblings was categorized as none, one, or two or more. Parents provided their own dates of birth, specified their relationship to the child (e.g., mother, father, other), and reported their educational attainment. For analytical purposes, the variable “parental education” was recoded into a dichotomous categorical variable: high school or below, encompassing parents whose highest educational attainment was a high school diploma, vocational training, or any lower qualification; and higher education, which included those who had completed any form of post-secondary education, including college degrees (e.g., bachelor’s), university certifications, or advanced postgraduate degrees (e.g., master’s, doctorate).
2.3 Measurement of sleep time
Sleep behavior was evaluated using the Spanish version of the Brief Infant Sleep Questionnaire (BISQ-E), which was completed by parents. This instrument gathers pertinent information on various aspects of a child’s sleep patterns (Cassanello et al., 2018). Parents were asked to detail their child’s sleep, specifically the duration of naps and nighttime sleep (in hours and minutes) and the frequency of nighttime awakenings. During school hours, ECEC teachers recorded the child’s nap duration.
2.4 Parent-reported screen time
Parents reported their toddler’s average screen time, detailing the number of hours and minutes spent with television, videos, computers, and portable devices. These data were collected separately for weekdays and weekend days. The toddlers’ daily screen time (min/day) was derived by calculating the weighted average of the time they spent watching television and using video games, computers, and portable devices.
2.5 Definitions of adherence
Compliance with the guidelines (Tremblay et al., 2016) was assessed based on the World Health Organization (WHO) recommendations for PA, SB, and sleep in children under 5 years old (World Health Organization [WHO], 2019) This study evaluated adherence to PA guidelines during the school hours by establishing two specific criteria, firstly based on the principle that children spend approximately half of their waking time in ECEC settings, so a threshold of 50% of the daily recommendation was adopted, corresponding to ≥90 min of TPA; and secondly adhering to the Institute of Medicine guideline, which stipulates a minimum of 15 min of physical activity per hour of care, where adherence was defined as achieving ≥105 min of TPA over the 7-h school day. Adherence to the SB guideline was defined as zero screen time for 1-year-olds, and 1 h or less for 2-year-olds. Furthermore, in line with the Australian 24-H Movement Guidelines, which recommend 11–14 h of sleep per day for toddlers, the average total sleep duration was categorized into a binary measure of whether or not this recommendation was met (Okely et al., 2017). According to guidelines for children under five (World Health Organization [WHO], 2019), 1-year-olds should have no screen time, while 2-year-olds should have no more than 1 h, and even less is preferred.
2.6 ECEC background information and school hours
The study was conducted in three regional capitals of Spain -Valencia, Murcia and Toledo- selected for representing the diversity of the national education system. Inclusion criteria for participating institutions were: public ECEC centers located within the metropolitan area of any study city, serving children across all three levels of the first ECEC cycle (0–1, 1–2, and 2–3 years), and holding operational authorization from the relevant authority. An invitation letter outlining the project’s main objectives was sent to the Education Council and the ECEC centers in the three cities. In each, the research group invited eight, seven, and four ECEC institutions to participate. All accepted the invitation. The characteristics of the ECEC institutions, such as the number of enrolled children, were collected from school curriculum documents and during interviews with the principal of each ECEC institution. In all of them, the school hours were from 9:00 a.m. to 4:30 p.m., and included allocated slots for recess (mean 45 min), lunch (30 min), and naps (90 min). Across all ECEC centers, meals were served in a central location within the building, while napping occurred in the toddlers’ classrooms. A ratio of two educators was maintained per classroom. Additionally, teachers provided information on the count of children with consistent attendance during the week the measurements were taken.
