Early Childhood Media Exposure and Self-Regulation: Bidirectional Longitudinal Associations

PROTOCOL: Key characteristics of effective preschool-based interventions to promote self-regulation: A systematic review and meta-analysis

This is the protocol for a Cochrane Review. The objectives are as follows: The aim of this systematic review is to advance our understanding of the key characteristics of effective preschool-based interventions designed to foster self-regulation. To accomplish this, the review addresses the following questions: 1. What types of preschool-based interventions have been developed to promote self-regulation? 2. What is the average effect of these preschool-based interventions on self-regulation, focusing on four key constructs: integrative effortful control, integrative executive function, self-regulation, and self-regulated learning? 3. What characteristics-such as Resource Allocation, Activity Type, and Instruction Method-could potentially contribute to the effects of preschool-based interventions in promoting self-regulation?

Screen Time and Socioemotional and Behavioural Difficulties Among Indigenous Children in Canada: Temps d'écran et difficultés socio-émotionnelles et comportementales chez les enfants autochtones du Canada

OBJECTIVES

To describe screen time levels and determine their association with socioemotional and behavioural difficulties among preschool-aged First Nations, Métis, and Inuit children.

METHOD

Data were taken from the Aboriginal Children's Survey, a nationally representative survey of 2-5-year-old Indigenous children in Canada. Socioemotional and behavioural difficulties were defined using parent/guardian reports on the Strengths and Difficulties Questionnaire. Multiple linear regression analyses were conducted separately for First Nations, Métis, and Inuit participants, and statistically adjusted for child age, child sex, and parent/guardian education. Statistical significance was set at P < 0.002 to adjust for multiple comparisons.

RESULTS

Of these 2-5-year-old children (mean [M] = 3.57 years) 3,085 were First Nations (53.5%), 2,430 Métis (39.2%), and 990 Inuit (7.3%). Screen time exposure was high among First Nations (M = 2 h and 58 min/day, standard deviation [SD] = 1.89), Métis (M = 2 h and 50 min [SD = 1.83]), and Inuit children (M = 3 h and 25 min [SD = 2.20]), with 79.7% exceeding recommended guidelines (>1 h/day). After adjusting for confounders, screen time was associated with more socioemotional and behavioural difficulties among First Nations (total difficulties β = 0.15 [95% CI, 0.12 to 0.19]) and Métis (β = 0.16 [95% CI, 0.12 to 0.20]) but not Inuit children (β = 0.12 [95% CI, 0.01 to 0.23]).

CONCLUSIONS

Screen time exposure is high among Indigenous children in Canada, and is associated with more socioemotional and behavioural difficulties among First Nations and Métis children. Contributing factors could include enduring colonialism that resulted in family dissolution, lack of positive parental role models, and disproportionate socioeconomic disadvantage. Predictors of poor well-being should continue to be identified to develop targets for intervention to optimize the health and development of Indigenous children.

Executive dysfunction as a possible mediator for the association between excessive screen time and problematic behaviors in preschoolers

Excessive screen time in children is a growing concern for parents and healthcare providers worldwide because it frequently leads to behavioral problems. Although executive dysfunction is proposed to be one of the contributing factors to maladaptive behaviors, little is known about the link between screen time and behaviors. This study aimed to identify whether executive dysfunction contributes to the negative behaviors of children exposed to excessive screen time. A cross-sectional study was conducted on preschool-aged children from public and private schools in Chiang Mai, Thailand. The parents/guardians of each child completed the questionnaires regarding clinical characteristics and screen time use, the Behavior Rating Inventory for Executive Function-Preschool (BRIEF-P), and the Strengths and Difficulties Questionnaire (SDQ). Children with more than one hour of media exposure per day were considered to have excessive screen time. Multivariable Gaussian regression was analyzed to compare the BRIEF-P and SDQ scores between the excessive and appropriate screen time groups. Causal mediation analysis was performed to examine the effects of total screen time on increasing behavioral problems with executive functioning as a mediator. A total of 1,126 preschoolers were included in the analyses. After controlling for age, sex, socioeconomic status, and maternal education, the excessive screen time group had significantly higher BRIEF-P global executive composite score than the appropriate screen time group (mean difference of global executive composite score = 1.49, 95% CI [0.12, 2.86], and p = 0.033). Concurrently, there were significant differences in externalizing behavior subscales and SDQ total difficulties scores between the excessive and appropriate screen time groups (mean difference of total difficulties score = 0.90, 95% CI [0.29, 1.50], and p = 0.004). A significant average causal mediation effect (ACME) of screen time on behavioral problems mediated through executive functioning was β = 0.28, 95% CI [0.13-0.44], which was more than half of the total effect (54.9%, 95% CI [37.4-100%]). The current study suggests that the increase in behavioral issues in preschoolers might be partly explained by the direct effect of excessive screen time and the mediating effect of impaired executive functioning. Our results may raise concerns about the necessity to limit screen time and monitor for executive function deficits and behavioral problems in young children with high screen time.

