Associations between duration and type of electronic screen use and cognition in US children

Associations between sedentary types, sedentary patterns and cognitive ability in preschool children

The preschool years are a critical period for developing cognitive abilities such as reasoning, memorization, comprehension, quick thinking, and problem-solving. Sedentary behavior (SB) is known to be associated with cognitive development in preschool children. However, limited research has focused on how different types of SB (active, passive) and sedentary patterns (bouts, breaks) affect preschool children's cognitive abilities. This cross-sectional study aimed to investigate: (1) the relationship between sedentary types and preschoolers' cognitive abilities; and (2) the relationship between sedentary patterns and preschoolers' cognitive abilities. Preschoolers aged 3 to 6 years (n = 353) were recruited from 5 kindergartens in Changsha, Hunan, China. Sedentary types were reported by parents, sedentary patterns were measured by preschoolers wearing an ActiGraph wGT3X-BT for seven consecutive days, and cognitive abilities were assessed using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV). The relationships between variables were analyzed using multiple linear regression models. Non-screen-based active SB was associated with higher full-scale IQ and fluid reasoning index in boys and higher visual spatial index in girls. Screen-based active SB was negatively associated with overall cognitive ability. Passive SB potentially had a negative effect on overall cognitive ability, but screen-based passive SB was positively associated with higher fluid reasoning indices in girls. Preschoolers' cognitive ability was positively associated with sedentary breaks, but not with sedentary bouts.

CONCLUSIONS

Not all types of SB are equal when examining optimal cognitive development in preschoolers. Frequent breaks from sedentary time were associated with better cognitive development. Encouraging more frequent breaks to interrupt prolonged SB may be a viable strategy for reducing sedentary time to promote optimal cognitive development. These findings should be further validated in larger prospective studies.

WHAT IS KNOWN

• Sedentary behavior is not advantageous for cognitive development.

WHAT IS NEW

• Not all types of sedentary behavior are harmful. • Active sedentary behaviors are beneficial to overall cognitive development, but screen-based active sedentary behaviors may negatively impact some areas of cognitive performance. • Cognitive abilities in preschoolers are associated with sedentary breaks, but not with sedentary bouts.

Digital Detox and Well-Being

In a May 2023 advisory, the US Surgeon General raised concerns about the effects of social media use on well-being. One implied strategy to reduce its impact is abstaining from digital media use. This state-of-the-art review summarizes the most recent studies on reducing or abstaining from digital media use, including social media (ie, "digital detox") and its effect on well-being to inform parents, educators, schools, policymakers, and the public when taking action. In June 2023, we conducted a literature search in Google Scholar, PubMed, and ScienceDirect. We included reviews and original research articles (1) focusing on interventions to reduce screen time/social media time and (2) its impact on/association with well-being. We summarized the key points of the 2 published reviews and 6 articles (published between 2013 and 2023), including 139 articles in total. Our main findings are: there is no clear definition of digital detox and no consistency in the assessment of interventions' effectiveness;reducing social media/smartphone time rather than promoting total abstinence showed more beneficial effects on well-being;the effect of the interventions and their duration varies depending on the type of outcome; andthe effects are influenced by gender, age, and contextual factors. Available evidence on interventions aiming at reducing social media use on well-being is limited, leaving no clear implications for policymaking at this point. More empirical, high-quality research is needed to understand the circumstances under which digital detox interventions are helpful and for whom.

Interconnections of screen time with neuroinflammation

The increasing prevalence of screen time among modern citizens has raised concerns regarding its potential impact on neuroinflammation and overall brain health. This review examines the complex interconnections between screen time and neuroinflammatory processes, particularly in children and adolescents. We analyze existing literature that explores how excessive digital media use can lead to alterations in neurobiological pathways, potentially exacerbating inflammatory responses in the brain. Key findings suggest that prolonged exposure to screens may contribute to neuroinflammation through mechanisms such as disrupted sleep patterns, diminished cognitive engagement, and increased stress levels. Similarly, we discuss the implications of these findings for mental health and cognitive development, emphasizing the need for a balanced approach to screen time. This review highlights the necessity for further research to elucidate the causal relationships and underlying mechanisms linking screen time and neuroinflammation, thereby informing guidelines for healthy media consumption.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Next-Generation Tear Meniscus Height Detecting and Measuring Smartphone-Based Deep Learning Algorithm Leads in Dry Eye Management

Purpose

This study aims to develop and assess an infrastructure using Python-based deep learning code for future diagnostic and management purposes related to dry eye disease (DED) utilizing smartphone images.

Design

Cross-sectional study using data which was gathered in Vision Health Research Clinic.

Participants

One thousand twenty-one eye images from 734 patients were included in this article that categorizes into 70% females and 30% males, with no sex and age limit.

Methods

One specialist captured eye images using Samsung A71 (601 images) and iPhone 11 (420 images) cell phones with the flashlight on and direct gaze to the camera. These images include the area of only 1 eye (left/right).

Main Outcome Measures

First, our specialist did 3 different segmentations for every eye image separately for 80% of the training data. This part contains eye, lower eyelid, and iris segmentation. In 20% of test data after automated cropping of the lower eyelid margin and upscaling by 8×, the appropriate tear meniscus height segmentation will be chosen and measured using a deep learning algorithm.

Results

The model was trained on 80% of the data and 20% of the data used for validation from both phones with different resolutions. The dice coefficient of the trained model for validation data is 98.68%, and the accuracy of the overall model is 95.39%.

Conclusions

It appears that this algorithm holds the potential to herald an evolution in the future of diagnosis and management of DED by homecare devices solely through smartphones.

Financial Disclosures

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Trajectories of Adolescent Media Use and Their Associations With Psychotic Experiences

Importance

Adolescent media use is thought to influence mental health, but whether it is associated with psychotic experiences (PEs) is unclear.