2.7 Measurement of PA and sedentary time
ActiGraph GT3X+ accelerometers (GT3X+Actigraph, Pensacola, FL, USA) were used to measure toddlers’ PA levels over a 1-week period. The monitors were worn on the right hip exclusively during ECEC operating hours. Teachers administered the devices, applying them at the start of the school day (9:00–9:15 a.m.) and removing them shortly before departure (4:15–4:30 p.m). Children wore the accelerometer throughout their entire stay at the center, including during the scheduled 90-min nap period. As teachers reported that all children in this age group napped, this time was included in the analyses. Non-wear time was determined and excluded to ensure the validity of the estimates. Periods of non-wear were defined as intervals of at least 10 consecutive minutes of zero counts. Furthermore, teachers were instructed to note if a child removed the accelerometer or if any unusual activity occurred. They were also asked to log the children’s daily routines and the spaces they used (e.g., outdoors, indoors). All algorithm-identified non-wear periods were cross-referenced with this teacher-reported data before being removed prior to the calculation of average daily wear time and PA and SB variables. The accelerometer data were processed using ActiLife software (v. 6.4, ActiGraph Inc.) and downloaded into 15-s epochs. To classify PA levels and sedentary time, Trost’s established cutoffs for 2-year-olds were applied (Trost et al., 2012). Accordingly, activity was categorized as follows: SB (0–48 counts/15 s), LPA (49–418 counts/15 s), and MVPA (>418 counts/15 s). TPA was defined as the sum of all light to vigorous intensity activity (Bisson et al., 2019). The final sample for these measurements included 213 young children. The Trost et al. (2012) cut-points, developed for children aged 2–3 years, were selected as the most age-appropriate and commonly used option for children under two, given the lack of validated alternatives (Carson and Kuzik, 2017; Hnatiuk et al., 2012). This methodological choice is further supported by developmental evidence: children between 14 and 23 months typically achieve key motor milestones (e.g., independent walking, running) that make their activity patterns more comparable to 2-year-olds than to younger infants.
2.8 Statistical analysis
Descriptive statistics summarized the continuous variables as means and SDs. The associations between the independent variables (age, gender, BMI, parental/social factors, screen time, and sleep adherence) and the outcomes (LPA, MVPA, TPA, SB) were determined using mixed-effects linear models. Associations between each exposure and outcome were analyzed both independently and with all predictors jointly, in unadjusted and adjusted models. Random effects were tested for the nested structure of child in classroom, classroom in school, and school in city, but the random effect of school nested in city was not significant, and was removed from the model, leaving only the effects of child in classroom and classroom nested in school. The chi-squared test was used to study the relationship between personal and social characteristics as well as adherence to recommendations and gender. Statistical significance was defined as p < 0.05. Data analysis was carried out in R (v.4.1) with the lme4 package (v.1.1-27.1).
3 Results
Table 1 presents descriptive information on toddlers’ and parental characteristics. The study group consisted of children with a mean age of 21.2 months (SD 2.6), and 49% of the sample was female. Notably, the combined prevalence of overweight (6.2%) and obesity (11%) reached 17% of the sample, approaching one-fifth of the cohort. Chi-squared analyses did not reveal any statistically significant associations between personal and social variables and gender.
Table 2 shows that on average, participants were sedentary for 292 min (SD 27) per day. TPA averaged 130 (SD 29 min), consisting of 103 min (SD 23) of LPA and 27 min (SD 7.6) MVPA. TPA and SB represented 31% and 69% of the total time young children spent in ECEC institutions, respectively (naptime included – 90 min daily). As shown in Table 1, results for the mean duration of different levels of PA were similar in girls and boys: (a) SB: 294 min (SD 26) vs. 290 min (SD 28); (b) LPA: 101 min (SD 20) vs. 105 min (SD 25); (c) MVPA: 26 min (SD 12) vs 27 min (SD 13); and (d) TPA: 128 min (SD 27) vs. 131 min (SD 32), respectively.
Table 2. Time spent at different levels of physical activity and in sedentary behavior during school hours, by gender.
As shown in Table 3, 90% of the participants met the health recommendations for quarter-hourly TPA per hour, and most (86%) also met the 50% TPA adherence threshold (≥90 min during total school hours). Gender-based analysis revealed nearly identical adherence patterns. A substantial majority (64%) exceeded recommended screen time limits (>1 h/day). Girls showed higher non-adherence rates (69%) compared to boys (59%). In total, a quarter of participants (26%) had more than one hour of screen time per day. Girls presented a 2.1-fold greater likelihood of excessive screen use compared to boys (χ2 10.639; df = 1; p = 0.002). Regarding sleep, most participants (81%) met sleep duration recommendations.
Table 3. Adherence to physical activity, sleep time and screen time recommendations in young children attending early childhood education and care institutions.
As shown in Table 4, after adjusting for gender, age, and BMI, the mixed-model regressions revealed statistically significant associations (p < 0.001) between age and all objectively measured movement variables: TPA, LPA, MVPA, and SB. Furthermore, there was a significant association between MVPA and visiting park (p = 0.05) and a trend association between MVPA and participation in extracurricular activities (p = 0.085). No other associations with objectively measured PA levels and SB were observed for gender, BMI, parental education, existence of siblings, or adherence to screen time recommendations.
