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Liu X, Geng S, Lei T, Cheng Y, Yu H. Connections between Parental Phubbing and Electronic Media Use in Young Children: The Mediating Role of Parent-Child Conflict and Moderating Effect of Child Emotion Regulation. Behav Sci (Basel) 2024; 14:119. [PMID: 38392472 PMCID: PMC10886405 DOI: 10.3390/bs14020119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
In this digital age, where parental attention is often diverted by digital engagement, the phenomenon of "parental phubbing," defined as parents ignoring their children in favor of mobile devices, is scrutinized for its potential impact on child development. This study, utilizing questionnaire data from 612 parents and Structural Equation Modeling (SEM) with moderated mediation, examines the potential association between parental phubbing and young children's electronic media use. The findings revealed a correlation between parental phubbing and increased electronic media use in children. Parent-child conflict, informed by instances of parental phubbing, was identified as a partial mediator in this relation. Notably, children's emotion regulation emerged as a moderating factor, with adept regulation linked to reduced adverse effects of parental phubbing and improved relational harmony. These findings underscore the importance of parental awareness of their digital behaviors and the benefits of fostering robust parent-child relationships and supporting children's emotional regulation to nurture well-adjusted "digital citizens" in the contemporary media landscape.
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Affiliation(s)
- Xiaocen Liu
- College of Preschool Education, Capital Normal University, Beijing 100048, China
| | - Shuliang Geng
- College of Preschool Education, Capital Normal University, Beijing 100048, China
| | - Tong Lei
- College of Preschool Education, Capital Normal University, Beijing 100048, China
| | - Yan Cheng
- College of Preschool Education, Capital Normal University, Beijing 100048, China
| | - Hui Yu
- College of Preschool Education, Capital Normal University, Beijing 100048, China
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Han J, Koser K, Mamey MR, Vanderbilt DL, Schonfeld DJ, Yin L, Deavenport-Saman A. Mediation of Parental Aggravation in the Association Between ADHD Severity and Electronic Media Use: A National Survey of Children's Health Study. J Atten Disord 2024; 28:127-138. [PMID: 37905519 DOI: 10.1177/10870547231205028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To determine whether the association between ADHD severity and electronic media use was mediated by parental aggravation. METHODS This was a retrospective analysis from the 2016 to 2017 National Survey of Children's Health (NSCH) involving children ages of 3 to 17 years with parent-reported ADHD (n = 5,930). Path analyses were used to model the relationships between ADHD severity with parental aggravation (PA) as a mediator, and electronic device (ED) and television (TV) use as outcomes, controlling for covariates. RESULTS Parental aggravation mediated the relationship between ADHD severity and ED use and TV use (indirect effects: β = .02, p < .001; β = .01, p = .004). When stratified by age, the mediation effect between ADHD and ED use remained significant for adolescents and school-age children, and mediation between ADHD and TV use remained significant only for adolescents. CONCLUSION These findings suggest a need to develop targeted interventions to address PA and manage excessive electronic media use in children with moderate/severe ADHD.
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Affiliation(s)
- Jennifer Han
- Kaiser Permanente Riverside Medical Center, CA, USA
| | | | | | - Douglas L Vanderbilt
- Children's Hospital Los Angeles, CA, USA
- USC Keck School of Medicine, Los Angeles, CA, USA
| | - David J Schonfeld
- Children's Hospital Los Angeles, CA, USA
- USC Keck School of Medicine, Los Angeles, CA, USA
| | - Larry Yin
- USC Keck School of Medicine, Los Angeles, CA, USA
- Children's Hospital Los Angeles, CA, USA
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Zoromba MA, Abdelgawad D, Hashem S, El-Gazar H, Abd El Aziz MA. Association between media exposure and behavioral problems among preschool children. Front Psychol 2023; 14:1080550. [PMID: 37546444 PMCID: PMC10403062 DOI: 10.3389/fpsyg.2023.1080550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/21/2023] [Indexed: 08/08/2023] Open
Abstract
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.