Screen time of toddlers in Paris suburbs: Quantitative and qualitative analysis

BACKGROUND

Our aim was to describe the exposure of French children aged 12-36 months to screens (time, content, age of first exposure) and to analyze different moderating factors: sociodemographic data, parents' screen time, and other factors (childcare arrangements, language spoken at home, book reading).

POPULATION AND METHODS

We conducted an observational, cross-sectional, descriptive and analytical study based on 171 questionnaires from parents of children aged 12-36 months who consulted different hospitals in the Paris region during the summer of 2020.

RESULTS

The median screen time was 1 h per day and was essentially television time. The median age of first exposure for children was 12 months. Among the most-watched sites, YouTube was in first place. One third of the children chose the content they watched alone, and the majority did so without any parental guidance (66%). Children watched a screen during mealtime every day in 25% of cases, before bedtime in 12.3% of cases, and 8.8% had a screen in their bedroom. More than one third of families left the television on in the background most of the time. In the multivariate analysis, a high level of screen time was notably linked to the child's age, the parents' screen time, and background television. However, the parental reason for exposure "to calm the child" was the most strongly correlated factor with significant child screen time. Reading books appeared to be a determining factor for less screen exposure.

CONCLUSION

These results emphasize the importance of raising parents' awareness about the potential negative effects of screen exposure (particularly on children's cognitive and emotional development) as early as possible during the maternity period. Implementing this prevention in the maternity wards could be an effective way of informing and educating parents about the potential negative effects of screen time on their child's development.

Reducing harm and promoting positive media use strategies: new perspectives in understanding the impact of preschooler media use on health and development

Most children grow up in homes with easy access to multiple screens. Screen use by children between the ages of 0 to 5 has become a worldwide preoccupation. In the present narrative review, we examine child and parent screen use and its contribution to physical, cognitive, and social developmental outcomes. As research has mostly focused on the adverse consequences of screen media, we aim to depict both the negative and the positive influences of screen usage. To provide a more nuanced portrait of the potential benefits and harms of screen use, we examine how consequences of media use vary according to the content of media (ex., educational, violent), context (ex., using screens during mealtimes), and the nature (ex., passive vs active use) of child screen use. Our review supports existing screen time guidelines and recommendations and suggests that media content, the context of use, and the nature of child use, as well as the parent's own screen use, be considered clinically. Future research should seek to clarify how these dimensions jointly contribute to child screen use profiles and associated consequences. Finally, child sex, behavioral/temperamental difficulties, and family adversity appear to contribute to child screen use and its consequences and should be considered in future research. Suggestions for harm-reduction approaches are discussed.

Screen time and preschool children: Promoting health and development in a digital world

COVID-19 transformed the family media environment and spurred research on the effects of screen media exposure and use on young children. This update of a 2017 CPS statement re-examines the potential benefits and risks of screen media in children younger than 5 years, with focus on developmental, psychosocial, and physical health. Four evidence-based principles-minimizing, mitigating, mindfully using, and modelling healthy use of screens-continue to guide children's early experience with a rapidly changing media landscape. Knowing how young children learn and develop informs best practice for health care providers and early years professionals (e.g., early childhood educators, child care providers). Anticipatory guidance should now include child and family screen use in (and beyond) pandemic conditions.

