Beyond Screen Time: A Synergistic Approach to a More Comprehensive Assessment of Family Media Exposure During Early Childhood

Toddler's memory and media-Picture book reading and watching video content are associated with memory at 2 years of age

Memory develops across the course of the first years of life and is influenced by daily experiences, such as exposure to media like books and television. Memory as tapped by Deferred imitation (DI) requires that toddlers form a representation of the target actions that they can later use to reproduce the actions and in addition to measuring memory for real live events, it can also be used to measure memory for events viewed through media. Toddlers are frequently exposed to multiple forms of digital media in addition to more traditional forms of picture book reading. In a within-subjects design, memory was assessed with a DI task in 2-year-olds (n = 89) using the Frankfurt Imitation Test. Deferred imitation was assessed after live and video demonstrations. Parents completed a survey about children's media use. Picture book reading for less than 30 min a day predicted lower memory scores for actions demonstrated live. Watching video content for more than 1 h a day predicted lower memory scores for actions demonstrated on video. Results are interpreted in terms of individual differences in experiences of traditional and digital media and the development of symbolic understanding.

Language environment and early language production in Slovenian infants: An exploratory study using daylong recordings

Daylong recordings provide an ecologically valid option for analyzing language input, and have become a central method for studying child language development. However, the vast majority of this work has been conducted in North America. We harnessed a unique collection of daylong recordings from Slovenian infants (age: 16-30 months, N = 40, 18 girls), and focus our attention on manually annotated measures of parentese (infant-directed speech with a higher pitch, slower tempo, and exaggerated intonation), conversational turns, infant words, and word combinations. Measures from daylong recordings showed large variation, but were comparable to previous studies with North American samples. Infants heard almost twice as much speech and parentese from mothers compared to fathers, but there were no differences in language input to boys and girls. Positive associations were found between the social-interactional features of language input (parentese, turn-taking) and infants' concurrent language production. Measures of child speech from daylong recordings were positively correlated with measures obtained through the Slovenian MacArthur-Bates Communicative Development Inventory. These results support the notion that the social-interactional features of parental language input are the foundation of infants' language skills, even in an environment where infants spend much of their waking hours in childcare settings, as they do in Slovenia.

Early-Childhood Tablet Use and Outbursts of Anger

Importance

Tablet use continues to increase in preschool-aged children. The use of mobile devices has been linked to child emotional dysregulation. However, few studies have been able to show a clear direction of association between child tablet use and the development of self-regulation skills. In addition, few studies have modeled within-person associations over time.

Objective

To estimate how child tablet use contributes to expressions of anger and frustration across the ages of 3.5 to 5.5 years at the within-person level. The study team also examined the extent to which associations are bidirectional to clarify the direction of the correlations.

Design, Setting, and participants

This prospective, community-based convenience sample of 315 parents of preschool-aged children from Nova Scotia, Canada, was studied repeatedly at the ages of 3.5 (2020), 4.5 (2021), and 5.5 years (2022) during the COVID-19 pandemic. All analyses were conducted between October 5, 2023, and December 15, 2023.

Exposure

Parent-reported tablet use at the ages of 3.5, 4.5, and 5.5 years.

Main outcome and measures

Parents reported child expressions of anger/frustration at the ages of 3.5, 4.5, and 5.5 years using the Children's Behavior Questionnaire.

Results

The sample was equally distributed across child sex (171 were identified by parents as being born boys [54%] and 144 as girls [46%]). Most reported being Canadian (287 [91.0%]) and married (258 [82.0%]). A random-intercept cross-lagged panel model revealed that a 1-SD increase in tablet use at 3.5 years (corresponding to 1.15 hours per day) was associated with a 22% SD scale increase in anger/frustration at age 4.5 years (standardized coefficient = 0.22; 95% CI, 0.01-0.44). A 1 SD scale increase in anger and frustration at 4.5 years was associated with a 22% SD (corresponding to 0.28 hours per day) increase in tablet use at 5.5 years (standardized coefficient = 0.22; 95% CI, 0.01-0.43).

Conclusion and relevance

In this study, child tablet use at age 3.5 years was associated with more expressions of anger and frustration by the age of 4.5 years. Child proneness to anger/frustration at age 4.5 years was then associated with more use of tablets by age 5.5 years. These results suggest that early-childhood tablet use may contribute to a cycle that is deleterious for emotional regulation.

Adolescent digital emotion regulation

The maturation of effective emotion regulation (ER) skills is a core achievement of adolescence and youth are now developing their ER habits and skills in a hybrid reality of digital and non-digital experiences. We present a new model of adolescent digital emotion regulation as a conceptual framework to help guide burgeoning research in this area. We distinguish two primary processes: the regulation of emotions that have been elicited within digital contexts (i.e., the regulation of digitally induced emotions), and how youth regulate their emotions through digital means (i.e., digitally regulated emotion). Following the explication of different pathways in the model and consideration of the affordances of digital contexts, we highlight how this framework connects to theory and guides future research.

Parental views on their children's smartphone use during personal and relational activities

Given the negative outcomes associated with smartphone use during personal and relational activities (SUPRA), parents strive to regulate its use among their children. However, media parenting recommendations lack knowledge of parental views on SUPRA and their relative occurrence in youths. This study aimed to (i) estimate SUPRA frequency among children and adolescents, (ii) assess parental dislike (PD) of SUPRA, and (iii) identify predictors of PD of SUPRA. An online survey was completed by 826 parents (49% mothers, age 25-74, Median = 43 years), capturing PD of SUPRA, estimated frequency of SUPRA in their children (49% female, age 6-18, Median = 10 years), parenting styles (warmth and control), parental attitudes toward screen media, and sociodemographic characteristics. The rate of frequent SUPRA was significantly higher in adolescents (2.7-48.1%) compared to children (2.1-27.2%) with odds ratios ranging from 0.67 to 3.04, depending on the activity type. PD of SUPRA was high in parents of children (M = 4.04, SD = 0.66) and adolescents (M = 3.93, SD = 0.71). Linear regression identified being a mother, having higher levels of control and warmth, and less positive attitudes toward screen media as significant predictors of SUPRA dislike. Our study was the first to report the estimated occurrence and parental dislike of smartphone use (SU) during various personal and relational activities, enabling their direct comparison. Experts warn against SU while studying and at bedtime, which frequently occurred in 4-5% of children and 10-12% of adolescents. More attention should be paid to SU during relational (peer/family) activities due to its relatively high occurrence and parental dissatisfaction.

Early Childhood Screen Use Contexts and Cognitive and Psychosocial Outcomes: A Systematic Review and Meta-analysis

Importance

The multifaceted nature of screen use has been largely overlooked in favor of a simplistic unidimensional measure of overall screen time when evaluating the benefits and risks of screen use to early childhood development.

Objective

To conduct a systematic review and meta-analysis to examine associations of screen use contexts in early childhood with cognitive and psychosocial outcomes.