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Affiliation(s)
- Mohamed A. Zoromba
- College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Psychiatric and Mental Health Nursing Department, Mansoura University, Mansoura, Egypt
| | - Doaa Abdelgawad
- Department of Pediatric Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Sahar Hashem
- Department of Pediatric Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Heba El-Gazar
- Department of Nursing Administration, Faculty of Nursing, Port Said University, Port Said, Egypt
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Rega V, Gioia F, Boursier V. Problematic Media Use among Children up to the Age of 10: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105854. [PMID: 37239580 DOI: 10.3390/ijerph20105854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
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.
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Affiliation(s)
- Valeria Rega
- Department of Humanities, University of Naples Federico II, 80100 Naples, Italy
| | - Francesca Gioia
- Department of Humanities, University of Naples Federico II, 80100 Naples, Italy
| | - Valentina Boursier
- Department of Humanities, University of Naples Federico II, 80100 Naples, Italy
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Eirich R, McArthur BA, Anhorn C, McGuinness C, Christakis DA, Madigan S. Association of Screen Time With Internalizing and Externalizing Behavior Problems in Children 12 Years or Younger: A Systematic Review and Meta-analysis. JAMA Psychiatry 2022; 79:393-405. [PMID: 35293954 PMCID: PMC8928099 DOI: 10.1001/jamapsychiatry.2022.0155] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Importance Currently, there is a lack of consensus in the literature on the association between screen time (eg, television, video games) and children's behavior problems. Objective To assess the association between the duration of screen time and externalizing and internalizing behavior problems among children 12 years or younger. Data Sources For this systematic review and meta-analysis, MEDLINE, Embase, and PsycINFO databases were searched for articles published from January 1960 to May 2021. Reference lists were manually searched for additional studies. Study Selection Included studies measured screen time (ie, duration) and externalizing or internalizing behavior problems in children 12 years or younger, were observational or experimental (with baseline data), were available in English, and had data that could be transformed into an effect size. Studies conducted during the COVID-19 pandemic were excluded. Of 25 196 nonduplicate articles identified and screened for inclusion, 595 met the selection criteria. Data Extraction and Synthesis The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Extracted variables were child age, sex, and socioeconomic status; informants and measurement type for screen time and behavior problems; study publication year; and study design and quality. Data were extracted by 2 independent coders and were pooled using a random-effects model. Main Outcomes and Measures The primary outcome was the association of screen time duration with externalizing (eg, aggression, attention deficit/hyperactivity disorder symptoms) and internalizing (eg, depression, anxiety) behaviors or diagnoses. Results Of the 595 full-text articles assessed for eligibility, 87 studies met all inclusion criteria, comprising 98 independent samples and 159 425 participants (mean [SD] age, 6.07 [2.89] years; 83 246 [51.30%] male). Increased duration of screen time had a small but significant correlation with more externalizing problems (90 samples; r, 0.11; 95% CI, 0.10-0.12) and internalizing problems (43 samples; r, 0.07; 95% CI, 0.05-0.08) in children. Several methodological moderators explained between-study heterogeneity. There was evidence of significant between study heterogeneity (I2 = 87.80). Conclusions and Relevance This systematic review and meta-analysis found small but significant correlations between screen time and children's behavior problems. Methodological differences across studies likely contributed to the mixed findings in the literature.
