Association Between Screen Media Use and Academic Performance Among Children and Adolescents: A Systematic Review and Meta-analysis

Early Childhood Screen Use Contexts and Cognitive and Psychosocial Outcomes: A Systematic Review and Meta-analysis

Importance

The multifaceted nature of screen use has been largely overlooked in favor of a simplistic unidimensional measure of overall screen time when evaluating the benefits and risks of screen use to early childhood development.

Objective

To conduct a systematic review and meta-analysis to examine associations of screen use contexts in early childhood with cognitive and psychosocial outcomes.

Data Sources

PsycINFO, Embase, MEDLINE Ovid, ProQuest, CINAHL, Web of Science, and Scopus were searched from inception to December 31, 2023.

Study Selection

A total of 7441 studies were initially identified. Studies were included if they examined associations between a contextual factor of screen use among children aged 0 to 5.99 years and cognitive or psychosocial development. Observational, experimental, and randomized clinical trial study designs were included.

Data Extraction and Synthesis

All studies were independently screened in duplicate following PRISMA guidelines. Effect sizes of associations (r) from observational studies were pooled using random-effects 3-level meta-analyses. The remaining study designs were narratively synthesized.

Main Outcomes and Measures

Screen use contexts included content (child directed and age inappropriate), type (program viewing and game or app use), co-use (or solo use), background television, caregiver screen use during child routines, and purpose. Outcomes were cognitive (executive functioning, language, and academic skills) or psychosocial (internalizing and externalizing behavior problems and socioemotional competence).

Results

Overall, 100 studies (176 742 participants) were included, and of these, 64 observational studies (pooled sample sizes ranging from 711 to 69 232) were included in meta-analyses. Program viewing (n = 14; k = 48; r, -0.16; 95% CI, -0.24 to -0.08) and background television (n = 8; k = 18; r, -0.10; 95% CI, -0.18 to -0.02) were negatively associated with cognitive outcomes, while program viewing (n = 6; k = 31; r, -0.04; 95% CI, -0.07 to -0.01), age-inappropriate content (n = 9; k = 36; r, -0.11; 95% CI, -0.17 to -0.04), and caregiver screen use during routines (n = 6; k = 14; r, -0.11; 95% CI, -0.20 to -0.03) were negatively associated with psychosocial outcomes. Co-use was positively associated with cognitive outcomes (n = 8; k = 28; r, 0.14; 95% CI, 0.03 to 0.25).

Conclusions and Relevance

Findings show small to moderate effect sizes that highlight the need to consider screen use contexts when making recommendations for families, clinicians, and educators beyond screen time limits; including encouraging intentional and productive screen use, age-appropriate content, and co-use with caregivers.

The prospective associations of 24-hour movement behaviors and domain-specific activities with executive function and academic achievement among school-aged children in Singapore

Background

Physical activity (PA), sedentary behavior (SB), and sleep are collectively referred to as 24-h movement behaviors, which may be linked to cognitive development in children. However, most of the evidence was based on cross-sectional studies and/or solely relied on parent-reported information on children's behaviors, and it remains uncertain whether all domains/contexts of PA and SB are similarly associated with executive function and academic achievement.

Objective

We investigated the prospective associations of accelerometer-measured 24 h-movement behaviors and domain-specific PA and SB with executive function and academic achievement among school-aged children in Singapore.

Methods

The Growing Up in Singapore Toward healthy Outcomes (GUSTO) cohort used a wrist-worn accelerometer (Actigraph-GT3x+) to measure 24 h-movement behaviors data at ages 5.5 and 8 years. Executive function and academic achievement were assessed using NEuroPSYchology (NEPSY) and Wechsler Individual Achievement Tests at ages 8.5 and 9-years, respectively. Compositional data analyses were conducted to explore the associations of 24 h-movement behavior with outcomes, and multiple linear regression models to examine the associations of domain-specific PA and SB with outcomes (n = 432).

Results

Among 432 children whose parents agreed to cognitive assessments (47% girls and 58% Chinese), the composition of 24 h-movement behaviors at ages 5.5 and 8 years was not associated with executive function and academic achievement. However, higher moderate-to-vigorous PA (MVPA) relative to remaining movement behaviors at age 5.5 years was associated with lower academic achievement [Mean difference (95% confidence interval): -0.367 (-0.726, -0.009) z-score], and reallocating MVPA time to sleep showed higher academic achievement scores [30 min from MVPA to sleep: 0.214 (0.023, 0.404) z-score]. Certain domains of PA and SB, notably organized PA/sports, outdoor play, and reading books were favorably associated with outcomes of interest, while indoor play and screen-viewing were unfavorably associated.

Conclusion

The associations between movement behaviors and cognitive outcomes are multifaceted, influenced by specific domains of PA and SB. This study underscores the importance of participation in organized PA/sports, outdoor active play, and reading books, while ensuring adequate sleep and limiting screen viewing, to enhance cognitive outcomes. These findings underscore the need for further research into time-use trade-offs. Such studies could have major implications for revising current guidelines or strategies aimed at promoting healthier 24 h-movement behaviors in children.

Study registration

https://clinicaltrials.gov/, NCT01174875.

Toddler's memory and media-Picture book reading and watching video content are associated with memory at 2 years of age

Memory develops across the course of the first years of life and is influenced by daily experiences, such as exposure to media like books and television. Memory as tapped by Deferred imitation (DI) requires that toddlers form a representation of the target actions that they can later use to reproduce the actions and in addition to measuring memory for real live events, it can also be used to measure memory for events viewed through media. Toddlers are frequently exposed to multiple forms of digital media in addition to more traditional forms of picture book reading. In a within-subjects design, memory was assessed with a DI task in 2-year-olds (n = 89) using the Frankfurt Imitation Test. Deferred imitation was assessed after live and video demonstrations. Parents completed a survey about children's media use. Picture book reading for less than 30 min a day predicted lower memory scores for actions demonstrated live. Watching video content for more than 1 h a day predicted lower memory scores for actions demonstrated on video. Results are interpreted in terms of individual differences in experiences of traditional and digital media and the development of symbolic understanding.

Socio-demographic and other factors contributing to excessive leisure screen time in preadolescent children

OBJECTIVES

Excessive screen use in early school age is associated with worsened health habits and negative child development in later age. We aimed to assess the time spent on modern and traditional screen-based devices and examine its associations with socio-demographic characteristics.

METHODS

This population-based cross-sectional observation study was conducted in Czechia, Slovakia and Finland between April and June 2021. Participants (N = 1,915) were parents/caregivers of children attending elementary school grades 1 to 3, selected by stratified random sampling. Children's daily leisure screen time (LST) based on parental reports was the main outcome. Descriptive statistics, mean comparison and linear regression analysis were used for the analysis.

RESULTS

The average daily LST was found to be as high as 3.5 hours and significantly associated with most socio-demographic variables. Eighty percent of children exceeded the threshold of two hours of LST per day, which was formerly introduced by the American Academy of Pediatrics. The most important predictor of LST in children was having their screen-based device(s) for their exclusive personal use (EPU). Linear regression with all predictors assessed together confirmed the significant effect of the screen-based devices' EPU, the child's sex and grade, the child's birth order and the parent's education, even when controlled for media parenting practices.

CONCLUSIONS

Given the widespread availability of smartphones for exclusive personal use among young children, the regulation of EPU and the reinforcement of effective media parenting practices, particularly in families with lower education and income, are critical public health strategies to mitigate the negative impact of excessive screen time on child development and overall well-being.

Adverse Childhood Experiences and Excessive Recreational Screen Time Among Adolescents in the United Kingdom: A National Longitudinal Study

PURPOSE

This study aimed to investigate the associations between adverse childhood experiences (ACEs) and excessive recreational screen time.

METHODS

Using data from the UK Millennium Cohort Study, we examined the associations of prospectively collected individual ACEs, ACE scores, and poverty with excessive recreational screen time (>4 hours) across different media types. We ran further analyses to investigate sex differences in the associations of ACEs with excessive screen time. The robustness of these associations were tested by controlling for sociodemographic factors.

RESULTS

Among the included 11,439 adolescents (49.9% boys), those who experienced three or more ACEs were more likely to partake in excessive screen time compared to those with no ACEs after adjusting for covariates. This included recreational internet time at age 14, television time at age 14, electronic game time at ages 14 and 17, and social networking time at ages 14 and 17. We found similar associations between individual ACEs and excessive screen time. For example, parental mental health problems were associated with excessive recreational internet time (odds ratio [OR]: 1.28; 95% confidence interval [CI]: 1.15, 1.42), excessive television time (OR: 1.14; 95% CI: 1.01, 1.28), and excessive electronic game time (OR: 1.34; 95% CI: 1.16, 1.56) at age 14. Boys showed stronger associations between certain ACEs and excessive screen time compared to girls.

DISCUSSION

ACEs and poverty are associated with adolescents' later excessive recreational screen time, including excessive time spent on television watching, electronic games, and social networking.