Data Sources

PsycINFO, Embase, MEDLINE Ovid, ProQuest, CINAHL, Web of Science, and Scopus were searched from inception to December 31, 2023.

Study Selection

A total of 7441 studies were initially identified. Studies were included if they examined associations between a contextual factor of screen use among children aged 0 to 5.99 years and cognitive or psychosocial development. Observational, experimental, and randomized clinical trial study designs were included.

Data Extraction and Synthesis

All studies were independently screened in duplicate following PRISMA guidelines. Effect sizes of associations (r) from observational studies were pooled using random-effects 3-level meta-analyses. The remaining study designs were narratively synthesized.

Main Outcomes and Measures

Screen use contexts included content (child directed and age inappropriate), type (program viewing and game or app use), co-use (or solo use), background television, caregiver screen use during child routines, and purpose. Outcomes were cognitive (executive functioning, language, and academic skills) or psychosocial (internalizing and externalizing behavior problems and socioemotional competence).

Results

Overall, 100 studies (176 742 participants) were included, and of these, 64 observational studies (pooled sample sizes ranging from 711 to 69 232) were included in meta-analyses. Program viewing (n = 14; k = 48; r, -0.16; 95% CI, -0.24 to -0.08) and background television (n = 8; k = 18; r, -0.10; 95% CI, -0.18 to -0.02) were negatively associated with cognitive outcomes, while program viewing (n = 6; k = 31; r, -0.04; 95% CI, -0.07 to -0.01), age-inappropriate content (n = 9; k = 36; r, -0.11; 95% CI, -0.17 to -0.04), and caregiver screen use during routines (n = 6; k = 14; r, -0.11; 95% CI, -0.20 to -0.03) were negatively associated with psychosocial outcomes. Co-use was positively associated with cognitive outcomes (n = 8; k = 28; r, 0.14; 95% CI, 0.03 to 0.25).

Conclusions and Relevance

Findings show small to moderate effect sizes that highlight the need to consider screen use contexts when making recommendations for families, clinicians, and educators beyond screen time limits; including encouraging intentional and productive screen use, age-appropriate content, and co-use with caregivers.

Sleep-dependent memory consolidation of televised content in infants

Infants face the constant challenge of selecting information for encoding and storage from a continuous incoming stream of data. Sleep might help in this process by selectively consolidating new memory traces that are likely to be of future relevance. Using a deferred imitation paradigm and an experimental design, we asked whether 15- and 24-month-old infants (N = 105) who slept soon after encoding a televised demonstration of target actions would show higher imitation scores (retention) after a 24-h delay than same-aged infants who stayed awake for ≥4 h after encoding. In light of infants' well-known difficulties in learning and remembering information from screens, we tested if increasing the relevance of the televised content via standardised caregiver verbalisations might yield the highest imitation scores in the sleep condition. Regardless of sleep condition, 24-month-olds exhibited retention of target actions while 15-month-olds consistently failed to do so. For 24-month-olds, temporal recall was facilitated by sleep, but not by parental verbalisations. Correlational analyses revealed that more time asleep within 4 h after encoding was associated with better retention of the target actions and their temporal order in 24-months-olds. These results suggest that sleep facilitates memory consolidation of screen-based content in late infancy and that this effect might not hinge on caregivers' verbal engagement during viewing.

Background TV and infant-family interactions: Insights from home observations

Background television has been found to negatively impact children's language development and self-regulatory skills, possibly due to decreased parent-child interactions. Most of the research on the relationship between background TV and caregiver-child interactions has been conducted in laboratory settings. In the current study, we conducted home observations and investigated whether infants engage in fewer interactions with family members in homes where background TV is more prevalent. We observed 32 infants at the ages of 8, 10, and 18 months in their home environments, coding for dyadic interactions (e.g., parent talking to and/or engaging with the child), triadic interactions (e.g., parent and infant play with a toy together), and infants' individual activities. Our findings revealed that background TV was negatively associated with the time infants spent in triadic interactions, positively associated with time spent engaging in individual activities, and not significantly related to the time spent in dyadic interactions. Apart from the relationship between background TV and individual activity time at 8 months, these associations remained significant even after accounting for families' socioeconomic status. These findings imply a correlation between background TV exposure and caregiver-infant-object interactions, warranting a longitudinal analysis with larger sample sizes.

Measurement Method Options to Investigate Digital Screen Technology Use by Children and Adolescents: A Narrative Review

The role and potential impact of digital screen technology in the lives of children is heavily debated. Current evidence is limited by the weakness of measures typically used to characterise screen use, predominantly proxy- or self-reports with known inaccuracy and bias. However, robust and detailed evidence is needed to provide practical trustworthy guidance to families and professionals working with families. The purpose of this paper is to support researchers to select measurement method(s) that will provide robust and detailed evidence. The paper outlines the challenges in measuring contemporary screen use by children, using a child-technology interaction model to organise considerations. A range of different methods used to measure digital screen technology use in children and adolescents (i.e., questionnaires, diaries, electronically prompted sampling, direct observation, fixed room cameras, wearable/portable cameras, audio recorders, screen-device onboard logging, remote digital trace logging and proximity logging) are described along with examples of their use and constructs typically measured as well as a summary of the advantages and disadvantages of each method. A checklist and worked examples are provided to support researchers determining the best methods or combination of methods for a research project.

Social interactions offset the detrimental effects of digital media use on children's vocabulary

Young children's rapid vocabulary growth during the first few years is supported by input during social interactions with caregivers and, increasingly, from digital media. However, the amount of exposure to both sources can vary substantially across socioeconomic classes, and little is known about how social interactions and digital media use together predict vocabulary in the first few years of life. The current study takes a first step toward examining whether increased social interactions with other individuals may buffer the potentially detrimental effects of digital media use on language among a socioeconomically diverse sample. 305 caregivers of children between 17 and 30-months completed questionnaires about their family demographics, their child's technology use, and the child's daily routines and social interactions. Findings suggest children who experience fewer human interactions and greater technology exposure have smaller vocabularies than their peers who socialize more and use less technology, and this disparity becomes greater as children get older. Moreover, the number of social interactions moderates the link between SES, digital media, and vocabulary such that the negative impact of digital media on vocabulary for children from low SES households can be offset with increased social interactions. Together, this suggests that increasing the amount of human interactions may serve as a protective factor for vocabulary outcomes in a world where digital media use is prominent.

Variability and patterns in children's media use and links with language development

AIM

Media use is widespread and rising, but how often and for what purpose young children use media varies, which has differential impacts on development. Yet little work has measured how and why children under 36 months use digital media or media's consequences for language.

METHODS

The current study measures how and why 17- to 30-month-old children use digital media and associations with their language abilities. The amount of use, type of activity and caregiver reasons for children's media use were then compared to the child's vocabulary and mean length of utterance.

RESULTS

About 17- to 30-month-old children are primarily exposed to TV/videos over other media forms, which are often used to occupy children. Video time (but not other activities) negatively predicts children's language. The negative impact of videos on vocabulary persists regardless of the reason for use, however, the effect of videos on expressive language may be tempered when videos are used for education or connecting.