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Affiliation(s)
- Rachel Eirich
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Ciana Anhorn
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Claire McGuinness
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Dimitri A Christakis
- Seattle Children's Hospital Research Institute, University of Washington, Seattle.,Editor, JAMA Pediatrics
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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Wilaisakditipakorn TJ, Ievers-Landis CE, Malay S, Burkhart K, Ibrahim S, Kralovic S, Diekroger EA. Sleep and media use among children with neurodevelopmental disorders during the COVID-19 pandemic. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2021.2013222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Tanaporn Jasmine Wilaisakditipakorn
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Carolyn E. Ievers-Landis
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sindhoosha Malay
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kimberly Burkhart
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sally Ibrahim
- Division of Pediatric Pulmonology and Sleep Medicine, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Shanna Kralovic
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Elizabeth A. Diekroger
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Li X, Vanderloo LM, Keown-Stoneman CDG, Cost KT, Charach A, Maguire JL, Monga S, Crosbie J, Burton C, Anagnostou E, Georgiades S, Nicolson R, Kelley E, Ayub M, Korczak DJ, Birken CS. Screen Use and Mental Health Symptoms in Canadian Children and Youth During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2140875. [PMID: 34962557 PMCID: PMC8715351 DOI: 10.1001/jamanetworkopen.2021.40875] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE Longitudinal research on specific forms of electronic screen use and mental health symptoms in children and youth during COVID-19 is minimal. Understanding the association may help develop policies and interventions targeting specific screen activities to promote healthful screen use and mental health in children and youth. OBJECTIVE To determine whether specific forms of screen use (television [TV] or digital media, video games, electronic learning, and video-chatting time) were associated with symptoms of depression, anxiety, conduct problems, irritability, hyperactivity, and inattention in children and youth during COVID-19. DESIGN, SETTING, AND PARTICIPANTS A longitudinal cohort study with repeated measures of exposures and outcomes was conducted in children and youth aged 2 to 18 years in Ontario, Canada, between May 2020 and April 2021 across 4 cohorts of children or youth: 2 community cohorts and 2 clinically referred cohorts. Parents were asked to complete repeated questionnaires about their children's health behaviors and mental health symptoms during COVID-19. MAIN OUTCOMES AND MEASURES The exposure variables were children's daily TV or digital media time, video game time, electronic-learning time, and video-chatting time. The mental health outcomes were parent-reported symptoms of child depression, anxiety, conduct problems and irritability, and hyperactivity/inattention using validated standardized tools. RESULTS This study included 2026 children with 6648 observations. In younger children (mean [SD] age, 5.9 [2.5] years; 275 male participants [51.7%]), higher TV or digital media time was associated with higher levels of conduct problems (age 2-4 years: β, 0.22 [95% CI, 0.10-0.35]; P < .001; age ≥4 years: β, 0.07 [95% CI, 0.02-0.11]; P = .007) and hyperactivity/inattention (β, 0.07 [95% CI, 0.006-0.14]; P = .04). In older children and youth (mean [SD] age, 11.3 [3.3] years; 844 male participants [56.5%]), higher levels of TV or digital media time were associated with higher levels of depression, anxiety, and inattention; higher levels of video game time were associated with higher levels of depression, irritability, inattention, and hyperactivity. Higher levels of electronic learning time were associated with higher levels of depression and anxiety. CONCLUSIONS AND RELEVANCE In this cohort study, higher levels of screen use were associated poor mental health of children and youth during the COVID-19 pandemic. These findings suggest that policy intervention as well as evidence-informed social supports are needed to promote healthful screen use and mental health in children and youth during the pandemic and beyond.
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Affiliation(s)
- Xuedi Li
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leigh M. Vanderloo
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
- School of Occupational Therapy, Western University, London, Ontario, Canada
- ParticipACTION, Toronto, Ontario, Canada
| | - Charles D. G. Keown-Stoneman
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Alice Charach
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L. Maguire
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Suneeta Monga
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christie Burton
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Research Institute, Toronto, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Rob Nicolson
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queens University, Kingston, Ontario, Canada
| | - Muhammad Ayub
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada
| | - Daphne J. Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S. Birken
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Tooth LR, Moss KM, Mishra GD. Screen time and child behaviour and health-related quality of life: Effect of family context. Prev Med 2021; 153:106795. [PMID: 34508730 DOI: 10.1016/j.ypmed.2021.106795] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/02/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022]
Abstract
This study investigated family contextual effects on the association between screen time, behaviour and health-related quality of life (HRQOL) in child siblings. Data were from 1772 participants in the Australian Longitudinal Study of Women's Health 1973-78 cohort and their three youngest children (N = 4010 siblings) aged two to 12, collected in Mothers and their Children's Health cross-sectional sub-study (2016/17). The exposure was average daily recreational screen time (televisions, computers, tablets, mobile phones, electronic games). Outcomes were child overall behaviour and prosocial behaviour, and psychosocial and physical HRQOL. Multilevel models were used to test 1) the absolute effect of screen time, and 2) change in the child's outcomes when their own screen time changes relative to their siblings (within-family contextual effects) and change in the child's outcomes when the sibling average screen time changes (between-family contextual effects). The children were average 7.37 years (SD 2.76). There was an absolute effect of screen time on behaviour and HRQOL. Between-family effects were found for child total behaviour (0·22 (95%CI, 0.06, 0.37)) and prosocial behaviour (-0.10 (-0.17, -0.04)), but there were no within-family effects. For HRQOL, within-family effects were found for psychosocial (-0.97 (-1.91, -0.02)) and physical (-1.32 (-2.25, -0.39)) HRQOL, but no between-family effects were found. In conclusion, the higher the average screen time by all children in the family, the worse the child's behaviour, while the greater the deviation of the child's screen time from their siblings, the poorer their HRQOL. Family contextual factors should be considered in screen time research and screen time recommendations.
