Interactional theory of childhood problematic media use

Family and developmental correlates of adolescent involvement in decision making about screen use

Objective

Assess how child involvement in making rules about screen time relates to age, child prosocial functioning, and amount of screen use.

Methods

NORC's AmeriSpeak Panel was used to recruit a nationally representative sample of parents or guardians of school-aged children (age 5-17) in the United States (n = 2084). Parents completed survey that included measures of screen time, child involvement in rule making about screen use, family functioning, and dimensions of child psychosocial functioning.

Results

Across all age categories, most families had some form of rules about the allowable amount of screen-based digital media for uses other than schoolwork: 86% of elementary school-aged children (ages 5 to 10), 81% of middle school-aged children (ages 11-13), and 61% of high school aged children (ages 14-17). Across all age groups, having rules was associated with fewer hours of screen time (elementary school: B = -1.31, 95% CI = -1.80 to -0.81, p < 0.001; middle school: B = -1.40, 95% CI = -2.20 to -0.59, p < 0.001; high school: B = -0.97, 95% CI = -1.68 to -0.27, p = 0.007). Child involvement in making rules was significantly greater for high school students as compared to elementary school students (ß=0.12, p < 0.001), and not associated with high school- or middle-school aged child screen time. Across all age groups, child involvement in making rules was associated with higher levels of prosocial functioning (elementary school: ß=0.07, p < 0.001; middle school: ß=0.19, p = 0.001; high school: ß=0.21, p < 0.001).

Conclusions

Child involvement in making rules about screen use may be an opportunity to strengthen developmentally important competencies, as part of a broader autonomy-supportive approach to parenting.

Digital Interventions for Combating Internet Addiction in Young Children: Qualitative Study of Parent and Therapist Perspectives

BACKGROUND

Internet addiction is an emerging mental health issue in this digital age. Nowadays, children start using the internet in early childhood, thus making them vulnerable to addictive use. Previous studies have reported that the risk of internet addiction tends to be higher in lower-income regions with lower quality of life, such as Indonesia. Indonesia has high risks and prevalence of internet addiction, including in children. Digital interventions have been developed as an option to combat internet addiction in children. However, little is known about what parents and therapists in Indonesia perceive about these types of interventions.

OBJECTIVE

This study aims to investigate the experiences, perceptions, and considerations of parents and therapists regarding digital interventions for combating internet addiction in young Indonesian children.

METHODS

This study used a qualitative exploratory approach through semistructured interviews. We involved 22 parents of children aged 7 to 11 years and 6 experienced internet addiction therapists for children. The interview data were transcribed and analyzed using thematic analysis.

RESULTS

Participants in this study recognized 3 existing digital interventions to combat internet addiction: Google Family Link, YouTube Kids, and Apple parental control. They perceived that digital interventions could be beneficial in continuously promoting healthy digital behavior in children and supporting parents in supervision. However, the existing interventions were not highly used due to limitations such as the apps' functionality and usability, parental capability, parent-child relationships, cultural incompatibility, and data privacy.

CONCLUSIONS

The findings suggest that digital interventions should focus not only on restricting and monitoring screen time but also on suggesting substitutive activities for children, developing children's competencies to combat addictive behavior, improving digital literacy in children and parents, and supporting parental decision-making to promote healthy digital behavior in their children. Suggestions for future digital interventions are provided, such as making the existing features more usable and relatable, investigating gamification features to enhance parental motivation and capability in managing their children's internet use, providing tailored or personalized content to suit users' characteristics, and considering the provision of training and information about the use of interventions and privacy agreements.

Attachment security and problematic media use in infancy: A longitudinal study in the United States

Media use during childhood has quickly become a norm across the United States and in other countries. One area still not well understood is the development of problematic (or maladaptive and disruptive) media use in children. This research examines the role of attachment security as a central component in the development of problematic media use over time in a sample of 248 parent-child dyads (9.50% African American, 20.66% Hispanic, 62.81% White, 2.07% Asian, 4.96% other ethnicities). We examined the relationship between attachment security and problematic media use one and 2 years later. We then constructed a mediation model examining parent responsiveness while jointly engaging in media use and during play as mediators between infant attachment security and problematic media use over time. Results suggest that while infant attachment security may be protective against developing problematic media use patterns, this relationship does not seem to be mediated by parent-child interactions while engaging in media or during play.

Increased Digital Media Use in Preschool Children: Exploring the Links with Parental Stress and Their Problematic Media Use

BACKGROUND

Intense or problematic media use behavior of parents could serve as a role model for their children's media use behavior. So far, knowledge is scarce about increased children's media use (ICMU) and its association with parental stress (PS) and problematic parental media use (PPMU).

METHODS

ICMU was examined using a modified set of the DSM-5 criteria for Internet Gaming Disorder. PS was assessed via the widely used Parenting Stress Index, and PPMU was assessed using the Short Compulsive Internet Use Scale. A multiple linear regression analysis was conducted to evaluate the links between ICMU, PS, and PPMU. A mediation analysis was performed to examine if PPMU mediated the relationship between PS and ICMU.

