Physical and cognitive development in preschool children during and after COVID-19 pandemic: a cross-sectional cohort comparison

The COVID-19 pandemic disrupted preschool children’s routines, potentially affecting their fundamental movement skills (FMS), physical activity (PA), physical fitness (PF), and executive function (EF). This study compared these outcomes in preschoolers during and after the pandemic and investigated their associations. Two cohorts of 5-6-year-olds from four Chinese preschool centers were evaluated: one during the pandemic (2021, n = 174) and one post-pandemic (2023, n = 189). FMS were measured using the Test of Gross Motor Development Third Edition (TGMD-3), PA was monitored with accelerometers, PF was measured by field tests, and EF was assessed through computerized tasks. Multivariate analysis of variance (MANOVA) was used to compare outcomes between cohorts, and linear mixed models (LMMs) were used to examine associations between FMS, PA, PF, and EF components. Post-pandemic participants demonstrated significantly better performance in locomotor skills, PF components (balance, flexibility, muscular strength, muscular endurance, speed-agility), and EF components (cognitive flexibility, inhibitory control, working memory) compared to their pandemic peers. Conversely, pandemic participants exhibited higher scores in ball skills and spent more time in moderate-to-vigorous physical activity (MVPA). During the pandemic, better balance was associated with higher cognitive flexibility. Post-pandemic, muscular strength was positively associated with cognitive flexibility, and speed-agility with inhibitory control, while light PA was negatively associated with inhibitory control. The findings reveal a mixed pattern of physical and cognitive outcomes between preschool children assessed during versus after the pandemic, with post-pandemic improvements in several domains but notable pandemic advantages in ball skills and MVPA. Furthermore, the associations between PF and EF were specific and context-dependent. These results provide descriptive evidence of developmental shifts associated with the pandemic context, though causal inferences are precluded by the cross-sectional design and small effect sizes.