CONCLUSION

Children under 36 months are using digital media at high rates. What they are doing and why they use media is critical to predict the effect it might have on language development. Further research and anticipatory guidance on the consequences of videos are needed.

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.

The association of maternal-infant interactive behavior, dyadic frontal alpha asymmetry, and maternal anxiety in a smartphone-adapted still face paradigm

Mother-infant interactions form a strong basis for emotion regulation development in infants. These interactions can be affected by various factors, including maternal postnatal anxiety. Electroencephalography (EEG) hyperscanning allows for simultaneous assessment of mother-infant brain-to-behavior association during stressful events, such as the still-face paradigm (SFP). This study aimed at investigating dyadic interactive behavior and brain-to-behavior association across SFP and identifying neural correlates of mother-infant interactions in the context of maternal postnatal anxiety. We measured frontal alpha asymmetry (FAA), a physiological correlate of emotion regulation and a potential marker of risk for psychopathology. To emulate real-life interactions, EEG and behavioral data were collected from 38 mother-infant dyads during a smartphone-adapted dual-SFP. Although the behavioral data showed a clear still-face effect for the smartphone-adapted SFP, this was not reflected in the infant or maternal FAA. Brain-to-behavior data showed higher infant negative affect being associated with more infant leftward FAA during the still-face episodes. Finally, mothers with higher postnatal anxiety showed more right FAA during the first still-face episode, suggesting negative affectivity and a need to withdraw from the situation. Our results form a baseline for further research assessing the effects of maternal postnatal anxiety on infants' FAA and dyadic interactive behavior.

Examining Profiles of U.S. Children's Screen Time and Associations with Academic Skills

Children's screen time (ST) increased in recent years, but investigations of the content and context (e.g., parental presence, and device type) of ST in predicting early academic skills remains understudied. In this study of 127 four- and five-year-olds, we examined whether the educational content and contextual information about children's ST from time diary interviews at age 4 predicted direct assessments of academic skills at age five. Cluster analyses detected three unique groups: Cluster One was "lowest ST and highest non-educational TV, with little parental presence," Cluster Two was "moderate ST and highest educational mobile devices, with moderate parental presence," and Cluster Three was "highest total ST and moderate educational ST and high parental presence." Children in Cluster Two scored significantly higher in literacy skills at age five than peers in Cluster One and Cluster Three. Children in Cluster One scored significantly higher in spatial skills compared to those in Cluster Three. No significant associations were detected between children's ST and number skills. Findings suggest that educational content and contextual features of ST combine in meaningful ways and appear to better predict children's literacy and spatial skills compared to variable-centered approaches. Methodological implications of this research and future directions are discussed.

A longitudinal study of the relationship between children's exposure to screen media and vocabulary development

AIM

This study addresses the scarcity of longitudinal research on the influence of screen media on children. It aims to explore the longitudinal relationship between children's vocabulary development and their exposure to screen media.

METHODS

The study, initiated in 2017, included 72 children (37 boys) in Östergötland, Sweden, at three key developmental stages: preverbal (9.7 months), early verbal (25.5 months) and preliterate (5.4 years). Parents completed online surveys at each time point, reporting their child's screen time. At 10 months and 2 years, age-appropriate vocabulary assessments were conducted online. At age 5, children's vocabulary was laboratory assessed.

RESULTS

Correlational analysis revealed a negative relationship between language scores and screen media use across all time points. Furthermore, a cross-lagged panel model demonstrated that screen media use showed significant continuity over time, with screen use at age 2 predicting language development at ages 2 and 5.

CONCLUSION

This longitudinal study, spanned from 9 months to 5 years of age, established a predictive negative association between children's exposure to screen media and their vocabulary development. These findings underscore the need to consider the impact of screen media on early childhood development and may inform guidelines for screen media use in young children.

The next generation of developmental psychopathology research: Including broader perspectives and becoming more precise

The current Special Issue marks a major milestone in the history of developmental psychopathology; as the final issue edited by Cicchetti, we have an opportunity to reflect on the remarkable progress of the discipline across the last four decades, as well as challenges and future directions for the field. With contemporary issues in mind, including rising rates of psychopathology, health disparities, and international conflict, as well as rapid growth and accessibility of digital and mobile technologies, the discipline of developmental psychopathology is poised to advance multidisciplinary, developmentally- and contextually- informed research, and to make substantial progress in supporting the healthy development of individuals around the world. We highlight key future directions and challenges for the next generation of developmental psychopathology research including further investigation of culture at multiple levels of analysis, incorporation of macro-level influences into developmental psychopathology research, methods advances to address heterogeneity in translational research, precision mental health, and the extension of developmental psychopathology research across the lifespan.

The utility of behavioral biometrics in user authentication and demographic characteristic detection: a scoping review

BACKGROUND

Objective measures of screen time are necessary to better understand the complex relationship between screen time and health outcomes. However, current objective measures of screen time (e.g., passive sensing applications) are limited in identifying the user of the mobile device, a critical limitation in children's screen time research where devices are often shared across a family. Behavioral biometrics, a technology that uses embedded sensors on modern mobile devices to continuously authenticate users, could be used to address this limitation.

OBJECTIVE

The purpose of this scoping review was to summarize the current state of behavioral biometric authentication and synthesize these findings within the scope of applying behavioral biometric technology to screen time measurement.

METHODS

We systematically searched five databases (Web of Science Core Collection, Inspec in Engineering Village, Applied Science & Technology Source, IEEE Xplore, PubMed), with the last search in September of 2022. Eligible studies were on the authentication of the user or the detection of demographic characteristics (age, gender) using built-in sensors on mobile devices (e.g., smartphone, tablet). Studies were required to use the following methods for authentication: motion behavior, touch, keystroke dynamics, and/or behavior profiling. We extracted study characteristics (sample size, age, gender), data collection methods, data stream, model evaluation metrics, and performance of models, and additionally performed a study quality assessment. Summary characteristics were tabulated and compiled in Excel. We synthesized the extracted information using a narrative approach.

RESULTS

Of the 14,179 articles screened, 122 were included in this scoping review. Of the 122 included studies, the most highly used biometric methods were touch gestures (n = 76) and movement (n = 63), with 30 studies using keystroke dynamics and 6 studies using behavior profiling. Of the studies that reported age (47), most were performed exclusively in adult populations (n = 34). The overall study quality was low, with an average score of 5.5/14.

CONCLUSION

The field of behavioral biometrics is limited by the low overall quality of studies. Behavioral biometric technology has the potential to be used in a public health context to address the limitations of current measures of screen time; however, more rigorous research must be performed in child populations first.

SYSTEMATIC REVIEW REGISTRATION

The protocol has been pre-registered in the Open Science Framework database ( https://doi.org/10.17605/OSF.IO/92YCT ).

The role of sleep in prospective associations between parent reported youth screen media activity and behavioral health

BACKGROUND

Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample.