RESULTS

In sum, 809 parents (M = 36.89 years; SD = 4.87; 81.4% female) of preschool children (average age: 44.75 months, SD = 13.68) participated in the study. ICMU was statistically significantly related to higher age of the parent, greater PPMU, and higher PS. Furthermore, we found that the association between PS and ICMU was partially mediated by PPMU.

CONCLUSIONS

The results indicate that more pronounced PS and PPMU are associated with ICMU, highlighting the necessity of considering these parental variables when developing early prevention strategies for preschool-age children.

Silencing screaming with screens: The longitudinal relationship between media emotion regulation processes and children's emotional reactivity, emotional knowledge, and empathy

Many parents use screens to regulate their young children's emotions. We know very little, however, about how this parenting practice is related to the development of emotional competencies (i.e., emotional reactivity, emotion knowledge, and empathy) over time. The current longitudinal study examined bidirectional associations between media emotion regulation and various emotional competencies across a 1-year period during early childhood (between ages 3.5 and 4.5 on average). Participants included 269 child/parent dyads who completed a number of in-home tasks and questionnaires. Results revealed that higher levels of media emotion regulation were associated with worse emotional knowledge and empathy and higher emotional reactivity at the cross-sectional level. However, early media emotion regulation was associated with higher levels of child empathy 1 year later. We discuss these results in the context of general parenting practices and encourage future research on the topic with a focus on how these processes develop over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations between nature exposure, screen use, and parent-child relations: a scoping review protocol

BACKGROUND

Today's youth are growing up in an evolving digital world, and concerns about the potential detrimental effects of excessive screen use on biopsychosocial outcomes in childhood are mounting. Parents worry about the impacts of screen-use on their children's wellbeing but at the same time frequently fail to meet their own ideal screen time limits regarding their children's screen use. There is an opportunity to shift research focus away from inflexible and often unrealistic childhood screen time guidelines towards exploration of positive parenting strategies that may have multiple beneficial and significant effects on children's screen-related outcomes. An emerging body of literature suggests that screen time and nature exposure act on psychosocial outcomes in contrasting ways. There is evidence to suggest that exposure to natural environments may counteract some of the potential negative psychosocial effects of excessive screen use; however, this relationship is poorly understood. The overarching aim of this scoping review is to source, categorise, and synthesise existing research exploring the associations between nature exposure, screen use, and parenting across childhood.

METHODS

This mixed-methods systematic scoping review will be conducted following Arksey and O'Malley's framework with methodological enhancements from Levac and associates and recommendations from the Joanna Briggs Institute's methodological guidance for conducting scoping reviews. Five electronic databases will be searched from August 2022 onwards. Two reviewers will independently screen titles, abstracts, and full-text articles. Peer reviewed articles related to the constructs of nature exposure, screen use, and parent/child relations will be considered in the context of early to late childhood. Study characteristics will be collated using a data charting tool collaboratively developed by the research team. Evidence will be presented using tabular and textual form and described using qualitative thematic analysis.

DISCUSSION

This review will gather information about how key definitions are conceptualised, defined, and measured across the literature and map existing trends and areas for future research. It is intended that this review will inform and guide future research direction, recommendations, and programs aimed at supporting parents to navigate the challenges of parenting in a digital age. OSF REGISTRATION: https://doi.org/10.17605/OSF.IO/TFZDV.

Assessment and Diagnostic Classification Using DC:0-5 in Early Childhood Mental Health Clinics: The Protocol for the Developmental Psychiatry Diagnostic Challenges Study (DePsy)

Mental health problems in early childhood are common, but there is a lack of psychiatric research on this age group. DC:0-5 is a multiaxial classification system for mental disorders in early childhood, providing a framework for standardizing clinical practice and research. However, research on the validity of DC:0-5 is scarce. The Developmental Psychiatry Diagnostic Challenges Study (DePsy) is a multi-site, prospective clinical study including six German early childhood mental health (ECMH) clinics. The main objective of the study is to contribute to the validation of Axis I and Axis II of DC:0-5. A second aim of the study is to describe the population of the participating clinics regarding diagnoses, family context, and treatment outcomes. Additionally, the impact of environmental risk factors, including parental Adverse Childhood Experiences (ACEs) and media use, on child psychopathology and caregiver-child relationships will be examined. Over two years, patients aged 0.0-5.9 years old will be enrolled in the study. Assessments include ICD-10 and DC:0-5 diagnoses, developmental tests, video-based observations of caregiver-child interactions, and questionnaires on child psychopathology, media use, parental stress, and treatment satisfaction. Study results will promote the standardization of assessment and treatment in ECMH clinics aiming to improve the development of patients and their families.