Objective

To examine longitudinal trajectories of adolescent media use and their associations with PEs at 23 years of age.

Design, Setting, and Participants

This cohort study included participants from the Québec Longitudinal Study of Child Development (1998-2021): children who were born in Québec, Canada, and followed up annually or biennially from ages 5 months through 23 years. Data were analyzed between January 2023 and January 2024.

Exposures

Participants reported their weekly amount of television viewing, video gaming, computer use, and reading at ages 12, 13, 15, and 17 years.

Main Outcome and Measures

Lifetime occurrence of PEs was measured at 23 years of age. Covariables included sociodemographic, genetic, family, and childhood characteristics between ages 5 months and 12 years.

Results

A total of 1226 participants were included in the analyses (713 [58.2%] female, 513 [41.8%] male). For each media type, latent class mixed modeling identified 3 group-based trajectories, with subgroups following trajectories of higher use: television viewing, 128 (10.4%); video gaming, 145 (11.8%); computer use, 353 (28.8%); and reading, 140 (11.4%). Relative to lower video gaming, higher video gaming was preceded by higher levels of mental health and interpersonal problems at age 12 years. Adjusting for these risk factors mitigated the association between higher video gaming and PEs at age 23 years. The curved trajectory of computer use (189 [15.4%] participants), characterized by increasing levels of use until age 15 years followed by a decrease, was associated with higher PEs (estimated difference, +5.3%; 95% CI, +1.5% to +9.3%) relative to lower use (684 [55.8%] participants). This association remained statistically significant after covariable adjustment.

Conclusions and Relevance

This study found that longitudinal trajectories of media use during adolescence were modestly associated with PEs at age 23 years, likely reflecting the influence of shared risk factors. Understanding the environmental determinants and psychosocial functions of media use during adolescence may help better integrate digital technologies in the prevention and management of PEs.

Night Screen Time is Associated with Cognitive Function in Healthy Young Adults: A Cross-Sectional Study

Background

In recent years, a significant shift toward remote work, virtual education, and social distancing measures was witnessed, thereby leading people to increasingly depend on digital devices for communication, work, and entertainment. This increased exposure to screens has raised concerns regarding its potential impact on cognitive function.

Purpose

This study investigated the relationship between screen time and cognitive function among healthy young adults.

Methods

One hundred forty-five healthy individuals (mean age 21.55 ± 2.84 years) participated in this cross-sectional study. Sociodemographic information including age, sex, height, weight, and level of education were obtained. Participants reported screen time using a screen time questionnaire. Cognitive function tests including, Paced Auditory Serial Addition Task (PASAT), Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT) were conducted. Multilinear regression analyses were used to examine the associations between age, sex, level of education, screen time, and cognitive function.

Results

One hundred thirty-nine participants (76 women) completed the study. Increased night screen time, bachelor's educational level, and women were associated with lower PASAT scores (R2=0.258; p≤0.047). Moreover, increased night screen time was associated with lower MoCA scores (R2=0.029; p=0.035). However, no associations were found between night screen time and SDMT scores.

Conclusion

Participants who had higher night screen exposure had lower cognitive scores in the information speed processing, working memory, calculation, and attention domains. Considering these findings, this study emphasizes on the importance of setting a future recommended screen time guidelines for young adults as well as to promote healthy cognitive habits in order to preserve cognitive function and reduce the risk of developing neurodegenerative disease in the future. Future prospective cohort studies involving a more diverse age range is needed.

Associations of screen use with cognitive development in early childhood: the ELFE birth cohort

BACKGROUND

The associations of screen use with children's cognition are not well evidenced and recent, large, longitudinal studies are needed. We aimed to assess the associations between screen use and cognitive development in the French nationwide birth cohort.

METHODS

Time and context of screen use were reported by parents at ages 2, 3.5 and 5.5. Vocabulary, non-verbal reasoning and general cognitive development were assessed with the MacArthur-Bates Communicative Development Inventory (MB) at age 2, the Picture Similarities subtest from the British Ability Scales (PS) at age 3.5 and the Child Development Inventory (CDI) at ages 3.5 and 5.5. Outcome variables were age-adjusted and standardized (mean = 100, SD = 15). Multiple imputations were performed among children (N = 13,763) with ≥1 screen use information and ≥1 cognitive measures. Cross-sectional and longitudinal associations between screen use and cognitive development were assessed by linear regression models adjusted for sociodemographic and birth factors related to the family and children, and children's lifestyle factors competing with screen use. Baseline cognitive scores were further considered in longitudinal analysis.

RESULTS

TV-on during family meals at age 2, not screen time, was associated with lower MB scores at age 2 (β [95% CI] = -1.67 [-2.21, -1.13]) and CDI scores at age 3.5 (-0.82 [-1.31, -0.33]). In cross-sectional analysis, screen time was negatively associated with CDI scores at ages 3.5 (-0.67 [-0.94, -0.40]) and 5.5 (-0.47 [-0.77, -0.16]), and, in contrast, was positively associated with PS scores (0.39 [0.07, 0.71]) at age 3.5. Screen time at age 3.5 years was not associated with CDI scores at age 5.5 years.

CONCLUSIONS

Our study found weak associations of screen use with cognition after controlling for sociodemographic and children's birth factors and lifestyle confounders, and suggests that the context of screen use matters, not solely screen time, in children's cognitive development.