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Affiliation(s)
- Leigh R Tooth
- The University of Queensland, Centre for Longitudinal and Life Course Research, School of Public Health, Herston, Queensland 4006, Australia.
| | - Katrina M Moss
- The University of Queensland, Centre for Longitudinal and Life Course Research, School of Public Health, Herston, Queensland 4006, Australia
| | - Gita D Mishra
- The University of Queensland, Centre for Longitudinal and Life Course Research, School of Public Health, Herston, Queensland 4006, Australia
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Srisinghasongkram P, Trairatvorakul P, Maes M, Chonchaiya W. Effect of early screen media multitasking on behavioural problems in school-age children. Eur Child Adolesc Psychiatry 2021; 30:1281-1297. [PMID: 32856131 DOI: 10.1007/s00787-020-01623-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/17/2020] [Indexed: 11/25/2022]
Abstract
Screen media multitasking (SMM), the act of exposure ≥ 2 screen media simultaneously, is increasing nowadays. Single media use was associated with child's behavioural problems in previous studies. However, the associations between SMM since early childhood and behavioural problems in school-age children had not been elucidated. This study aimed to investigate the association between SMM from age 6 months to 4 years and behavioural problems in 6-year-old children. Two hundred and ninety-one (52.6% girls) healthy children were enrolled since age 6 months and 259 participants were followed-up until age 6 years. SMM was obtained at age 6, 12, 18, 24 months, 3 and 4 years. Behavioural concerns were assessed at age 4 years by the Child Behaviour Checklist and by both the Strengths and Difficulties Questionnaire with the Conners Kiddie Continuous Performance Test at age 6 years. Parenting style, cognitive ability, and baseline characteristics were also ascertained. Partial least squares path modelling was performed to determine both direct and indirect relationships among variables. Results showed that children who had been exposed to SMM for longer duration, specifically at age 18 months, showed more behavioural problems at age 4 and 6 years. Positive parenting during preschool and behavioural concerns at age 4 years were main mediators of those associations. Moreover, SMM in minutes at age 18 months was related to decreased preschool cognition. To minimise behavioural problems in school-age children, SMM should be avoided before 2 years of age so that positive parenting may be successfully implemented since early childhood.
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Affiliation(s)
- Pornchada Srisinghasongkram
- Maximizing Thai Children's Developmental Potential Research Unit, Division of Growth and Development, Department of Paediatrics, Sor Kor Building, 11th Floor, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV. Road, Pathumwan, Bangkok, 10330, Thailand
- Division of Growth and Development, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Pon Trairatvorakul
- Maximizing Thai Children's Developmental Potential Research Unit, Division of Growth and Development, Department of Paediatrics, Sor Kor Building, 11th Floor, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV. Road, Pathumwan, Bangkok, 10330, Thailand
- Division of Growth and Development, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Weerasak Chonchaiya
- Maximizing Thai Children's Developmental Potential Research Unit, Division of Growth and Development, Department of Paediatrics, Sor Kor Building, 11th Floor, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV. Road, Pathumwan, Bangkok, 10330, Thailand.