Editorial: Benign Versus Problematic Media Use Profiles in Youth: Correlates, Concerns, and Future Directions

The potential impact of screen media activity (SMA) on youth development is a topic of heated debate, with inconsistent findings and concerns about SMA measurement.1 There is a growing call for more precise measurement and analyses of SMA, focusing more on how (in what way youth are using screens) and less on how much (aggregate screen time). There is also a need to distinguish normative vs problematic SMA (eg, addiction-like behaviors)2,3 in youth. In the current issue, Song et al.4 advance this field by using a sophisticated assessment of SMA, considering problematic vs benign SMA profiles, and exploring associations between SMA and measures of brain and behavior.

Problematic media use in early childhood: The role of parent-child relationships and parental wellbeing in families in New Zealand and the United States

Problematic media use (PMU) during early childhood has the potential to interfere with the healthy functioning of family systems and may be associated with significant long-term problems for the child. However, we know very little about what contributes to early childhood PMU, particularly in the family context. We examine parenting factors as correlates of child PMU in two studies, from two different countries, using two different methods. Study 1 (N=93, Mage=45.3months, SD=10.15, 58%males, 87%mothers) investigated the concurrent role of self-reported parental burnout and parent-child conflict and closeness as correlates of child PMU in an early childhood sample in New Zealand. Study 2 (N=269, Mage=41.17months, SD=3.06 months, 49%males, 95%mothers) investigated observed parental warmth and harsh criticism as predictors of concurrent and longitudinal PMU in an early childhood sample in the United States. Together, findings showed that in both countries approximately 22-25% of young children show symptoms of PMU. After controlling for parent's PMU, parent-child conflict, warmth and parental burnout were not associated with child PMU. Low levels of parent-child closeness and parent's use of harsh criticism were predictive of child PMU. The findings advance our understanding of some of the parenting factors that influence the development of PMU in young children.

Association between media exposure and behavioral problems among preschool children

Background

The prevalence of behavioral problems among preschool children is remarkably increasing in the clinical setting.

Aim

The current study aimed to investigate the association between media exposure and behavioral problems among preschool children.

Methods

This survey study recruited 560 children from 10 nurseries selected randomly, located in El-Mansoura, Egypt. Tools included socio-demographic characteristics the Media Exposure Questionnaire and the Conners Comprehensive Behavior Rating Scales (CBRS-48).

Results

The participants were exposed to media for an average of 105.84 min per day and displayed moderate levels in all subscales of CBRS-48. The duration of media exposure was significantly correlated to the hyperactivity index, learning problems, hyperactivity/impulsivity, conduct problem, anxiety, and psychosomatic problems (r = 0.372, 0.356, 0.323, 0.306, 0.298, 0.291, and 0.255, respectively).

Conclusion

The duration of media exposure was significantly correlated to the subscales of CBRS-48.

Implication for nursing practice

Preschool children should be engaged in concrete activities and social interactions that may lessen negative media effects such as hyperactivity, learning problems, hyperactivity/impulsivity, conduct problem, anxiety, and psychosomatic problems.

Maternal COVID-19 Distress and Chinese Preschool Children's Problematic Media Use: A Moderated Serial Mediation Model

Introduction

Maternal distress increased during the COVID-19 pandemic, significantly impacting children's media use. The purpose of this study was to explore the influence mechanism of maternal COVID-19 distress on preschoolers' problematic media us through a moderated mediation model; specifically, we examined the possible mediating roles of parenting stress and negative instrumental use of media in parenting and the moderating role of supportive co-parenting.

Methods

An online survey was conducted in a sample of 1357 children (M_age = 4.01, SD = 1.06; 47.4% boys) and their parents from six public kindergartens in Shanghai, China. The mothers provided information by completing measures on their levels of distress related to COVID-19, parenting stress levels, digital parenting practices, and perception of supportive co-parenting from their partners. Additionally, both parents rated their children's problematic media use.

Results

(1) maternal COVID-19 distress was significantly and positively related to children's problematic media use; (2) this relationship was sequentially mediated by parenting stress and parents' negative instrumental use of media in parenting; and (3) supportive co-parenting moderated the serial mediation path by reducing the effect of maternal COVID-19 distress on parenting stress.

Conclusion

The findings provide some support and guidance for preventing children's problematic media use and enhancing parental adaptation during the COVID-19 pandemic or in potentially adverse situations.

Structures for Screens: Longitudinal associations between parental media rules and problematic media use in early childhood

Media use is increasingly becoming an important facet of early childhood, and while professional organizations and researchers have attempted to present guidelines to parents to help them structure their children's media use, many parents either are not aware of these guidelines, or struggle to effectively implement them into their children's daily routine. This research aimed to examine what rules parents of young children are implementing to structure their children's media use and how specific media rules affected development of children's problematic media use (an early indicator of media dependence) longitudinally from ages 2-4 (three time points, each one year apart) in a sample of n = 435 children. We found that more parents have rules around their child's TV use than tablet use when children are around age 2 ½ years old, and that a sizable minority of parents (n = 45; 10.30%) or parents do not allow their child to use tablets at this same age. There was no relationship between media rules and problematic media use at Time 2. However, parents who did not allow their child to use tablets at Time 1 had lower levels of child problematic media use at Time 3, implying that the rules parents set around young children's use of tablets and other personal media devices may be impactful in protecting children from the development of problematic media use.

