Prospective associations between television in the preschool bedroom and later bio-psycho-social risks

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.

A Scoping Review of Digital Well-Being in Early Childhood: Definitions, Measurements, Contributors, and Interventions

Digital well-being concerns the balanced and healthy use of digital technology, and the existing studies in this area have focused on adolescents and adults. However, young children are more vulnerable to digital overuse and addiction than adults; thus, their digital well-being deserves empirical exploration. In this scoping review, we synthesized and evaluated 35 collected studies on young children's digital use and their associated well-being that were published up to October of 2022 to understand the related definitions, measurements, contributors, and interventions. The synthesis of the evidence revealed that (1) there was no consensus about the definition of the concept of digital well-being; (2) there were no effective ways of measuring young children's digital well-being; (3) both child factors (the duration and place of digital use, as well as the child's demographic characteristics) and parent factors (digital use, parental perception, and mediation) contribute to young children's well-being; and (4) there were some effective applications and digital interventions reported in the reviewed studies. This review contributes to the development of this concept by mapping the existing research on young children's digital well-being, as well as proposing a model and identifying the research gaps for future studies.

Psychometric properties of the ScreenQ for measuring digital media use in Portuguese young children

AIM

Digital media use is prevalent among children and linked to potential developmental and health risks, but validated measures of children's digital media use are lacking. The aim of this study was to validate the Portuguese version of the ScreenQ with three distinct children's age groups.

METHODS

Parents of children living in Portugal completed an online survey including the 16-item version of the ScreenQ and items related to home activities and digital media use. A combination of classical and modern theory (Rasch) methods was used for analysis.

RESULTS

A total of 549 mothers and 51 fathers of 325 girls and 322 boys from 6 months to 9 years and 11 months-old responded to the survey. Point-measure correlations were all positive and endorsement of item values were within acceptable ranges. Cronbach's coefficient α was acceptable for a new measure and test-retest reliability was high. Statistically significant correlations were found between ScreenQ total scores and relevant demographic, play-related, parenting, and digital media-use items.

CONCLUSION

The Portuguese version of the ScreenQ exhibited sound psychometric properties, including internal consistency and concurrent validity referenced to external items. Higher ScreenQ scores were correlated with higher digital media multitasking, lower parent-child interaction, and higher concerns regarding child's learning and behaviour.

The influence of sedentary behaviour on mental health among children and adolescents: A systematic review and meta-analysis of longitudinal studies

BACKGROUND

Systematic reviews that have examined associations between sedentary behaviour (SB) and mental health among children and adolescents are mainly based on cross-sectional investigations. There is a lack of evidence for a prospective relationship between SB and mental health in children and adolescents. This systematic review synthesized longitudinal studies that examined prospective associations between SB and mental health among children and adolescents.

METHODS

We conducted computer searches for English language literature from electronic databases of PubMed, Embase, PsycInfo and Google scholar, and manually screened the references of existing relevant studies to select studies for the synthesis. We included observational longitudinal studies that assessed the association between SB and mental health among children and adolescents. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

In total, 58 longitudinal studies met the inclusion criteria and were synthesized in the review. We found that higher SB among children and adolescents was associated with increased depression, anxiety and other mental health problems later in life. A dose-response association between SB and mental health was observed, suggesting that children and adolescents who spend more time on SB may have a higher risk of developing poorer mental health later.

CONCLUSIONS

The findings in the present study suggest that intervention programs targeting reducing SB may benefit to the prevention of poor mental health among children and adolescents. Future intervention studies especially randomized controlled trials are needed to elucidate a causal relationship between SB and mental health among children and adolescents.

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.

