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Peng X, Xue Y, Dong H, Ma C, Jia F, Du L. A study of the effects of screen exposure on the neuropsychological development in children with autism spectrum disorders based on ScreenQ. BMC Pediatr 2024; 24:340. [PMID: 38755571 PMCID: PMC11097434 DOI: 10.1186/s12887-024-04814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To investigate the relationship between multi-dimensional aspects of screen exposure and autistic symptoms, as well as neuropsychological development in children with ASD. METHODS We compared the ScreenQ and Griffiths Development Scales-Chinese Language Edition (GDS-C) of 636 ASD children (40.79 ± 11.45 months) and 43 typically developing (TD) children (42.44 ± 9.61 months). Then, we analyzed the correlations between ScreenQ and Childhood Autism Rating Scale (CARS), and GDS-C. We further used linear regression model to analyze the risk factors associated with high CARS total scores and low development quotients (DQs) in children with ASD. RESULTS The CARS of children with ASD was positively correlated with the ScreenQ total scores and "access, frequency, co-viewing" items of ScreenQ. The personal social skills DQ was negatively correlated with the "access, frequency, content, co-viewing and total scores" of ScreenQ. The hearing-speech DQ was negatively correlated with the "frequency, content, co-viewing and total scores" of ScreenQ. The eye-hand coordination DQ was negatively correlated with the "frequency and total scores" of ScreenQ. The performance DQ was negatively correlated with the "frequency" item of ScreenQ. CONCLUSION ScreenQ can be used in the study of screen exposure in children with ASD. The higher the ScreenQ scores, the more severe the autistic symptoms tend to be, and the more delayed the development of children with ASD in the domains of personal-social, hearing-speech and eye-hand coordination. In addition, "frequency" has the greatest impact on the domains of personal social skills, hearing-speech, eye-hand coordination and performance of children with ASD.
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Affiliation(s)
- Xinyue Peng
- Department of Developmental and Behavioral Pediatrics, Children's Medical Center, The First Hospital of Jilin University, Changchun, 130021, China
| | - Yang Xue
- Department of Developmental and Behavioral Pediatrics, Children's Medical Center, The First Hospital of Jilin University, Changchun, 130021, China
| | - Hanyu Dong
- Department of Developmental and Behavioral Pediatrics, Children's Medical Center, The First Hospital of Jilin University, Changchun, 130021, China
| | - Chi Ma
- Department of Developmental and Behavioral Pediatrics, Children's Medical Center, The First Hospital of Jilin University, Changchun, 130021, China
- School of Nursing, Jilin University, Changchun, 130021, China
| | - Feiyong Jia
- Department of Developmental and Behavioral Pediatrics, Children's Medical Center, The First Hospital of Jilin University, Changchun, 130021, China
| | - Lin Du
- Department of Developmental and Behavioral Pediatrics, Children's Medical Center, The First Hospital of Jilin University, Changchun, 130021, China.
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Xue Y, Bai MS, Dong HY, Wang TT, Mohamed ZA, Jia FY. Altered intra- and inter-network brain functional connectivity associated with prolonged screen time in pre-school children with autism spectrum disorder. Eur J Pediatr 2024; 183:2391-2399. [PMID: 38448613 DOI: 10.1007/s00431-024-05500-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
Prolonged screen time (ST) has adverse effects on autistic characteristics and language development. However, the mechanisms underlying the effects of prolonged ST on the neurodevelopment of children with autism spectrum disorder (ASD) remain unclear. Neuroimaging technology may help to further explain the role of prolonged ST in individuals with ASD. This study included 164 cases, all cases were divided into low-dose ST exposure (LDE group 108 cases) and high-dose ST exposure (HDE group 56 cases) based on the average ST of all subjects. Spatial independent component analysis (ICA) was used to identify resting state networks (RSNs) and investigate intra- and inter-network alterations in ASD children with prolonged ST. We found that the total Childhood Autism Rating Scale (CARS) scores in the HDE group were significantly higher than those in the LDE group (36.2 ± 3.1 vs. 34.6 ± 3.9, p = 0.008). In addition, the developmental quotient (DQ) of hearing and language in the HDE group were significantly lower than those in the LDE group (31.5 ± 13.1 vs. 42.5 ± 18.5, p < 0.001). A total of 13 independent components (ICs) were identified. Between-group comparison revealed that the HDE group exhibited decreased functional connectivity (FC) in the left precuneus (PCUN) of the default mode network (DMN), the right middle temporal gyrus (MTG) of the executive control network (ECN), and the right median cingulate and paracingulate gyri (MCG) of the attention network (ATN), compared with the LDE group. Additionally, there was an increase in FC in the right orbital part of the middle frontal gyrus (ORBmid) of the salience network (SAN), compared with the LDE group. The inter-network analysis revealed increased FC between the visual network (VN) and basal ganglia (BG) and decreased FC between the sensorimotor network (SMN) and DMN, SMN and ATN, SMN and auditory network (AUN), and DMN and SAN in the HDE group, compared with the LDE group. There was a significant negative correlation between altered FC values in MTG and total CARS scores in subjects (r = - 0.18, p = 0.018). Conclusion: ASD children with prolonged ST often exhibit lower DQ of language development and more severe autistic characteristics. The alteration of intra- and inter-network FC may be a key neuroimaging feature of the effect of prolonged ST on neurodevelopment in ASD children. Clinical trial registration: ChiCTR2100051141. What is Known: • Prolonged ST has adverse effects on autistic characteristics and language development. • Neuroimaging technology may help to further explain the role of prolonged ST in ASD. What is New: • This is the first study to explore the impact of ST on intra- and inter-network FC in children with ASD. • ASD children with prolonged ST have atypical changes in intra- and inter-brain network FC.