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.

Masters of Media: A longitudinal study of parental media efficacy, media monitoring, and child problematic media use across early childhood in the United States

The development of problematic media use in early childhood is not well understood. The current study examined long-term associations between parental media efficacy, parental media monitoring, and problematic media use across a three-year period of time during early childhood. Participants included 432 parents who reported on their own parenting and their child's use of problematic media once a year for three years (M age of child at Wave 1 = 29.68 months, SD = 3.73 months). Results revealed that early parental media efficacy predicted lower levels of child problematic media use over time. Restrictive media monitoring was also related to lower levels of child problematic media use over time. Additionally, general parental efficacy was related to parental media efficacy and lower child problematic media use, both at the cross-sectional and longitudinal levels. Discussion focuses on encouraging early parental media efficacy (and exploring other potential mechanisms) as a way to mitigate the development of problematic media use over time.

Toddlers and the Telly: A latent profile analysis of children's television time and content and behavioral outcomes one year later in the U.S

Despite the ubiquity of tablets and smartphones, television remains the most frequently used screen media consumed by young children. However, it is likely that variability exists in how young children use media; for example, while some may view small amounts of aggressive content, others may view many hours each day of aggressive and prosocial media content. It is possible that differences in toddler television time and content also impact behavioral outcomes. The aims of this study were two-fold; first, we examined profiles of children's time spent watching television and media content viewed. Second, we examined longitudinal relations between media use profiles and outcomes including aggression, prosocial behavior, and problematic media use. Results suggested a three-profile solution of children's television time and content, including "Low TV content," "High child-centered content," and "High aggressive content" profiles. The "High aggressive content" group experienced higher levels of problematic media use and aggressive behavior one year later compared to other classes. The discussion focuses on implications of these findings. We urge parents to become aware of both television time and media content as they may relate to problematic media use behaviors in young children.

Screen media exposure and behavioral adjustment in early childhood during and after COVID-19 home lockdown periods

There is ample evidence that young children's screen media use has sharply increased since the outbreak of the novel 2019 coronavirus disease (COVID-19). However, the long-term impact of these changes on children's adjustment is currently unclear. The goals of the current study were to assess longitudinal trajectories of young children's screen media exposure through a series of national COVID-19 home lockdowns and to examine the predictive associations between different aspects of media exposure and post-lockdown behavioral adjustment. Data were collected at four timepoints during and after home lockdown periods in Israel. Longitudinal data measuring various aspects of media use, behavioral conduct and emotional problems were gathered from a sample of 313 Israeli children (54% females) between the ages two to five years (Mage at T1 = 3.6), by surveying their mothers at 5 points in time. Child overall screen time use, exposure to background television, use of media to regulate child distress and maternal mobile device use all changed throughout the lockdown periods. Moreover, during lockdowns children's behavior problems were concurrently and positively correlated with screen time, use of media to regulate child distress, and exposure to background television. However, these were not longitudinally related to child behavior problems in the post-lockdown period. Possible implications for family media use during a public health crisis are discussed.

How the home learning environment contributes to children's social-emotional competence: A moderated mediation model

Introduction

The home learning environment is the earliest contact learning environment in early childhood development, which plays an important role in the development of children's social-emotional competence. However, previous studies have not clarified the precise mechanisms by which the home learning environment influences children's social-emotional competence. Therefore, the purpose of the study is to explore the relationship between the home learning environment and its intrinsic structure (i.e. structural family characteristics, parental beliefs and interests, and the educational processes) and children's social-emotional competence, and whether gender plays a moderating role in the relationship.

Method

The study randomly selected a sample of 443 children from 14 kindergartens in western China. The Home Learning Environment Questionnaire and the Chinese Inventory of Children's Social-emotional competence scale were used to investigate the home learning environment and social-emotional competence of these children.

Results

(1) Structural family characteristics and parental beliefs and interests both had a significant positive predictive effect on children's social-emotional competence. (2) The educational processes fully mediate between structural family characteristics, parental beliefs and interests, and children's social-emotional competence. (3) Gender moderated the effect of the home learning environment on children's social-emotional competence. Gender moderates not only the indirect effects between parental beliefs and interests and children's social-emotional competence, but also the indirect effects between structural family characteristics and children's social-emotional competence. At the same time, gender also moderated the direct effects between parental beliefs and interests and children's social-emotional competence.

Discussion

The results emphasize the crucial role of the home learning environment in the development of children's early social-emotional competence. Therefore, parents should pay attention to the home learning environment and improve their ability to create a home learning environment that promotes the positive development of children's social-emotional competence.

