Does TV viewing during toddlerhood predict social difficulties and conduct problems?

The relationship between screen time before bedtime and behaviors of preschoolers with autism spectrum disorder and the mediating effects of sleep

BACKGROUND

There are overlapping effects of screen time and sleep on children's behavior. The purpose of this study was to explore the relationship of screen time with behavior problems in children with autism spectrum disorder (ASD) and the probable mediating effects of sleep, in order to provide evidence for the need for clinical identification and intervention.

METHODS

A sample of 358 preschoolers with ASD were included. We investigated the children's basic characteristics of sex and age, ASD symptoms (ABC, CARS, and ADOS-2), neurodevelopment (GDS-C), sleep habits (CSHQ), and behavior (CBCL). Pearson correlation tests were used to determine the direct correlations among children's screen time, CBCL, and CSHQ. Linear regression analysis was used to explore whether screen time predicted total score of CBCL. Multi-step linear regression analysis was used to investigate the mediating effect of sleep on the relationship between screen time and total score of CBCL.

RESULTS

Screen time before bedtime was correlated with CBCL and CSHQ, which indicated that screen time before bedtime was correlated with sleep and behavior in children with ASD. Screen time before bedtime was a predictor of CBCL total score (indicating children's behavior), and CSHQ total score (indicating children's sleep habits) played a partial mediating role between screen time before bedtime and children's behavior.

CONCLUSION

Clinicians should support and educate parents of children with ASD, which should focus on managing screen time, especially screen time before bedtime.

High levels of screen time were associated with increased probabilities of lagged development in 3-year-old children

AIM

This study determined whether higher screen time was associated with the development of 3-year-old children in Taiwan. It also examined whether differences would be found between television and other screen-based media in the probability of lagged development.

METHODS

We examined 2139 children aged 3 years and their parents. The association between daily screen time was assessed using multiple logistic regression analysis. All the odds ratios (ORs) were calculated using the rates of lagged developmental achievement, with the group who used screens for less than 1 h a day as the reference category. Screen time comprised television and other screen-based media, such as smartphones, touch screens, computers and laptops.

RESULTS

Children who used screens for more than 3 h per day had the lowest developmental scores and highest probabilities of lagged development. The children who used other screen-based media for more than 1 h per day had greater probabilities of lagged developmental achievements (ORs 1.85-4.98, all p < 0.05) than those who watched television for the same amount of time (OR 1.41-2.77, all p < 0.05).

CONCLUSION

Increased screen time was associated with higher probabilities of lagged developmental achievement in multiple development domains in 3-year-old children, particularly other screen-based media.

Predictors of television at bedtime and associations with toddler sleep and behavior in a medicaid-eligible, racial/ethnic minority sample

This study examined predictors of TV use at bedtime and associations with toddlers' sleep and behavior using data from the Smart Beginnings study with 403 Medicaid-eligible, racial/ethnic minority participants from two cities in the United States. We first estimated predictors of TV use at bedtime at 18 months. We then examined whether TV at bedtime was associated with concurrent parent-report of nighttime sleep duration and quality, and later problem behavior at 24 months. Results showed that around half of the sample reported using TV at bedtime with their toddlers, and particularly first-time mothers and those receiving public assistance. We also found that use of TV at bedtime was related to concurrent sleep issues and increases in later problem behavior. Mediational path analyses revealed that TV at bedtime affected behavior via sleep quality. Despite the heterogeneity within this Medicaid-eligible sample, the results underscore the universally harmful effects of TV use at bedtime and lend support for structuring nighttime routines for toddlers to promote better sleep and behavioral outcomes.

Measurement of screen time among young children aged 0-6 years: A systematic review

The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.