Measuring Parental Behavior towards Children's Use of Media and Screen-Devices: The Development and Psychometrical Properties of a Media Parenting Scale for Parents of School-Aged Children

Children's excessive screen use is associated with health risks such as obesity, sleep problems, attention problems, and others. The effect of parental regulative efforts focused on screen/media use (media parenting) is currently unclear and difficult to examine given the heterogeneity of measuring tools used for its assessment. We aimed to develop an inventory that would enable reliable and valid measurement of media parenting practices (especially active and restrictive mediation) in parents of primary school children. The inventory builds on existing tools, it is comprehensive, yet easy to use in research setting. The original MEPA-36 (36 items) and revised MEPA-20 (20 items) inventories were examined using data from 341 Czech and Slovak parents of children aged between 6 and 10 years. Psychometrical properties were estimated using confirmatory factor and reliability analyses. Model fit was better for MEPA-20 and similar to other currently available tools. Both active and restrictive mediation subscales demonstrated high internal consistency. The internal consistency of newly constructed risky mediation subscales (risky active, risky restrictive, and over-protective mediation) was low. MEPA-20, especially active and restrictive mediation subscales, can be recommended for research on media parenting in context of screen/media use of school-aged children.

Infant Television Watching Predicts Toddler Television Watching in a Low-Income Population

OBJECTIVE

This study examines the development of active television (TV) watching behaviors across the first 2 years of life in a racially and ethnically diverse, low-income cohort and identifies caregiver and child predictors of early TV watching.

METHODS

We used longitudinal data from infants enrolled in the active control group (N = 235; 39% Latino; 29% Black; 15% White) of Greenlight, a cluster randomized multisite trial to prevent childhood obesity. At preventive health visits from 2 months to 2 years, caregivers were asked: "How much time does [child's first name] spend watching television each day?" Proportional odds models and linear regression analyses were used to assess associations among TV introduction age, active TV watching amount at 2 years, and sociodemographic factors.

RESULTS

Sixty-eight percent of children watched TV by 6 months, and 88% by 2 years. Age of TV introduction predicted amount of daily active TV watching at 2 years, with a mean time of 93 minutes if starting at 2 months; 64 minutes if starting at 4 or 6 months; and 42 minutes if starting after 6 months. Factors predicting earlier introduction included lower income, fewer children in household, care away from home, male sex, and non-Latino ethnicity of child.

CONCLUSIONS

Many caregivers report that their infants actively watch TV in the first 6 months of life. Earlier TV watching is related to sociodemographic factors yet predicts more daily TV watching at 2 years even controlling those factors. Interventions to limit early TV watching should be initiated in infancy.

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.

A novel, composite measure of screen-based media use in young children (ScreenQ) and associations with parenting practices and cognitive abilities

BACKGROUND

Screen-based media use is prevalent in children and is associated with health risks. American Academy of Pediatrics (AAP) recommendations involve access to screens, frequency, content, and co-viewing. The aim of this study was to test the ScreenQ, a composite measure of screen-based media use.

METHODS

ScreenQ is a 15-item parent report measure reflecting AAP recommendations. Range is 0-26, higher scores reflecting greater non-adherence. With no "gold standard" available, four validated measures of skills and parenting practices cited as influenced by overuse were applied as the external criteria, including expressive language, speed of processing, emergent literacy, and cognitive stimulation at home. Psychometric analyses involved Rasch methods and Spearman's ρ correlations.

RESULTS

Sixty-nine families were administered ScreenQ. Child age ranged from 36 to 63 months old (52 ± 8; 35 girls). Mean ScreenQ score was 9.6 (±5.0; 1-22). Psychometric properties were strong (r_Co-α = 0.74). ScreenQ scores were negatively correlated with CTOPP-2 (Comprehensive Test of Phonological Processing, Second Edition) (r_ρ = -0.57), EVT-2 (Expressive Vocabulary Test, Second Edition) (r_ρ = -0.45), GRTR (Get Ready to Read!) (r_ρ = -0.30) and StimQ-P (r_ρ = -0.42) scores (all p ≤ 0.01).

CONCLUSIONS

ScreenQ shows potential as a composite measure of screen-based media use in young children in the context of AAP recommendations. ScreenQ scores were correlated with lower executive, language and literacy skills, and less stimulating home cognitive environment.