Applying a family stress model to understand U.S. families' patterns of stress, media use, and child behavior during the COVID-19 pandemic

The COVID-19 pandemic has greatly altered family life, and research among adults and families is finding increases in financial stress, mental health problems, screen time, parental conflict, and child behavior problems. Given these patterns, we sought to replicate these findings with a younger and largely non-white sample and consider how these constructs might relate to each other by using the Family Stress Model. From surveys of 247 predominately Latine mothers and fathers of children under 4 years in the U.S., we found that financial strain was related to children's media exposure and use, largely through impacts on parents' mental health and coparenting relationship. Interestingly, only use of television in the background and during mealtimes were associated with increases in children's behavior problems. Such findings better capture how stress may operate in a family system and offer a way to counsel parents about healthier media habits for children.

Changes in children's anger, sadness, and persistence across blocked goals: Implications for self-regulation

The current study took a person-centered approach to examine the heterogeneity of changes in children's emotions and persistence during a goal-blocking task and examined how different profiles of emotions and persistence related to children's self-regulation. Children's anger, sadness, and persistence were rated in a goal-blocking task in toddlerhood (T1; N = 140, 72 boys, M_age  = 2.67 years, 90.7% White) and preschool (T2). Children's self-regulation, specifically sustained attention and engagement, was assessed at T1, T2, and early school-age (T3) from 2005 to 2012. Growth mixture modeling revealed two classes of children at T1 and three classes at T2 with different patterns of anger, sadness, and persistence. Children's classification at T2, but not T1, significantly predicted their sustained attention and engagement both concurrently and longitudinally.

Toward a dimensional model of risk and protective factors influencing children's early cognitive, social, and emotional development during the COVID-19 pandemic

Variation in infants' home environment is implicated in their cognitive and psycho-social development. The pandemic has intensified variations in home environments through exacerbating socioeconomic inequalities, and increasing psychological stressors for some families. This study investigates the effects of parental (predominantly maternal) mental health, enriching activities and screen use on 280 24- to 52-month-olds' executive functions, internalising and externalising problems, and pro-social behaviour; with socioeconomic status and social support as contextual factors. Our results indicate that aspects of the home environment are differentially associated with children's cognitive and psycho-social development. Parents who experienced sustained mental distress during the pandemic tended to report higher child externalising and internalising problems, and executive function difficulties at follow-up. Children who spent more time engaged in enriching activities with their parents showed stronger executive functions and social competence six months later. Screen use levels during the first year of the pandemic were not associated with outcomes. To mitigate the risk of persistent negative effects for this 'pandemic generation' of infants, our study highlights the importance of supporting parents' mental health. As our results demonstrate the impact of social support on mental health, investing in support services and interventions promoting building support networks are likely to be beneficial.

Longitudinal Associations Between Use of Mobile Devices for Calming and Emotional Reactivity and Executive Functioning in Children Aged 3 to 5 Years

IMPORTANCE

Mobile devices are often used to keep young children occupied or calm, but it is not known whether this practice influences child development.

OBJECTIVE

To examine the longitudinal, bidirectional associations between the parent-reported frequency of using mobile devices to calm young children and children's executive functioning (EF) and emotional reactivity, testing moderation by child sex and temperament.

DESIGN, SETTING, AND PARTICIPANTS

This prospective cohort study included a community-based convenience sample of English-speaking parents of typically developing children aged 3 to 5 years. The study duration was from August 2018 to January 2020, with baseline (T1), 3-month follow-up (T2), and 6-month follow-up (T3) waves.

EXPOSURES

Parent-reported frequency of use of mobile devices to calm children when upset (5-point Likert scale).

MAIN OUTCOMES AND MEASURES

At each wave, the child's EF was assessed with the Behavior Rating Inventory of Executive Function-Preschool Version Global Executive Composite and emotional reactivity with the Child Behavior Checklist Emotional Reactivity subscale. Structural equation models were built to examine cross-lagged associations of the use of devices for calming, EF, and emotional reactivity, testing for moderation by child sex or temperament (Child Behavior Questionnaire-Very Short Form surgency score, median split).