Infant media use: A harm reduction approach

There are a myriad of potentially harmful developmental outcomes associated with infant digital media use. Studies revealing risk associated with early media use have informed the current American Academy of Pediatrics (AAP) recommendations that discourage most digital media use among children under 18 months of age. Recent research advances, however, suggest potential benefits of technology engagement in this age group. Additionally, surveys of parents reveal that most infants engage with digital media for at least 30 min a day, exceeding the AAP recommendations. In response to these discoveries and cultural trends, some scholars have made compelling cases to adapt the AAP guidelines for infants. A helpful model for developing infant digital media use guidelines for families may be the harm reduction approach. The intent of this review is to suggest adaptations to the AAP guidelines for infant media engagement using a harm reduction framework. This review describes the challenge of restrictive guidelines, briefly summarizes the harm reduction approach, provides a review of risks and benefits associated with infant media use in each developmental domain (physical, cognitive, and socioemotional), summarizes correlates of infant screen media use, and examines intervention strategies for reducing screen time. The paper concludes with examples of possible adaptations to current AAP infant media use recommendations using harm reduction and bioecological frameworks.

Adverse Childhood Experiences and Digital Media Use Among U.S. Children

INTRODUCTION

Increasing amounts of time using digital media (i.e., texting, social media, electronic gaming, and general smartphone and computer use) among children and adolescents is becoming a growing concern given its potentially deleterious effects on health. However, little is known about the social and developmental underpinnings of digital media use among children and youth. This study examines the link between adverse childhood experiences and digital media use among a recent, nationally representative sample of children and adolescents.

METHODS

Data pertaining to children/youth aged 6-17 years from the 2018 National Survey of Children's Health were analyzed in 2020 (N=21,954). The association between 9 distinct forms of childhood adversity and time spent on digital media among youth was assessed using multinomial logistic regression. The mediating roles of family-, parent-, and child-level factors were determined using the Karlson-Holm-Breen method.

RESULTS

Net of covariates, the relative risk of heavy digital media use was 3 times higher among youth experiencing ≥4 adverse childhood experiences than among those experiencing none. Both family resilience and connection as well as parenting stress emerged as significant mediators of the association between adverse childhood experiences and heavy digital media use, collectively accounting for approximately 39% of the association.

CONCLUSIONS

In an effort to mitigate heavy digital media use, providers and practitioners who consistently interact with youth should consider screening for adverse childhood experiences and referring high-risk youth and their families for various prevention and treatment programs poised to address these risk factors.

Infant screen media usage and social-emotional functioning

There has been little research on whether and how screen media usage affects social-emotional (SE) function prior to two years of age, even though early SE development is understood to be nurtured through interpersonal experience, mainly withthe primary caregiver. This study sought to characterise infant screen media usage and understand how it may link with concurrent SE function by testing associated effects on reducing parent-infant interaction and of parent psychological factors. Questionnaire responses from 327 UK-based parents of infants aged 6-24 months showed diverse usage in the amount of time spent on screen media ('screen time') and amount of parental involvement (co-sharing and co-referencing). Infants with possible SE delay experienced more screen time than those at low risk. The study tested three mediation models and found support for the displacement and not distancing hypothesis based on this community sample. While screen time predicted both SE competence and SE problems, reduced parent-infant play partially mediated the effect on SE competence. Parent depressed mood was positively linked with infant SE problems, but there was little evidence that increased screen time mediated this effect. Also, parent reflective function and attitudes toward parent-infant play were unrelated to screen time. Though longitudinal study is warranted, the findings implicate screen media usage as potentially directly and indirectly relevant when addressing infant mental health.

Parental education, television exposure, and children's early cognitive, language and behavioral development

The association between television exposure and children's development is subject to controversial debates. Heavy television exposure may be detrimental to children by overstimulating their developing brains. It may also infringe on time that children would otherwise spend on more developmentally beneficial activities or parental interactions. In the present analysis, we use data from the 2004/5 birth cohort of the Growing Up in Scotland study to investigate relations between hours of weekly television measured around the ages of two to four and as average over this period with children's linguistic, cognitive, and behavioral outcomes around the age of five. Our analysis shows differences in the level and growth of television exposure by parental education. However, we did not find any substantive associations between television exposure and children's cognitive or language ability. We found small associations of television exposure with conduct problems and prosocial behavior, particularly for children of less-educated parents. Overall, the results suggest that the impact of television on children's development is less pronounced than often assumed.