Table 4. Final mixed model regression estimates (beta and 95% CI) for factors associated with physical activity and sedentary behavior during early childhood education and care (ECEC) hours.
4 Discussion
National and international health guidelines emphasize that an active lifestyle in early childhood offers both immediate benefits and lays the foundation for lifelong healthy habits (Institute of Medicine, 2011; World Health Organization [WHO], 2019), and to support this, they establish specific daily recommendations for PA. Quantifying this activity and identifying its key correlates provides valuable guidance for families, educators, and public administrators, enabling the development of targeted strategies to promote active lifestyles among young children. Given the particular importance of this life stage, numerous studies use accelerometry as an objective measure to assess compliance with these guidelines (Wijtzes et al., 2013; Johansson et al., 2015; Prioreschi et al., 2017; Alhassan et al., 2022; Vega-Perona et al., 2022a).
To the best of our knowledge, this study is the first in the post-pandemic era to objectively assess PA levels and adherence to PA guidelines during school hours in young children (1–2 years old). This study evaluated adherence to PA guidelines during the school hours based on the principle that children spend approximately half of their waking time in ECEC settings. Furthermore, it uniquely evaluates the individual, social, and parental correlates of their PA and SB during school hours in ECEC institutions. Given the inherent limitations of accelerometry—as well as the need to situate the interpretation of our PA findings within the broader context of developmental heterogeneity—we maintain that the data from our week-long, cross-sectional monitoring during the school day retain their value.
The key results reveal that during ECEC hours, toddlers accumulated 130 min (SD 29) TPA, 103 min (SD 23) LPA, 27 min (SD 12) MVPA, and 292 min (SD 27) SB, achieving 72% of daily TPA recommendations (World Health Organization [WHO], 2019), despite being sedentary 69% of the time. In other words, ECEC settings account for 72% of children’s adherence to daily PA recommendations. Considering children spend only about half of their waking time there, this demonstrates that ECEC institutions are highly efficient in promoting physical activity, contributing disproportionately to the daily goal. Notably, 90% exceeded the Institute of Medicine’s minimum TPA threshold (Institute of Medicine, 2011). This aligns with studies showing ECEC effectively supports PA guidelines: Hnatiuk et al. (2012) reported toddlers meeting Australian standards; Kwon et al. (2019) documented high PA levels; Vega-Perona et al. (2022a), Díaz-Quesada et al. (2021) confirmed efficacy in Spanish ECEC institutions. Consistent with our high SB, Alhassan et al. (2022) noted 73% of time spent in SB in childcare; Johansson et al. (2015), 55% SB in Swedish 2-year-olds; and Wijtzes et al. (2013), 85.6% SB in Dutch toddlers. These results suggest that despite young children (1–2 years old) spending more time doing sedentary activities in the ECEC setting, this context still enables the achievement of PA recommendations. Given that the total time spent at school is 7 h (from arrival to departure), this equates to a recommendation of over 105 min of physical activity per school day. In our study, 90% of children exceeded this target, achieving an average of 130 min of TPA.
On the other hand, the World Health Organization [WHO] (2019) recommends that toddlers get 180 min of TPA daily. Since the present study focused solely on the school day and considered that children spend roughly half of their waking hours in ECEC settings, a target of 90 min of TPA (50% of the daily recommendation) was established for the 7-h school period. The study’s results indicate that 90% of children met this goal, achieving an average of 130 min of TPA. Therefore, the responsibility for the remaining 28% of TPA falls to parents and other caregivers outside of school hours. These results align with broader evidence linking early childhood PA patterns to holistic wellbeing, demonstrating that ECECs enable children to achieve a substantial portion of their daily recommended activity (Taylor et al., 2021). Furthermore, systematic reviews indicate that meeting PA guidelines in early childhood is broadly linked to favorable outcomes, including enhanced cognitive development, emotional regulation, motor competence, and positive social behaviors (Rico-González et al., 2025a). Therefore, the ECEC environment’s role in promoting TPA, as shown in the present study, likely contributes to these foundational aspects of early wellbeing by providing movement opportunities during school hours.