The bidirectional longitudinal association between academic performance and cardiovascular disease risk factors in adolescents

INTRODUCTION

The limited prior research examining the association between academic performance and cardiovascular disease (CVD) risk factors in youth did not explore the reciprocal association between these constructs, and analyzed CVD risk factors individually. Thus, the aim of the present study was to explore the bidirectional longitudinal association between clustered CVD risk score and academic performance in adolescents over a 24-month interval.

METHODS

A total of 237 adolescents (45.6% girls), aged 13.9 ± 0.3 years old at baseline, from DADOS (Deporte, ADOlescencia y Salud) study were included in this study. A clustered CVD risk score was created by calculating the mean age- and gender-standardized z-scores of waist circumference, systolic blood pressure, total cholesterol to high-density lipoprotein cholesterol ratio, triglycerides, homeostatic model assessment of insulin resistance, and cardiorespiratory fitness (inversed). Academic performance was assessed through the final academic grades and the test of educational abilities.

RESULTS

Our results showed that the clustered CVD risk score at baseline was not associated with academic performance 24 months later (all p > .05). Nevertheless, except for physical education, academic grades at baseline were inversely associated with clustered CVD risk score at follow-up in adolescents (β ranged from -0.140 to -0.102; all p < .05). No associations were found between academic abilities at baseline and clustered CVD risk score at follow-up (all p > .05).

CONCLUSION

Academic grades could help predict CVD risk 24 months later during adolescence. Education professionals should foster adolescents' academic performance not only to improve academic results but also to maximize future cardiovascular health benefits.

Evocative effects on the early caregiving environment of genetic factors underlying the development of intellectual and academic ability

This study examined gene-environment correlation (rGE) in intellectual and academic development in 561 U.S.-based adoptees (57% male; 56% non-Latinx White, 19% multiracial, 13% Black or African American, 11% Latinx) and their birth and adoptive parents between 2003 and 2017. Birth mother intellectual and academic performance predicted adoptive mother warmth at child age 6 (β = .14, p = .038) and 7 (β = .12, p = .040) but not 4.5 years, and adoptive father warmth at 7 (β = .18, p = .007) but not 4.5 or 6 years. These rGE effects were not mediated by children's language. Contrary to theory that rGE accounts for increasing heritability of intellectual ability, parenting did not mediate genetic effects on children's language or academic performance.

Screen time, sleep, brain structural neurobiology, and sequential associations with child and adolescent psychopathology: Insights from the ABCD study

Background and Aims

The precise roles of screen media activity (SMA) and sleep problems in relation to child/adolescent psychopathology remain ambiguous. We investigated temporal relationships among sleep problems, SMA, and psychopathology and potential involvement of thalamus-prefrontal-cortex (PFC)-brainstem structural covariation.

Methods

This study utilized data from the Adolescent Brain Cognitive Development study (n = 4,641 ages 9-12) at baseline, Year1, and Year2 follow-up. Cross-Lagged Panel Models (CLPMs) investigated reciprocal predictive relationships between sleep duration/problems, SMA, and psychopathology symptoms. A potential mediating role of baseline Thalamus-PFC-brainstem covariation on SMA-externalizing relationships was examined.

Results

Participants were divided into discovery (n = 2,359, 1,054 girls) and replication (n = 2,282, 997 girls) sets. CLPMs showed 1) bidirectional associations between sleep duration and SMA in late childhood, with higher frequency SMA predicting shorter sleep duration (β = -0.10 [95%CI: -0.16, -0.03], p = 0.004) and vice versa (β = -0.11 [95%CI: -0.18, -0.05], p < 0.001); 2) externalizing symptoms at age 10-11 predicting sleep problems (β = 0.11 [95%CI: 0.04, 0.19], p = 0.002), SMA (β = 0.07 [95%CI: 0.01, 0.13], p = 0.014), and internalizing symptoms (β = 0.09 [95%CI: 0.05, 0.13], p < 0.001) at age 11-12; and 3) externalizing behavior at age 10-11 partially mediating the relationship between baseline thalamus-PFC-brainstem covariation and SMA at age 11-12 (indirect effect = 0.032 [95%CI: 0.003, 0.067], p-value = 0.030). Findings were replicable.

Conclusion

We found bi-directional SMA-sleep-duration associations in late childhood. Externalizing symptoms preceded future SMA and sleep disturbances and partially mediated relationships between structural brain covariation and SMA. The findings emphasize the need for understanding individual differences and developing and implementing integrated strategies addressing both sleep concerns and screen time to mitigate potential impacts on psychopathology.

Early childhood sleep quantity, but not caregiver-reported sleep problems, predicts impulse control in children at age 8 years

Short duration of sleep and poor sleep quality have been linked to poor attention and impulse control in children. We aimed to determine the longitudinal predictive value of sleep quantity and quality during early childhood on objective and caregiver-report measures of attention, impulse control, and executive function in children at age 8 years. We used data from the Health Outcomes and Measures of the Environment (HOME) Study, a pregnancy and birth cohort. Caregivers reported on their child's sleep at ages 2, 2.5, 3, 4, and 5 years. Analysis included 410 participants. We used longitudinal growth curve models of early childhood sleep patterns to predict neurobehavioral functioning at age 8 years. Sleep problems did not predict any of our outcome measures at age 8 years. Sleep duration trended shorter as children matured, so predictive models examined both intercept and slope. Children with the least decline in sleep duration across early childhood had fewer impulsive errors at age 8 years on a continuous performance test (unadjusted p = .013; adjusted p = .013). Children with shorter duration of sleep across early childhood had worse caregiver-reported behavioral regulation at age 8 years (unadjusted p = .002; adjusted p = .043). Neither sleep duration slope nor intercept predicted inattention or metacognitive skills at age 8 years (p > .05). Total sleep time across early childhood predicts behavior regulation difficulties in school-aged children. Inadequate sleep during early childhood may be a marker for, or contribute to, poor development of a child's self-regulatory skills.

Is adherence to the 24-h movement guidelines associated with greater academic-related outcomes in children and adolescents? A systematic review and meta-analysis

The purpose of this systematic review was to synthesise the evidence for the association of adherence to the 24-h movement guidelines with academic-related outcomes in children and adolescents. This systematic review was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. PubMed, PsycINFO, Scopus, WOS, SPORTDiscus, and EMBASE were searched from their inception to 12 December 2023. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess the risk of bias of included studies. In total, 4326 records were identified through database searches; 10 articles met the inclusion criteria and were included in this systematic review. There were eight cross-sectional studies and two longitudinal studies; the main academic-related outcomes were academic achievement and cognitive function. A small association between adherence to all three recommendations and academic achievement (k = 5, r = 0.17, 95% CI = 0.10-0.24, I2 = 49%) was found compared to those who did not adhere to any recommendations.   Conclusion: Findings from this systematic review and meta-analysis reveal a small association between adherence to all three recommendations and greater academic achievement in children and adolescents. Nevertheless, it is imperative to underscore the need for more studies to establish robust evidence underpinning this relationship.   Trial registration: PROSPERO (CRD42021295403). What is Known: • Regular physical activity, reduced screen time, and optimal sleep duration are independently associated with improved academic-related outcomes in children and adolescents. • The associations between adherence to the 24-h movement guidelines and academic-related outcomes in children and adolescents have not been quantitatively synthesised. What is New: • There is a small but positive association between adherence to all three recommendations of the 24-h movement guidelines and greater academic achievement in children and adolescents. • Further well-designed research is needed to focus on academic achievement, cognitive function and classroom behaviours in young individuals.

Digital Eye Straining: Exploring Its Prevalence, Associated Factors, and Effects on the Quality of Life

BACKGROUND

Digital eye strain (DES) has become a pervasive issue in contemporary society due to increased reliance on electronic devices. This study aims to comprehensively explore the symptoms, severity, and associated factors of DES, considering demographic, behavioral, and health-related variables.

METHODOLOGY

A cross-sectional study was conducted among participants with diverse demographic backgrounds. A structured questionnaire collected data on participant characteristics, electronic device usage patterns, symptoms of DES, and its impact on various aspects of quality of life. Statistical analyses, including chi-square tests, were employed to assess associations and significance.

RESULTS

The majority of participants reported symptoms of DES, with eye dryness, headache, and eye redness being the most prevalent. Symptom severity varied, with age, daily device usage, adherence to the 20-20-20 rule, and studying with electronic devices demonstrating statistically significant associations. Participants diagnosed with eye diseases exhibited higher symptom severity. While disagreement was common regarding DES increasing stress, a substantial proportion acknowledged its impact on productivity and attention.

CONCLUSION

The current study showed that there is a significant correlation between the incidence of digital eye straining and longer screen exposure time. The findings underscore the importance of age, behavior, and ocular health in understanding and addressing DES. The results contribute to the broader discourse on digital eye health and emphasize the need for targeted interventions to alleviate the impact of DES on daily life.