METHOD

Parents completed questions about their child (N = 564) ages 3-17 at Wave 1, Wave 2 (4-8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration.

RESULTS

SMA was significantly associated with greater sleep disturbance, β = .11, 95% CI [.01, .21] and shorter sleep duration, β = -.16 [-.25, -.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, β = .14 [.04, .24], externalizing, B = .23 [.12, .33], attention, β = .24 [.15, .34], and peer problems, β = .25 [.15, .35]. Longer sleep duration was associated with more externalizing, β = .13 [.04, .21], and attention problems, β = .12 [.02, .22], and fewer peer problems, β = -.09 [-.17, -.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, β = -.15 [-.23, -.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems.

CONCLUSIONS

Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use.

Do parent media habits contribute to child global development?

Background/objective

Parents of preschoolers' report using screen media frequently. More frequent screen use by parents may undermine child development by displacing time for foundational parent-child interactions. The objective of the present study is to examine the extent to which parent screen use contributes to child global development 1 year later.

Methods

Data are from a cohort of 315 preschoolers from Nova Scotia, Canada and their parents during the COVID-19 pandemic. Parents reported the number of hours per day they spent using screens, as well as child screen time and sex, and parent educational attainment. Our outcome is child global development scores, which combine assessments of communication, cognitive, personal-social, and motor skills measured at 4.5 using the Ages and Stages Questionnaire (ASQ) (N = 249, 79% retained).

Results

Parents in our sample spent on average 6.35 h per day using screen media outside of work (SD = 3.07) and children spent on average 3.43 h per/day using screens. Multivariate linear regression indicated that each 1-h increase in parents daily screen media use, corresponded to a 1.25 decrease in child global development scores, B = -1.25 p < 0.05, 95% CI between -2.37 and -0.13.

Conclusion

Our results indicate that parent screen use may represent a key component of children's media ecology. Given the importance of global development in early childhood for later health and achievement, the present results suggest that interventions should include parent screen use habits in media wellness interventions.

The relationships between screen exposure, parent-child interactions and comprehension in 8-month-old infants: The mediating role of shared viewing and parent-child conversation

OBJECTIVE

To explore the relationships between screen exposure, parent-child interactions and comprehension in 8-month-old infants, and to examine whether shared viewing and parent-child conversation during screen exposure may play mediating role in that relationships.

METHODS

The sample included 437 infants aged 8 months from the Children's Health Department of Guiyang Maternal and Child Health Hospital during January 2022 to February 2023. The use of electronic screen devices was assessed using a screen exposure questionnaire. The Brigance Parent-child interactions Scale was used to assess parent-child interactions and the Putonghua Communicative Development Inventory (PCDI) scale was used to assess infants' word comprehension.

RESULTS

48.7% of infants were found to be using screens 1-2 days per week. There was a significant difference (p < 0.05) in the PCDI-comprehension scores of screen-exposed infants compared to non-screen-exposed infants. Shared viewing and parent-child conversation during screen exposure were positively associated with parent-child interactions (p < 0.05). Mediation analysis revealed that parent-child conversation fully mediated between screen exposure and PCDI-comprehension, but partially mediated between parent-child interactions and PCDI-comprehension.

CONCLUSIONS

Shared viewing and parent-child conversation during screen exposure may mediate between screen exposure and comprehension development. Shared viewing, parent-child conversation and parent-child interactions may be protective factors for screen exposure in comprehension development. Suggests that parents should accompany and communicate with their children when they use electronic screen devices to reduce the negative impact of screen exposure on children's comprehension.

Managing Screen Use in the Under-Fives: Recommendations for Parenting Intervention Development

The impact of excessive screen use on children's health and development is a public health concern and many countries have published recommendations to limit and guide the use of screen media in childhood. Despite this, international studies report that the majority of parents and children do not adhere to screen use recommendations. Existing research aiming to understand children' screen use has largely focused on older children, and on demographic and structural aspects of the child's environment. Parents play a central role in determining young children's screen use and identify numerous barriers to developing healthy screen use practices with their children. However, no clear models exist that incorporate key parenting factors in understanding children's screen use, which presents an impediment to intervention development. Likewise, while some evidence exists for interventions to improve children's screen use behaviours, most are focused on older children and parental involvement has generally been limited. In this paper, we overview key factors associated with screen use in young children (< 5 years) and summarise the existing evidence base for interventions designed to support healthy screen use. This paper proposes a conceptual model linking aspects of parenting and the socio-ecological environment to young children's screen use. Our proposed model could be used to design longitudinal studies of screen use predictors and outcomes, and inform intervention development. Finally, the paper provides key recommendations for future research, intervention development and testing.

ScreenLife Capture: An open-source and user-friendly framework for collecting screenomes from Android smartphones

As our interactions with each other become increasingly digitally mediated, there is growing interest in the study of people's digital experiences. To better understand digital experiences, some researchers have proposed the use of screenomes. This involves the collection of sequential high-frequency screenshots which provide detailed objective records of individuals' interaction with screen devices over time. Despite its usefulness, there remains no readily available tool that researchers can use to run their own screenome studies. To fill this gap, we introduce ScreenLife Capture, a user-friendly and open-source software to collect screenomes from smartphones. Using this tool, researchers can set up smartphone screenome studies even with limited programming knowledge and resources. We piloted the tool in an exploratory mixed-method study of 20 college students, collecting over 740,000 screenshots over a 2-week period. We found that smartphone use is highly heterogeneous, characterized by threads of experiences. Using in-depth interviews, we also explored the impact that constant background surveillance of smartphone use had on participants. Participants generally had slight psychological discomfort which fades after a few days, would suspend screen recording for activity perceived to be extremely private, and recounted slight changes in behavior. Implications for future research is discussed.

Meeting preschool screen time recommendations: which parental strategies matter?

Background

High levels of screen use by preschoolers may contribute to adverse health and developmental outcomes. Little is known about which parental strategies may be protective against intensive screen use by children. Our aim is to estimate whether parent strategies for mediating child screen time including restrictive and instructive mediation and social coviewing, predict preschooler adherence to the screen time recommendation of ≤1 h/day during the COVID-19 pandemic. We also examine if parent restrictive mediation interacts with child temperament characteristics.

Methods

Our sample is composed of 315 Canadian parents of preschoolers surveyed during the COVID-19 pandemic. Parents provided measures of child adherence to screen time guidelines at ages 3.5 (baseline) and 4.5 years. Parents also reported how often they used restrictive and instructional mediation, and social coviewing to manage their child's screen use. Control variables include child sex and temperament (effortful control, negative affectivity, extraversion), educational attainment, and parenting stress at age 3.5.

Results

A logistic regression revealed that parental restrictiveness was associated with a 4 time increase in the odds of adherence to screen time guidelines, OR = 4.07 (95% CI [1.70-13.03]). Parental social coviewing decreased the chances of adherence by 80% (OR = 0.20, 95% CI [0.09-0.48]). Furthermore, children not meeting recommendation at 3.5 were 98% less likely to respect the recommendation 1 year later (OR = 0.02, 95% CI [0.01-0.07]). Results were adjusted for child sex, temperament, baseline screen time, and parent education and stress The interaction between the restriction mediation and child temperament on later screen time was not significant.