Children's excessive digital media use, mental health problems and the protective role of parenting during COVID-19

COVID-19's outbreak in March 2020 and the social distancing measures that followed it changed the lives of children worldwide. Studies assessing the pandemic's implications for children have reported an alarming increase in the use of digital media (DM) and warned of its adverse impacts on children's functioning and development. The current study aimed to assess the relationship between excessive and problematic DM use and emotional, behavioral, and academic functioning among Israeli adolescents during COVID-19 and to identify adolescents at elevated risk of developing problematic DM use. Three hundred forty-seven Israeli parent-child dyads (M age = 11.81, SD = 1.41) separately completed measures assessing children's DM use (time and addiction), functioning (academic, social, emotional, and behavioral), behavioral dysregulation, and the parents' parenting practices. The results showed that DM addiction, but not DM use, was related to children's emotional, behavioral, and academic difficulties. Moreover, the results indicated that negative parenting and behavioral dysregulation increased the risk of DM addiction, which in turn increased emotional, behavioral, and academic difficulties. The results underscored parents' role in preventing problematic DM use and highlighted the need to treat DM use and problematic DM use as distinct constructs.

The status quo, contributors, consequences and models of digital overuse/problematic use in preschoolers: A scoping review

Digital devices play a critical role in preschoolers' learning and development. Despite the evidence that digital devices use may facilitate preschoolers' learning and development, their overuse/problematic use has become a global concern as the popularity and widespread use of digital devices. This scoping review aims to synthesize the empirical evidence to identify the status quo, influential factors, developmental outcomes, and models of overuse/problematic use in preschoolers. This search has identified 36 studies published in international peer-reviewed journals during 2001-2021, converging into four common topics: the current situation, the influential factors, the consequences, and the models. First, the average percentages of overuse and problematic use across the studies collected in this research were 48.34%, and 26.83%, separately. Second, two influential factors were identified: (1) children's characteristics and (2) parental and family factors. Third, early digital overuse/problematic use was found to have a negative impact on the following domains: (1) physical health, (2) psychosocial health, (3) problematic behaviors, and (4) cognitive development; Fourth, most relevant studies adopted general linear models, while few of them adopted experimental designs. Finally, the implications for future studies and practical improvements are also addressed.

Development and Validation of a New Gadget Addiction Scale (Screen Dependency Scale) among Pre-School Children in Malaysia

BACKGROUND

Excessive screen time in young children is associated with many harmful consequences including screen dependency. Research has shown a worrying prevalence of media-related dependency among adolescents and pre-school children. There are a few available questionnaires among adolescents but none for pre-school children. This study aimed to design and validate a questionnaire to assess screen dependency among pre-school children aged 4 to 6 years old.

METHODOLOGY

A cross-sectional two-phase study was carried out to develop the scale. In phase 1, a preliminary parent-report measure questionnaire was developed in Bahasa Malaysia. Later, it was sent to four experts for content validity followed by face validity. In Phase 2, a total of 386 parents of pre-school children aged 4 to 6 years old, split into two samples, were involved in the field study for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

RESULT

Sample 1 was used to perform EFA to determine the factorial structure of the SDS. All items with a factor loading of >0.4 were included. Sample 2 was used to perform the CFA. RMSEA and CFI analysis showed that the SDS has a good fit and confirms the dimensional structure found via EFA. The final questionnaire consists of 15 items with a 4 factors' structure and has excellent internal consistency reliability.

CONCLUSIONS

The Screen Dependency Scale (SDS) is a reliable and valid questionnaire to detect screen dependency among pre-school children aged 4 to 6 years old in Malaysia.

Child Media Use During COVID-19: Associations with Contextual and Social-Emotional Factors

OBJECTIVE

The aim of this study was to test associations between (1) contextual factors and types of digital media use and (2) types of digital media use and children's social-emotional and sleep outcomes during COVID-19.

METHODS

In February to March 2021, 303 parents of elementary schoolers participated in this cross-sectional survey gathering information on demographics, child school format, contextual factors, duration of types of digital media use, social-emotional outcomes, and sleep. Multivariable regressions examined associations outlined in the objective, adjusting for school format, only child, race/ethnicity, and parental stress, depressive symptoms, education, and material hardship.

RESULTS

Children were aged 5 years to younger than 11 years and spent approximately 4 hours on screen media daily. In multivariable analyses, remote school format; greater material hardship; Black, Indigenous, and people of color child race/ethnicity; lower parenting stress; and parent depressive symptoms were associated with longer duration of various digital media. Longer daily duration of streaming video and video chat were associated with higher prosocial scores, while console games, mobile apps/games, and video-sharing platforms were associated with greater problematic media use (PMU) (defined as interfering with adaptive functioning). More time on mobile apps/games, video-sharing platforms, and video streaming was linked with shorter sleep.

CONCLUSION

Lower parenting stress predicted greater digital media use. Greater digital media use during the pandemic may have enabled parents to focus on other needs. Use of media for social connection predicted greater prosocial behaviors. Engagement-prolonging digital media predicted PMU. Pediatric providers may wish to consider family context when addressing digital media use and encourage socially oriented digital media.