In our study, boys and girls exhibited similar levels of TPA, LPA, MVPA, and SB during ECEC hours. In contrast to our ECEC-based findings showing no gender differences, multiple studies analyzing all waking hours report associations: Carson and Kuzik (2017) found higher sedentary time and lower MVPA in Canadian girls, Prioreschi et al. (2017) observed gender-based PA intensity differences in South Africa. In the USA, Hager et al. (2016) identified gender as a correlate of MVPA, while Kwon et al. (2019) observed comparable MVPA levels between boys and girls but noted boys got 15 more min of daily TPA. Critically, these studies included substantial home-based time (e.g., 63% non-ECEC in Kwon study; 32% parent care in Carson’s study), underlining that context matters: ECEC settings have distinct PA correlates (Tonge et al., 2020), and home environments may involve differential parental practices by gender (Prioreschi et al., 2017). This contextual divergence could mask gender associations (Vega-Perona et al., 2022a), especially as ECEC hours significantly boost weekday PA (Rico-González et al., 2025b). Consequently, as indicated by the findings of this study, within a more structured and adult-guided context such as ECEC, the notion of gender as a social construct that exerts a detrimental influence on girls’ opportunities for movement could be challenged, at least at very young ages (Martínez-Bello et al., 2024). Furthermore, the findings of this study indicate that the ECEC environment can potentially provide girls with avenues for PA that will persist throughout their subsequent educational years. By focusing on individual needs rather than gender, the ECEC environment supports each child’s unique development path. Future research should therefore longitudinally examine both ECEC and home settings to clarify how gender roles in PA evolve as girls grow older, particularly during key developmental transitions. Understanding these temporal dynamics is essential for designing age- and gender-specific strategies that promote sustained PA engagement from toddlerhood into early childhood.
Regarding other personal factors, young children’s age was the only correlate associated with LPA, MVPA, and TPA, and inversely associated with SB. In particular, older children exhibited approximately 16 min more LPA than younger ones. Evidence consistently links older age in early childhood with increased PA across various intensities. Multiple studies report higher TPA (Prioreschi et al., 2017) and substantially greater MVPA – nearly double that in older toddlers (Hager et al., 2016) – alongside reduced SB and elevated MVPA in older children (Wijtzes et al., 2013). Furthermore, Vega-Perona et al. (2022a) found a positive association between age and LPA in Spanish toddlers aged 2–3 years, reinforcing the overall trend of heightened activity levels with advancing age.
In line with the results of the present study, several others consistently demonstrate no significant association between BMI and PA patterns in young children. Vega-Perona et al. (2022a) observed no relationship between BMI and PA intensities or SB within Spanish ECEC settings. This pattern extends internationally: Johansson et al. (2015) detected no BMI-PA association in Swedish 2-year-olds across full daytime periods, while Kelly et al. (2022), Wijtzes et al. (2013) did not find meaningful interaction between overweight status and SB, LPA, or MVPA in US and Dutch samples, respectively. Collectively, these findings indicate that personal characteristics have minimal influence on PA levels and patterns among toddlers (1–2 years old) during their time in ECEC settings. Because 12–24-month toddlers’ interest in continuous exploration grows as they do, more studies are necessary to explain how other personal correlates could explain PA and SB during school hours.
As for social factors, on the one hand, after ECEC hours, families with toddlers strongly preferred informal outdoor play over structured activities. Though 82% reported no extracurricular participation, this contextual factor demonstrated a trend toward being associated with MVPA levels (p = 0.085). On the other hand, 62% went to the park at least three times/week, showing an association with MVPA (p = 0.05). Critically, no gender differences existed in park-visit practices. The literature reports that parental practices (role modeling, support, PA encouragement) positively correlate with child PA (Kwon et al., 2019; Arts et al., 2023), suggesting that unstructured community play (e.g., parks) as toddlers’ primary non-ECEC source for PA —far exceeds PA as part of structured programs.