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Affiliation(s)
- Yang Xue
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China
- The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Miao-Shui Bai
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China
- The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Han-Yu Dong
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China
- The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Tian-Tian Wang
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China
- The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Zakaria Ahmed Mohamed
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China
- The Child Health Clinical Research Center of Jilin Province, Changchun, China
| | - Fei-Yong Jia
- Department of Developmental and Behavioral Pediatrics, Children's Hospital of the First Hospital of Jilin University, The First Hospital of Jilin University, Jilin University, Changchun, China.
- The Child Health Clinical Research Center of Jilin Province, Changchun, China.
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Heffler KF, Acharya B, Subedi K, Bennett DS. Early-Life Digital Media Experiences and Development of Atypical Sensory Processing. JAMA Pediatr 2024; 178:266-273. [PMID: 38190175 PMCID: PMC10775079 DOI: 10.1001/jamapediatrics.2023.5923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/30/2023] [Indexed: 01/09/2024]
Abstract
Importance Atypical sensory processing is challenging for children and families, yet there is limited understanding of its associated risk factors. Objective To determine the association between early-life digital media exposure and sensory processing outcomes among toddlers. Design, Setting, and Participants This multicenter US study used data that were analyzed from the National Children's Study (NCS), a cohort study of environmental influences on child health and development, with enrollment from 2011 to 2014. Data analysis was performed in 2023. The study included children enrolled in the NCS at birth whose caregivers completed reports of digital media exposure and sensory processing. Exposures Children's viewing of television or video at 12 months (yes or no), 18 months, and 24 months of age (hours per day). Main Outcomes and measures Sensory processing was reported at approximately 33 months of age on the Infant/Toddler Sensory Profile. Quadrant scores (low registration, sensation seeking, sensory sensitivity, and sensation avoiding) were categorized into groups representing typical, high, and low sensory-related behaviors, and multinomial regression analyses were performed. Results A total of 1471 children (50% male) were included. Screen exposure at 12 months of age was associated with a 2-fold increased odds of being in the high category of low registration (odds ratio [OR], 2.05; 95% CI, 1.31-3.20), while the odds of being in the low category instead of the typical category decreased for sensation seeking (OR, 0.55; 95% CI, 0.35-0.87), sensation avoiding (OR, 0.69; 95% CI, 0.50-0.94), and low registration (OR, 0.64; 95% CI, 0.44-0.92). At 18 months of age, greater screen exposure was associated with increased risk of high sensation avoiding (OR, 1.23; 95% CI, 1.03-1.46) and low registration (OR, 1.23; 95% CI, 1.04-1.44). At 24 months of age, greater screen exposure was associated with increased risk of high sensation seeking (OR, 1.20; 95% CI, 1.02-1.42), sensory sensitivity (OR, 1.25; 95% CI, 1.05-1.49), and sensation avoiding (OR, 1.21; 95% CI, 1.03-1.42). Conclusions and Relevance In this cohort study, early-life digital media exposure was associated with atypical sensory processing outcomes in multiple domains. These findings suggest that digital media exposure might be a potential risk factor for the development of atypical sensory profiles. Further research is needed to understand the relationship between screen time and specific sensory-related developmental and behavioral outcomes, and whether minimizing early-life exposure can improve subsequent sensory-related outcomes.