ABCs or Attack-Boom-Crash? A longitudinal analysis of associations between media content and the development of problematic media use in early childhood

Researchers have begun to extensively examine pathological (or addictive-like) media use during adolescence and adulthood. However, few studies have examined precursors to these types of behavior (termed problematic media use) in early childhood, with even fewer examining predictors of this behavior over time. The current longitudinal study examined bi-directional associations between television content (educational, prosocial, and violence) and problematic media use over a 1-year period during early childhood. Participants included 443 children (M age at Wave 1 = 29.68 months) and their parents. Results revealed that early educational media was protective against developing problematic media use over time. However, early problematic media use was not predictive of future media content choices longitudinally. Additionally, problematic media use was moderately stable over time. Implications for parents and policy makers regarding the importance of early media content for later outcomes and consideration of media use trajectories are discussed.

"You're damned if you do, you're damned if you don't": a qualitative exploration of parent motives for provision of mobile screen devices in early childhood

BACKGROUND

Exploring parental motives for providing smartphones and tablets to young children is important to better understand ways to optimise healthy use of mobile screens in early childhood. To date, no study has qualitatively examined the factors underpinning parental motives of providing mobile screens to young children, using a theoretically driven approach.

METHODS

We conducted 45 in-depth, semi structured online interviews with primary caregivers of toddlers and pre-schoolers from diverse family backgrounds who participated in a large online survey in Australia. Themes were generated from the transcribed interviews using template thematic analysis. The coding was completed deductively using the Theory of Planned Behaviour (TPB) and data-driven induction.

RESULTS

Participants consistently reported a spectrum of attitudes, subjective norms and perceived behavioural control aspects which drove their decision to provide or not provide a mobile screen device to their child. Five main descriptive themes were generated, guided by the TPB: (1) Convenience, connection, and non-traditional learning experience; (2) Negative behavioural consequences and potential activity displacement through mobile screens; (3) Influences of society and resources; (4) Managing and achieving a balance; (5) External challenges.

CONCLUSIONS

Overall, the findings demonstrated that parents experienced cognitive dissonance between their attitudes and behaviour, primarily from perceived behavioural control and subjective norms negating the influence of attitudes on their motives to provide a device. These insights offer important avenues for public health messaging and resources to better involve and support parents in decision-making relating to mobile screens in everyday lives of young children.

Association of Parental Screen Addiction with Young Children's Screen Addiction: A Chain-Mediating Model

Preschool children are immersed in screen media, yet little study has been conducted on screen addiction among them. This study aimed to investigate the relationship between parental screen addiction and young children's screen addiction and to verify factors that mediate this relationship. A total of 477 parents of kindergarteners (3-6 years old) were recruited via six kindergartens in Henan province, China. They completed the Problematic Media Use Measure Short Form of Children, the Self-Rating Anxiety Scale, the Child-Parent Relationship Scale, and the Parental Screen Addiction Scale. The results showed that the relationships between each pair of parental screen addiction, parental anxiety, and children's screen addiction were significantly positive, but the parent-child relationship was negatively correlated with the other variables. Parental screen addiction can directly and indirectly affect children's screen addiction through parental anxiety and the parent-child relationship. The findings contribute to the development of family protection mechanisms against screen addiction in children.

A Study of Occupational Therapy Strategies and Psychological Regulation of Students' Internet Addiction in the Mobile Social Media Environment

This paper provides an in-depth research analysis of occupational therapy strategies and psychological regulation of students' Internet addiction in the existing mobile social media environment. Based on the definition of Internet use peer pressure, a preliminary scale with 2 dimensions of specific behavioral pressure and psychological cognitive pressure was developed. First, a professor of mental health education and a master's degree student in mental health education were invited to rate the scale, while 47 junior high school students were selected to try the scale to ensure that the questions of the scale were clearly expressed. Secondly, 461 subjects were selected to take the initial test of the scale, and item tests and exploratory factor analysis were conducted to ensure that the structure of the scale was as expected and the scale was expressed to psychometric standards. Finally, 810 subjects were selected for the scale retest, and item analysis and validated factor analysis were conducted, and their results met the psychometric criteria. Student peer attachment significantly and positively predicted adolescent Internet addiction; Internet use peer pressure played an incomplete mediating role in the prediction of peer attachment to Internet addiction; loneliness played a moderating role in the pathway of peer attachment to Internet addiction, and loneliness also played a moderating role in the pathway of peer attachment to Internet use peer pressure. The attitude towards online games is entertainment to kill time, a tool to escape the pressure of study and to gain the fun of friends comparing with each other. The main online motivations of adolescents included individual and situational factors, and behaviors were characterized by pan-entertainment and gamification, mainly through mobile social networks to obtain external information and knowledge, maintain interpersonal relationships, and gain a sense of belonging; they were characterized by a fixation on time, space, and online content. The interaction of family members is more of a behavioral habit, and the communication habits and behavior patterns established in the family will influence the construction of children's relationships with others, while parents' head-down behavior will also influence children's attention to various needs of an Internet-dependent behavior problem, which in turn affects children's problem-solving and intimate relationships with family members.