Conclusion

Our results indicate that some parental strategies may be more effective than others for managing preschooler screen time. Parent use of restrictive mediation was most likely to forecast child adherence to later screen time recommendations. The present results may contribute to the development of targeted family-based interventions designed to promote healthy development from a young age.

Assessment and Diagnostic Classification Using DC:0-5 in Early Childhood Mental Health Clinics: The Protocol for the Developmental Psychiatry Diagnostic Challenges Study (DePsy)

Mental health problems in early childhood are common, but there is a lack of psychiatric research on this age group. DC:0-5 is a multiaxial classification system for mental disorders in early childhood, providing a framework for standardizing clinical practice and research. However, research on the validity of DC:0-5 is scarce. The Developmental Psychiatry Diagnostic Challenges Study (DePsy) is a multi-site, prospective clinical study including six German early childhood mental health (ECMH) clinics. The main objective of the study is to contribute to the validation of Axis I and Axis II of DC:0-5. A second aim of the study is to describe the population of the participating clinics regarding diagnoses, family context, and treatment outcomes. Additionally, the impact of environmental risk factors, including parental Adverse Childhood Experiences (ACEs) and media use, on child psychopathology and caregiver-child relationships will be examined. Over two years, patients aged 0.0-5.9 years old will be enrolled in the study. Assessments include ICD-10 and DC:0-5 diagnoses, developmental tests, video-based observations of caregiver-child interactions, and questionnaires on child psychopathology, media use, parental stress, and treatment satisfaction. Study results will promote the standardization of assessment and treatment in ECMH clinics aiming to improve the development of patients and their families.

Screen media exposure and young children's vocabulary learning and development: A meta-analysis

This meta-analysis synthesizes research on media use in early childhood (0-6 years), word-learning, and vocabulary size. Multi-level analyses included 266 effect sizes from 63 studies (Ntotal  = 11,413) published between 1988-2022. Among samples with information about race/ethnicity (51%) and sex/gender (73%), most were majority White/Non-Hispanic and between 40%-60% female. Analyses revealed a small overall positive relation between screen media exposure and vocabulary (r = .23). Experimental studies yielded a small-to-medium effect (r = .30), with stronger effects for e-books than TV/video or games/apps, and non-significant effects for video chat. In correlational studies, there was no overall association between vocabulary size and naturalistic media exposure (r = .07), with the exception of naturalistic exposure to educational media (r = .17).

Media in the Moment: An Observational Assessment of the Digital Media Context in Early Childhood

The majority of research on media use in the digital age during early childhood has consisted of parental reports or experimental lab research, however, little research has captured media use in the home. Thus, the purpose of the current study was to capture early childhood media use in the moment it occurs. Participants included 231 parent-child dyads (M child age = 41.17 months) who completed a one-week study. Parents were contacted multiple times per day via text. If children happened to be using media (or be in a room where media was present) when parents received the notification, parents were asked to take a 10-15 second video of their child. Most families submitted at least one video over the course of the week. These videos were coded in the current study using a coding scheme to capture the context around media use in early childhood (including the environment, child behavior, and media characteristics). Results revealed that children were most likely to view media on a television or tablet. Although most children were paying attention to media, about half were also physically active while consuming media. Another person was present in the majority of videos with children, most frequently siblings or peers. Most children showed a very flat and calm affect while viewing media. These findings were generally consistent across gender and family income. Overall, this study adds to the literature on children and media that uses other methods, but provides additional insight into the importance of the specific context during early childhood media use in the digital age.

[Impact of electronic devices used at an early age on language]

Background

The acquisition of language in infants is largely the result of the process of brain maturation, as well as environmental stimulation. Currently, society is in an era of technology and use of electronic devices from an early age.

Objective

The aim of this study was to demonstrate if the amount of time of use of electronic devices in children under 5 years of age affects language development.

Methods

An observational, comparative, survey-type study was carried out in 269 infants of both sexes, with an age range of 6 to <60 months. The language development section of the Child Development Scale (EDI) was used. A logistic regression was performed to determine the strength of association between the factors to be studied.

Results

269 participants were included, of which 224 (83.2%) presented their level of neurological maturation, 44 infants (16.4%) presented laged development and one (0.4%) was classified as having developmental delay. It was found that the number of daily hours that an electronic device is used behaved as a risk factor by increasing the risk of delayed language development by 1.37 times for each hour of exposure (OR: 1.37, CI95%: 1.15-1.62).

Conclusions

It was shown that a greater number of hours of use of electronic devices is a risk factor for delayed language development in children under 5 years of age. Therefore, it is vital to limit its use in this population.

Problematic media use in early childhood: The role of parent-child relationships and parental wellbeing in families in New Zealand and the United States

Problematic media use (PMU) during early childhood has the potential to interfere with the healthy functioning of family systems and may be associated with significant long-term problems for the child. However, we know very little about what contributes to early childhood PMU, particularly in the family context. We examine parenting factors as correlates of child PMU in two studies, from two different countries, using two different methods. Study 1 (N=93, Mage=45.3months, SD=10.15, 58%males, 87%mothers) investigated the concurrent role of self-reported parental burnout and parent-child conflict and closeness as correlates of child PMU in an early childhood sample in New Zealand. Study 2 (N=269, Mage=41.17months, SD=3.06 months, 49%males, 95%mothers) investigated observed parental warmth and harsh criticism as predictors of concurrent and longitudinal PMU in an early childhood sample in the United States. Together, findings showed that in both countries approximately 22-25% of young children show symptoms of PMU. After controlling for parent's PMU, parent-child conflict, warmth and parental burnout were not associated with child PMU. Low levels of parent-child closeness and parent's use of harsh criticism were predictive of child PMU. The findings advance our understanding of some of the parenting factors that influence the development of PMU in young children.

Prospective associations between child screen time and parenting stress and later inattention symptoms in preschoolers during the COVID-19 pandemic

Introduction

Child attention skills are critical for supporting self-regulation abilities, especially during the first years of life. On the other hand, inattention symptoms in preschoolers have been associated with poor school readiness, literacy skills and academic achievement. Previous research has linked excessive screen time with increased inattention symptoms in early childhood. However, most research has only focused on TV exposure and did not investigate this association during the COVID-19 pandemic. This atypical context has increased screen time in children worldwide, including preschoolers. We hypothesize that higher levels of child screen media and parenting stress at age 3.5 will be associated with higher child inattention symptoms at age 4.5.

Method

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 = 315, 2020). A follow-up with this sample was completed in 2021 (N = 264).

Results

Analyses using multiple linear regression, revealed a positive association between child screen time at age 3.5 and inattention symptoms at 4.5 years. Parental stress was also positively associated with child inattention symptoms. Associations were observed above individual (child age, inhibitory control, and sex) and family (parent education and family income) characteristics.