The Relationship between Language and Technology: How Screen Time Affects Language Development in Early Life-A Systematic Review

Screen time refers to the amount of time a child is exposed to a screen, that is, television, computer, smartphone, or any other digital medium. Prolonged screen time in the first years of life may affect a child's cognitive abilities, especially language acquisition. A systematic review was conducted, following the PRISMA-P guidelines, with the aim to explore the available literature relating to the impact of screen time on children's language development. This review identified 18 articles. The articles reviewed showed that prolonged screen time and exposure to screens in the first 2 years of life can negatively affect language development and communication skills, in terms of comprehension and vocabulary range. In addition, overexposure to screens in the early years can affect overall cognitive development, especially attention to environmental stimuli, social experiences, problem solving, and communication with others, e.g., the alternance of rhythms and roles in a conversation. In conclusion, our systematic review supports the idea that preschool screen time has negative effects on children's cognitive and language development. Television seems to be the medium most detrimental to children's skills, as it is used in a passive manner and is often characterised by language and content that do not suit the child's processing mode. Future studies should increasingly focus on the digital media that children possess at an early age, such as mobile phones and tablets, and on how children relate to the online world, such as social networks.

Appropriate Vestibular Stimulation in Children and Adolescents-A Prerequisite for Normal Cognitive, Motor Development and Bodily Homeostasis-A Review

The structural development of the vestibular part of the inner ear is completed by birth but its central connections continue to develop until adolescence. Their development is dependent on vestibular stimulation-vestibular experience. Studies have shown that vestibular function, modulated by experience and epigenetic factors, is not solely an instrument for body position regulation, navigation, and stabilization of the head and images but also influences cognition, emotion, the autonomous nervous system and hormones. To emphasize the importance of appropriate vestibular stimulation, we present a literature review of its effect on bodily homeostasis, cognition and emotion.

A network analysis involving mental difficulties, cognition, physical fitness, 24-hour movement components, fatness, and sociodemographic factors in children

Background

Evidence supports the beneficial linear influence of diverse lifestyle behaviors on brain health since childhood; however, multiple behaviors -and not only one-simultaneously affect such outcomes. Therefore, the aim was to explore the multivariate relationship through a network analysis among mental difficulty and cognitive function with physical fitness (PF), 24-h movement components, fatness, and sociodemographic factors in children.

Methods

Cross-sectional study involved 226 children (52.2 % boys) aged between six and 11 years. Mental difficulties were evaluated through the Strengths and Difficulties Questionnaire and cognitive function by the Raven's Colored Progressive Matrices Test. The body mass index and PF were assessed according to the procedures suggested by the Proesp-Br, while moderate-to vigorous-intensity physical activity (MVPA) using accelerometry. The socioeconomic level, sleep, and screen time were evaluated by questionnaires. A network analysis was carried out to evaluate the associations among variables and establish centrality measures.

Results

Age and PF moderated the negative relationship between cognitive function and MVPA. Furthermore, the direct and inverse relationship between cognitive function and mental difficulties appears to be affected by the 24-h movement components. Finally, age, PF, and screen time are the nodes with higher values of expected influence, indicating more sensitivity to interventions for decreasing mental difficulty and improving cognitive function.

Conclusion

Mental health and cognitive function were moderated by the multivariate interaction among age, PF, and the three 24-h movement components. Nonetheless, centrality measures from the network analysis suggest that PF, MVPA, and screen time are crucial nodes in order to implement future interventions.

Time Use and Cognitive Achievement among Adolescents in China: Depression Symptoms as Mediators

Everyone's time is limited, and there is competition between different aspects of time use; this requires comprehensive consideration of the effects of different aspects of time use on cognitive achievement in adolescents. This study uses a dataset of 11,717 students from a nationally representative large-scale survey project conducted in 2013 to 2014 to clarify the relationship between time use (including working on homework, playing sports, surfing the Internet, watching TV, and sleeping) and cognitive achievement among Chinese adolescents, and explores the mediating role of depression symptoms in the relationship between time use and cognitive achievement. The results of the correlation analysis show that the average daily time spent on homework, playing sports, and sleeping is significantly positively correlated with cognitive achievement (p < 0.01), while time spent surfing the Internet and watching TV are significantly negatively correlated with cognitive achievement (p < 0.01). The results of the mediating effect model show that depression symptoms play a mediating role in the relationship between time use and cognitive achievement among Chinese adolescents. Specifically, time spent playing sports (indirect effect = 0.008, p < 0.001) and sleeping (indirect effect = 0.015, p < 0.001) have a positive effect on cognitive achievement when using depression symptoms as mediators; time spent on homework (indirect effect = -0.004, p < 0.001), surfing the Internet (indirect effect = -0.002, p = 0.046), and watching TV (indirect effect = -0.005, p < 0.001) have a negative effect on cognitive achievement when using depression symptoms as mediators. This study contributes to the understanding of the relationship between time use and cognitive achievement among Chinese adolescents.

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

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

[Use of neurodevelopmental disorder screening tool in primary care : A multicenter observational study]

INTRODUCTION

Neurodevelopmental disorders (NDD) affect 5 to 15% of the population. Improved management largely depends on early detection in primary care. A screening tool was developed by an expert consensus and its use has been recommended since 2019. This tool has never been evaluated to date. The aim of this study was to investigate the prevalence and factors associated with the identification of neurodevelopmental disorders in primary care in children aged 6 months to 5 years.

METHOD

This work is a multicentric observational study carried out in general practice in two regions of France: Île-de-France and Auvergne-Rhône-Alpes. A multivariate analysis was performed to identify the factors associated with the presence of abnormal signs on the grid.

RESULTS

Five hundred and sixty-four (564) children aged 6 months to 4 years were included. The prevalence of children identified on the grid was 3.9%. The factors associated with the neurodevelopmental disorders identified in multivariate analysis were: low socio-professional status of the mother, male gender and parental concern about the child's neurodevelopment. Factors associated with identifying a developmental trajectory gap were male gender (OR = 2.10 (1.22-3.62)) and low socio-professional status of the mother (OR = 2.23 [1.05-4.70]).

CONCLUSION

This original work allowed us to carry out first-line testing of a tool for the identification of NDD in primary care and to evaluate the prevalence of identification of these disorders. A complementary cohort study will be necessary to evaluate the sensitivity and specificity of this identification tool.