- Division of Growth and Development, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
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Alghamdi S, Bawageeh D, Alkhaibari H, Almutairi A, Aljuhani S. Media use and behavioral disorders among Saudi Arabian children. BELITUNG NURSING JOURNAL 2021; 7:31-36. [PMID: 37469794 PMCID: PMC10353598 DOI: 10.33546/bnj.1294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 07/21/2023] Open
Abstract
Background Despite children's frequent use of electronic devices, there is a lack of evidence showing how such media use influences their behavior. Objective This study was to assess the relationship between media use and behavior among a sample of children aged three to 11 years. Methods This was a descriptive cross-sectional study. An electronic self-administered questionnaire was completed from January 2020 to March 2020 by a convenience sample of 234 parents with healthy children in the target age group. Descriptive statistics and One-Way Analysis of Variance (ANOVA) were used for data analysis. Results There was no significant difference in children's behavior according to the type of media [F(3, 230) = 1.673, p = 0.174]. In contrast, there was a significant difference in children's behavior according to hours per day of media use [F(4, 229) = 2.701, p = 0.031]. The most commonly used mobile device was the smartphone (n = 87, 37.2%). More than a quarter of the children spent three hours a day using media. Conclusions This study offers insight into associations between children's frequent media use and their behavior. The results suggest that the significant factor associated with behavioral problems is not the type of media but the time spent using it. Nurses are encouraged to use these findings in developing educational programs that raise awareness among parents and children regarding the consequences of excessive media use.
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Affiliation(s)
- Salmah Alghamdi
- Maternity and Child Health Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Duaa Bawageeh
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hessa Alkhaibari
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amwaj Almutairi
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shoug Aljuhani
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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11
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Are psychological symptoms a risk factor for musculoskeletal pain in adolescents? Eur J Pediatr 2021; 180:2173-2183. [PMID: 33655417 PMCID: PMC8195761 DOI: 10.1007/s00431-021-04002-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/31/2021] [Accepted: 02/18/2021] [Indexed: 12/21/2022]
Abstract
Adolescent musculoskeletal pain is common and is associated with musculoskeletal pain in adulthood. Psychological symptoms, also common in adolescence, have been shown to be associated with musculoskeletal pain, but the current evidence is mixed and may be dependent on effect modifiers. This study investigated whether adolescents with psychological symptoms (internalizing and externalizing constructs) at age 13 years were at higher odds for musculoskeletal pain at age 17 years and whether the associations were modified by pubertal status and sex. A prospective cohort design examined data on 3865 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC). Associations between baseline (aged 13 years) internalizing and externalizing symptoms and musculoskeletal pain at follow-up (aged 17 years) were investigated using logistic regression producing odds ratios (OR) and 95% confidence intervals (95% CI). In total 43.1% of adolescents reported musculoskeletal pain at follow-up. Externalizing symptoms at baseline increased the odds of musculoskeletal pain (OR 1.68, 95% CI 1.28, 2.20), and internalizing symptoms demonstrated a non-significant increase (OR 1.26, 95% CI 0.98, 1.62). Effect modification analysis showed an increased effect dependent on pubertal status.Conclusion: Adolescents with externalizing symptoms, and to some extent internalizing symptoms, are at increased odds of later musculoskeletal pain. Future research is now required to understand the reasons for these associations. What is Known: • Current evidence regarding the association between internalizing symptoms and externalizing symptoms and future musculoskeletal pain in adolescents is mixed. What is New: • This study found that adolescents with externalizing symptoms, and to some extent internalizing symptoms, are at increased odds for musculoskeletal pain, with an increased influence dependent on pubertal status. • These results are of interest for the development of timely preventative interventions designed to reduce the risk of musculoskeletal pain.
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Liu S, Chang FC, Chiu CH, Li F, Chen PH, Chen CY, Lin YP, Chiang JT. Parent-Child Discrepancies in Reports of Exposure to Violence/Pornography on Mobile Devices and the Impact on Children's Psychosocial Adjustment. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 24:390-398. [PMID: 33211544 DOI: 10.1089/cyber.2020.0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study assessed the discrepancies between reports from parents and children concerning children's exposure to violence/pornography on mobile devices and the impact on the psychosocial adjustment of children. Data were obtained from a sample of 2,230 parent-child dyads recruited from 16 elementary schools (1,140 dyads) in Taiwan and 9 schools (1,090 dyads) in China. A self-administered questionnaire was used. The results showed that about 30 percent of children reported being exposed to violence on mobile devices. Approximately 70 percent of their parents were unaware of their child's exposure to violence on mobile devices. About 16 percent of children reported exposure to pornography on mobile devices, and 80 percent of their parents were unaware of this exposure. Multinomial logistic regression results showed that after controlling for parent and child sociodemographic variables, factors related to parental unawareness of child exposure to violence on mobile devices included a child's ownership of mobile devices, smartphone/tablet use time, a lower level of parental understanding, and a residence in China or in a rural area, whereas the parent-child relationship and a child's smartphone/tablet use time were associated with parents who were unaware of their child's exposure to pornography. Multiple regression results showed that children who were living with household poverty, had a poor parent-child relationship, spent much time using a smartphone/tablet, and with parents who were unaware of their exposure to violence/pornography on mobile devices were more likely to have emotional and behavioral problems.
