Association Between Compliance With the 24‐h Movement Guidelines and Development in Uruguayan Preschool‐Aged Children: A Cross‐Sectional Study
Franco Souza‐Marabotto, Sofia Fernandez‐Gimenez, Enrique Pintos‐Toledo, Cesar Corvos‐Hidalgo, Danilo R. Silva, Javier Brazo‐SayaveraABSTRACT
Background
The 24‐h movement behaviours paradigm integrates sleep, sedentary behaviour and physical activity across the day. The World Health Organization has issued 24‐h movement guidelines for children under 5 to support optimal development. Evidence suggests low compliance with these guidelines, particularly in South America and few studies have examined their association with developmental outcomes in Uruguay. The aim of this study was to analyse the association between meeting the 24‐h movement guidelines and the risk of developmental difficulties across multiple developmental domains in preschool‐aged children.
Methods
A cross‐sectional study was conducted using data from the Nutrition, Child Development and Health Survey. A total of 1508 children aged 12–59 months with complete data on physical activity, screen time, sleep and developmental outcomes assessed using the Ages and Stages Questionnaires, Third Edition (ASQ‐3) and ASQ:SE (social–emotional) were included. Children were classified according to compliance with the World Health Organization 24‐h movement guidelines. Modified Poisson regression models with robust variance estimation were used to estimate Prevalence Ratios (PR) for the association between compliance with the 24‐h movement guidelines and developmental outcomes, adjusting for sex, age, body mass index and number of books at home.
Results
Among participants (50.7% boys), only 21.3% met all three 24‐h movement guidelines. Across ASQ‐3 domains, 72%–86% were in the normal range; 83.3% showed no social–emotional concerns. No significant associations were observed between guideline adherence and developmental outcomes.
Conclusions
These findings challenge the consistency of previously reported associations between 24‐h movement behaviours and developmental outcomes, suggesting that such relationships may not generalise across contexts. Contextual and measurement factors may play a key role, highlighting the need for longitudinal studies using objective measures in diverse settings.