Cumulative Social Risk and Child Screen Use: The Role of Child Temperament

Developing language in a digital world

Young children's screen time is increasing, raising concerns about its negative impact on language development, particularly vocabulary. However, digital media is used in a variety of ways, which likely differentially impact language development. Instead of asking 'how much' screen time, the focus should be on how digital media is used.

Maternal Phubbing and Problematic Media Use in Preschoolers: The Independent and Interactive Moderating Role of Children's Negative Affectivity and Effortful Control

Purpose

Given that mother plays the main nurturing role in a family unit and their unique influence on children's development, the current study aimed to examine the influence of maternal phubbing on children's problematic media use and the independent and interactive moderating role of children's negative affectivity and effortful control.

Methods

Participants were 1986 children aged 3 to 6 years in Shanghai, China. Their mothers were asked to complete a series of questionnaires including parental phubbing scale, problematic media use measure, and child behavior questionnaire. To investigate the moderating influence of children's negative affectivity and effortful control, hierarchical linear regression analyses were conducted using SPSS 24.0. Simple slopes analyses and the Johnson-Neyman technique were further used to depict moderation effects.

Results

Maternal phubbing was associated with higher levels of problematic media use in preschool children (β = 0.18, p <.001, [0.14, 0.22]). Children's negative affectivity acts as a risk factor, exacerbating the adverse effects of maternal phubbing on children's problematic media use (β = 0.05, t = 2.69, p < 0.05), whereas children's effortful control acts as a protective factor, buffering the link between maternal phubbing and children's problematic media use (β = -0.10, t = -5.00, p < 0.001).

Conclusion

These results suggest that interventions seeking to promote appropriate digital development in preschoolers should take the child's temperament into account and be complemented by active parental mediation and involvement.

Preschooler Screen Time During the Pandemic Is Prospectively Associated With Lower Achievement of Developmental Milestones

OBJECTIVE

The aim of this study was to assess the developmental risks associated with total screen time, and specifically newer mobile devices, in the context of the pandemic.

METHODS

This study uses parent-reported data from a prospective cohort of Canadian preschool-age children. The exposure variable is child daily screen time measured at the age of 3.5 years categorized as light (<1 hr/d), moderate (1-4 hr/d), or intensive (>4 hr/d) use (N = 315). Time spent on mobile devices was considered separately as a continuous variable. Our outcome is child global development scores, which combine assessments of communication, cognitive, personal-social, and motor skills measured at the age of 4.5 years using the Ages and Stages Questionnaire (ASQ) (N = 249, 79% retained). ASQ scores were dichotomized to distinguish children at risk of developmental delays (below the 15th percentile) from those not at risk. We estimate associations between child screen time and later global development using multiple regressions adjusted for child sex and temperament, and parent education. We also examine whether associations are moderated by child and parent characteristics.

RESULTS

Logistic regressions revealed that intensive users were more at risk of global developmental delays compared with light users (OR = 4.29, p = 0.020). Mobile device use was also associated with lower global scores (β = -3.064; p = 0.028), but not with risk of delays. We found no evidence that associations were moderated by child sex and temperament, or parent education.

CONCLUSION

The findings suggest that intensive screen time may be associated with delays in child global development. Early childhood professionals should encourage families with preschoolers to prioritize screen-free activities to promote optimal cognitive, language, social, and motor development.

Infant screen media and child development: A prospective community study

The current study examined longitudinal associations between early screen media exposure (assessed at 6, 12, and 24 months) and the child's motor and language/communication development at the ages of 24 and 36 months. We also aimed to study whether these associations varied by socioeconomic status (SES). Participants were 179 parent-infant dyads, recruited from well-baby clinic services during routine visits. Child development measures included standardized measures of developmental milestones as assessed by professionals and referral data to child developmental centers. Both measures were retrieved from the official health maintenance organization records by an expert in child development. Results indicated that screen exposure at 6 and 12 months was associated with a higher risk for language/communication deficits at 36 months in children with moderate or high SES but not in children with low SES. Our findings are consistent with existing literature demonstrating cross-sectional and longitudinal associations between early screen exposure and language development deficits. Given that media use practices and motivations vary among families from different backgrounds, further investigation of the interaction between SES and screen exposure is needed.

Family Meal Environment Differentially Conditions the Prospective Association between Early Childhood Screen Time and Key Social Relationships in Adolescent Girls

Background: Despite screen time recommendations, children are increasingly spending time on electronic devices, rendering it an important risk factor for subsequent social and developmental outcomes. Sharing meals could offer a way to promote psychosocial development. This study examines the interaction between family meal environment and early childhood screen time on key adolescent social relationships. Methods: Participants are 1455 millennial children (49% boys) from the Quebec Longitudinal Study of Child Development birth cohort. Parents reported on child screen use at ages 2 and 6 years and family meal environment quality at age 6 years. Parents and children reported on parent-child relationships and peer victimization experiences, respectively, at age 13 years. Sex-stratified multiple regression estimated the direct association between screen time trends, family meal environment quality, and their interaction on later social relationship outcomes. Results: For girls, when preschool screen time increased, sharing family meals in high-quality environments was associated with more positive and less conflictual relationships with their mothers, whereas meals shared in low- and moderate-quality environments were associated with fewer instances of victimization by their peers. Non-linear associations were not significant for boys. Conclusion: Capitalizing on family meal environment represents a simple/cost-efficient activity that can compensate for some long-term risks associated with increased screen use, above and beyond pre-existing and concurrent individual and family characteristics. Public health initiatives may benefit from considering family meals as a complementary intervention strategy to screen use guidelines.