RESULTS

Of 422 eligible parents with data at T1, 375 (88.9%) provided data at T2 and 366 (86.7%) at T3. At baseline, the mean (SD) age of the 422 children was 3.8 (0.5) years, the number of boys in the sample was 224 (53.1%), the number of individuals of non-Hispanic White race and ethnicity was 313 (74.2%), and among the parents, 254 (60.2%) had a college degree or higher. Among the boys, the use of devices to calm at T2 was associated with higher emotional reactivity at T3 (r [standardized regression coefficient] = 0.20; 95% CI, 0.10-0.30), while higher emotional reactivity at T2 had a nonsignificant association with increased device use for calming at T3 (r = 0.10; 95% CI, -0.01 to 0.21). Among children with high temperamental surgency, the use of devices to calm at T2 was associated with increased emotional reactivity at T3 (r = 0.11; 95% CI, 0.01-0.22), while higher emotional reactivity at T2 was associated with increased device use for calming at T3 (r = 0.13; 95% CI, 0.02-0.24).

CONCLUSIONS AND RELEVANCE

The findings of this study suggest that the frequent use of mobile devices for calming young children may displace their opportunities for learning emotion-regulation strategies over time; therefore, pediatric health care professionals may wish to encourage alternate calming approaches.

Screen Media Exposure in Early Childhood and Its Relation to Children’s Self-Regulation

Self-regulation, the ability to control thoughts, emotions, and behavior for goal-directed activities, shows rapid development in infancy, toddlerhood, and preschool periods. Early self-regulatory skills predict later academic achievement and socioemotional adjustment. An increasing number of studies suggest that screen media use may have negative effects on children’s developing self-regulatory skills. In this systematic review, we summarized and integrated the findings of the studies investigating the relationship between young children’s screen media use and their self-regulation. We searched the ERIC, PsycINFO, PubMed, and Web of Science databases and identified 39 relevant articles with 45 studies. We found that screen time in infancy is negatively associated with self-regulation, but findings were more inconsistent for later ages suggesting that screen time does not adequately capture the extent of children’s screen media use. The findings further indicated that background TV is negatively related to children’s self-regulation, and watching fantastical content seems to have immediate negative effects on children’s self-regulatory skills. We suggest that future studies should take the content and context of children’s screen media use into account and also focus on parent- and home-related factors such as parental behaviors that foster the development of self-regulatory skills.

Raising the Child-Do Screen Media Help or Hinder? The Quality over Quantity Hypothesis

Screen media are ubiquitous in human life across all age, cultural and socioeconomic groups. The ceaseless and dynamic growth of technological possibilities has given rise to questions regarding their effect on the well-being of children. Research in this area largely consists of cross-sectional studies; experimental and randomized studies are rare, which makes drawing causative conclusions difficult. However, the prevailing approach towards the use of screen media by children has focused on time limitations. The emerging evidence supports a more nuanced perspective. It appears that the older the child, the more important how the screen media are used becomes. Concentrating on the quality of the screen, time has become increasingly relevant in the recent COVID-19 pandemic, which necessitated a transfer of educational and social functioning from real-life to the digital world. With this review, we aimed at gathering current knowledge on the correlations of different screen media use and development outcomes, as well as providing an overview of potential benefits that new technologies may provide to the pediatric population. To summarize, if one cannot evade screen time in children, how can we use it for children's maximum advantage?

Longitudinal Associations of Children’s Hyperactivity/Inattention, Peer Relationship Problems and Mobile Device Use

Children with emotional, behavioral or relationship problems may be more inclined to use mobile touchscreen devices (MTSDs: mobiles and tablets) to regulate their emotions or compensate for the lack of social relationships, which, in turn, may affect their symptoms. Bi-directional longitudinal associations between behavioral difficulties and MTSD use were analyzed. Participants were parents of children aged 4–6 years old at first data collection (n = 173), and 7–9 years old at second data collection (n = 98). They reported on their child’s MTSD use and behavioral difficulties at two time points (T1 and T2). It was analyzed whether T1 MTSD use predicts T2 behavioral difficulties (controlling for demographics and T1 behavioral difficulties); and whether T1 behavioral difficulties predict T2 MTSD use (controlling for demographics and T1 MTSD use). Additionally, cross-sectional associations between behavioral difficulties and MTSD use were analyzed. Children’s T1 hyperactivity/inattention score positively associated with T2 MTSD use, and peer relationship problems and MTSD use positively associated in T2. Pre-schoolers with more hyperactive inattentive symptoms may use MTSDs more to regulate their emotions. The association between peer relationship problems and MTSD use in T2 is consistent with poorer socio-cognitive skills in MTSD user children and may be bi-directional.