Sedentary behavior and lifespan brain health

Higher levels of physical activity are known to benefit aspects of brain health across the lifespan. However, the role of sedentary behavior (SB) is less well understood. In this review we summarize and discuss evidence on the role of SB on brain health (including cognitive performance, structural or functional brain measures, and dementia risk) for different age groups, critically compare assessment approaches to capture SB, and offer insights into emerging opportunities to assess SB via digital technologies. Across the lifespan, specific characteristics of SB (particularly whether they are cognitively active or cognitively passive) potentially act as moderators influencing the associations between SB and specific brain health outcomes. We outline challenges and opportunities for future research aiming to provide more robust empirical evidence on these observations.

Meeting 24-h movement behavior guidelines is linked to academic engagement, psychological functioning, and cognitive difficulties in youth with internalizing problems

BACKGROUND

This study aimed to investigate associations of meeting 24-h movement behavior (24-HMB: physical activity [PA], screen time [ST] in the school-aged youth, and sleep) guidelines with indicators of academic engagement, psychological functioning, and cognitive function in a national representative sample of U.S. youth.

METHODS

In this cross-sectional study, 1794 participants aged 6 to 17 years old were included for multivariable logistic regression to determine the above-mentioned associations, while adjusting for sociodemographic and health covariates.

RESULTS

The proportion of participants who met 24-HMB guideline(s) varied greatly (PA+ ST+ sleep = 34 [weighted 1.17 %], PA + ST = 23 [weighted 1.72 %], PA + sleep = 52 [weighted 2.15 %], PA = 34 [weighted 2.88 %], ST = 142 [weighted 7.5 %], ST+ sleep = 209 [weighted 11.86 %], sleep = 725 [weighted 35.5 %], none = 575 [weighted 37.22 %]). Participants who met ST guideline alone and integrated (ST + Sleep and ST + sleep + PA) guidelines demonstrated the consistently beneficial associations with learning interest/curiosity, caring for school performance, completing required homework, resilience, cognitive difficulties, self-regulation (ps < 0.05).

CONCLUSION

Meeting 24-HMB guidelines in an isolated or integrative manner was associated with improved academic engagement, psychological functioning, and reduced cognitive difficulties. These findings highlight the importance of the promotion of 24-HMB guidelines in youth with internalizing problems. Future longitudinal studies are needed to investigate whether changes or modifications of meeting specific 24-HMB guidelines (especially ST) is beneficial for youth with internalizing problems.

Effect of College Students' Smartphone Addiction on Academic Achievement: The Mediating Role of Academic Anxiety and Moderating Role of Sense of Academic Control

Background

College students are the backbone of future national construction and shoulder the hope of the future development of the country and the nation. Smartphone addiction among college students will not only affect their own mental health and learning attitude, but it will also significantly affect their future academic achievement, academic emotion and academic engagement. However, the relationship between academic anxiety and academic control and academic achievement, as well as their internal mechanisms and boundary conditions, has received little attention. The purpose of this study is to examine whether and how smartphone addiction influences academic achievement.

Purpose

This study aims to explore the mechanistic role of academic anxiety and academic control in the influence of smartphone addiction on academic achievement in college students, and hopes that the results can guide education and teaching.

Methods

A sample of N=2097 participants, this study evaluated the relationship between smartphone addiction, academic control, academic anxiety and academic achievement among college students, and the participants filled in the college students' smartphone addiction scale, academic control questionnaire, academic anxiety questionnaire and grade points.

Results

(1) There is a significant negative correlation between smartphone addiction and academic achievement; (2) academic anxiety serves as a complete mediator in the relationship between smartphone addiction and academic achievement; (3) the interaction between smartphone addiction and academic control moderates academic anxiety, with higher levels of academic control associated with a weaker impact of smartphone addiction on academic anxiety; (4) academic control also moderates the mediating role of academic anxiety between smartphone addiction and academic achievement, demonstrating a moderated mediating effect.

Conclusion

Smartphone addiction had negative direct effect on academic achievement, as well as completely mediating effect through academic anxiety. Academic control moderated the relationship between of smartphone addiction and academic anxiety. This study enriches the research on the relationship between smartphone addiction and academic achievement in theory, and has important guiding significance for education and teaching in practice.

National Trends in the Prevalence of Screen Time and Its Association With Biopsychosocial Risk Factors Among Korean Adolescents, 2008-2021

PURPOSE

Prior studies suggested an increase in screen time among adolescents during the COVID-19 pandemic; however, due to limited sample size and a short-term observation period, these associations are inconclusive and inconsistent. Thus, we aimed to compare screen time during the pandemic and the long-term trend through a Korean large-scale and long-term study of one million adolescents.

METHODS

Data from 2008 to 2021 on 913,191 Korean adolescents aged 12-18 years were obtained via a nationwide, large-scale, and serial study. We investigated the change of screen time use over time and the change in trend before and during the pandemic (2008-2019 vs. 2020-2021) by using weighted linear regression model with estimates of β-coefficients and 95% confidence intervals (CIs). Moreover, we analyzed the differences in vulnerability of biopsychosocial factor before and during the pandemic.

RESULTS

A total of 913,191 adolescents were included in this analysis. During the pandemic, the overall screen time of Korean adolescents significantly increased compared to the expected based on the prepandemic period during the pre-COVID-19 period (weighted screen time before the pandemic [133.24 min/day; 95% CI, 132.08-134.40] vs. during the pandemic [303.66 min/day; 95% CI, 300.59-306.73]; βdiff 0.331; 95% CI, 0.311-0.351). Comparing before and during the pandemic, potential risk factors associated with screen exposure included female sex, sadness, suicidal thoughts, alcohol consumption, low educational level of parents, low level of vigorous physical activity, middle school students, and low household income.

DISCUSSION

Through large-scale nationwide study, this study described the 14-year trend of screen time among Korean adolescents. In the era of COVID-19, the prevalence of screen exposure has been increasing more rapidly than before at the population level. Also, the pandemic amplified the differences in screen time across grade, sex, sadness, suicidal thoughts, smoking, alcohol consumption, education level of parents, physical activity, and household income groups.

Computer gaming alters resting-state brain networks, enhancing cognitive and fluid intelligence in players: evidence from brain imaging-derived phenotypes-wide Mendelian randomization

The debate on whether computer gaming enhances players' cognitive function is an ongoing and contentious issue. Aiming to delve into the potential impacts of computer gaming on the players' cognitive function, we embarked on a brain imaging-derived phenotypes (IDPs)-wide Mendelian randomization (MR) study, utilizing publicly available data from a European population. Our findings indicate that computer gaming has a positive impact on fluid intelligence (odds ratio [OR] = 6.264, P = 4.361 × 10-10, 95% confidence interval [CI] 3.520-11.147) and cognitive function (OR = 3.322, P = 0.002, 95% CI 1.563-7.062). Out of the 3062 brain IDPs analyzed, only one phenotype, IDP NET100 0378, was significantly influenced by computer gaming (OR = 4.697, P = 1.10 × 10-5, 95% CI 2.357-9.361). Further MR analysis suggested that alterations in the IDP NET100 0378 caused by computer gaming may be a potential factor affecting fluid intelligence (OR = 1.076, P = 0.041, 95% CI 1.003-1.153). Our MR study lends support to the notion that computer gaming can facilitate the development of players' fluid intelligence by enhancing the connectivity between the motor cortex in the resting-state brain and key regions such as the left dorsolateral prefrontal cortex and the language center.

Private screen access in early adolescence predicts subsequent academic and social impairment at the end of high school for boys and girls

INTRODUCTION

Youth media guidelines in Canada and the United States recommend that bedrooms should remain screen-free zones. This study aims to verify whether bedroom screens at age 12 years prospectively predict academic and social impairment by age 17 years.

METHODS

Participants were from the Quebec Longitudinal Study of Child Development birth cohort (661 girls and 686 boys). Linear regression analyses estimated associations between having a bedroom screen (television or computer) at age 12 years and selfreported overall grades, dropout risk, prosocial behaviour and likelihood of having experienced a dating relationship in the past 12 months at age 17 years, while adjusting for potential individual and family confounding factors.

RESULTS

For both girls and boys, bedroom screens at age 12 years predicted lower overall grades (B = -2.41, p ≤ 0.001 for boys; -1.61, p ≤ 0.05 for girls), higher dropout risk (B = 0.16, p ≤ 0.001 for boys; 0.17, p ≤ 0.001 for girls) and lower likelihood of having experienced a dating relationship (B = -0.13, p ≤ 0.001 for boys; -0.18, p ≤ 0.001 for girls) at age 17. Bedroom screens also predicted lower levels of prosocial behaviour (B = -0.52, p ≤ 0.001) at age 17 years for boys.

CONCLUSION

The bedroom as an early adolescent screen-based zone does not predict long-term positive health and well-being. Pediatric recommendations to parents and youth should be more resolute about bedrooms being screen-free zones and about unlimited access in private exposures in childhood.