Screen Time and Developmental Performance Among Children at 1-3 Years of Age in the Japan Environment and Children's Study

Importance

It is unclear whether increased television (TV) and DVD viewing in early childhood from age 1 year decreases development or whether poor development increases TV/DVD viewing.

Objective

To investigate the directional association between TV/DVD screen time and performance on developmental screeners in children aged 1 to 3 years.

Design, Setting, and Participants

This longitudinal cohort study analyzed data from 57 980 children and mothers from a national birth cohort, the Japan Environment and Children's Study. Data were collected in collaboration with 15 regional centers across Japan. The mothers were recruited between January 2011 and March 2014. Analyses using random intercept, cross-lagged panel models were performed for children aged 1, 2, and 3 years. Of 100 303 live births, children with missing developmental screening test scores and screen time data, those with congenital diseases or cerebral palsy, and those diagnosed with an autism spectrum disorder were excluded. Statistical analyses were conducted from October 2022 to July 2023.

Exposures

TV and DVD screen time.

Main Outcomes and Measures

Child development at ages 1, 2, and 3 years was assessed via the mother's or guardian's report using the Ages and Stages Questionnaire, third edition.

Results

Of 57 980 included children, 29 418 (50.7%) were male, and the mean (SD) maternal age at delivery was 31.5 (4.9) years. A negative association between screen time and developmental scores was observed. Increased TV/DVD screen times at age 1 and 2 years were associated with lower developmental scores at age 2 and 3 years, respectively (2 years: β = -0.05; 95% CI, -0.06 to -0.04; 3 years: β = -0.08; 95% CI, -0.09 to -0.06). An obverse association was observed from the Ages and Stages Questionnaires, third edition, score in the communication domain at age 1 and 2 years to subsequent screen time (2 years: γ = -0.03; 95% CI, -0.04 to -0.02; 3 years: γ = -0.06; 95% CI, -0.07 to -0.04).

Conclusions and Relevance

In this study, increased TV/DVD screen time from age 1 year negatively affected later development. To reduce the negative consequences of excessive media use, researchers and health care professionals should encourage family media management and recommend social support for parents who tend to rely on the media.

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.

Children's media use and food approach behavior: Associations with temperament and food parenting

Children's media use has been found to be associated with obesogenic eating and obesity risk. Children's temperament and food parenting have been found to be important factors associated with children's eating behavior. The current study examined whether children's temperament and food parenting moderated the associations between children's media use and children's food approach behaviors. Parents (n = 214) of children between 3- to 5- years old were recruited to complete an online survey. Findings showed that children's temperament (i.e., negative affectivity and effortful control) and food parenting (i.e., coercive control) moderated the relationship between children's media use and children's food approach behavior. The results suggest that children's temperament and food parenting play important roles in understanding the relationship among children's media use and children's eating behavior.

Correlation of temperament characteristics and early functional exercise compliance in school-age children with limb fractures: Implication for clinical nursing care

Early functional exercise plays a very important role in the rehabilitation and nursing care of children with fractures. We aimed to evaluate the role of temperament characteristics in the early functional exercise compliance in school-age children with limb fractures, to provide evidence to clinical nursing care. School-age children with limb fractures admitted to our hospital from January 1, 2021 to June 30, 2022 were selected. We collected the general information, evaluated the temperament characteristics and their functional exercise compliance in school-age children. Correlation and regression analyses were conducted to assess the correlation of temperament characteristics and early functional exercise compliance. A total of 126 school-age children with limb fractures were finally included. There were 68, 36, and 22 children that were rated as easy-going, troublesome and initiate slow temperament, respectively. The children with easy-going temperament had the best early functional exercise compliance, followed by children with initiate slow temperament, and compliance of children with troublesome temperament was the worst. The reaction intensity factor in the temperament characteristics of school-age children with fracture was negatively correlated with early functional exercise compliance (P = .007). Reaction intensity was a risk factor for early functional exercise compliance in school-age children with fractures (P = .004). Health care providers must consider the influence of temperament characteristics on compliance in school-age children with fractures, and take targeted nursing measures according to different temperament characteristics of children to improve early functional exercise compliance in school-age children with fractures, so as to improve the functional recovery and prognosis of children.

