Comparing Caregiver and Child Perceptions With Actual Child Physical Activity and Motor Skill Competence: A Collective Case Study Approach

Background The purpose of this study was to explore the alignment of caregivers’ perceptions and expectations of their preschool-aged children’s physical activity (PA) and motor competence (MC) with children’s actual performance located within the rural southeastern United States. Emphasizing a systems approach, we identified gaps in caregiver understanding of PA and MC to inform future interventions targeting health disparities in young children. Method A collective case study design involved 11 caregiver-child dyads from the southeastern United States. Data included caregiver interviews and visual representations of their children’s PA alongside objective measures of PA, body mass index, and MC. Analyses followed a two-phase process through the examination of individual case narratives and cross-case synthesis for emergent themes. Results Five key themes were identified: (1) caregivers’ high valuation of PA; (2) vague definitions of PA; (3) overestimation of child PA levels; (4) limited awareness of MC; and (5) differences in PA engagement (sport-oriented vs. general PA). Caregivers consistently valued PA but often misjudged their children’s PA levels and MC. Child step-counts were low-to-average, with only about half reaching the equivalent of 60–100 minutes per day, highlighting discrepancies between perceived and actual PA. Conclusion Findings highlight the need for accessible caregiver education on PA and MC. Tailored community programs through a systems approach could be the next step to bridge gaps in caregiver perceptions and shrink children’s health disparities.