Current guidelines from both the World Health Organization [WHO] (2019) and the Spanish Ministry of Health (2022) recommend no screen exposure for children under 2 years of age, as early media exposure harms development (Gou and Perceval, 2023; Ogata et al., 2025). However, it is noteworthy that 64% of young children do not meet the recommendations. Globally, screen time is prevalent: 61% of 1–2-year-olds use media (mean 35 min/day) in Germany (Paulus et al., 2024), while estimated screen time stands at over 3.5 h/day in Turkey (Konca, 2022), over 60% of 13-month-olds are exposed in the USA (Kwon et al., 2019), and only 6.82% Canadian toddlers avoid screens (Vanderloo and Tucker, 2015). Increased screen time in early childhood is linked to diminished home cognitive stimulation (Duch et al., 2013) and rises with age (Carson and Kuzik, 2017; Paulus et al., 2024). Our findings indicate excessive screen exposure at this young age, with 26% of the children engaging with screens for more than one hour per day. In this line, the chi-square analysis showed a statistically significant association between excessive screen use (>1 h of screen time per day) and gender, with girls spending nearly twice the time watching a screen compared to boys. In the same line, Paulus et al. (2024) found that girls had more screen time and higher average daily media usage time than boys. Carson and Kuzik (2017) found that compared to boys, girls engaged with screens for 27.1 more min/day on average. Therefore, in consonance with our results, it seems that when young girls are at home, they spend more time on screens, suggesting that parents should have strategies for promoting active behaviors. Several key factors may explain why 64% of the sample exceeded recommended screen time limits at such a young age: (a) parents could lack structured strategies or routines to replace screen time with active play, experiential learning, or other engaging activities; (b) families often use screens as an easily accessible tool to occupy children, manage daily tasks, or provide comfort; and (c) a misalignment likely exists between the ECEC environment and the home. The ECEC may not be effectively communicating the importance of screen time reduction or providing parents with practical, actionable strategies to consistently implement this guidance at home. Taken together, the findings of this study indicate that prevalent exposure to passive screens during the early developmental stage of young toddlers (1–2 years) necessitates the urgent replacement of such screen-based activities with active play and experiential learning. ECEC communities must help families reduce screen time through parental awareness and strategies (Vega-Perona et al., 2022b; Paulus et al., 2024).
Finally, 81% of participants achieved adherence to sleep guidelines. The literature reports that screen time is associated with poorer sleep outcomes in infants and toddlers (Janssen et al., 2020). In addition, recent research shows that parents’ knowledge of movement behavior guidelines (e.g., screen time) is associated with greater adherence to individual and combined movement guidelines (Rivera et al., 2024). According to the mixed-model regression, there was no association between objective measures of PA and SB and adherence to recommendations on screen time or sleep time. However, despite the absence of observed associations between screen time and sleep, and a borderline association between TPA and MVPA levels and adherence to screen time guidelines, further research is necessary to fully elucidate the potential implications of these factors in young children’s PA when attending ECEC institutions. Meeting combined PA and screen time guidelines shows a strong positive link to health-related quality of life, while following sleep and screen time recommendations benefits social-cognitive development (Cliff et al., 2017; Xiong et al., 2022). As discussed above, as screen exposure becomes normalized in young children, prioritizing parental and public education about its adverse effects on PA, sleep, and developmental trajectories is essential.
4.1 Strengths and limitations
To the best of our knowledge, no prior study in the post-pandemic era has used accelerometers to objectively assess the factors associated with PA in children aged 1–2 years during their time at ECEC. Furthermore, a major methodological strength lies in the large sample size drawn from numerous ECEC centers across distinct cities and classrooms. Nevertheless, this research is subject to certain limitations, notably those inherent in the cross-sectional methodology and the failure to account for environmental variables. Furthermore, there could be a potential misclassification of PA and SB due to the absence of established accelerometer cutoffs for toddlers. Furthermore, the generalizability of our results is constrained by the convenience sampling strategy, the exclusion of private ECEC institutions, and the exclusive focus on urban settings. Although our analysis accounted for the variability of cities, centers, and classrooms, and it gathered valuable parent-reported data, we acknowledge that a deeper, qualitative understanding of children’s motor experiences was beyond the scope of this quantitative study. Finally, the interpretation of our PA findings should be situated within the broader context of developmental heterogeneity. To address this, future investigations are encouraged to adopt innovative qualitative or mixed-method designs. Utilizing techniques like direct observation or in-depth interviews could illuminate the nuanced ways in which children engage with their environment and express physical activity. These methodologies are essential for building a more comprehensive explanatory model of physical activity in the early years. Additionally, assessing screen time and sleep in toddlers poses significant methodological challenges. Consequently, we utilized proxy reports from parents and educators, a method that is well-established in epidemiological research involving young children (Bingham et al., 2016; Carson and Kuzik, 2017). Future studies, however, should aim to analyze the relationship between PA during school hours and motor development. Furthermore, measuring PA and sedentary behavior with accelerometry would help validate the data reported in the questionnaires.