An umbrella review of the benefits and risks associated with youths' interactions with electronic screens

The influence of electronic screens on the health of children and adolescents and their education is not well understood. In this prospectively registered umbrella review (PROSPERO identifier CRD42017076051 ), we harmonized effects from 102 meta-analyses (2,451 primary studies; 1,937,501 participants) of screen time and outcomes. In total, 43 effects from 32 meta-analyses met our criteria for statistical certainty. Meta-analyses of associations between screen use and outcomes showed small-to-moderate effects (range: r = -0.14 to 0.33). In education, results were mixed; for example, screen use was negatively associated with literacy (r = -0.14, 95% confidence interval (CI) = -0.20 to -0.09, P ≤ 0.001, k = 38, N = 18,318), but this effect was positive when parents watched with their children (r = 0.15, 95% CI = 0.02 to 0.28, P = 0.028, k = 12, N = 6,083). In health, we found evidence for several small negative associations; for example, social media was associated with depression (r = 0.12, 95% CI = 0.05 to 0.19, P ≤ 0.001, k = 12, N = 93,740). Limitations of our review include the limited number of studies for each outcome, medium-to-high risk of bias in 95 out of 102 included meta-analyses and high heterogeneity (17 out of 22 in education and 20 out of 21 in health with I2 > 50%). We recommend that caregivers and policymakers carefully weigh the evidence for potential harms and benefits of specific types of screen use.

Determinants of academic achievement among higher education student found in low resource setting, A systematic review

BACKGROUND

Academic success is a measure of students' ability to attain their educational objectives, often assessed through regular evaluations or examinations. To establish effective policies and programs that align with academic accomplishments, conducting comprehensive data analysis is pivotal. Hence, this systematic review aimed to synthesize the factors impeding the academic achievements of Ethiopian students in higher education.

METHODS

A comprehensive review was conducted on studies involving Ethiopian university students from 2013 to 2022. The review encompassed 24 papers that were gathered from different databases like PubMed, Google Scholar, African Journals Online, Scopus, and Web of Science.

RESULTS

The findings of this research revealed that inadequate classroom environments, experiencing dysmenorrhea, and engaging in excessive social media usage were all linked to a decline in academic performance. Conversely, adopting healthy sleep habits, achieving high scores in entrance exams, and avoiding recent substance abuse were all factors positively influencing academic success. In addition, there was a positive correlation between academic excellence and being a health science college student and age range of 20 to 24 years old.

CONCLUSION

To enhance academic performance, it is crucial to address the negative factors identified, such as inadequate classroom environments, dysmenorrhea, and excessive social media usage, while promoting positive factors like healthy sleep habits, high scores in exams, and avoiding substance abuse. Additionally, being a health science college student and belonging to the age range of 20 to 24 were found to be associated with academic excellence.

Is neuroimaging ready for the classroom? A systematic review of hyperscanning studies in learning

Whether education research can be informed by findings from neuroscience studies has been hotly debated since Bruer's (1997) famous claim that neuroscience and education are "a bridge too far". However, this claim came before recent advancements in portable electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) technologies, and second-person neuroscience techniques that brought about significant headway in understanding instructor-learner interactions in the classroom. To explore whether neuroscience and education are still two very separate fields, we systematically review 15 hyperscanning studies that were conducted in real-world classrooms or that implemented a teaching-learning task to investigate instructor-learner dynamics. Findings from this investigation illustrate that inter-brain synchrony between instructor and learner is an additional and valuable dimension to understand the complex web of instructor- and learner-related variables that influence learning. Importantly, these findings demonstrate the possibility of conducting real-world classroom studies with portable neuroimaging techniques and highlight the potential of such studies in providing translatable real-world implications. Once thought of as incompatible, a successful coupling between neuroscience and education is now within sight.

Digital media exposure and cognitive functioning in European children and adolescents of the I.Family study

The digital environment can pose health risks through exposure to unhealthy content. Yet, little is known about its relation to children's cognitive functioning. This study investigates the association between digital media (DM) exposure and children's cognitive functioning. This cross-sectional study is based on examinations of children aged 8-18 years (N = 8673) of the I.Family cohort (2013-2014). Exposure to television, computer, smartphone and internet was self-reported (hours/day). Media multitasking (MMT) was defined as simultaneous use of computers with other digital or non-screen-based activities. Standard instruments were used to assess cognitive inflexibility (score: 0-39), decision-making ability (- 100 to + 100) and impulsivity (12-48). Adjusted regression coefficients and 99.9%CIs were calculated by generalized linear mixed-effects models. In total, 3261 participants provided data for impulsivity, 3441 for cognitive inflexibility and 4046 for decision-making. Exposure to smartphones and media multitasking were positively associated with impulsivity (βsmartphone = 0.74; 99.9%CI = 0.42-1.07; βMMT = 0.73; 99.9%CI = 0.35-1.12) and cognitive inflexibility (βsmartphone = 0.32; 99.9%CI = -0.02-0.66; βMMT = 0.39; 99.9%CI = 0.01-0.77) while being inversely associated with decision-making ability. Extensive smartphone/internet exposure combined with low computer/medium TV exposure was associated with higher impulsivity and cognitive inflexibility scores, especially in girls. DM exposure is adversely associated with cognitive functioning in children and adolescents. Children require protection against the likely adverse impact of digital environment.

Media Parenting Scale for School-Aged Children (MEPA-20): Psychometric Properties of the Turkish Version

BACKGROUND AND PURPOSE

Media parenting refers to the strategies and behaviors parents use to interact with their children regarding the amount, content, and context of screen use. Children's media/screen use is a significant indicator of media parenting practices. Therefore, this study aimed to determine the psychometric properties of the Turkish version of the Media Parenting Scale for School-Aged Children (MEPA-20).

METHODS

This methodological study involved 524 parents with children aged 6-10 and was conducted between October 15, 2022, and February 15, 2023. In the data analysis, the Content Validity Index, Explanatory and Confirmatory Factor Analyses, Cronbach's alpha, Test-retest reliability, Hotelling T2 test, and item-total score correlation were used. The test-retest reliability analysis of the Turkish version of MEPA-20 was performed with 30 parents after 4 weeks.

RESULTS

MEPA-20 consists of 20 items and three sub-dimensions (active, restrictive, and over-protective mediation). The MEPA-20 Turkish version and its three factors were found to indicate acceptable levels of internal consistency and reliability. The three-factor construct validity of the MEPA-20 Turkish version determined with Explanatory Factor Analyses was successfully confirmed with Confirmatory Factor Analysis.

CONCLUSION

The MEPA-20 is a valid and reliable tool for assessing the media parenting practices of parents of children aged 6-10 years in the Turkish population.

PRACTICE IMPLICATIONS

Based on the impact of media parenting practices on child and family health, nurses should raise awareness and support parents regarding children's healthy screen use.

Relationships between physical activity, sleep, and screen time with academic performance and psychological functioning among US children and adolescents with depression

OBJECTIVE

This cross-sectional study examined the relationships between adherence to 24-HMB guidelines (including physical activity [PA], screen time [ST], and sleep) with academic performance and psychological functioning among children and adolescents with depression.

METHODS

This study consists of 2165 participants aged 6-17 years with depression. Independent variables were components of 24-HMB guideline adherence, while outcomes of interest were academic performance (i.e., caring about school performance and completion of required homework) and psychological functioning (i.e., resilience and self-regulation). Logistic regression analysis was conducted while adjusting for confounding variables.

RESULTS

Only 1.03 % of the participants adhered to PA + ST + Sleep guidelines. Compared to non-adherence, adherence to PA + ST guidelines was significantly linked to a greater likelihood of caring about school performance (OR = 2.17), while ST + Sleep guidelines adherence was significantly linked to a greater likelihood of caring about school performance (OR = 2.02), completing homework (OR = 2.91), resilience (OR = 2.51), and self-regulation (OR = 2.51). Furthermore, adherence to PA + ST + Sleep guidelines was significantly linked to a higher likelihood of caring about school performance (OR = 5.01), resilience (OR = 2.49), and self-regulation (OR = 2.88) among these participants with depression.

CONCLUSION

Adhering to 24-HMB guidelines is positively linked to academic performance and psychological functioning among children and adolescents with depression. Thus, establishing healthy lifestyle behaviors should be promoted in school settings.

Consideration of Developmental Stage and the Debate on the Effects of Screens Use-Not All Things Are Created Equal

This Viewpoint discusses the role of childhood developmental stage in research evaluating the effects of screen use among youth and its application to practice, policy, and the public.

Screen media activity in youth: A critical review of mental health and neuroscience findings

This review has two primary objectives: (1) to offer a balanced examination of recent findings on the relationship between screen media activity (SMA) in young individuals and outcomes such as sleep patterns, mood disturbances, anxiety-related concerns, and cognitive processes; and (2) to introduce a novel multi-level system model that integrates these findings, resolves contradictions in the literature, and guides future studies in examining key covariates affecting the SMA-mental health relationship. Key findings include: (1) Several meta-analyses reveal a significant association between SMA and mental health issues, particularly anxiety and depression, including specific negative effects linked to prolonged screen time; (2) substantial evidence indicates that SMA has both immediate and long-term impacts on sleep duration and quality; (3) the relationship between SMA and cognitive functioning is complex, with mixed findings showing both positive and negative associations; and (4) the multifaceted relationship between SMA and various aspects of adolescent life is influenced by a wide range of environmental and contextual factors. SMA in youth is best understood within a complex system encompassing individual, caregiver, school, peer, and environmental factors, as framed by Bronfenbrenner's ecological systems theory, which identifies five interrelated systems (microsystem, mesosystem, exosystem, macrosystem, and chronosystem) that influence development across both proximal and distal levels of the environment. This model provides a framework for future research to examine these interactions, considering moderating factors, and to develop targeted interventions that can mitigate potential adverse effects of SMA on mental well-being.