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Affiliation(s)
- Shumei Liu
- Department of Preschool Education, Hangzhou Normal University, Hangzhou, China
| | - Fong-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Chiung-Hui Chiu
- Graduate Institute of Information and Computer Education, National Taiwan Normal University, Taipei, Taiwan
| | - Fubao Li
- Research Center of Educational Science, Shouguang Education and Physical Bureau, Shouguang, Shandong, China
| | - Ping-Hung Chen
- The Graduate Institute of Mass Communication, National Taiwan Normal University, Taipei, Taiwan
| | - Chen-Yu Chen
- Taipei City Hang-An Seniors' Home Multiple Long-Term Care Services, Taipei, Taiwan
| | - Yi-Pin Lin
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Jeng-Tung Chiang
- Department of Statistics, National Chengchi University, Taipei, Taiwan
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Oswald TK, Rumbold AR, Kedzior SGE, Moore VM. Psychological impacts of "screen time" and "green time" for children and adolescents: A systematic scoping review. PLoS One 2020; 15:e0237725. [PMID: 32886665 PMCID: PMC7473739 DOI: 10.1371/journal.pone.0237725] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/31/2020] [Indexed: 12/14/2022] Open
Abstract
Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5-11 years), early adolescents (12-14 years), and older adolescents (15-18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era.
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Affiliation(s)
- Tassia K. Oswald
- School of Public Health, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Alice R. Rumbold
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sophie G. E. Kedzior
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Vivienne M. Moore
- School of Public Health, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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Mundy LK, Canterford L, Hoq M, Olds T, Moreno-Betancur M, Sawyer S, Kosola S, Patton GC. Electronic media use and academic performance in late childhood: A longitudinal study. PLoS One 2020; 15:e0237908. [PMID: 32877427 PMCID: PMC7467319 DOI: 10.1371/journal.pone.0237908] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 08/05/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The effects of electronic media use on health has received much attention but less is known about links with academic performance. This study prospectively examines the effect of media use on academic performance in late childhood. MATERIALS AND METHODS 1239 8- to 9-year-olds and their parents were recruited to take part in a prospective, longitudinal study. Academic performance was measured on a national achievement test at baseline and 10-11 years of age. Parents reported on their child's duration of electronic media use. RESULTS After control for baseline reading, watching more than two hours of television per day at 8-9 years of age predicted a 12-point lower performance in reading at 10-11 years, equivalent to the loss of a third of a year in learning. Using a computer for more than one hour a day predicted a similar 12-point lower numeracy performance. Regarding cross-sectional associations (presumed to capture short-term effects) of media use on numeracy, after controlling for prior media exposure, watching more than two hours of television per day at 10-11 years was concurrently associated with a 12-point lower numeracy score and using a computer for more than one hour per day with a 13-point lower numeracy performance. There was little evidence for concurrent effects on reading. There was no evidence of short- or long-term associations between videogame use and academic performance. DISCUSSION Cumulative television use is associated with poor reading and cumulative computer use with poorer numeracy. Beyond any links between heavy media use and health risks such as obesity, physical activity and mental health, these findings raise a possibility of additional risks of both television and computer use for learning in mid-childhood. These findings carry implications for parents, teachers and clinicians to consider the type and timing of media exposure in developing media plans for children.