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Affiliation(s)
- Karen Frankel Heffler
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania
- Tower Health, West Reading, Pennsylvania
| | - Binod Acharya
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania
| | - Keshab Subedi
- Institute for Research on Equity and Community Health (iREACH), Christiana Care Health Systems, Newark, Delaware
| | - David S Bennett
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania
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Slobodin O, Hetzroni OE, Mandel M, Saad Nuttman S, Gawi Damashi Z, Machluf E, Davidovitch M. Infant screen media and child development: A prospective community study. Infancy 2024; 29:155-174. [PMID: 38157284 DOI: 10.1111/infa.12575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
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.
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Affiliation(s)
- Ortal Slobodin
- School of Education, Ben-Gurion University, Beer-Sheva, Israel
| | - Orit E Hetzroni
- Faculty of Education, Department of Special Education, Haifa University, Haifa, Israel
| | - Moran Mandel
- Department of Psychology, Ben-Gurion University, Beer-Sheva, Israel
| | | | - Zainab Gawi Damashi
- Faculty of Education, Department of Special Education, Haifa University, Haifa, Israel
| | - Eden Machluf
- Faculty of Education, Department of Special Education, Haifa University, Haifa, Israel
| | - Michael Davidovitch
- Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
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Kyono Y, Nishiyama M, Kawamura A, Oikawa S, Tokumoto S, Yamaguchi H, Tomioka K, Nozu K, Mishina H, Nagase H. Association of perinatal factors with neurodevelopmental referrals in a population-based cohort study in Japan. Sci Rep 2024; 14:3492. [PMID: 38347064 PMCID: PMC10861581 DOI: 10.1038/s41598-024-54167-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 02/09/2024] [Indexed: 02/15/2024] Open
Abstract
Although the causes of neurodevelopmental disorders remain unknown, several environmental risk factors have attracted considerable attention. We conducted a retrospective, longitudinal, population-based cohort study using data from infant health examinations of children born to mothers with pregnancies between April 1, 2014 and March 31, 2016 in Kobe City to identify the perinatal factors associated with neurodevelopmental referrals in 3-year-old children. There were 15,223 and 1283 children in the normal and referral groups, respectively. Neurodevelopmental referrals at the health checkup for 3-year-old children were significantly associated with the lack of social support during pregnancy (adjusted odds ratio [aOR] 1.99, 99% CI 1.14-3.45, p = 0.001), history of psychiatric consultation (aOR 1.56, 99% CI 1.10-2.22, p = 0.001), no social assistance post-delivery (aOR 1.49, 99% CI 1.03-2.16, p = 0.006), Edinburgh Post-natal Depression Scale (EPDS) score ≥ 9 (aOR 1.36, 99% CI 1.01-1.84, p = 0.008), infant gender (male) (aOR 2.51, 99% CI 2.05-3.06, p < 0.001), and cesarean delivery (aOR 1.39, 99% CI 1.11-1.75, p < 0.001). In conclusion, this exploratory study in the general Japanese population identified six perinatal factors associated with neurodevelopmental referrals in 3-year-old children: infant gender (male), cesarean section, maternal history of psychiatric consultation, EPDS score ≥ 9, lack of social support during pregnancy, and no social assistance post-delivery.
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Affiliation(s)
- Yuki Kyono
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Masahiro Nishiyama
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan.
- Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
| | - Aoi Kawamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Shizuka Oikawa
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Shoichi Tokumoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Hiroshi Yamaguchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Kazumi Tomioka
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | | | - Hiroaki Nagase
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
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Yamada M, Sekine M, Tatsuse T. Association between excessive screen time and school-level proportion of no family rules among elementary school children in Japan: a multilevel analysis. Environ Health Prev Med 2024; 29:16. [PMID: 38494706 PMCID: PMC10957336 DOI: 10.1265/ehpm.23-00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/24/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Excessive screen time (ST) in children is a global concern. We assessed the association between individual- and school-level factors and excessive ST in Japanese children using a multilevel analysis. METHODS A school-based cross-sectional study was conducted in Toyama, Japan in 2018. From 110 elementary schools in Toyama Prefecture, 13,413 children in the 4th-6th grades (boys, 50.9%; mean, 10.5 years old) participated. We assessed lifestyle, recreational ST (not for study use), psychological status, and school and family environment including family rules. We defined ≥3 hours ST as excessive. We calculated the school-level proportions of no family rules and divided them into four categories (<20%, 20% to <30%, 30% to <40%, and ≥40%). A modified multilevel Poisson regression analysis was performed. RESULTS In total, 12,611 children were included in the analysis (94.0%). The average school-level proportion of those with no family rules was 32.1% (SD = 9.6). The prevalence of excessive ST was 29.9% (34.9% in boys; 24.8% in girls). The regression analysis showed that excessive ST was significantly associated with both individual-level factors, such as boys (adjusted prevalence ratio (aPR); 1.39), older grades (aPR; 1.18 for 5th grades and 1.28 for 6th grades), late wakeup (aPR; 1.13), physical inactivity (aPR; 1.18 for not so much and 1.31 for rarely), late bedtime (aPR; 1.43 for 10 to 11 p.m. and 1.76 for ≥11 p.m.), frequent irritability (aPR; 1.24 for sometimes and 1.46 for often), feelings of school avoidance (aPR; 1.17 for sometimes and 1.22 for often), infrequent child-parental interaction (aPR; 1.16 for rare and 1.21 for none), no family rules (aPR; 1.56), smartphone ownership (aPR; 1.18), and the school-level proportion of no family rules (aPR; 1.20 for 20% to <30%, 1.29 for 30% to <40%, and 1.43 for ≥40%, setting <20% as reference). CONCLUSION Besides individual factors, a higher school-level proportion of no family rules seemed influential on excessive ST. Increasing the number of households with family rules and addressing individual factors, could be deterrents against excessive ST in children.