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.

Screen Media Overuse and Associated Physical, Cognitive, and Emotional/Behavioral Outcomes in Children and Adolescents: An Integrative Review

INTRODUCTION

Screen media overuse is seen as a public health concern because of its negative effects on child and adolescent health. This integrative literature review examines recent empirical evidence on the relationship between screen media overuse and physical, cognitive, and emotional/behavioral outcomes in children and adolescents.

METHODS

Empirical research of experimental design, observational studies, and systematic reviews from several data sources was reviewed and synthesized to form the basis of this integrative review.

RESULTS

Screen media overuse is associated with poor sleep quality, shorter sleep duration, greater likelihood for overweight/obesity, lower executive functioning, poorer academic performance, and increased internalizing and externalizing problems. Bidirectional associations may exist.

DISCUSSION

Findings support the importance of understanding the impact of screen media use on health and wellbeing. Generating screen time guidelines and developing effective prevention/intervention strategies are critical to mitigating screen media overuse and its adverse outcomes in children and families.

Not all babies are in the same boat: Exploring the effects of socioeconomic status, parental attitudes, and activities during the 2020 COVID-19 pandemic on early Executive Functions

Early executive functions (EFs) lay the foundations for academic and social outcomes. In this parent‐report study of 575 UK‐based 8‐ to 36 month olds (218 followed longitudinally), we investigate how variation in the home environment before and during the 2020 pandemic relates to infants’ emerging EFs. Parent‐infant enriching activities were positively associated with infant Cognitive Executive Function (CEF) (encompassing inhibitory control, working memory, cognitive flexibility). During the most‐restrictive UK lockdown—but not subsequently—socioeconomic status (SES) was positively associated with levels of parent‐infant enriching activities. Parents who regard fostering early learning, affection, and attachment as important were more likely to engage in parent‐infant enriching activities, yet there was no significant pathway from parental attitudes or SES to CEF via activities. Infant screen use was negatively associated with CEF and Regulation. Screen use fully mediated the effect of SES on CEF, and partially mediated the effect of SES on regulation. Parental attitudes toward early learning, affection, and attachment did not significantly influence screen use. These results indicate that although parental attitudes influence the development of early EFs, interventions targeting attitudes as a means of increasing enriching activities, and thus EF are likely to be less effective than reducing barriers to engaging in enriching activities.

The negative effects of new screens on the cognitive functions of young children require new recommendations

Television studies have shown that some negative effects of screens could depend on exposure time, but more importantly on the characteristics of the child, the type of content viewed, and the context in which it is viewed. Studies on newer screens show that these factors are still valid but new ones now play a negative role: portable screens increase the duration of exposure and lowered the age at which exposure begins. More worryingly, new screen persuasive designs and dark patterns largely used incite more frequent use, attracting the attention of children and parents, resultantly interfering deeply in parent/child relationships. In this text we suggest that current academic recommendations have to be more broadly shared but also that new recommendations are needed: especially to advise parents not to let their screen interactions compete with real interactions with their child which are the core of learnings (especially language) and emotional regulations but also of their security.

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.

