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Journal article review: Use of time in childhood and adolescence

Dr Carolyn DunfordUse of time in childhood and adolescence: A literature review on the nature of activity participation and depression – reviewed by Dr Carolyn Dunford, Senior Lecturer, York St John University.

The focus of this article was to explore the relationship between mental health and activity participation in childhood and adolescence. The study reviewed time use studies to gain a deeper understanding of the relationship between children and adolescents’ time use and depression. The authors do not describe how the chosen studies were identified. The findings are then applied to occupational therapy practice.

The authors start with descriptions of the various time use research methodologies such as observational studies, experience sampling methods, survey stylised questionnaires and time diaries. The findings are presented as they relate to depression and leisure, productivity, self-care and sleep.

Depression and participation in leisure activities: Leisure activities are often divided into structured and unstructured activities. Unstructured activities “have few explicit goals, are spontaneous in nature, frequently unorganised and typically led by young people”. This type of leisure activity is also referred to as time-out leisure and is passive and usually solitary in nature. Structured activities “are usually organised or directed by adults, guided by rules, involve regular commitment, demand sustained attention, and are goal directed with the emphasis on skill development”. Time-out leisure has been “negatively associated with mental well-being” whilst it has been suggested that structured activities “provide the most developmentally enhancing ways of spending time”. Ten year olds who spent more time on reading, hanging out or alone were more likely to be depressed at 12 years. There is a suggestion that physical activity may be protective against depression but this requires further investigation.

Depression and participation in productive activities: Productive activities for children and young people include household chores, schoolwork, homework and paid work for older adolescents. There is little research into this area but one study has shown that young people with depression spend less time performing productive activities than controls or those who have recovered from depression. One prospective longitudinal study suggested work with adequate pay, that was not too stressful and related to future academic aspirations was linked with reduced levels of depression at four year follow-up.

Depression and participation in self-care activities: There has been little research into this area although it is known that children with physical disabilities spend more time on self-care, displacing other activities.

Depressive symptoms and sleep: It is important to be aware of developmental trends for the amount of time children and young people spend sleeping as this generally reduces as children grow older. It is known that efficiency and duration of sleep is an important factor for adults with affective disorders. One study found that increased time sleeping for children under 13 years was linked to fewer behaviour issues.

The authors start their summary by noting that there is limited research but studies to date suggest spending more time in structured leisure may be beneficial and young people with depression spend less time in productive activities. More research is required into the role of time spent in self-care activities. The amount of time sleeping may be an important factor in depression.

Relevance to occupational therapy practice

Time use studies inform us about developmental trends and changes with age in the use of time for children and young people. Information gained through exploring individual children and young people’s time use could enable us to identify activity limitations for children and young people with depression. This information could guide and structure interventions to increase participation in age appropriate and meaningful occupations. Much more research is required to enable a greater understanding of the relationship between time use of children and adolescents and depressive symptoms.

Whilst this paper identified many gaps in our knowledge on the nature of activity participation and depression I found it made interesting reading and highlighted how time use studies are relevant to providing occupation focused interventions.

Full reference: Desha LN and Ziviani JM (2007) Use of time in childhood and adolescence: A literature review on the nature of activity participation and depression. Australian Occupational Therapy Journal 54, 4-10