5 Conclusion
The key results of this research can be summarized as follows. (a) ECEC settings significantly contribute to young children (1–2 years old) achieving daily TPA recommendations (72%), despite high sedentary time (69%) during school hours; (b) Most young children (64%) exceeded screen time recommendations, with prevalence of non-adherence twice as high in girls as in boys. Although sleep guidelines were largely met (81% adherence), no associations were found with PA or SB; (c) Age was positively correlated with LPA, MVPA, and TPA, and inversely correlated with SB, whereas no associations were observed for gender, BMI, or other personal and social factors with any PA or SB variables. (d) After ECEC hours, children strongly preferred unstructured outdoor recreation over structured activities. No gender differences were observed in parenting practices related to these activities. Furthermore, went to the park at least three times/week was associated with MVPA. ECEC practitioners must collaborate with parents to address home/social factors limiting PA opportunities. Finally, parents need to be aware of their influence on children’s media habits, and ECEC settings should develop strategies to reduce excessive screen time. Practitioners and parents should also actively promote PA equally for girls across settings, despite the absence of gender-based differences in the findings. Based on the provided research, a balanced approach to PA, reduced sedentary time, and limited screen exposure—alongside healthy sleep habits supported by such routines—is consistently linked in emerging evidence to better early childhood wellbeing.
To build on these findings, subsequent research should prioritize longitudinal designs to track the evolution of PA and SB over time. Such studies are a critical first step, as they allow for the examination of causal pathways and developmental trajectories by identifying how key correlates (e.g., environmental, familial, or policy factors) influence behavior over time. This longitudinal data would provide the essential foundation for designing and evaluating targeted intervention programs. Future research should, therefore, move beyond correlation to analyze the causal impact of such interventions. Furthermore, to enhance the generalizability of findings, future research must endeavor to include more diverse and representative samples. This includes recruiting participants from a wider range of demographic and socioeconomic backgrounds, expanding study populations to include the often-overlooked rural areas where access to resources may differ, and extending studies to include children enrolled in private early childhood education centers. This would enable a comparative analysis of movement behaviors across different geographic, socioeconomic, and educational settings and ensure that successful interventions can be effectively translated into various real-world contexts.
Data availability statement
The raw data supporting the conclusions of this article will be made available by the authors, subject only to the necessary restrictions to protect participants’ personal data.
Ethics statement
The studies involving humans were approved by Ethics Committee of the University of Valencia (UV-2023-3118978). The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants’ legal guardians/next of kin.
Author contributions
HV-P: Investigation, Writing – original draft. NF: Methodology, Investigation, Writing – original draft. FG-B: Investigation, Writing – original draft, Methodology. JA-D: Writing – original draft, Methodology, Investigation. DAM-B: Writing – review & editing, Formal analysis. MMB-V: Writing – review & editing, Conceptualization, Writing – original draft, Funding acquisition. VEM-B: Writing – original draft, Writing – review & editing, Funding acquisition.
Funding
The author(s) declared that financial support was received for this work and/or its publication. Vladimir E. Martínez-Bello and María del Mar Bernabé-Villodre were supported by Grant PID2022-141095NB-I00 funded by MICIU/AEI/and “ERDF A way of making Europe”, “ERDF/EU”, and the “European Union”. Herminia Vega-Perona was recipient of a research fellowship from the Generalitat Valenciana (Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital).
Acknowledgments
To young children, families, and, in particular, to ECEC teachers and principals for their collaboration during the research process.
Conflict of interest
The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declared that generative AI was not used in the creation of this manuscript.
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Keywords: early years, physical activity, screen time, sleep, toddlers
Citation: Vega-Perona H, Filenko N, Gertrúdix-Barrio F, Azorín-Delegido JM, Martínez-Bello DA, Bernabé-Villodre MM and Martínez-Bello VE (2026) Physical activity, sedentary behavior and screen time in young toddlers (1–2 years old) attending Spanish ECEC institutions. Front. Educ. 10:1735315. doi: 10.3389/feduc.2026.1735315
Received: 29 October 2025; Revised: 29 December 2025; Accepted: 02 January 2026;
Published: 09 February 2026.
Edited by:
Iker Sáez, University of Deusto, SpainReviewed by:
José Eugenio Rodríguez-Fernández, University of Santiago de Compostela, SpainEneko Sanchez Mencia, Universidad de Deusto, Spain
Copyright © 2026 Vega-Perona, Filenko, Gertrúdix-Barrio, Azorín-Delegido, Martínez-Bello, Bernabé-Villodre and Martínez-Bello. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Vladimir E. Martínez-Bello, dmxhZGlpbXIubWFydGluZXpAdXYuZXM=
†These authors have contributed equally to this work