Does physical activity moderate the association between screen time and psychosocial development in early childhood? Analysis of a longitudinal infant cohort study in Ireland

The objective of this study was to explore the extent to which the association between screen time and psychosocial development in preschool children differed between the sexes and according to their frequency of engagement in physical activity. Data are based on a prospective cohort of Irish children, collected between 2010 and 2013 when children were ages 3 (n=9786) and 5 years (n=9001). Children's screen time (h/day), psychosocial development (Strengths and Difficulties Questionnaire), and physical activity (bouts/week) were assessed via caregiver report. The magnitude of the association between screen time and changes in behavioural difficulties differed significantly between the sexes. For boys, the association between increased screen time and the onset of behavioural problems coincided directly with a reduction in their frequency of engagement in physical activity. The association between screen time and changes in behavioural difficulties was not moderated by girls' engagement in physical activity, however; and there was no difference in the association between screen time and prosocial behaviours at different frequencies of engagement in physical activity for either boys or girls.Conclusions: Results support recommendations to establish greater balance between physical activity and sedentary behaviours in token economy systems to minimise the negative effects of excessive screen time. What is Known: • Provision of screen time has become normalised as a behavioural reinforcer for use with young children. • Screen viewing above recommended guidelines is associated with behavioural problems that reflect poor self-regulation. What is New: • Boys' levels of engagement in physical activity moderated the relationship between screen time and changes in behavioural difficulties between the ages of 3 and 5 years. • Neither screen time nor physical activity was significantly associated with changes in prosocial behaviours between the ages of 3 and 5 years for either boys or girls.

Why do parents use screen media with toddlers? The role of child temperament and parenting stress in early screen use

Considering child characteristics may be an important piece to understanding parental decision-making for children's screen use. The current cross-sectional study examined the mediating role of maternal parenting stress in the relation of child temperament to young children's screen use. Recognizing the multidimensional aspects of temperament, three mediated pathways for three temperament domains (i.e., negative affectivity, surgency, and effortful control) were tested. Mothers of toddlers, 18-36 months (N = 296), completed an online survey, reporting on child temperament, total parenting stress, and child screen use. The results showed that mother-child dynamics were related to toddlers' screen use. Toddlers' negative affectivity and effortful control were each associated with toddlers' screen use through maternal parenting stress. Higher negative affectivity was associated with higher maternal parenting stress, which in turn, was related to greater screen use in toddlers. Toddlers' lower effortful control was related to higher maternal parenting stress, which in turn, was associated with greater screen use. Toddlers' surgency was not related to either maternal parenting stress or toddlers' screen use. The findings from this study contribute to an understanding of media-related parenting in toddlerhood and may help with the development of strategies for supporting healthy media habits in families with young children.

Links between television exposure and toddler dysregulation: Does culture matter?

Television exposure in early childhood has increased, with concerns raised regarding adverse effects on social-emotional development, and emerging self-regulation in particular. The present study addressed television exposure (i.e., amount of time watching TV) and its associations with toddler behavioral/emotional dysregulation, examining potential differences across 14 cultures. The sample consisted of an average of 60 toddlers from each of the 14 countries from the Joint Effort Toddler Temperament Consortium (JETTC; Gartstein & Putnam, 2018). Analyses were conducted relying on the multi-level modeling framework (MLM), accounting for between- and within-culture variability, and examining the extent to which TV exposure contributions were universal vs. variable across sites. Effects of time watching TV were evaluated in relation to temperament reactivity and regulation, as well as measures of emotional reactivity, attention difficulties, and aggression. Results indicated that more time spent watching TV was associated with higher ratings on Negative Emotionality, emotional reactivity, aggression, and attention problems, as well as lower levels of soothability. However, links between TV exposure and both attention problems and soothability varied significantly between cultures. Taken together, results demonstrate that increased time spent watching television was generally associated with dysregulation, although effects were not consistently uniform, but rather varied as a function of culturally-dependent contextual factors.

Media use and behavioral disorders among Saudi Arabian children

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.

Cross-Sectional Associations of Application Use and Media Program Viewing with Cognitive and Psychosocial Development in Preschoolers