Discussion

These results confirmed our hypothesis and highlight that preschooler screen use and parenting stress may undermine attentional skills. Since attention is a crucial component for children development, behavior and academic outcomes, our study reinforces the importance for parents of adopting healthy media habits.

Toddlers and the Telly: A latent profile analysis of children's television time and content and behavioral outcomes one year later in the U.S

Despite the ubiquity of tablets and smartphones, television remains the most frequently used screen media consumed by young children. However, it is likely that variability exists in how young children use media; for example, while some may view small amounts of aggressive content, others may view many hours each day of aggressive and prosocial media content. It is possible that differences in toddler television time and content also impact behavioral outcomes. The aims of this study were two-fold; first, we examined profiles of children's time spent watching television and media content viewed. Second, we examined longitudinal relations between media use profiles and outcomes including aggression, prosocial behavior, and problematic media use. Results suggested a three-profile solution of children's television time and content, including "Low TV content," "High child-centered content," and "High aggressive content" profiles. The "High aggressive content" group experienced higher levels of problematic media use and aggressive behavior one year later compared to other classes. The discussion focuses on implications of these findings. We urge parents to become aware of both television time and media content as they may relate to problematic media use behaviors in young children.

Parent perspectives on young children's changing digital practices: Insights from Covid-19

Young children's use of digital technologies has presented challenges for parents, particularly in response to an increased reliance on digital resources during the Covid-19 pandemic. This mixed-methods study explored young children's digital practices within the context of their families and homes. Although this study was originally planned, the timing of data collection meant that it was uniquely positioned to capture parent perspectives as the pandemic and first lockdown was unfolding in Australia. Data was collected through questionnaire (N = 101) and semistructured interview (n = 20) about status and change in children's digital practices, and parents' rules and flexibility in governing these experiences. Quantitative findings suggested children's frequency and duration of digital device use trended upwards during lockdown, and parents were more flexible in their rules about the amount of screen time, as well as when and where children could use digital devices. Qualitative results suggested that, more than a temporary and situational change, for many parents, exposure to new ways of engaging with digital technologies facilitated a shift in their perceptions, leading to greater consideration of quality in their choices for their children. This study highlights the influential role of parents in shaping children's digital experiences. Understanding their perceptions, as well as children's current and shifting digital practices in the home, is important for informing efforts and guidance for supporting young children's safe and effective use of digital technologies.

Screen media exposure and behavioral adjustment in early childhood during and after COVID-19 home lockdown periods

There is ample evidence that young children's screen media use has sharply increased since the outbreak of the novel 2019 coronavirus disease (COVID-19). However, the long-term impact of these changes on children's adjustment is currently unclear. The goals of the current study were to assess longitudinal trajectories of young children's screen media exposure through a series of national COVID-19 home lockdowns and to examine the predictive associations between different aspects of media exposure and post-lockdown behavioral adjustment. Data were collected at four timepoints during and after home lockdown periods in Israel. Longitudinal data measuring various aspects of media use, behavioral conduct and emotional problems were gathered from a sample of 313 Israeli children (54% females) between the ages two to five years (Mage at T1 = 3.6), by surveying their mothers at 5 points in time. Child overall screen time use, exposure to background television, use of media to regulate child distress and maternal mobile device use all changed throughout the lockdown periods. Moreover, during lockdowns children's behavior problems were concurrently and positively correlated with screen time, use of media to regulate child distress, and exposure to background television. However, these were not longitudinally related to child behavior problems in the post-lockdown period. Possible implications for family media use during a public health crisis are discussed.

Patterns of parent screen use, child screen time, and child socio-emotional problems at 5 years

Digital media screens have become an essential part of our family life. However, we have insufficient knowledge about parental screen use patterns and how these affect children's socio-emotional development. In total, 867 Canadian parents of 5-year-old children from the TARGet Kids! Cohort (73.1% mothers, mean ± SD age = 38.88 ± 4.45 years) participated in this study from 2014 to the end of 2019. Parents reported parental and child time on television (TV) and handheld devices and completed the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis identified six latent profiles of parent screen use: low handheld users (P1, reference; n = 323), more TV than handheld (P2; n = 261), equal TV and handheld (P3; n = 177), more handheld than TV (P4; n = 57), high TV and handheld (P5; n = 38), and extremely high TV and handheld (P6; n = 11). Parents that were more likely to belong to P6 were also more likely to be living in single-parent households compared to P1 (estimate = -1.49 ± 0.70), p = .03). High membership probability for P2 (estimate = -0.67 ± 0.32, p = .04) and P4 (estimate = -1.42 ± 0.40, p < 0.001) was associated with lower household income compared to P1. Children of parents with higher P4 (χ²  = 12.32, p < 0.001) or P5 (χ²  = 9.54, p = .002) membership probability had higher total screen time compared to P1. Finally, a higher likelihood to belong to P6 (χ²  = 6.82, p = .009) was associated with a higher SDQ Total Difficulties Score compared to P1. Thus, patterns of parent screen use were associated with child screen use and child socio-emotional problems. The emerging link between parental screen use profiles and child behaviors suggests the need for more research on parent screen time.

The association between time spent on screens and reading with myopia, premyopia and ocular biometric and anthropometric measures in 6- to 7-year-old schoolchildren in Ireland

PURPOSE

More time spent on near tasks has consistently been associated with the promotion of myopia. The World Health Organization advises limiting daily screentime to less than 2 h for children aged five and over. This study explored the relationship between time spent on screens and reading/writing with refractive status, ocular biometric and anthropometric factors in 6- to 7-year-olds in Ireland.

METHODS

Participants were 723 schoolchildren (377 boys [51.8%]), mean age 7.08 (0.45) years. The examination included cycloplegic autorefraction (1% cyclopentolate hydrochloride), ocular biometry (Zeiss IOLMaster), height (cm) and weight (kg). Screentime and reading/writing time were reported by parents/legal guardians by questionnaire. Myopia (≤-0.50D) and premyopia (>-0.50D ≤ 0.75D) risk assessments were performed using logistic regression, and multivariate linear regression was used to analyse continuous variables.

RESULTS

Reported daily screentimes were 31% <1 h, 49.5% 1-2 h, 15.6% 2-4 h and 3.9% >4 h. Reading/writing times were 42.2% frequently, 48.0% infrequently and 9.8% seldom/never. Linear regression, controlling for age and ethnicity, revealed >2 h/day on screens was associated with a more myopic spherical equivalent [β = -1.15 (95% confidence intervals {CIs}: 1.62-0.69, p < 0.001)], increased refractive astigmatism (β = 0.29, CI: 0.06-0.51, p = 0.01), shorter corneal radius (β = 0.12, CI: 0.02-0.22, p = 0.02), higher axial length/corneal radius (β = 0.06, CI: 0.03-0.09, p < 0.001), heavier weight (β = 1.60, CI: 0.76-2.45, p < 0.001) and higher body mass index (BMI) (β = 1.10, CI: 0.28-1.12, p < 0.001). Logistic regression, controlling for age and ethnicity, revealed daily screentime >2 h was associated with myopia (OR = 10.9, CI: 4.4-27.2, p = 0.01) and premyopia (OR = 2.4, CI: 1.5-3.7, p < 0.001). Frequent reading/writing was associated with screentime ≤2 h/day (OR = 3.2, CI: 1.8-5.8, p < 0.001).