Problematic Child Media Use During the COVID-19 Pandemic

OBJECTIVES

Assess how family stressors (including structural stressors, social determinants of health inequities, and parent psychological distress) relate to media rule implementation and problematic child media use during the coronavirus disease 2019 pandemic.

METHODS

Nationally representative survey of 1000 United States parents with at least one 6 to 17 year old child was conducted in October through November 2020.

RESULTS

Problematic use was greater in families where parents were employed full time, present in the home (eg, working from home), had low levels or formal educational attainment, and were experiencing more psychological distress. Although there was a small decline in the number of media-related rules implemented during the pandemic (fewer parents enforced screen limits on weekdays or weekends or limited screen use at mealtimes), there was no association between rule implementation and problematic media use.

CONCLUSIONS

Family stressors were associated with problematic child media use during the coronavirus disease 2019 pandemic. As we emerge from the pandemic, it will be important to help parents adjust their family's media practices cognizant of the fact that additional children may have developed problematic screen use behaviors. Such efforts should center the role of structural and social determinants of health inequities on the stressors that families experience and that impact media use.

Screen-Based Media Use Among Children During the COVID-19 Pandemic

This questionnaire-based study was conducted to assess screen-based media use during the coronavirus disease 2019 (COVID-19) pandemic in children (n=278) aged between 1 to 12 years. Television was the most common media available for use (246, 88.5%), and mobile was the next most commonly available media (230, 82.7%). Daily screen time exposure and use of television (P<0.001), computer/Laptop (P<0.001), and tablet (P=0.001) were significantly more common in those aged 5–12 years. Majority (214, 76.9%) were using screen-based media for educational purposes.

Associations between screen time and internalizing disorder diagnoses among 9- to 10-year-olds

BACKGROUND

Children and adolescents spend an increasing amount of time with screen media. Identifying correlates of youth mental disorders has become more urgent with rates of depression, self-harm, suicide attempts, and suicide deaths rising sharply among U.S. children and adolescents after 2012. This study examined the relationship between screen time and internalizing disorders in preadolescent children between the ages of 9 and 10.

METHODS

Participants were 9- and 10-year-old youth (n = 11,780) in the baseline of the multi-site Adolescent Brain and Cognitive Development Study (ABCD). Youth reported the number of hours a day they spent watching TV shows or movies, watching videos online, playing video games, texting, using social media, and video chatting. Youth responded to an abbreviated version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-5), a semi-structured clinical interview measuring current and past symptoms of internalizing disorders using DSM-5 criteria.

RESULTS

Youth spending 2 or more hours (vs. less than 2) a day with screen media were more likely to fit criteria for depressive disorders, self-harm, and suicidal ideation or attempts, even after adjustment for demographic covariates. For anxiety disorders, associations with digital media use (social media, texting, gaming, and online videos) were stronger than with screen time generally.

LIMITATIONS

This is a cross-sectional study utilizing retrospective screen time reports, which limits our ability to determine causality and the accuracy of the reports.

CONCLUSIONS

Preadolescents who spend more time using screens, especially digital media, are more likely to fit DSM-5 criteria for internalizing disorders.

Adolescent Resilience during the COVID-19 Pandemic: A Review of the Impact of the Pandemic on Developmental Milestones

This review explores the literature regarding the ways in which the COVID-19 pandemic has affected the navigation of developmental milestones among adolescents, specifically those in late adolescence, across several domains of their lives. The exploration is contextualized globally, focusing on five key areas: mental health, physical health, education, peer relationships, and family relationships. Implications for practice and interventions are explored in each key area to provide recommendations for those working with adolescents, as well as future research. The changes brought about by the pandemic and the readjustment to what some have referred to as the “new normalcy” will undoubtedly have lasting effects on all areas of life for this cohort of adolescents, who have shown remarkable resilience navigating this new and unfamiliar world. These changes are synthesized, with the aim to highlight differences and similarities of the shared experiences of the pandemic globally. After exploring the current realities, this chapter goes on to outline the ways in which the experience of such a significant developmental period of one’s life during the COVID-19 pandemic will have an impact on adolescents for years to come. Although it is still impossible to comprehend the long-term effects, in examining proximal effects, we can postulate distal implications and potential future effects, as well as possible ways to mitigate these implications as we transition back to more of what was experienced pre-pandemic life, from a post-pandemic experience.

Children aged 3-4 years were more likely to be given mobile devices for calming purposes if they had weaker overall executive functioning

AIM

Young children with weaker self-regulation use more digital media, but studies have been limited by parent-reported screen time measures. We examine associations between early childhood executive functioning and objective mobile device usage.