Executive functions and psychosocial health during childhood are positively associated with health and developmental outcomes into adulthood. Electronic media use has been reported to adversely affect health and development in children; however, what remains unclear is whether contemporary media behaviors, such as electronic application (app) use, exerts similar effects on health and development. We investigated the associations of electronic media use (program viewing and app use) with cognitive and psychosocial development in preschoolers. Parents of preschool children (n = 247, 4.2 ± 0.6 years) reported the time their child spent using electronic media. Direct assessment of the children’s executive functions (working memory, inhibition, and shifting) and educator-reported psychosocial difficulties were also collected. Associations were examined using linear regression adjustments for covariates and preschool clustering. Small, but significant, negative associations were observed for total electronic media use (b = −0.001; 95% CI: −0.003, −0.000; p = 0.026) and program viewing (b = −0.002; 95% CI: −0.003, −0.000; p = 0.033) with children’s visual–spatial working memory. However, high-dose app users demonstrated higher phonological working memory scores compared to non-users (MD = 0.31; 95% CI: 0.04, 0.58; p = 0.025). Similarly, compared to non-users, low-dose app users displayed statistically significantly fewer total difficulties (MD = −1.67; 95% CI: −3.31, −0.02; p = 0.047). No associations were evident for high-dose app users and the remaining outcomes. The results may suggest that attempts to reduce program viewing while promoting moderate levels of app use may exert positive influences on children’s executive functions and psychosocial development.

Prosocial television and prosocial toddlers: A multi-method, longitudinal investigation

How screen use might affect early childhood outcomes is an important question for parents, but existing research is patchy. In particular, screen time is often examined in relation to sleep and aggression, but much less is known about its links with prosocial behaviour. To address this gap, we conducted semi-structured observations and interviews / questionnaires with both mothers and fathers in a sample of 195 (predominantly affluent and educated) British families tracked across three time-points, when the first-born child was 14-, 24-, and 36-months old. We also applied an objective coding scheme to assess the relative frequency of prosocial behaviour in the programmes and films children were watching at age 24-months. While our results showed no overall associations between prosocial behaviour and either screen time or screen content, there were interaction effects. Specifically, children whose favourite programmes were slow-paced and rich in prosocial content were particularly likely to show developmental gains in sharing. We discuss these findings in terms of their implications for parents, researchers, and policy makers.

Screen Time and Executive Function in Toddlerhood: A Longitudinal Study

Technology is pervasive in homes with young children. Emerging evidence that electronic screen-based media use has adverse effects on executive functions may help explain negative relations between media use and early academic skills. However, longitudinal investigations are needed to test this idea. In a sample of 193 British toddlers tracked from age 2 to 3 years, we test concurrent and predictive relations between screen use and children’s executive function. We find no concurrent association between screen use and executive function; however, screen time at age 2 is negatively associated with the development of executive functions in toddlerhood from age 2 to 3, controlling for a range of covariates including verbal ability. Implications for parenting, education, and pediatric recommendations are discussed.

Longitudinal Links Between Media Use and Focused Attention Through Toddlerhood: A Cumulative Risk Approach

Previous studies that examined the links between media use and children's attention abilities have yielded inconclusive findings. In the current study, we aimed to move beyond the focus on isolated aspects of media use to a comprehensive assessment of both direct and indirect media use and practices in early childhood. Drawing from the cumulative risk literature, we examined whether cumulative media use is related to children's subsequent attention abilities. Participants were 199 mothers of toddlers (60% male) who completed questionnaires assessing various aspects of children's media use, as well as children's focused attention abilities at three time points: 18 months (T1), 22 months (T2), and 26 months (T3) of age. Cumulative media use scores were computed based on four indicators: (1) child average daily screen time; (2) household background television; (3) maternal use of media to regulate child distress; and (4) maternal use of mobile devices while spending time with the child. An autoregressive cross-lagged (ARCL) path model controlling for child sex, maternal education, and general parenting practices showed that cumulative media use at 18 months negatively predicted children's focused attention at 22 months. Moreover, there was a significant negative indirect effect from cumulative media use at 18 months to focused attention at 26 months via focused attention at 22 months. Finally, the cumulative media index appeared to be a better predictor of focused attention than any of the singular media use indicators. Children's focused attention did not predict subsequent cumulative media use across time, providing no evidence for bidirectional links. Findings suggest that exposure to multiple (rather than single) aspects of media use is related to decreased subsequent focused attention abilities during toddlerhood. Family media plans that designate media-free time and increase parental awareness to media use habits in the household should therefore be encouraged.