CONCLUSION

Increased screentime was associated with a more myopic refraction, higher axial length/corneal radius ratio, increased odds of myopia, premyopia, higher degrees of astigmatism, increased weight, BMI and decreased reading/writing time. Dedicated education programmes promoting decreased screentime in children are vital to prevent myopia and support eye and general health.

Levels of orientation bias differ across digital content categories: Implications for visual perception

With the continued growth of digital device use, a greater portion of the visual world experienced daily by many people has shifted towards digital environments. The "oblique effect" denotes a bias for horizontal and vertical (canonical) contours over oblique contours, which is derived from a disproportionate exposure to canonical content. Carpentered environments have been shown to possess proportionally more canonical than oblique contours, leading to perceptual bias in those who live in "built" environments. Likewise, there is potential for orientation sensitivity to be shaped by frequent exposure to digital content. The potential influence of digital content on the oblique effect was investigated by measuring the degree of orientation anisotropy from a range of digital scenes using Fourier analysis. Content from popular cartoons, video games, and social communication websites was compared to real-life nature, suburban, and urban scenes. Findings suggest that digital content varies widely in orientation anisotropy, but pixelated video games and social communication websites were found to exhibit a degree of orientation anisotropy substantially exceeding that observed in all measured categories of real-world environments. Therefore, the potential may exist for digital content to induce an even greater shift in orientation bias than has been observed in previous research. This potential, and implications of such a shift, is discussed.

Validated assessment tools for screen media use: A systematic review

OBJECTIVE

Accurate measurement of adult and child screen media use are needed to robustly assess its impact on health outcomes. Our objective was to systematically review screen media use measurement tools that have been validated against an objective "gold standard" tool.

METHODS

The search strategy was initially conducted in Medline Ovid and translated to Embase, Web of Science, PsychInfo and Cochrane. A modified natural language search was conducted in Google Scholar and IEEE. The initial search was conducted in March 2021, and an updated search was conducted in June 2022. Additional studies were included from the references. Studies had to describe the validation of a tool to measure screen media use on participants of any age against a 'gold standard' or comparable objective measure. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was used to assess the criterion validity. Four authors reviewed the titles in two rounds and extracted data.

RESULTS

Twenty-nine articles were included in the review. Studies measured TV, computer, mobile device and social media site screen media use through: self or parent report, direct or video observation, computer and mobile device use tracking programs, and through other novel devices such as wearable devices and cameras. Correlations of self or parent report of screen media with the gold standard were lower than correlations of technology-based measures, and video observation with the gold standard. The COSMIN criterion validity ratings ranged from poor to excellent; most of the studies received a global score of fair or poor.

CONCLUSIONS

Technology based validated tools that more directly measure screen use are emerging that have been validated against a gold standard for measuring screen use. However, practical, objective measures of diverse types of screen media use that have been tested on diverse populations are needed to better understand the impact of screen media use on the development and physical and mental health of children and adults.

A Survey of Screen Media Access and Use in Primary School Children's Households

Our primary aim was to gain a better understanding of current technology availability and use in the homes of primary school children. The online-accessible questionnaire was made available for families with a child enrolled at primary school, with over 300 families participating. The results suggest that it is common for children to be introduced to screen media early in life and that they watch a wide range of content. While many families have rules regarding their children's technology use, screen media is a significant part of their lives, with many children exceeding the recommended two hours of viewing per day. Future research could investigate whether media access and use differ between ethnic and socio-demographic groups, and whether changes have occurred as a result of the coronavirus pandemic.

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.

Child Media Use During COVID-19: Associations with Contextual and Social-Emotional Factors

OBJECTIVE

The aim of this study was to test associations between (1) contextual factors and types of digital media use and (2) types of digital media use and children's social-emotional and sleep outcomes during COVID-19.

METHODS

In February to March 2021, 303 parents of elementary schoolers participated in this cross-sectional survey gathering information on demographics, child school format, contextual factors, duration of types of digital media use, social-emotional outcomes, and sleep. Multivariable regressions examined associations outlined in the objective, adjusting for school format, only child, race/ethnicity, and parental stress, depressive symptoms, education, and material hardship.

RESULTS

Children were aged 5 years to younger than 11 years and spent approximately 4 hours on screen media daily. In multivariable analyses, remote school format; greater material hardship; Black, Indigenous, and people of color child race/ethnicity; lower parenting stress; and parent depressive symptoms were associated with longer duration of various digital media. Longer daily duration of streaming video and video chat were associated with higher prosocial scores, while console games, mobile apps/games, and video-sharing platforms were associated with greater problematic media use (PMU) (defined as interfering with adaptive functioning). More time on mobile apps/games, video-sharing platforms, and video streaming was linked with shorter sleep.

CONCLUSION

Lower parenting stress predicted greater digital media use. Greater digital media use during the pandemic may have enabled parents to focus on other needs. Use of media for social connection predicted greater prosocial behaviors. Engagement-prolonging digital media predicted PMU. Pediatric providers may wish to consider family context when addressing digital media use and encourage socially oriented digital media.

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

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

Virtual Grandparenting: Identifying Barriers to Supportive Video Chat between Grandparents and Grandchildren

Many grandparents today are physically separated from their families. Given that maintaining close family relationships (with both adult children and grandchildren) is associated with increased physical, mental, and emotional health across generations, it is important to determine how families can maintain close relationships with grandparents when physically separated. Technology offers one potential support: the proliferation of video chat. Recent work suggests that the frequency of video chat and the variety of behaviors engaged in during video calls predicts family closeness and enjoyment of using this communication method, regardless of the physical distance between parties. However, the frequency of grandparent-grandchild video chat varies across families. Here, we explore how demographic, physical (e.g., distance), technological (e.g., number of devices and barriers), and social factors (e.g., children are distracted) predicted: (1) whether or not video chat was used by grandparent-grandchild dyads, and (2) the frequency of video chat in the families using the technology. This work suggests that geographical distance, having met in person, and the number of devices owned were positive predictors of grandparents and grandchildren having ever video chatted. However, the factors associated with the frequency of video chat were different in the parent and grandparent models and included grandparents’ comfort with technology and the type of device used by the parent and child. These findings not only have implications for supporting grandparent-grandchild relationships but also for all family members separated by distance, immigration, incarceration, health emergencies, and displacement.

Feasibility and Acceptability of Wearable Sensor Placement for Measuring Screen Time of Children

Introduction/Purpose

Wearables that include a color light sensor are a promising measure of electronic screen use in adults. However, to extend this approach to children, we need to understand feasibility of wear placement. The purpose of this study was to examine parent perceptions of children's acceptability of different sensor placements and feasibility of free-living 3- to 7-day wear protocols.

