OtherChild: care, health and development2025

Beyond the (Log)book: Comparing Accelerometer Nonwear Detection Techniques in Toddlers.

Elyse Letts, Sarah M da Silva, Natascja Di Cristofaro and 2 others

PMID 40613392

WHAT IT FOUND

Automated nonwear detection methods alter reported toddler wear time by up to 129 minutes per day.

Short consecutive zero-count rules match logbook-based awake wear time, while longer or raw-data rules align better when naps are counted as wear.

Key findings

01Nonwear detection method choice changes reported toddler wear time by up to 129 minutes per day.

02When naps are excluded from wear time (awake wear criterion), only the 5-minute consecutive zero-count method was statistically equivalent to the logbook standard.

03When naps are included in wear time (all wear criterion), five methods were equivalent, including the 30-minute consecutive zero-count and Ahmadi raw data methods.

STILL TO COME

How it was doneWhat they found

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What it does not show

Logbooks are self-reported and may contain errors, so the criterion measure may not reflect the exact ground truth of device wear. The study sample was mostly White, English-speaking, and highly educated, which may limit generalizability to more diverse populations. The wide age range of toddlers (12 to 36 months) means that motor development differences could affect how zero-count periods are interpreted. Using ActiLife software to fill in missing logbook times could have artificially increased agreement between methods.

Declared interests

The authors declare no conflicts of interest. The study was funded by the Canadian Institutes of Health Research.

The easy way to misread this

Do not assume any automated method is equally accurate. If you need to exclude naps from wear time, only the 5-minute consecutive zero-count method matched the logbook criterion; other common methods like Troiano or Choi significantly overestimated wear time.

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The study

Participants
109 toddlers
Certainty of evidence
Low

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    Cite

    Elyse Letts, Sarah M da Silva, Natascja Di Cristofaro, et al. Beyond the (Log)book: Comparing Accelerometer Nonwear Detection Techniques in Toddlers. Child: care, health and development. 2025.

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