Combinations of Physical Activity, Sedentary Behavior, and Sleep Duration and Their Associations With Physical, Psychological, and Educational Outcomes in Children and Adolescents: A Systematic Review

We conducted a systematic review to evaluate combinations of physical activity, sedentary behavior, and sleep duration (defined as "movement behaviors") and their associations with physical, psychological, and educational outcomes in children and adolescents. MEDLINE, CINAHL, PsychInfo, SPORTDiscus, PubMed, EMBASE, and ERIC were searched in June 2020. Included studies needed to 1) quantitatively analyze the association of 2 or more movement behaviors with an outcome, 2) analyze a population between 5 and 17 years of age, and 3) include at least an English abstract. We included 141 studies. Most studies included the combination of physical activity and sedentary behavior in their analyses. Sleep was studied less frequently. In combination, a high level of physical activity and a low level of sedentary behavior were associated with the best physical health, psychological health, and education-related outcomes. Sleep was often included in the combination that was associated with the most favorable outcomes. Sedentary behavior had a stronger influence in adolescents than in children and tended to be associated more negatively with outcomes when it was defined as screen time than when defined as overall time spent being sedentary. More initiatives and guidelines combining all 3 movement behaviors will provide benefit with regard to adiposity, cardiometabolic risk factors, cardiorespiratory fitness, muscular physical fitness, well-being, health-related quality of life, mental health, academic performance, and cognitive/executive function.

EEG source derived salience network coupling supports real-world attention switching

While the brain mechanisms underlying selective attention have been studied in great detail in controlled laboratory settings, it is less clear how these processes function in the context of a real-world self-paced task. Here, we investigated engagement on a real-world computerized task equivalent to a standard academic test that consisted of solving high-school level problems in a self-paced manner. In this task, we used EEG-source derived estimates of effective coupling between brain sources to characterize the neural mechanisms underlying switches of sustained attention from the attentive on-task state to the distracted off-task state. Specifically, since the salience network has been implicated in sustained attention and attention switching, we conducted a hypothesis-driven analysis of effective coupling between the core nodes of the salience network, the anterior insula (AI) and the anterior cingulate cortex (ACC). As per our hypothesis, we found an increase in AI - > ACC effective coupling that occurs during the transitions of attention from on-task focused to off-task distracted state. This research may inform the development of future neural function-targeted brain-computer interfaces to enhance sustained attention.

The effect of online social evaluation on mood and cognition in young people

Adolescence is characterised by increased peer interactions and heightened sensitivity to evaluation by peers. Increasingly, social interactions and evaluation happen in online contexts. Yet, little is known about the impact of online social interactions and evaluation on adolescent emotional and cognitive functioning. The present study examined the impact of online social evaluative threat on young people's mood and learning and whether this varied as a function of known offline social risk and protective factors. 255 participants completed a perceptual learning task under online social evaluative threat and a perceptually-matched control condition. Participants were aged 11-30 years, to allow for the exploration of age differences in the impact of online social evaluative threat from adolescence to early adulthood. Participants reported a greater increase in negative mood (self-reported levels of stress, anxiety, and anhedonia), following social evaluative threat compared to the control condition. Heightened social rejection sensitivity (measured using the Online and Offline Social Sensitivity Scale) and lower perceived social support (measured using the Schuster Social Support Scale) were associated with elevated negative mood across the study. Social evaluative threat adversely impacted overall accuracy on the perceptual matching task, but not learning. These findings provide preliminary evidence that online social evaluative threat impacts adolescent mood and cognitive functioning.

The convergent effects of primary school physical activity, sleep, and recreational screen time on cognition and academic performance in grade 9

Lab-based experiments and randomized controlled trials consistently demonstrate improvements in youth cognition following physical activity (PA), while cross-sectional studies suggest that sedentary behavior (especially recreational screen time [RST]) and poor sleep are inversely related to cognition. However, little is known about how these 24-h movement behaviors—sleep, PA, and sedentary behavior—converge to affect youth cognition. Therefore, the purpose of this study is to test the associations between childhood 24-h movement behaviors and adolescent cognition using a longitudinal design and examine moderating effects of each behavior. This study utilized structural equation modeling with data from the NICHD Study of Early Child Care and Youth Development (N = 1,364, 52% female, 80% White). Independent variables—sleep, RST, and PA—were collected in grade 5. Dependent variables of cognitive and academic performance were collected at grade 9, including the Stroop task, Woodcock-Johnson, and Tower of London. Grade 5 PA was inversely associated with grade 9 cognition, but this relationship was no longer significant once grade 5 cognition was controlled for in analyses. Grade 5 sleep was positively related to grade 9 cognition, whether baseline cognition was controlled for or not. Finally, grade 5 RST was inversely related to cognition and academic performance, regardless of whether baseline values were controlled. Moderation analyses showed the relationship between grade 5 RST and grade 9 cognition was moderated by grade 5 PA, while the relationship between grade 5 PA and grade 9 cognition was moderated by grade 5 sleep. In each case, more PA and sleep blunted the negative relationships. These findings extend evidence that greater sleep promotes cognition and greater RST impairs cognition, by affirming these relationships over a longer period. They extend the evidence by demonstrating that the longitudinal relationship between individual 24-h movement behavior and cognition is moderated by other behaviors.

Association of Video Gaming With Cognitive Performance Among Children

IMPORTANCE

Although most research has linked video gaming to subsequent increases in aggressive behavior in children after accounting for prior aggression, findings have been divided with respect to video gaming's association with cognitive skills.

OBJECTIVE

To examine the association between video gaming and cognition in children using data from the Adolescent Brain Cognitive Development (ABCD) study.