Methods

This study was conducted in three phases. In phase 1, caregivers (n=161) of 3- to 8-year-old children completed an online survey to rate aspects of fitting and likelihood of wear for seven methods (headband, eyeglasses, skin adhesive patch, shirt clip/badge, mask, necklace, and vest). In phase 2, children (n=31) were recruited to wear one of the top five prototypes for three days (n=6 per method). In phase 3, children (n=23) were recruited to wear prototypes of the top three prototypes from phase 2 (n=8 per method) for 7 days. In phases 2 and 3, parents completed wear logs and surveys about their experiences. Parents scored each wearable on three domains (ease of use, likelihood of wear, and child enjoyment). Scores were averaged to compute an everyday "usability" score (0, worst, to 200, best).

Results

Phase 1 results suggested that the headband, eyeglasses, patch, clip/badge, and vest had the best potential for long-term wear. In phase 2, time spent wearing prototypes and usability scores were highest for the eyeglasses (10.4 hours/day, score=155.4), clip/badge (9.8 hours/day, score=145.8), and vest (7.1 hours/day, score=141.7). In phase 3, wearing time and usability scores were higher for the clip/badge (9.4 hours/day, score=169.6) and eyeglasses (6.5 hours/day, score=145.3) compared to the vest (4.8 hours/day, score=112.5).

Conclusion

Results indicate that wearable sensors clipped to a child's shirt or embedded into eyeglasses are feasible and acceptable wear methods in free-living settings. The next step is to asses the quality, validity, and reliability of data captured using these wear methods.

Feasibility of Measuring Screen Time, Activity, and Context Among Families With Preschoolers: Intensive Longitudinal Pilot Study

Background

Digital media has made screen time more available across multiple contexts, but our understanding of the ways children and families use digital media has lagged behind the rapid adoption of this technology.

Objective

This study evaluated the feasibility of an intensive longitudinal data collection protocol to objectively measure digital media use, physical activity, sleep, sedentary behavior, and socioemotional context among caregiver-child dyads. This paper also describes preliminary convergent validity of ecological momentary assessment (EMA) measures and preliminary agreement between caregiver self-reported phone use and phone use collected from passive mobile sensing.

Methods

Caregivers and their preschool-aged child (3-5 years) were recruited to complete a 30-day assessment protocol. Within 30-days, caregivers completed 7 days of EMA to measure child behavior problems and caregiver stress. Caregivers and children wore an Axivity AX3 (Newcastle Upon Tyne) accelerometer to assess physical activity, sedentary behavior, and sleep. Phone use was assessed via passive mobile sensing; we used Chronicle for Android users and screenshots of iOS screen time metrics for iOS users. Participants were invited to complete a second 14-day protocol approximately 3-12 months after their first assessment. We used Pearson correlations to examine preliminary convergent validity between validated questionnaire measures of caregiver psychological functioning, child behavior, and EMA items. Root mean square errors were computed to examine the preliminary agreement between caregiver self-reported phone use and objective phone use.

Results

Of 110 consenting participants, 105 completed all protocols (105/110, 95.5% retention rate). Compliance was defined a priori as completing ≥70%-75% of each protocol task. There were high compliance rates for passive mobile sensing for both Android (38/40, 95%) and iOS (64/65, 98%). EMA compliance was high (105/105, 100%), but fewer caregivers and children were compliant with accelerometry (62/99, 63% and 40/100, 40%, respectively). Average daily phone use was 383.4 (SD 157.0) minutes for Android users and 354.7 (SD 137.6) minutes for iOS users. There was poor agreement between objective and caregiver self-reported phone use; root mean square errors were 157.1 and 81.4 for Android and iOS users, respectively. Among families who completed the first assessment, 91 re-enrolled to complete the protocol a second time, approximately 7 months later (91/105, 86.7% retention rate).

Conclusions

It is feasible to collect intensive longitudinal data on objective digital media use simultaneously with accelerometry and EMA from an economically and racially diverse sample of families with preschool-aged children. The high compliance and retention of the study sample are encouraging signs that these methods of intensive longitudinal data collection can be completed in a longitudinal cohort study. The lack of agreement between self-reported and objectively measured mobile phone use highlights the need for additional research using objective methods to measure digital media use.

International Registered Report Identifier (IRRID)

RR2-36240

The impact of adolescent's daily electronic media use on sleep: Insights from adolescent's and their mother's point of view

Several studies demonstrated that electronic media use (EMU) is negatively associated with sleep in adolescents. Most studies however are cross-sectional, self- or parents reports, and not distinguishing between different EMU types. Therefore, this study aimed to examine associations between adolescent's EMU and sleep reported by adolescents and from their mothers' perspective in a dyadic ambulatory assessment design. One hundred and five mother-adolescent dyads reported for 14 consecutive days adolescent's EMU for different EMU types and sleep duration. Mothers reported less EMU in the evening and more sleep of their adolescents than adolescents themselves. Multilevel analyses revealed that at the between- and within-person level, EMU in the evening was negatively associated with sleep. Different EMU types differed in effect sizes of associations with sleep. No effects were found for watching TV/DVD/video, whereas for gaming at the between- and within-person level, negative associations with sleep duration were found. For PC/tablet and smartphone use in the evening significant between-person association with sleep duration for adolescent's self-reports and from mother's point of view was found. It is important to investigate adolescent's EMU on a daily basis, from a dyadic perspective, and for different EMU types separately.

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

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

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.

Translation and Psychometric Testing of the Arabic Version of the Problematic Media Use Measure Short Form for Children

Background. There is growing concerns that excessive use of media among children will become problematic. Research on the management of children’s problematic use of media would be improved if screening tools are widely applied. Problematic Media Use Measure Short Form (PMUM-SF) was developed to screen problematic use of media among 4- to 11-year-old US children. Purpose. The study is aimed at developing and validating a cross-cultural version of the PMUM-SF for use in Arabic-talking parents of children from age 3 to 13 years. Design. Cross-cultural adaptation and cross-sectional psychometric testing study. Methods. Using the World Health Organization (WHO) framework for instrument translation and adaptation, the instrument was translated, back translated, pretested, and reviewed by a committee. The PMUM-SF was tested in 180 parents of children aging from 3 to 13 years. Results. The results demonstrated that the Arabic version of the PMUM-SF had high reliability (Cronbach’s alpha was 0.90); it has good convergent and predictive validity. The factor structure of the Arabic version of PMUM-SF was confirmed through exploratory and confirmatory factor analysis (comparative fit index $\left(\text{CFI}\right)=0.93$ ; goodness of fit index $\left(\text{GFI}\right)=0.90$ ; incremental fit index $\left(\text{IFI}\right)=0.93$ ). Conclusion. Because the Arabic version of the PMUM-SF seems to be reliable and valid in assessing problematic use of media of children in Arabic-speaking parents, the use of this translated version is recommended in future research.