Excessive use of electronic devices among children and adolescents is associated with musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life: a cross-sectional study

Objective

Electronic devices have become an indispensable part of our daily lives. The frequency and duration of device use in children and adolescents have increased drastically over the years and the study of its negative musculoskeletal, visual and psychosocial health impacts is necessary.

Materials and methods

This cross-sectional study aimed to evaluate the associations between electronic device use and the prevalence and severity of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life in children and adolescents studying at primary and secondary schools. Data were collected through confidential online and paper-and-pencil questionnaires. Primary 4-5 and Secondary 1-4 students were recruited from 3 schools in Hong Kong. Demographics, frequency and duration of electronic device use, frequencies of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life outcomes were measured.

Results

1,058 children and adolescents aged 9-17  years participated. Sixty-one percent and 78% of all students spent more than 2  h per day using electronic devices during school days and weekend/holidays, respectively. Extended electronic device use was associated with increased prevalence and severity of musculoskeletal symptoms (ρ's = 0.28-0.33, P's < 0.001), visual symptoms (ρ's = 0.33-0.35, P's < 0.001), and poorer device use-related psychosocial health (ρ's = 0.38-0.47, P's < 0.001). Secondary school students reported greater device use and severity of symptoms than primary school students.

Conclusion

Excessive electronic device use was associated with increased prevalence and severity of physical and psychosocial symptoms, and such use is more prevalent in adolescents when compared to the children. The findings have important health implications for children and adolescents, suggesting that early intervention is needed to reduce the risk of developing device use-related disorders.

The Impact of Social Media Use for News on Academic Performance in Underrepresented Undergraduate College Students

Researchers have demonstrated that the relationship between social media use (SMU) and academic performance is mixed. This study extends those findings by examining how SMU for news predicts grade point average (GPA) for Hispanic, Black/African American, and White college students while controlling for gender. Students (N = 378) completed surveys where they reported how many times per week they used various social media platforms for news, whether or not they used those platforms to consume certain types of news, and demographic information. For Hispanic students, results indicated that using YouTube for entertainment news predicted lower GPAs, whereas using YouTube for news predicted higher GPAs. Black/African American students' use of Facebook for news predicted lower GPAs. SMU for news for White students did not predict GPA. Findings indicate that race/ethnicity should be considered when examining the relationship between SMU and academic performance and that minority students' GPAs are affected by their use of social media for news.

Problematic Media Use among Children up to the Age of 10: A Systematic Literature Review

INTRODUCTION

Digital screen media use has significantly grown in all age groups and at an increasingly young age, including toddlers, schoolers, and primary school children. Although there is evidence that excessive early childhood media exposure can lead to several negative developmental outcomes, no systematic review on Problematic Media Use (PMU) of children under 10 years old have been provided. The aim of the present systematic review was to identify (i) the main instruments used to measure children's PMU across different studies; (ii) the risk and protective factors which might increase or reduce children's PMU; and (iii) the negative outcomes associated with children's PMU.

METHODS

This study was conducted following the systematic review guidelines proposed in the PRISMA statement. A total of 35 studies published between 2012-2022 and with a mean sample age between 0 and 10 years old were ultimately included in this literature review.

RESULTS

Use of media for more than 2 h a day, male gender, and higher age increased the risk of developing PMU among children. PMU led to several negative consequences for children's development and well-being (e.g., more problematic behaviors, sleep problems, higher depressive symptoms, lower emotional intelligence, and lower academic achievements). Children who experienced negative psychological symptoms, a dysfunctional parent-child relationship, and difficulties in school context were more prone to develop PMU. However, an authoritative parenting style and restrictive parental mediation reduced the risk of developing PMU among children. Finally, self-report measures specifically designed to get the younger children's perspective are still few and not so widely used.

CONCLUSIONS

Overall, this research field is still in its infancy and needs further investigation. Likely, a dysfunctional family system can lead children to experience emotional distress and negative psychological symptoms, which they try to manage by escaping into the virtual world, thus increasing the risk of developing PMU. As the children's PMU is closely affected by the family environment, future prevention interventions should target both children and their parents to improve their self-regulatory and mentalizing capabilities, as well as parental mediation strategies and general parenting practices.

Sedentary behaviour profiles and longitudinal associations with academic performance in youth: The UP&DOWN study

The current study evaluated longitudinal associations between profile transitions of context-specific sedentary behaviour (SB) and changes in academic performance (AP) among school-aged youth. Participants were 466 children and 717 adolescents (50.8% males) aged 8-18 years (children = 7.92 ± 0.41 years; adolescents = 11.85 ± 1.53 years). Non-school SBs and AP were evaluated at baseline and two years later. General linear mixed models were implemented, controlling for age, region, parental education, body mass index, and cardiorespiratory fitness. Cross-sectionally, participants with an Educative-profile (i.e., highest scores in doing homework with/without computer and reading for fun) had higher AP when compared to other profiles. Longitudinally, males who changed from a Screen- to an Educative-profile had higher AP than males who changed from an Educative- to a Social- or Screen-SB profile (p < 0.01). No significant differences were found in females. These findings show the importance of analysing SB patterns from a qualitative perspective (i.e., context-specific for boosting school children AP) and highlighting time spent in educative as the most positive for AP, as well the need to implement interventions to reduce time on screen and social behaviours, especially targeting males.

The association between academic performance indicators and lifestyle behaviors among Kuwaiti college students

BACKGROUND

Lifestyle behaviors are developed during young adulthood and carried through life. Accordingly, early detection of unhealthy behaviors can help prevent the increase in non-communicable diseases in the population. College students are an especially vulnerable group who, upon entering a new environment, tend to engage in unhealthy behaviors.

OBJECTIVE

The present study aims to evaluate the lifestyle behaviors of Kuwaiti college students and their association with markers of academic achievements.

METHODS

One thousand two hundred fifty-nine students participated in the present study and answered an online questionnaire pertaining to their sociodemographic status, academic performance indicators, body weight and height, and lifestyle behaviors. Data were collected from November 2020 to February 2021.

RESULTS

Results of the present study showed that obesity was significantly more prevalent among male participants than among females even though males were more physically active. Alternatively, females had a greater grade point average in college, slept more, and had more screen time. Interestingly, we were unable to detect a significant correlation between lifestyle behaviors and academic achievements.

CONCLUSION

The observed differences in body mass index between genders may have been attributed to energy intake rather than energy expenditure.

Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder

BACKGROUND

Evidence-based 24-h movement behavior (24-HMB) guidelines have been developed to integrate recommendations for the time spent on physical activity, sedentary behavior, and sleep. For children and adolescents, these 24-HMB guidelines recommend a maximum of two hours of recreational screen time (as part of sedentary behavior), a minimum of 60 min per day of moderate to vigorous physical activity (MVPA), and an age-appropriate sleep duration (9-11 h for 5 to 13-year-olds; 8-10 h for 14 to 17-year-olds). Although adherence to the guidelines has been associated with positive health outcomes, the effects of adhering to the 24-HMB recommendations have not been fully examined in children and adolescents with attention eficit/hyperactive disorder (ADHD). Therefore, this study examined potential associations between meeting the 24-HMB guidelines and indicators of cognitive and social difficulties in children and adolescents with ADHD.

METHODS

Cross-sectional data on 3470 children and adolescents with ADHD aged between 6 and 17 years was extracted from the National Survey for Children's Health (NSCH 2020). Adherence to 24-HMB guidelines comprised screen time, physical activity, and sleep. ADHD-related outcomes included four indicators; one relating to cognitive difficulties (i.e., serious difficulties in concentrating, remembering, or making decisions) and three indicators of social difficulties (i.e., difficulties in making or keeping friends, bullying others, being bullied). Logistic regression was performed to determine the associations between adherence to 24-HMB guidelines and the cognitive and social outcomes described above, while adjusting for confounders.

RESULTS

In total, 44.8% of participants met at least one movement behavior guideline, while only 5.7% met all three. Adjusted logistic regressions further showed that meeting all three guidelines was associated with lower odds of cognitive difficulties in relation to none of the guidelines, but the strongest model included only screen time and physical activity as predictors (OR = 0.26, 95% CI 0.12-0.53, p < .001). For social relationships, meeting all three guidelines was associated with lower odds of difficulty keeping friends (OR = 0.46, 95% CI 0.21-0.97, p = .04) in relation to none of the guidelines. Meeting the guideline for screen time was associated with lower odds of being bullied (OR = 0.61, 95% CI 0.39-0.97, p = .04) in relation to none of the guidelines. While screen time only, sleep only and the combination of both were associated with lower odds of bullying others, sleep alone was the strongest predictor (OR = 0.44, 95% CI 0.26-0.76, p = .003) in relation to none of the guidelines.