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

BACKGROUND

Both excessive screen time and early screen exposure have been linked to children's health outcomes, but few studies considered these two exposures simultaneously. The aim of this study was to explore the independent and interactive associations of excessive screen time and early screen exposure with health-related quality of life (HRQOL) and behavioral problems among Chinese children attending preschools.

METHODS

A cross-sectional study of 4985 children aged between 3 and 6 years was conducted in Chengdu, China. Each parent has finished an online questionnaire regarding their children's screen use, HRQOL, and behavioral problems. Children with screen time over 1 h/day were considered as having excessive screen time. Early screen exposure was defined if the children had started using screen-based media before the age of 2 years. HRQOL was assessed by the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0), while behavioral problems were confirmed with the 48-item Conners' Parent Rating Scale (CPRS-48).

RESULTS

Of the 4985 children (2593 boys and 2392 girls) included, the mean age was 4.6 (SD: 1.0) years. After adjustment for confounders and early screen exposure, excessive screen time was significantly associated with worse HRQOL scores in all dimensions and summary scales, as well as each type of behavioral problems (all p values < 0.05). We also found that compared to children with later initiation of screen exposure, those with screen use before the age of 2 years had significantly lower emotional functioning score (β: - 2.13, 95%CI: - 3.17, - 1.09) and psychosocial health summary score (β: - 0.82, 95%CI: - 1.54, - 0.10) of HRQOL, as well as higher risks of conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, and hyperactivity index, which were independent of excessive screen use. Furthermore, there were significant interactive effects of excessive screen time and early screen exposure on emotional functioning domain of HRQOL scores and conduct problems.

CONCLUSION

Excessive screen time and early screen exposure are two independent and interactive factors to children's HRQOL and behavioral problems. Our findings support current guidelines to limit screen exposure in children. Appropriate screen use may represent an important intervention target to improve children's HRQOL and reduce their behavioral problems.

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.

Is the Association Between Early Childhood Screen Media Use and Effortful Control Bidirectional? A Prospective Study During the COVID-19 Pandemic

Individual differences in effortful control, a component of temperament, reflecting the ability to use attention and other cognitive processes to self-regulate emotion and behavior, contribute to child academic adjustment, social competence, and wellbeing. Research has linked excessive screen time in early childhood to reduced self-regulation ability. Furthermore, research suggests that parents are more likely to use screens with children who have more challenging temperaments, such as low levels of effortful control. Since screen time by children between the ages of 0 and 18 has increased during the COVID-19 pandemic, it remains timely to investigate the developmental pattern of association between child screen media use and effortful control. We hypothesize that higher levels of screen media intake at age 3.5 will be associated with lower effortful control at age 4.5 and that lower effortful control at 3.5 will contribute to more screen media intake at age 4.5. This study draws on participants followed longitudinally over the span of 2-years for an investigation of Canadian preschoolers' screen media use during the pandemic (N = 316, Wave 1). A follow-up with this sample was completed in 2021 (N = 265, Wave 2). Analyses using a cross-lagged panel model revealed stability in child screen time and effortful control between the ages of 3.5 and 4.5. Child screen time at age 3.5 significantly contributed to decreased effortful control scores at the age of 4.5, whereas effortful control at age 3.5 did not contribute to screen time at age 4.5. Our results partially confirmed our hypothesis and indicated that higher levels of screen time intake were detrimental to the development of effortful control. These results suggest that screen media use, an exceedingly frequent activity, may play an enduring role in development by shaping young children's temperaments.

An examination of bedtime media and excessive screen time by Canadian preschoolers during the COVID-19 pandemic

Background

Risky media use in terms of accumulating too much time in front of screens and usage before bedtime in early childhood is linked to developmental delays, reduced sleep quality, and unhealthy media use in later childhood and adulthood. For this reason, we examine patterns of media use in pre-school children and the extent to which child and family characteristics contribute to media use during the COVID-19 pandemic.

Methods

A cross-sectional study of digital media use by Canadian preschool-aged children (mean age = 3.45, N = 316) was conducted at the start of the COVID-19 pandemic between April and August of 2020. Parents completed a questionnaire and 24-h recall diary in the context of an ongoing study of child digital media use. From these responses we estimated hours of average daily screen time, screen time in the past 24 h, average daily mobile device use, and media use before bedtime. Parents also answered questions about their child (i.e., age, sex, temperament), family characteristics (parental mediation style, parental screen time, education, income), and contextual features of the pandemic (ex., remote work, shared childcare). Daycare closures were directly assessed using a government website.

Results

Our results indicate that 64% of preschoolers used more than 2 h of digital media hours/day on average during the pandemic. A majority (56%) of children were also exposed to media within the hour before bedtime. Logistic and multinomial regressions revealed that child age and temperament, restrictive parental mediation, as well as parent digital media use, education, satisfaction with the division of childcare, remote work, and number of siblings and family income were all correlates of risky digital media use by preschoolers.

Conclusions

Our results suggest widespread risky media use by preschoolers during the pandemic. Parenting practices that include using more restrictive mediation strategies may foster benefits in regulating young children’s screen time.