Longitudinal Associations Between Early Childhood Externalizing Behavior, Parenting Stress, and Child Media Use

Limited research has examined bidirectional associations between modern media (e.g., smartphone, tablet) use and behavior in early childhood. This study aimed to test the hypotheses that, over 6 months, (H1) child externalizing behavior would predict later media use, mediated by parenting stress, and (H2) media use would predict later externalizing behavior. Participants included mothers and fathers from 183 heterosexual couples with a child 1-5 years old, followed for 6 months-assessed at baseline, 1, and 6 months. Frequency of child media use was assessed at baseline and 6 months through parent report across eight items (e.g., television [TV], smartphone, tablet use). Child externalizing behavior was assessed through the Child Behavioral Checklist, and parent stress through the Parenting Stress Index. Hypotheses were tested using structural equation modeling. Mothers were 31.8 (standard deviation [SD] = 4.2), fathers 33.3 (SD = 4.9), and children 3.0 years old (SD = 1.2). Structural equation models showed good overall fit. As hypothesized, we found that (H1) greater child externalizing behavior predicted greater parenting stress (β = 0.48, p < 0.001), which predicted increases in child media use (β = 0.15, p < 0.05); however, (H2) child media use did not predict later externalizing behavior (β = 0.06, p = 0.23). In post hoc analyses, results differed slightly by specific type of media; for example, externalizing behavior was associated with later tablet and game use, whereas TV use predicted increases in externalizing behavior. Our results suggest that child behavior problems associate with later media use habits, possibly as a parent coping strategy, which should be considered when providing clinical guidance.

Maternal Use of Media to Regulate Child Distress: A Double-Edged Sword? Longitudinal Links to Toddlers' Negative Emotionality

Although the American Academy of Pediatrics recommends not to heavily rely on screen media devices to regulate children's distress, many parents often resort to this regulatory strategy. However, little is known about the long-term implications of using this strategy for children's emotional functioning. To address this issue, this study examined the longitudinal links between the use of media to regulate distress and children's negative emotionality (NE) during toddlerhood, a period in which children strongly rely on external regulation. We also examined whether children with initially high NE were more sensitive to the effects of this regulatory strategy on subsequent NE. Participants were 207 mothers who completed questionnaires assessing child NE, use of media to regulate distress, child screen time, and demographic covariates at 2 time points: 18 months (T1) and 26 months (T2) of children's age. Use of media to regulate child distress at T1 did not directly predict child NE at T2, and vice versa. However, there was a significant interaction between child NE and use of media to regulate distress at T1 in predicting NE at T2. Simple slopes analysis indicated that maternal use of media to regulate distress was positively related to increases in children's NE, but only for children with initially low NE, and not for children with initially high NE. Our findings can inform family-based prevention initiatives that may be delivered in community pediatric settings, aiming at promoting thoughtful use of media in young children's everyday lives.

An Exploration of Electronic Media Use Profiles for Preschoolers of Low-Income Families

OBJECTIVE

To characterize the electronic media (e-media) use of preschoolers from low-income families comprehensively, in terms of platform interaction potential and content.

METHODS

Parents of 380 preschoolers (mean age, 52.5 ± 3.7 months) from diverse, low-income backgrounds reported on their child's age of exposure to various e-media types, frequency of use, amount of background television, and listed all child shows/cartoons and adult shows/general audience shows the child watches, as well as all electronic games/apps the child plays. We calculated descriptive statistics and conducted latent profile analyses to characterize e-media use.

RESULTS

Most children in the sample began watching TV before age 1 year and nearly half watch child shows/cartoons several times a day or more. Most children began playing games/apps before age 3 years and more than one quarter play games several times a day or more. More than 20% of children are exposed to >3 hours of background TV on a typical weekday and 30% are exposed to this amount on a typical weekend day. A Modest E-Media Use profile characterized most children in the sample (70%). Fewer children were characterized by a High Educational Games profile (14%) or a High Adult TV/Elevated Entertainment Games Use and Background TV profile (16%).

CONCLUSIONS

Collectively, the 3 profiles reflect heterogeneous use patterns with regard to platform interaction potential and educational quality during the course of a typical week. Additional research is warranted to assess linkages between e-media use profiles and indicators of school readiness in cognitive, academic, and social and behavioral domains in diverse, low-income samples.