CONCLUSION

Meeting 24-HMB guidelines was associated with reduced likelihood of cognitive and social difficulties in children and adolescents with ADHD. These findings highlight the importance of adhering to healthy lifestyle behaviors as outlined in the 24-HMB recommendations with regard to cognitive and social difficulties in children and adolescents with ADHD. These results need to be confirmed by longitudinal and interventional studies with a large sample size.

The Association Between Screen Time and Outdoor Time on Adolescent Mental Health and Academic Performance: Evidence from Rural China

Purpose

We examine how adolescent free time allocation-namely, screen time and outdoor time-is associated with mental health and academic performance in rural China.

Methods

This paper used a large random sample of rural junior high school students in Ningxia (n = 20,375; age=13.22), with data collected from self-reported demographic questionnaires (to assess free time allocation), the Strengths and Difficulties Questionnaire (to assess mental health), and a standardized math test (to measure academic performance). We utilized a multivariate OLS regression model to examine associations between free time allocation and adolescent outcomes, controlling for individual and family characteristics.

Results

Our sample's screen time and outdoor time both averaged around 1 hour. About 10% of the sample adolescents reported behavioral difficulties, while a similar percentage (11%) reported abnormal prosocial behaviors. Adolescents with higher levels of screen time (>2 hours) were 3 percentage points more likely to have higher levels of behavioral difficulties (p<0.001), indicating that excessive screen time was associated with worse mental health. Meanwhile, outdoor time was associated with better mental health, and positive correlations were observed at all levels of outdoor time (compared to no outdoor time, decreasing the likelihood of higher levels of behavioral difficulties by between 3 and 4 percentage points and of lower prosocial scores by between 6 and 8 percentage points; all p's<0.001). For academic performance, average daily screen times of up to 1 hour and 1-2 hours were both positively associated with standardized math scores (0.08 SD, p<0.001; 0.07 SD, p<0.01, respectively), whereas there were no significant associations between outdoor time and academic performance.

Conclusion

Using a large sample size, this study was the first to examine the association between adolescent free time allocation with mental health and academic performance, providing initial insights into how rural Chinese adolescents can optimize their free time.

The bidirectional longitudinal association between health-related quality of life and academic performance in adolescents: DADOS study

PURPOSE

Although previous evidence has suggested a relationship between health-related quality of life (HRQoL) and academic performance, the directionality of this association is understudied and remains to be clarified. Thus, the primary objective of this study was to explore the bidirectional association between HRQoL and academic performance in adolescents between two timepoints with a 24-month interval. A secondary aim was to analyze whether this association varies between boys and girls.

METHODS

This is a bidirectional longitudinal analysis with 257 adolescents (13.9 ± 0.3 years at baseline) from the DADOS study. HRQoL was measured using the KIDSCREEN-10 questionnaire. Academic performance was assessed through academic grades and the Spanish version of the Science Research Associates Test of Educational Ability.

RESULTS

Cross-lagged analyses revealed that HRQoL at baseline was not associated with academic performance 24 months later, while all the academic grades and the overall score of academic abilities at baseline were positively associated with HRQoL at follow-up in adolescents. Results of the stratified analyses by sex were largely similar. Specifically, in girls, math, language, physical education, and grade point average at baseline were positively associated with HRQoL 24 months later, while in boys, all the academic grades indicators (except physical education), numeric ability, and the overall score of academic abilities at baseline were positively associated with HRQoL at follow-up.

CONCLUSION

These findings suggest that academic performance in early adolescence may predict HRQoL 24 months later. Health and education professionals could benefit from collaborating to achieve both improved academic performance and HRQoL in youth.

Association Between Screen Time of Mobile Devices and TV and School Readiness in Preschool Children: A Cross-Sectional Study

We aimed to investigate the relationship between screen time and school readiness. A total of 80 ppreschool children were included. Parents were interviewed about their children's daily screen time. The Metropolitan Readiness Test was utilized. Results showed that the school readiness of those with a total screen time of 3 hours or less was significantly higher. TV time was inversely associated with reading readiness (B=- 2.30,p < .001), whereas mobile device time was inversely associated with both reading (B = -0.96,p = .04) and numbers readiness (B = -0.98,p = .02). This study point to the importance of supervising children's screen use, and of awareness of parents and professionals.

Screen use, sleep duration, daytime somnolence, and academic failure in school-aged adolescents

In this study, we examined the relationship between screen time use, sleep characteristics, daytime somnolence, and academic performance in school-aged adolescents. We surveyed 1,257 12- to 18-year-old adolescents attending 52 schools in urban or suburban areas of Argentina. We recorded the daily exposure to various screen-based activities, including video- and online-gaming, social media, TV or streaming. Screen time and device type in the hour before bedtime, sleep patterns during weekdays and weekends, somnolence (Pediatric Daytime Sleepiness Scale score), and grades in language and mathematics were also assessed. Structural Equation Modelling was used to identify a path connecting the latent variables. Results are expressed as standardized regression weights (srw). Missing data were present in 393 subjects, and thus the final sample consisted of 864 complete responses. Daytime somnolence (i.e., PDSS score ≥ 15) was observed in 614 participants (71%), and academic failure (i.e., grades < 7/10) in 352 of them (41%). Time spent using video gaming consoles was negatively associated with sleep duration (srw = -0.22, p<0.01) and positively connected with daytime somnolence (srw = 0.11, p<0.01). Use of mobile devices was associated with lower academic performance (srw = -0.11, p<0.01). Sleep duration was inversely related to daytime somnolence (srw = -0.27, p<0.01), which was in turn negatively associated with academic performance (srw = -0.18, p<0.05). Bedtime computer use did not influence any outcome. In summary, among adolescents, screen use adversely affected nighttime sleep, daytime somnolence, and academic performance. These findings call for the implementation of educational public campaigns aimed at promoting healthy sleep and reducing screen exposure among adolescents.

Sedentary behaviours and their relationship with academic performance in adolescents: A mediation analysis

The present research aims to examine the relationship between the four dimensions of sedentary behaviours and academic performance, as well as to test the association between sedentary behaviours and academic performance in boys and girls in a sample of Spanish adolescents. A total of 2,216 adolescents aged 11 to 16 years old, both males (13.30 ± 0.92) and females (13.06 ± 0.86), participated. Sleep duration, physical activity, and sedentary behaviours were measured through questionnaires. Academic performance was assessed with students´ marks. Potential confounders such as sex, age, socioeconomic status, and cardiorespiratory fitness were also measured. Descriptive analysis, correlation analysis, analysis of differences, and multiple mediation analysis were conducted. It was observed that girls spend more time on sedentary educational or social behaviours, while boys spend much more time on screen time. Sedentary behaviours such as educational time, screen time, and relaxing time were associated with academic performance. Specifically, educational time appears to be positively related to academic performance. Nevertheless, screen time and relaxing time were negatively associated with academic performance. The multiple mediation analysis revealed that screen time was the most negative behaviour on academic performance. The outcomes are discussed to improve knowledge about sedentary behaviours and academic performance.

Parents Rate Problematic Video Streaming in Adolescents: Conceptualization and External Assessment of a New Clinical Phenomenon Based on the ICD-11 Criteria of Gaming Disorder

In recent years, video streaming (VS) increased substantially. Adolescents are at significant risk of presenting problematic VS patterns associated with a spectrum of mental-health difficulties. Because VS platforms rely on similar mechanisms as digital games, the ICD-11 criteria for Gaming Disorder (GD) have been successfully implemented to measure Streaming Disorder (StrD) in adolescents. For proper diagnoses, external rating scales are urgently required in addition to self-reports. The Streaming Disorder Scale for Parents (STREDIS-P) was created and validated in a representative sample of n = 891 adolescent-parent dyads. Mental health problems were assessed with standardized instruments. Confirmatory factor analysis was conducted to examine the underlying factor structure. Cutoff scores were determined using ROC analysis. Accordance between parental and adolescents' self-ratings was calculated. Consistent with the results of previous validation studies for screening instruments assessing similar phenomena based on ICD-11-GD criteria, two factors, cognitive-behavioral symptoms and negative consequences, were confirmed. STREDIS-P demonstrated good to excellent internal consistency, criterion validity, and discriminatory power. Accordance with adolescents' self-ratings was moderate. STREDIS-P is the first screening tool for assessing StrD in adolescents by parental ratings. It is highly relevant for conceptualizing a new phenomenon in clinical routine and academic research.

Association of Individual and Neighborhood Characteristics to Problematic Internet Use among Youths and Adolescents: Evidence from Vietnam

INTRODUCTION

This study aimed to determine latent profiles from the Problematic Internet Use Questionnaire Short Form-6 (PIUQ-SF-6) score of Vietnamese youths and adolescents, which supports the diagnosis of problematic internet use among a large sample size. Moreover, it also explored factors that affect each latent profile of the PIUQ-SF-6 score among participants.