DESIGN, SETTING, AND PARTICIPANTS

In this case-control study, cognitive performance and blood oxygen level-dependent (BOLD) signal were compared in video gamers (VGs) and non-video gamers (NVGs) during response inhibition and working memory using task-based functional magnetic resonance imaging (fMRI) in a large data set of 9- and 10-year-old children from the ABCD study, with good control of demographic, behavioral, and psychiatric confounding effects. A sample from the baseline assessment of the ABCD 2.0.1 release in 2019 was largely recruited across 21 sites in the US through public, private, and charter elementary schools using a population neuroscience approach to recruitment, aiming to mirror demographic variation in the US population. Children with valid neuroimaging and behavioral data were included. Some exclusions included common MRI contraindications, history of major neurologic disorders, and history of traumatic brain injury.

EXPOSURES

Participants completed a self-reported screen time survey including an item asking children to report the time specifically spent on video gaming. All fMRI tasks were performed by all participants.

MAIN OUTCOMES AND MEASURES

Video gaming time, cognitive performance, and BOLD signal assessed with n-back and stop signal tasks on fMRI. Collected data were analyzed between October 2019 and October 2020.

RESULTS

A total of 2217 children (mean [SD] age, 9.91 [0.62] years; 1399 [63.1%] female) participated in this study. The final sample used in the stop signal task analyses consisted of 1128 NVGs (0 gaming hours per week) and 679 VGs who played at least 21 hours per week. The final sample used in the n-back analyses consisted of 1278 NVGs who had never played video games (0 hours per week of gaming) and 800 VGs who played at least 21 hours per week. The VGs performed better on both fMRI tasks compared with the NVGs. Nonparametric analyses of fMRI data demonstrated a greater BOLD signal in VGs in the precuneus during inhibitory control. During working memory, a smaller BOLD signal was observed in VGs in parts of the occipital cortex and calcarine sulcus and a larger BOLD signal in the cingulate, middle, and frontal gyri and the precuneus.

CONCLUSIONS AND RELEVANCE

In this study, compared with NVGs, VGs were found to exhibit better cognitive performance involving response inhibition and working memory as well as altered BOLD signal in key regions of the cortex responsible for visual, attention, and memory processing. The findings are consistent with videogaming improving cognitive abilities that involve response inhibition and working memory and altering their underlying cortical pathways.

Screen Time and Attention Subdomains in Children Aged 6 to 10 Years

Using digital media has become the most popular leisure activity for children and adolescents. The effects of digital media use on the developing brain and cognitive processes of children are subject to debate. Here, we examine the effect of digital media use on attention subdomains in children aged 6 to 10 years. In total, 77 children participated in the study. Selective and divided attention as well as switching between attentional subdomains were quantified by the SwAD-task. Parents were asked to assess the screen time of their children (smartphone, laptop/PC, game console, tablet, TV). Results show no main or interaction effects of screen time on any of the attention conditions investigated. Based on the present findings as well as previous studies, we suggest a possible non-linear relationship between the amount of screen time and attention function. Furthermore, we emphasize the relevance of considering the socio-economic background of children and a need for longitudinal studies.

Influence of Screen Time during COVID-19 on Health-Related Quality of Life of Early Adolescents

This study investigated the influence of screen time during COVID-19 on the physical and mental domains of the health-related quality of life of early adolescents. A total of 860 early adolescents were recruited. The 36-Item Short Form Health Survey was used to measure their health-related quality of life. The early adolescents reported their average daily time spent using smartphones and computers and watching television over the previous week. The results show that most early adolescents, on average, spent less than 1 h to more than 4 h per day during COVID-19 using smartphones (n = 833, 96.9%) and computers (n = 783, 91.0%), and watching television (n = 804, 93.5%), respectively. Though early male and female adolescents spent a similar amount of time daily on average using smartphones, early male adolescents spent more time using computers and watching television than early female adolescents and reported a significantly lower mean score for three out of the eight scales in the physical and mental domains of health-related quality of life. While health-related quality of life of early female adolescents was negatively associated with time spent using smartphones only, early male adolescents were adversely affected by the time spent using smartphones and computers and watching television (p < 0.05). Therefore, early adolescents who spent more time using display devices during COVID-19 had significantly poorer outcomes in their health-related quality of life, and gender difference was found in the influence of screen time on health-related quality of life.

Associations of Passive and Mentally Active Screen Time With Perceived School Performance of 197,439 Adolescents Across 38 Countries

OBJECTIVE

To examine the associations of passive (ie, television) and active (ie, electronic games, computer use) screen time (ST) with perceived school performance of adolescents across gender.

METHODS

Data were from the 2014 Health Behaviour in School-aged Children survey conducted across 38 European countries and Canada. Perceived school performance was assessed using an item and dichotomized as high (good/very good) versus the remainder (average/below-average as reference). Participants reported hours per day of time spent watching television, playing electronic games, and using a computer in their free time. Multilevel logistic regression was used to estimate the associations.

RESULTS

A total of 197,439 adolescents (average age 13.6 [standard deviation 1.63] years; 51% girls) were analyzed. Multivariable modeling showed that engaging in >2 h/d of ST was progressively and adversely associated with high performance in both boys and girls. Adolescents reporting >4 h/d of television time (≤1 h/d as reference) had 32% lower odds in boys (odds ratio [OR] 0.68; 95% confidence interval [CI]: 0.65-0.71) and 39% lower odds in girls (OR 0.61; 95% CI, 0.58-0.65) of reporting high performance. Playing electronic games for >4 h/d was associated with high performance with odds being 38% lower in boys (OR 0.62; 95% CI, 0.59-0.66) and 45% lower in girls (OR 0.55; 95% CI, 0.52-0.57). Sex differences in the estimates were mixed.

CONCLUSIONS

High screen use, whether active or passive, was adversely associated with perceived high school performance, with association estimates being slightly stronger in girls than boys, and for mentally active than passive screen use. Discouraging high levels of screen use of any type could be beneficial to school performance.

