Associations between sedentary behaviour and fine and gross motor skills in 3- to 4-year-olds: A secondary data analysis from sunrise international study pilot studies

Background: The evidence on associations between sedentary behaviour (SB) and motor skills in 3- to 4-year-olds is unclear and mostly from high-income countries. 

Objective: The objective of this study is to examine associations between (1) screen time (h/day) and total daily SB (h/day), and gross and fine motor skills, and (2) meeting the restraint, screen time and overall SB (restraint and screen time) guidelines and fine and gross motor skills. 

Methods: Cross-sectional study of 1394 3- to 4-year-olds from the pilot phase of the SUNRISE International study. Time spent in SB was measured using the activPAL accelerometer, whereas screen time and restraint were measured using a parent questionnaire. Fine and gross motor skills were measured using parent-reported Ages and Stages Questionnaire (ASQ-3). Associations between SB and motor skills were determined using linear and logistic regression, adjusting for sex and socioeconomic status. 

Results: Every additional 1 h of screen time was associated with 0.50-point reduction in gross motor skills scores (p = 0.008). More screen time was associated with decreased odds of being on track for fine and gross motor skill development (p < 0.001 and p = 0.017, respectively). Meeting the screen time (p = 0.009) and overall SB guidelines (p = 0.006) were favourably associated with fine motor skills scores. Meeting the screen time, restraint and overall SB guidelines were favourably associated with gross motor skills scores (p = 0.007, p < 0.001 and p < 0.001, respectively), higher odds of being on track for fine (p = 0.033, p = 0.015 and p < 0.001, respectively) and gross motor skills (p = 0.006, p < 0.001 and p < 0.001, respectively) development. 

Conclusion: The present study adds to the evidence on the importance of sedentary behaviour for the motor development of 3- to 4-year-olds. It is important that policy makers and health educators develop strategies that will encourage and promote adherence to sedentary behaviour guidelines among 3- and 4-year-olds. Copyright © 2025 The Author(s).