METHODS

A sample of 1477 Vietnamese people, aged 14 to 24, across five provinces participated in the study. Multinomial logistic regression determined factors related to the levels of the Problematic Internet Use Questionnaire Short Form-6 (PIUQ-SF-6) after using latent profile analysis.

RESULTS

Participants were divided into three profiles, including those at low, moderate, and high risk of internet addiction. The high-risk latent profile was obtained for 23.1% of adolescents, and the remaining percentages were, respectively, 40.2% and 36.7% of adolescents belonging to the moderate and low-risk groups. Moreover, factors including age, living alone, high Kessler psychological distress scale, excessive time on the internet, living in central cities, and high neighborhood disorder scores were found to be related to moderate- and high-risk internet addiction profiles.

CONCLUSIONS

Factors analyzed according to individual and social characteristics further explore the reasons underlying increasing internet addiction among Vietnamese youths and inform early interventions.

The association between meeting physical activity guidelines and academic performance among junior high school adolescents in China-evidence from the China education tracking survey

Purpose

To examine how well Chinese adolescents meet the physical exercise time and screen time recommendations in the Physical Activity Guidelines for Chinese Residents (2021), and the relationship between adolescents' physical exercise time, screen time and their academic performance.

Method

Daily physical exercise time, screen time and academic performance were collected from Grade 8 adolescents (n = 9,449). Academic performance included standardized scores on Chinese, Math and English tests and responses to the School Life Experience Scale.

Results

Meeting the physical activity time and screen time in the Physical Activity Guidelines for Chinese Residents was associated with adolescents' academic performance. Specifically, having at least 60 min of physical exercise per day was associated with adolescents' school life experiences compared to adolescents who did not meet the physical exercise time and screen time in the Chinese Residents' Physical Activity Guidelines. Less than 2  h of cumulative screen time per day was associated with adolescent mathematics test scores, English test scores and school life experiences. Meeting both physical exercise time and screen time to be recommended had more significant effects on adolescents' mathematics, Chinese, English and school life experiences. Meeting both the physical exercise time and screen time recommendations in the Physical Activity Guidelines for Chinese Residents was more significantly associated with boys' mathematics test scores, Chinese test scores and School life experience. Meeting both the physical exercise time and screen time requirements in the Physical Activity Guidelines for Chinese Residents had a more significant effect on School life experience for girls.

Conclusion

Physical exercise participation of at least 60 min per day and/or less than 2  h of cumulative screen time per day were both associated with adolescent academic performance. Stakeholders should actively promote adolescents to follow the Physical Activity Guidelines for Chinese Residents (2021).

The impact of screen exposure on attention abilities in young children: a systematic review

BACKGROUND

The neurocognitive consequences of exposure to screens in school-aged children have been the subject of multiple studies. However, the relationship between screen exposure and neurocognitive development, especially attentional functions, remains unclear in preschool children. The aim of this systematic review was to evaluate the immediate and long-term impact of screen exposure on attentional functions in preschoolers.

METHODS

Three electronic databases (PubMed, COCHRANE, and SCOPUS) were searched for studies published between January 1, 2000, and November 30, 2020. Two reviewers independently selected studies. Inclusion criteria were observational studies, inclusion of children aged less than seven years with no neurodevelopmental disorders, evaluation of screen time, and evaluation of attentional functions. Data extracted including participants' ages, number of participants, screen exposure time, attention assessment tool, and confounding factors. Study quality was evaluated using the Newcastle-Ottawa Scale.

RESULTS

Five cross-sectional studies were included: all reported significant, positive associations between high levels of screen exposure and attention difficulties. Ten longitudinal studies were included: six found a significant impact of earlier screen exposure on subsequent attentional function and four found no relationship. Eight of the studies included evaluated the direction of the relationship between screen exposure and attentional difficulties: seven suggested the relationship is bidirectional.

CONCLUSIONS

These findings support current guidelines to limit screen time in preschoolers to prevent the development of attention difficulties.

Internet and Video Games: Causes of Behavioral Disorders in Children and Teenagers

Even though video games have been present among children for many years, children are using them more continuously and in an abusive and indiscriminate way nowadays because of the "technological boom". It is affecting the behavior of children and adolescents. This is the reason why we are carrying out this systematic review. The main objective of this article is to investigate literature that directly connects the continuous and undifferentiated use of video games with the emergence of behavioral disorders in children and young people. The PRISMA statement was followed in the process of this article. We used SCOPUS, Web of Science and PubMed as databases, moreover, we searched studies with a scoping review. The results indisputably supported six out of seven of our hypotheses. We find that the excessive use of video games causes addiction to technology, aggressive behaviors, sleep disorders, and poor school performance. In addition, it hinders social relationships and the development of emotional intelligence. To conclude, it is necessary to correctly use video games in particular, and technologies in general, adapting their content to children's age, as well as the amount of time that they dedicate to use them.

Assessment of Changes in Child and Adolescent Screen Time During the COVID-19 Pandemic: A Systematic Review and Meta-analysis

IMPORTANCE

To limit the spread of COVID-19, numerous restrictions were imposed on youths, including school closures, isolation requirements, social distancing, and cancelation of extracurricular activities, which independently or collectively may have shifted screen time patterns.

OBJECTIVE

To estimate changes in the duration, content, and context of screen time of children and adolescents by comparing estimates taken before the pandemic with those taken during the pandemic and to determine when and for whom screen time has increased the most.

DATA SOURCES

Electronic databases were searched between January 1, 2020, and March 5, 2022, including MEDLINE, Embase, PsycINFO, and the Cochrane Central Register of Controlled Trials. A total of 2474 nonduplicate records were retrieved.

STUDY SELECTION

Study inclusion criteria were reported changes in the duration (minutes per day) of screen time before and during the pandemic; children, adolescents, and young adults (≤18 years); longitudinal or retrospective estimates; peer reviewed; and published in English.

DATA EXTRACTION AND SYNTHESIS

A total of 136 articles underwent full-text review. Data were analyzed from April 6, 2022, to May 5, 2022, with a random-effects meta-analysis.

MAIN OUTCOMES AND MEASURES

Change in daily screen time comparing estimates taken before vs during the COVID-19 pandemic.

RESULTS

The meta-analysis included 46 studies (146 effect sizes; 29 017 children; 57% male; and mean [SD] age, 9 [4.1] years) revealed that, from a baseline prepandemic value of 162 min/d (2.7 h/d), during the pandemic there was an increase in screen time of 84 min/d (1.4 h/d), representing a 52% increase. Increases were particularly marked for individuals aged 12 to 18 years (k [number of sample estimates] = 26; 110 min/d) and for device type (handheld devices [k = 20; 44 min/d] and personal computers [k = 13; 46 min/d]). Moderator analyses showed that increases were possibly larger in retrospective (k = 36; 116 min/d) vs longitudinal (k = 51; 65 min/d) studies. Mean increases were observed in samples examining both recreational screen time alone (k = 54; 84 min/d) and total daily screen time combining recreational and educational use (k = 33; 68 min/d).

CONCLUSIONS AND RELEVANCE

The COVID-19 pandemic has led to considerable disruptions in the lives and routines of children, adolescents, and families, which is likely associated with increased levels of screen time. Findings suggest that when interacting with children and caregivers, practitioners should place a critical focus on promoting healthy device habits, which can include moderating daily use; choosing age-appropriate programs; promoting device-free time, sleep, and physical activity; and encouraging children to use screens as a creative outlet or a means to meaningfully connect with others.

Correlates of domain-specific sedentary behaviors and objectively assessed sedentary time among elementary school children

Understanding the correlates of sedentary behavior among children is essential in developing effective interventions to reduce sitting time in this vulnerable population. This study aimed to identify correlates of domain-specific sedentary behaviors and objectively assessed sedentary time among a sample of children in Japan. Data from 343 children (aged 6-12 years) living in Japan were used. Domain-specific sedentary behaviors were assessed using a questionnaire. Total sedentary time was estimated using hip-worn accelerometers. Twenty-two potential correlates across five categories (parental characteristics, household indoor environment, residential neighborhood environment, school environment, and school neighborhood environment) were included. Multivariable linear regression models were used to identify correlates of domain-specific sedentary behaviors and objectively assessed sedentary time. Eight correlates were significantly associated with children's domain-specific sedentary behaviors: mother's and father's age, mother's educational level, having a video/DVD recorder/player, having a video console, having a TV one's own room, home's Walk Score^®, and pedestrian/cycling safety. No significant associations were found between potential correlates and accelerometer-based total sedentary time. These findings highlight that strategies to reduce children's sedentary time should consider the context of these behaviors. For example, urban design attributes such as perceived pedestrian and cycling safety can be improved to reduce children's car sitting time.