The impact of digital media on children's intelligence while controlling for genetic differences in cognition and socioeconomic background

Digital media defines modern childhood, but its cognitive effects are unclear and hotly debated. We believe that studies with genetic data could clarify causal claims and correct for the typically unaccounted role of genetic predispositions. Here, we estimated the impact of different types of screen time (watching, socializing, or gaming) on children’s intelligence while controlling for the confounding effects of genetic differences in cognition and socioeconomic status. We analyzed 9855 children from the USA who were part of the ABCD dataset with measures of intelligence at baseline (ages 9–10) and after two years. At baseline, time watching (r = − 0.12) and socializing (r = − 0.10) were negatively correlated with intelligence, while gaming did not correlate. After two years, gaming positively impacted intelligence (standardized β =  + 0.17), but socializing had no effect. This is consistent with cognitive benefits documented in experimental studies on video gaming. Unexpectedly, watching videos also benefited intelligence (standardized β =  + 0.12), contrary to prior research on the effect of watching TV. Although, in a posthoc analysis, this was not significant if parental education (instead of SES) was controlled for. Broadly, our results are in line with research on the malleability of cognitive abilities from environmental factors, such as cognitive training and the Flynn effect.

A rapid review of the evidence for children’s TV and online advertisement restrictions to fight obesity

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The relationship between obesity and exposure to food advertising meets all criteria commonly used to demonstrate the presence of a causal relationship in epidemiology.

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Younger children (≤8 years of age) are more susceptible to the impacts of food marketing, in terms of quantity and quality of calories consumed, than older children and adults, although emerging evidence suggests that adolescents (10–19 years) may be most susceptible to the impacts of online advertisements.

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Children from socio-economically disadvantaged and ethnic minority backgrounds are disproportionately exposed to unhealthy food advertisements.

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Statutory regulation is a potentially cost-effective policy option, in terms of healthcare savings outweighing the costs of implementing the policy. However, advertising restrictions must be accompanied by community-based interventions that address other causes of poor diet and sedentary behaviour; this is because online and TV advertisements represent one small dimension in the wider obesogenic environment.

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Voluntary bans are ineffective. Exposure to unhealthy food advertising is similar before and after the introduction of voluntary food advertisements.

The World Health Organisation has urged all governments to address rising rates of obesity by implementing population-based interventions, such as restrictions on the marketing to children of unhealthy food and beverage items. However, the relationship between unhealthy food advertisements and childhood obesity is disputed by industry-sponsored reports, which recommend promoting physical activity and weight loss campaigns rather than policies to limit exposure to advertisements. We aimed to elucidate this debate by providing a narrative review of the evidence on the relationship between unhealthy TV and online food advertisements, short-term food consumption and childhood obesity. We also examined the impact of unhealthy food advertisements on vulnerable groups and identified which policy interventions are supported by current evidence.

We conducted a rapid overview of reviews published since 2006. From a synthesis of 18 reviews meeting the inclusion criteria, we conclude that exposure to unhealthy TV and online food advertising is a contributing factor to childhood obesity. Evidence of a relationship between exposure to unhealthy food advertisements and childhood obesity was evident at all stages of the causal pathway, including a clear dose-response relationship. The evidence base was particularly strong for children aged 3–12 years of age and for children from socio-economically disadvantaged and minority ethnic backgrounds.

The introduction of statutory regulation is a potentially cost-effective policy option, in terms of healthcare savings outweighing the costs of implementing the policy, although voluntary codes were shown to be ineffective, with exposure to unhealthy food advertisements similar in countries before and after their introduction. Food advertising, however, is just one factor in the wider obesogenic environment and further advertising restrictions must be implemented alongside population-based interventions that aim to address systemic causes of poor diet.

Cyberbullying involvement and short sleep duration among adolescents

BACKGROUND

Research has shown that cyberbullying victimization is associated with short sleep duration among adolescents; however, the association between cyberbullying perpetration and sleep duration is unclear. Furthermore, little is known about the factors that could moderate these associations. Thus, the objectives of this study were to investigate the associations of cyberbullying victimization, perpetration, or both with short sleep duration among adolescents, and to test whether age, sex, and adherence to the screen time recommendations (≤2 hours/day) moderate these associations.

METHODS

Data on 6834 adolescents aged 11-20 years were derived from a representative cross-sectional study of middle and high school students across Ontario, Canada. Short sleep duration was self-reported and defined as sleeping less than the age-appropriate sleep duration recommendations. Multivariable logistic regression models were adjusted for important covariates. Adjusted odds ratios (AOR) and their 95% confidence intervals (CI) are reported.

RESULTS

Cyberbullying victimization (AOR = 1.60, 95% CI = 1.37-1.86), perpetration (AOR = 1.44, 95% CI = 1.16-1.79), or both perpetration and victimization (AOR = 1.71, 95% CI = 1.27-2.30) was associated with greater odds of short sleep duration. Results further indicated that younger students who were not cyberbullied had a lower probability of short sleep duration, but there was no difference in the probability of short sleep duration between being cyberbullied or not among older adolescents. Sex and screen time did not moderate any of the associations between cyberbullying involvement and short sleep duration.

CONCLUSION

Involvement in cyberbullying as either a victim, a perpetrator, or both is associated with short sleep duration among adolescents. Strategies that can help to eliminate cyberbullying are needed in public health.

Screen time and early childhood development in Ceará, Brazil: a population-based study

BACKGROUND

Globally, children's exposure to digital screens continues to increase and is associated with adverse effects on child health. We aimed to evaluate the association of screen exposure with child communication, gross-motor, fine-motor, problem-solving, and personal-social development scores.

METHODS

We conducted a population-based, cross-sectional study with cluster sampling among children 0-60 months of age living in the state of Ceará, Brazil. Child screen time was assessed by maternal report and the World Health Organization (WHO) recommendations were used to define excessive screen time exposure. Child development was assessed with the Brazilian Ages and Stages Questionnaire. Generalized linear regression was used to determine the association of screen exposure with developmental outcomes. We also examined the potential non-linear relationship of screen time with development scores using spline analyses.