METHODS

The parents of 368 American children (51.6% male) aged 3-4 years of age completed standardised measures of executive functioning, parenting stress and household chaos. They provided mobile sampling data for 1 week in 2018-2019 and reported how often the children used mobile devices to calm themselves.

RESULTS

The children's mean age was about 3.8 years. A third of the children who were given devices to calm them down had weaker executive functioning in the overall and multivariable models, including working memory, planning and organisation. So did 39.7% of the children who used educational apps. Streaming videos, using age-inappropriate apps and using the mobile device for more than1 h per day were not associated with executive functioning levels. Parenting stress and household chaos did not moderate the associations.

CONCLUSION

This study confirms previous studies that suggesting that children with weaker overall executive functioning used devices more for calming purposes. It also raises questions about whether children with weaker executive functioning should use educational apps.

An Initial Investigation into Parental Perceptions Surrounding the Impact of Mobile Media Use on Child Behavior and Executive Functioning

Children demonstrate increasing early engagement with mobile media facilitated by its portability and interactivity. Parents are known to employ a range of mediation strategies for mobile media use but continue to have limited awareness about the impact of mobile media on their child’s executive functioning. Mobile media use has previously been shown to be negatively correlated with the executive functioning development of a child; however, little is known of how parents approach their child’s mobile media use. This study employed a survey design ( $N=281$ ) to examine how parents access information related to mobile media and document their perspectives about the impact of mobile media on their child’s behavior and executive functioning. Correlational analyses and cooccurrence graphs showed that parents implement several mediation strategies but rarely access guidelines on mobile media use. A confirmatory factor analysis examined the model fit for four latent constructs of the Behavior Rating Inventory of Executive Function (BRIEF®), which included the Inhibit, Emotional Control, Initiate, and Working Memory scales. Structural equation modelling substantiated the association between parental perception of negative impacts of mobile media related to their child’s behavior, academics, and/or attention and a lower observed executive functioning. Overall, these findings suggest that parents recognize the negative impacts of mobile media on their child’s behavior, and this is associated with how they see the development of their child’s executive functioning. The results emphasize the importance of educating parents as to the role of mobile media in shaping their child’s behavior and associated executive functions.

Children's screen and problematic media use in the United States before and during the COVID-19 pandemic

This mixed methods study examined parent-reported child screen media use before and during the COVID-19 pandemic by examining 2019-2020 changes in parent perceptions of media, screen media use (SMU), and problematic media use (PMU) in children aged 2-13 years (N = 129; 64 boys, 64 girls, 1 nonbinary; 90.7% White, 4.6% Hispanic/Latino, 0.8% Black, 8.5% multiethnic; primarily middle-to-high income). Quantitative analyses showed a significant SMU and PMU increase (medium effect size). There was a steeper increase in PMU among school-age (older) children. Together, the qualitative and quantitative results suggest that the PMU and SMU increase were influenced by distal, proximal, and maintaining factors including the COVID-19 pandemic, distance learning, child behaviors, other children, parental mediation, and positive media reinforcement.

Adverse Childhood Experiences and Problematic Media Use: Perceptions of Caregivers of High-Risk Youth

Youth with a history of adverse childhood experiences (ACEs) are more likely to develop risky health behaviors. With the increase of media use in the general population, it is likely that these high-risk youth are developing maladaptive behaviors associated with media use (i.e., problematic media use). The goals of this article are (1) to describe symptoms of problematic media use in high-risk youth and (2) to determine whether ACEs are related to problematic media use in this population. Data were collected through online questionnaires from 348 parents or legal guardians of children ages 5 to 18 years, the majority of whom had been adopted. Parents and guardians reported on the child's history of ACEs and completed the Problematic Media Use Measure-Short Form (PMUM-SF). Almost half of the participants reported that their child had a history of four or more ACEs (48.9%). Caregivers of foster or adopted children reported more symptoms of problematic media use than those reporting on their biological children. After adjusting for covariates, the number of ACEs predicted problematic media use above and beyond variance explained by demographic factors or screen time amount. Children with a history of ACEs had higher problematic media use compared to children without ACEs.

A qualitative case study about overuse of digital play at home

The prevalence of digital play devices, including tablets and smartphones, has led to overuse among some young children. The purpose of this research is to examine the overuse cases among young children. Participants of this qualitative case study were five children aged five to seven years, their parents, and a psychiatrist. The data were mainly obtained through semi-structured interviews. Interviews were further supported by close observations, a collection of digital play diaries, as well as an interview with a psychiatrist who specializes in childhood gaming addiction. Then data analyzed using content analysis techniques. The results are presented in five themes: practices, reasons, feelings about overuse, restricting playtime, and content. The first three themes described the nature of the overuse, while the last two themes described the parents' efforts to restrict their children's digital play. Findings revealed that the joint effects of different factors triggered children's overuse, that parents and children felt a range of emotions from happiness to aggression, and that parents' restrictive mediation strategies were mostly infective.