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Affiliation(s)
- Lisa K. Mundy
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Louise Canterford
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Monsurul Hoq
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Margarita Moreno-Betancur
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susan Sawyer
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Silja Kosola
- Integrated Health and Social Welfare Unit, New Children’s Hospital, Pediatric Research Center and University of Helsinki, Helsinki, Finland
| | - George C. Patton
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Zink J, Belcher BR, Imm K, Leventhal AM. The relationship between screen-based sedentary behaviors and symptoms of depression and anxiety in youth: a systematic review of moderating variables. BMC Public Health 2020; 20:472. [PMID: 32272906 PMCID: PMC7147040 DOI: 10.1186/s12889-020-08572-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
Background To elucidate the populations and conditions where screen-based sedentary behaviors (SB) and internalizing symptoms are coupled, this review synthesized the evidence for factors that may moderate the associations between screen-based SB, depressive symptoms, and anxiety symptoms among youth. Methods Two independent researchers conducted a systematic literature search of the Medline, psycINFO, and Scopus electronic databases in late 2018 for observational studies assessing moderators of the association between screen-based SB and depressive and anxiety symptoms. Studies among children and adolescents were eligible if moderation was assessed by statistical test (interaction) or stratification; and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines. Results Seventy empirical studies (46 cross-sectional, 19 longitudinal, and 5 both) of 13 different moderating variables of screen-based SB-internalizing symptom associations met the eligibility criteria. Of these, 40 studies were of depressive symptoms, 2 were of anxiety symptoms, and 28 studies assessed symptoms of both. The most consistent evidence of moderation was for screen-type, such that TV viewing was not as strongly associated with internalizing symptoms compared to other forms of screen-based SB. There was also inconsistent evidence for physical activity buffering screen-based SB-internalizing symptom associations and for female sex amplifying screen-based SB-internalizing symptom associations. In general, the body of evidence for anxiety symptoms was more limited than that for depressive symptoms, and were therefore more inconsistent. Conclusions Screen-type, physical activity, and sex may influence the magnitude of screen-based SB-internalizing symptom coupling; highlighting potential sources of heterogeneity of screen-based SB-internalizing symptom associations. Additional studies aimed at understanding potential mechanistic explanations for the above moderators are needed prior to the development of tailored intervention strategies designed to decouple screen-based SB and internalizing symptoms among youth.
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Affiliation(s)
- Jennifer Zink
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 North Soto Street, Third Floor, California, Los Angeles, 90032, USA
| | - Britni R Belcher
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 North Soto Street, Third Floor, California, Los Angeles, 90032, USA.
| | - Kellie Imm
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 North Soto Street, Third Floor, California, Los Angeles, 90032, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 North Soto Street, Third Floor, California, Los Angeles, 90032, USA.,Department of Psychology, University of Southern California, Los Angeles, USA
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Tombeau Cost K, Korczak D, Charach A, Birken C, Maguire JL, Parkin PC, Szatmari P. Association of Parental and Contextual Stressors With Child Screen Exposure and Child Screen Exposure Combined With Feeding. JAMA Netw Open 2020; 3:e1920557. [PMID: 32022883 DOI: 10.1001/jamanetworkopen.2019.20557] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
IMPORTANCE Parents may use screen exposure or screen exposure combined with feeding for infants and toddlers to alleviate their own stress. OBJECTIVE To evaluate the association of individual and contextual stressors with child screen exposure (CSE) and CSE combined with feeding (CSE+F) in children aged 7 to 18 months as measured by parent-reported use and variation in quantity of CSE and CSE+F. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, population-based study drew parent-child participants from TARGet Kids, a network of primary health care research settings throughout Toronto, Ontario, Canada, between November 1, 2011, and July 31, 2018. The included children were aged 7 to 18 months. Exclusion criteria were health conditions affecting growth, acute conditions, chronic conditions, severe developmental delay, and families who were unable to communicate in the English language. Data were analyzed from April 1, 2019, to July 31, 2019. EXPOSURES Parenting stress, child age, child negative affectivity, family living arrangements, and family income were assessed with parent-completed questionnaires. MAIN OUTCOMES AND MEASURES The primary outcome was CSE and the variation in CSE, which represented