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BACKGROUND: Research has shown that participating in activities outside of school hours is associated with lower dropout rates, enhanced school performance, improved social skills, and reduced problem behaviors. However, most prior studies have been limited to small populations of older children (>12 years). This analysis focuses on children aged 6 to 11 to assess the potential association between participation in activities outside of school hours and behavior in middle childhood in a nationally representative survey.

METHODS: Estimates were based on 25,797 children from the 2003‐2004 National Survey of Children's Health. Outside of school activity was defined as participating in sports teams/lessons, clubs/organizations, or both at least once in the past year. Analysis of variance was used to evaluate the differences in behavior problems and social skills adjusting for sociodemographic factors, among …