School and non-school day screen time profiles and their differences in health and educational indicators in adolescents

Sedentary behavior and screen-based devices in particular have been negatively associated with a wide range of health and educational indicators. However, few have examined these relationships separately for school days and non-school days, and none have used a person-centered approach. This study aimed to identify school and non-school day screen time profiles, as well as examine possible differences in health indicators (physical fitness, fatness, physical activity, sleep duration, and Mediterranean diet) and academic performance. This study involved the participation of 1573 Spanish adolescents aged 12-16 years (54.73% girls). Academic performance was measured through grades in Mathematics, Language, English, and Physical Education. Physical fitness was measured through a battery of tests (cardiorespiratory fitness was measured using the 20 m shuttle run test, and muscular strength with both handgrip and standing long jump tests), while fatness (skinfold thicknesses) was assessed with calipers. Finally, physical activity, screen time, sleep duration, and adherence to the Mediterranean diet were measured using self-reported questionnaires. Hierarchical cluster analyses based on square Euclidian distances and Ward's method were performed based on daily minutes of screen time recorded on school and non-school days. We identified four clusters labeled and described as: (1) "High-high": highest screen time on school and non-school days; (2) "High-low": high screen time on school days and low screen time on non-school days; (3) "Low-high": low screen time on school days and high screen time on non-school days; (4) "Low-low": lowest screen time on school and non-school days. Adolescents who belonged to the "High-high" profile had worse health-related behaviors (i.e., physical activity, sleep duration, and adherence to Mediterranean diet) and academic performance than most other profiles, while adolescents who belonged to "Low-low" profile showed the opposite pattern. Adolescents in the "Low-high" profile had a higher sleep duration on school days and better academic performance than those in the "High-low" profile. No differences in body fat, cardiorespiratory fitness, and muscular strength were found between the four different profiles. The results suggest that adolescents who accumulated a large amount of screen time on school and non-school days reported worse health-related behaviors and academic performance. Moreover, adolescents who had high screen time on school days reported only a short sleep duration on school days and worse academic performance than on non-school days. Conducting interventions to reduce screen time in these four profiles, particularly in the groups of students with more screen time on school days, becomes essential to improving adolescents' healthy lifestyles and academic performance.

The Family Level Assessment of Screen Use-Mobile Approach: Development of an Approach to Measure Children's Mobile Device Use

BACKGROUND

There is a strong association between increased mobile device use and worse dietary habits, worse sleep outcomes, and poor academic performance in children. Self-report or parent-proxy report of children's screen time has been the most common method of measuring screen time, which may be imprecise or biased.

OBJECTIVE

The objective of this study was to assess the feasibility of measuring the screen time of children on mobile devices using the Family Level Assessment of Screen Use (FLASH)-mobile approach, an innovative method that leverages the existing features of the Android platform.

METHODS

This pilot study consisted of 2 laboratory-based observational feasibility studies and 2 home-based feasibility studies in the United States. A total of 48 parent-child dyads consisting of a parent and child aged 6 to 11 years participated in the pilot study. The children had to have their own or shared Android device. The laboratory-based studies included a standardized series of tasks while using the mobile device or watching television, which were video recorded. Video recordings were coded by staff for a gold standard comparison. The home-based studies instructed the parent-child dyads to use their mobile device as they typically use it over 3 days. Parents received a copy of the use logs at the end of the study and completed an exit interview in which they were asked to review their logs and share their perceptions and suggestions for the improvement of the FLASH-mobile approach.

RESULTS

The final version of the FLASH-mobile approach resulted in user identification compliance rates of >90% for smartphones and >80% for tablets. For laboratory-based studies, a mean agreement of 73.6% (SD 16.15%) was achieved compared with the gold standard (human coding of video recordings) in capturing the target child's mobile use. Qualitative feedback from parents and children revealed that parents found the FLASH-mobile approach useful for tracking how much time their child spends using the mobile device as well as tracking the apps they used. Some parents revealed concerns over privacy and provided suggestions for improving the FLASH-mobile approach.

CONCLUSIONS

The FLASH-mobile approach offers an important new research approach to measure children's use of mobile devices more accurately across several days, even when the child shares the device with other family members. With additional enhancement and validation studies, this approach can significantly advance the measurement of mobile device use among young children.

24-h movement behaviours in Spanish youth before and after 1-year into the covid-19 pandemic and its relationship to academic performance

Most studies have shown a decline in the adherence to 24-Hour Movement Guidelines because of Covid-19 lockdown. However, there is little evidence regarding changes 1-year after the pandemic in these guidelines and their possible impact on academic performance. The study aims were: (1) to examine the possible changes in 24-Hour Movement Guidelines for youth (i.e., at least 60 min per day of moderate-to-vigorous physical activity, ≤ 2 h per day of recreational screen time, and 9 to 11 h of sleep per day for children and 8 to 10 h for adolescents) before and after 1-year into the Covid-19 pandemic, and (2) to examine the possible changes in the relationship between 24-Hour Movement Behaviours (physical activity, screen time, and sleep duration) and academic performance before and after 1-year into the Covid-19. This is a repeated cross-sectional study in two different samples of young Spanish at different times. Firstly, a total of 844 students (13.12 ± 0.86; 42.7% girls) completed a series of valid and reliable questionnaires about physical activity levels, recreational screen time, sleep duration and academic performance before Covid-19 pandemic (March to June 2018). Secondly, a different sample of 501 students (14.39 ± 1.16; 55.3% girls) completed the same questionnaires 1-year after Covid-19 pandemic (February to March 2021). Adherence to the three 24-Hour Movement Guidelines was significantly lower 1-year after into the Covid-19 pandemic (0.2%) than before the pandemic (3.3%), while adherence to none of these three recommendations was significantly higher 1-year after the Covid-19 pandemic (66.3%) than before the pandemic (28.9%). The positive relationship between physical activity levels and academic performance was no longer significant after 1-year into Covid-19 pandemic (β = − 0.26; p < 0.001). 1-year after Covid-19 pandemic, the relationship between recreational screen time (β = − 0.05; p > 0.05) and sleep duration (β = 0.05; p < 0.001) with academic performance did not change compared to pre-pandemic. The results suggest that 24-Hour Movement Behaviours have worsened among young people 1-year after Covid-19 pandemic compared to pre-pandemic period. Moreover, the physical activity benefits associated in terms of academic performance seem to have disappeared because of the Covid-19 pandemic. Therefore, there is a public health problem that requires priority and coordinated action by schools, policy makers, and researchers to mitigate the adverse effects of the pandemic on 24-Hour Movement Behaviours.

The Academic Cost of Worry Among Socioeconomically Disadvantaged Children

OBJECTIVES

Worry and loneliness looms large in American schools, especially in the social years of early adolescence where friendships are in flux and children strive to fit in and do well academically. We examine a nationally-representative sample of American 5th graders to document the extent of academic worry and loneliness, its costs for academic performance, and how social class can disrupt or exacerbate its associations.

METHODS

Based on a nationally representative longitudinal survey (ECLS-K 2010-2011) of childhood (N = 5750), we examine if a child's self-reported worry and loneliness are associated with standardized math and reading scores using OLS regression. We explore whether these associations vary by socioeconomic status.

RESULTS

We find that academic worry is a strong predictor of math and reading skill. The association is amplified for disadvantaged students. Patterns hold when accounting for a host of other factors and are replicated in the ECLS-K 1998-1999. Loneliness and its association with math and reading performance was not statistically significant.

CONCLUSIONS FOR PRACTICE

As academic worry is negatively associated with standardized math and reading skills, practitioners can be especially attuned to how these patterns are amplified for children in low socioeconomic households. Utilizing a nationally representative survey of early adolescence, we show that worry (and less so loneliness) is associated with math and reading skills and that these associations are moderated by socioeconomic status-disadvantaged students have a higher negative association with math and reading performance when they worry about their academic performance compared to advantaged students.

Internet use and internet-based addictive behaviours during coronavirus pandemic

PURPOSE OF REVIEW

The COVID-19 outbreak profoundly influenced human lives on different levels. This narrative review aims to present recent data relating to the COVID-19 pandemic and internet use and internet-based addictive behaviours [problematic Internet use (PIU), Internet addiction, Internet gaming disorder, problem gambling or gambling disorder, social media addiction including smartphone use disorder, problematic pornography use, and compulsive buying].

RECENT FINDINGS

During the COVID-19 pandemic, the prevalence of Internet use and Internet-based addictive behaviours increased in all age groups. The COVID-19 pandemic and related containment measures were been associated with increased levels of stress, anxiety, and depression in the general population, especially among children and adolescents, which are the vulnerable groups for the development of mental disorders during the crisis. Furthermore, the fear resulting from the disease, the 'lockdown' measures, high levels of uncertainty regarding the future, and financial insecurity increased levels of loneliness, PIU, and Internet addiction.

SUMMARY

Longitudinal researches focused on the negative impacts of Internet use in prolonged stress situations on mental health, vulnerable groups, and quality of life (QoL) are needed to help clinicians and policymakers to reduce adverse consequences. Prevention programs for Internet use and Internet-based addictive behaviours must be customized to meet the needs of children, adolescents, and adults. Also, treatment programs must be tailored to the needs of patients with different Internet-based addictions.