the amount of background and engaged use of screens (television, videos or DVDs, video games, computers, and mobile devices) in a typical week. The secondary outcome was CSE+F, which represented the frequency of breakfast, lunch, dinner, and snack consumption during screen exposure in a typical week. Both CSE and CSE+F were assessed with the parent-completed Nutrition and Health Questionnaire; Infant Behavior Questionnaire, Revised Very Short; and Parenting Stress Index, Short Form. RESULTS The final sample size was 1085 children for the analysis of CSE and 1083 children for the analysis of CSE+F. Among 914 respondents, the children's mean (SD) age was 11.6 (2.3) months, and 478 (52.3%) were male. Among 910 respondents, 839 (92.2%) were mothers, with a mean (SD) age among 873 respondents of 34.4 (4.2) years. In a typical week, 581 of 779 children (74.6%) were reported to have any CSE, and 321 of 874 children (36.7%) had some CSE+F. Higher parenting stress levels (odds ratio [OR], 1.01; 95% CI, 1.00-1.02; P = .04) and older child age (OR, 1.43; 95% CI, 1.01-2.03; P = .04) were associated with CSE. Higher parenting stress levels (incidence rate [IR], 1.00; 95% CI, 1.00-1.01; P = .002) and lower household income (IR, 1.26; 95% CI, 1.10-1.45; P = .01) were associated with increased CSE. Older child age (OR, 1.79; 95% CI, 1.35-2.38; P < .001) and lower household income (OR, 2.54; 95% CI, 1.72-3.74; P < .001) were associated with CSE+F. Lower household income (IR, 1.21; 95% CI, 1.03-1.42; P = .02) was associated with increased CSE+F. CONCLUSIONS AND RELEVANCE This study found that parenting stress, income, and child age were associated with CSE, and child age and household income were associated with CSE+F. Given these findings, interventions to improve parental coping mechanisms may decrease child screen exposure.
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Affiliation(s)
| | - Daphne Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alice Charach
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Catherine Birken
- Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sick Kids Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sick Kids Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Paediatric Outcomes Research Team, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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The Relationship Among Screen Use, Sleep, and Emotional/Behavioral Difficulties in Preschool Children with Neurodevelopmental Disorders. J Dev Behav Pediatr 2019; 40:519-529. [PMID: 31107771 DOI: 10.1097/dbp.0000000000000683] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Despite evidence that excessive screen use may contribute to negative health, developmental, emotional, and behavioral outcomes, more children are engaging in increasing amounts of screen-related activities. For children with neurodevelopmental conditions, increased screen use could exacerbate emotional/behavioral difficulties (EBDs) by interfering with sleep quantity and quality. AIMS This study examined the possible mediating role of sleep in the relationship between screen use and EBDs in preschool children with neurodevelopmental disorders (NDDs) clinically referred to a child development center in Singapore. METHODS A screen use questionnaire developed for the purposes of the present study, the Children's Sleep Habits Questionnaire, and the Strengths and Difficulties Questionnaire were completed by 367 caregivers of 2- to 5-year-old children with NDDs (39.5% autism spectrum disorder; 36.8% speech-language disorders; 23.7% others). RESULTS Average daily screen use duration was 3.98 hours, with 93.9% exceeding 1 hour of screen time daily. 57.7% of children had screen devices in their bedrooms, while 52% commenced screen use at the age of 18 months or earlier. Sleep problems fully mediated the relationship between the number of bedroom screen devices and children's EBDs, as well as between the age of first screen use and EBDs, but not between hours of screen use and EBDs. Controlling for age, developmental level, and family income, children who started using screens earlier than 18 months and who had screen devices in their bedrooms had significantly more sleep problems and EBDs than those without. CONCLUSION Children with neurodevelopmental conditions may have more difficulties disengaging from screen devices in their bedrooms, and an earlier age of screen exposure may contribute to more chronic disruption of sleep.
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Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López F, Muñoz NE, Mora-Gonzalez J, Migueles JH, Molina-García P, Henriksson H, Mena-Molina A, Martínez-Vizcaíno V, Catena A, Löf M, Erickson KI, Lubans DR, Ortega FB, Esteban-Cornejo I. Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Med 2019; 49:1383-1410. [DOI: 10.1007/s40279-019-01099-5] [Citation(s) in RCA: 330] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Guxens M, Vermeulen R, Steenkamer I, Beekhuizen J, Vrijkotte TG, Kromhout H, Huss A. Radiofrequency electromagnetic fields, screen time, and emotional and behavioural problems in 5-year-old children. Int J Hyg Environ Health 2019; 222:188-194. [DOI: 10.1016/j.ijheh.2018.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/17/2018] [Accepted: 09/26/2018] [Indexed: 02/04/2023]
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