RESULTS

A total of 3155 children 0-60 months of age had screen time exposure evaluated and 69% percent were identified as exposed to excessive screen time. This percentage of excess screen time increased with child age from 41.7% for children 0-12 months to 85.2% for children 49-60 months. Each additional hour of screen time was associated with lower child communication (standardized mean difference (SMD): -0.03; 95% CI: - 0.04, - 0.02), problem solving (SMD: -0.03; 95% CI: - 0.05, - 0.02) and personal-social (SMD: -0.04; 95% CI: - 0.06, - 0.03) domain scores.

CONCLUSIONS

Excess screen time exposure was highly prevalent and independently associated with poorer development outcomes among children under 5 years of age in Ceará, Brazil.

Selective Attention and Concentration Are Related to Lifestyle in Chilean Schoolchildren

The objective of this investigation was to determine the association between selective attention and concentration with physical fitness (i.e., cardiorespiratory fitness (CRF), V˙O_2max, the standing long jump test (SLJ) and handgrip muscle strength (HGS)), lifestyle parameters (i.e., physical activity (PA) level, screen time (ST), sleep duration and food habits) and anthropometric measures (i.e., body mass index (BMI) and waist circumference (WC)) among Chilean schoolchildren. Two hundred and forty-eight schoolchildren (137 boys, 111 girls, 11.80 ± 1.17 and 11.58 ± 1.09 years, respectively) participated. Selective attention, concentration and lifestyle (PA, ST, sleep duration and Mediterranean diet (MD) adherence) were determined using a standard questionnaire. CRF, SLJ, HGS and anthropometric indicators (BMI and WC) were also measured. Selective attention showed a positive association with MD adherence score (β; 5.012, p = p < 0.05). Concentration was linked inversely to ST (β; −5.498, p = p < 0.05). Likewise, concentration presented a positive association with MD adherence (β; 2.904, p = p < 0.05). In conclusion, children’s lifestyles are related to the selective attention and concentration of children; therefore, promoting healthy habits could be a cost-effective strategy in the promotion of cognitive development, as it relates to selective attention and concentration.

The Relationship Between Dry Eye Disease and Digital Screen Use

Dry eye disease is characterized by tear film instability that can result in ocular surface damage. Patients with dry eye disease may experience ocular pain/discomfort and visual disturbances that may negatively impact quality of life. Increased use of digital screens for work, communication, and entertainment, especially during times of pandemic, may contribute to dry eye. Extensive cross-sectional studies have shown that digital screen use duration is associated with an increased risk of severe symptoms and clinical diagnosis of dry eye disease in adults. Smartphone use duration has also been found to be greater in school-age children with dry eye disease than in those without dry eye disease. A commonly accepted hypothesis for the relationship between digital screen use and dry eye disease is that digital screen use changes blinking dynamics, leading to ocular dryness. This review describes evidence that digital screen use is associated with dry eye disease, that digital device use alters blinking dynamics, and that dry eye affects mental health and work productivity in digital screen users. Helpful prevention and management strategies for dry eye disease exist for those who use digital screens.

YouTube's growth in use among children 0-5 during COVID19: The Occidental European case

YouTube has become an educational and entertainment tool among Western European families, particularly during the COVID-19 pandemic. This study monitored the main channels for children aged 0-5 years by using the social media analysis (SNA) methodology from March 24, 2020 to August 24, 2020. The software used has been FanpageKarma, which allows the collection and interpretation of data. The results indicate not only a growth in the use of such channels during confinement, but also how their expansion is related to the evolution of the COVID-19, reflecting, in turn, the consequences of the government policies adopted. Social distancing generated a greater consumption of recreational content, but not a greater growth in educational content regardless of the country or culture.

Predictors of Parental Barriers to Reduce Excessive Child Screen Time Among Parents of Under-Five Children in Selangor, Malaysia: Cross-sectional Study

Background

Globally, there is an increasing prevalence of excessive screen time exposure among young children, including in Malaysia. Parents are advised to limit this exposure, but there are barriers for many of them to follow this recommendation. To date, there is a lack of research on the factors that cause these parental barriers.

Objective

This study aimed to determine the parental barrier toward the reduction of excessive child screen time and its predictors among parents of children aged younger than 5 years in the Petaling District, Selangor, Malaysia.

Methods

A cross-sectional study was conducted from April 2019 to June 2020 among 789 parent-child dyads attending child health clinics in the Petaling District. Validated self-administered questionnaires were used to capture information on sociodemographic, parental, child-related, and environmental factors and parental barriers. Stratified sampling with probability proportionate to size was employed. Data were analyzed using SPSS Statistics version 25 (IBM Corp). Descriptive analysis and bivariable analysis were performed before multiple linear regression was used to identify predictors of parental barriers.

Results

The overall mean score of parental barriers was 3.51 (SD 0.83), indicating that the average numbers of barriers experienced by parents were more than 3. The multivariable analysis showed that the predictors of parental barriers included monthly household income (adjusted β=–.03, 95% CI –0.05 to –0.02), parents who worked in public sectors (adjusted β=.18, 95% CI 0.06 to 0.29), positive parental attitude on screens (adjusted β=.68, 95% CI 0.58 to 0.79), low parent self-efficacy to influence child’s physical activity (adjusted β=–.32, 95% CI –0.43 to –0.20), and child screen time (adjusted β=.04, 95% CI 0.02 to 0.06).

Conclusions

The strongest predictor of parental barriers to reduce excessive child screen time was the positive parental attitude on screen time which could contribute to their abilities to limit child screen time. Thus, future intervention strategies should aim to foster correct parental attitudes toward screen time activities among young children.

Screen time is independently associated with serum brain-derived neurotrophic factor (BDNF) in youth with obesity

Low levels of brain derived-neurotrophic factor (BDNF) and excessive screen exposure are risk factors for neurocognitive deficits and obesity in youth, but the relationship between screen time and BDNF remains unknown. This study examined whether duration and/or type of sedentary screen time behaviour (TV viewing, video games, recreational computer use) are associated with serum BDNF levels in youth with obesity. The sample consisted of 250 inactive, postpubertal adolescents with obesity (172 females/78 males, aged 15.5 ± 1.4 years) at the baseline assessment of the Healthy Eating, Aerobic, Resistance Training in Youth Study. After controlling for self-reported age, sex, race, parental education, puberty stage, physical activity, and diet, higher total screen exposure was significantly associated with lower serum BDNF levels (β = -0.21, p = 0.002). TV viewing was the only type of screen behaviour that was associated with BDNF levels (β = -0.22, p = 0.001). Higher exposure to traditional forms of screen time was independently associated with lower serum BDNF levels, and this association appears to be driven primarily by TV viewing. Future intervention research is needed to determine whether limiting screen time is an effective way to increase BDNF and associated health benefits in a high-risk population of youth with obesity. Trial Registration: ClinicalTrials.Gov NCT00195858. Novelty: This study is the first to show that recreational screen time is inversely associated with serum BDNF levels. The inverse association between screen time and BDNF is driven primarily by TV viewing, indicating the type of screen might matter.

Children's Internet Use Profiles in Relation to Behavioral Problems in Lithuania, Latvia, and Taiwan

This study explored the profiles of elementary-school-aged children’s Internet use in relation to their emotional and behavioral problems. Participating in this cross-sectional study were 877 child–parent dyads from Latvia, Lithuania, and Taiwan. Children (8–10 years old) provided information on three variables: the amount of time they spent online, frequency of online activities, and knowledge of how to do things online. Latent profile analysis including these three variables provided a four-class solution for child Internet use. A comparison between Latvia, Lithuania, and Taiwan on the percentage of the sample distribution in each class showed that there was no difference between sites for the high class (high ratings on all three variables). The largest differences were for the low and average classes (low and average ratings on all three variables, namely, time online, frequency, and knowledge): the Lithuanian and Taiwanese samples were similar in that a higher percentage of each sample was in the low class, whereas the Latvian sample had children equally distributed between the low class and the average class. Analysis of the data from the entire sample for differences in parent-reported child behavioral difficulties suggested that children in the high class had an elevated level of behavioral problems and compulsive Internet use.

Associations between the Canadian 24 h movement guidelines and different types of bullying involvement among adolescents

BACKGROUND

The Canadian 24-Hour Movement Guidelines for Children and Youth recommend ≥60 min of physical activity per day, ≤2 h of recreational screen time per day, and 9-11 hours of sleep per night for 11-13 years old and 8-10 hours per night for 14-17 years old.

OBJECTIVE

This study examined the association between combinations of these recommendations and school bullying and cyberbullying victimization and perpetration among adolescents.

PARTICIPANTS AND SETTING

A total of 5615 Canadian students (mean age = 15.2 years) who participated in the 2017 Ontario Student Drug Use and Health Survey (OSDUHS) self-reported their physical activity, screen time, sleep duration, and their involvement in bullying.

METHODS

Logistic regression analyses were adjusted for important covariates.

RESULTS

Meeting the screen time recommendation alone was associated with lower odds of being a victim (OR: 0.64; 95 % CI: 0.46-0.88) or a bully (OR: 0.64; 95 % CI: 0.43-0.96) at school and a victim of cyberbullying (OR: 0.67; 95 % CI: 0.49-0.91). Meeting both the screen time and sleep duration recommendations was associated with lower odds of being a bully (OR: 0.51; 95 % CI: 0.30-0.88). Meeting all 3 recommendations showed stronger associations (i.e. lowest risk) with being a victim of school bullying (OR: 0.32; 95 % CI: 0.19-0.54), a bully-victim (OR: 0.25; 95 % CI: 0.08-0.78) or a victim of cyberbullying (OR: 0.37; 95 % CI: 0.17-0.84).

CONCLUSIONS

Our findings provide evidence that meeting the 24 -h movement guidelines is associated with lower odds of bullying involvement. Encouraging adherence to the 24 -h movement guidelines could be a good behavioural target to prevent involvement in both school bullying and cyberbullying.

24-hour movement guidelines and suicidality among adolescents

BACKGROUND

The 24-hour movement guidelines for children and youth recommend ≥60 min/day of moderate-to-vigorous physical activity, ≤2 h/day of screen time, 9-11 h/night of sleep for 11-13 years and 8-10 h/night for 14-17 years. The objectives of this study were to examine the associations between meeting combinations of the recommendations contained within the 24-hour movement guidelines for children and youth and suicidal ideation and suicide attempts, and test whether age and gender moderate these associations.

METHODS

Data on 10,183 students were obtained from the 2015-2017 Ontario Student Drug Use and Health Survey, a representative cross-sectional survey of Ontario students in grades 7-12 (mean [SD] age, 15.2 [1.8] years).

RESULTS

Suicidal ideation and suicide attempts were reported by 13.1% and 3.3% of students, respectively. Meeting individual recommendations or combinations of recommendations were differentially associated with suicidal ideation and suicide attempts between adolescent boys and girls and younger and older (three-way interactions statistically significant for both outcomes). Meeting all 3 recommendations was associated with lower odds of suicidal ideation (OR: 0.24, 95% CI: 0.09 - 0.69) and suicide attempts (OR: 0.08, 95% CI: 0.02 - 0.41) among boys aged 15 to 20 years, but not those aged 11 to 14 years nor girls in both age groups.

LIMITATIONS

The cross-sectional nature of the data precludes causal inferences and there is possibility of bias related to self-reports.

CONCLUSIONS

These findings suggest that adherence to the 24-hour movement guidelines among adolescents is related to lower odds of suicidality in older boys.