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Affiliation(s)
- Masaaki Yamada
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama, Toyama, Japan
| | - Michikazu Sekine
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama, Toyama, Japan
| | - Takashi Tatsuse
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama, Toyama, Japan
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Ophir Y, Rosenberg H, Tikochinski R, Dalyot S, Lipshits-Braziler Y. Screen Time and Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2346775. [PMID: 38064216 PMCID: PMC10709772 DOI: 10.1001/jamanetworkopen.2023.46775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/26/2023] [Indexed: 12/18/2023] Open
Abstract
Importance Contemporary studies raise concerns regarding the implications of excessive screen time on the development of autism spectrum disorder (ASD). However, the existing literature consists of mixed and unquantified findings. Objective To conduct a systematic review and meta-analyis of the association between screen time and ASD. Data Sources A search was conducted in the PubMed, PsycNET, and ProQuest Dissertation & Theses Global databases for studies published up to May 1, 2023. Study Selection The search was conducted independently by 2 authors. Included studies comprised empirical, peer-reviewed articles or dissertations published in English with statistics from which relevant effect sizes could be calculated. Discrepancies were resolved by consensus. Data Extraction and Synthesis This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Two authors independently coded all titles and abstracts, reviewed full-text articles against the inclusion and exclusion criteria, and resolved all discrepancies by consensus. Effect sizes were transformed into log odds ratios (ORs) and analyzed using a random-effects meta-analysis and mixed-effects meta-regression. Study quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Publication bias was tested via the Egger z test for funnel plot asymmetry. Data analysis was performed in June 2023. Main Outcomes and Measures The 2 main variables of interest in this study were screen time and ASD. Screen time was defined as hours of screen use per day or per week, and ASD was defined as an ASD clinical diagnosis (yes or no) or ASD symptoms. The meta-regression considered screen type (ie, general use of screens, television, video games, computers, smartphones, and social media), age group (children vs adults or heterogenous age groups), and type of ASD measure (clinical diagnosis vs ASD symptoms). Results Of the 4682 records identified, 46 studies with a total of 562 131 participants met the inclusion criteria. The studies were observational (5 were longitudinal and 41 were cross-sectional) and included 66 relevant effect sizes. The meta-analysis resulted in a positive summary effect size (log OR, 0.54 [95% CI, 0.34 to 0.74]). A trim-and-fill correction for a significant publication bias (Egger z = 2.15; P = .03) resulted in a substantially decreased and nonsignificant effect size (log OR, 0.22 [95% CI, -0.004 to 0.44]). The meta-regression results suggested that the positive summary effect size was only significant in studies targeting general screen use (β [SE] = 0.73 [0.34]; t58 = 2.10; P = .03). This effect size was most dominant in studies of children (log OR, 0.98 [95% CI, 0.66 to 1.29]). Interestingly, a negative summary effect size was observed in studies investigating associations between social media and ASD (log OR, -1.24 [95% CI, -1.51 to -0.96]). Conclusions and Relevance The findings of this systematic review and meta-analysis suggest that the proclaimed association between screen use and ASD is not sufficiently supported in the existing literature. Although excessive screen use may pose developmental risks, the mixed findings, the small effect sizes (especially when considering the observed publication bias), and the correlational nature of the available research require further scientific investigation. These findings also do not rule out the complementary hypothesis that children with ASD may prioritize screen activities to avoid social challenges.
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Affiliation(s)
- Yaakov Ophir
- Department of Education, Ariel University, Ariel, Israel
- Centre for Human Inspired Artificial Intelligence, University of Cambridge, Cambridge, United Kingdom
| | | | - Refael Tikochinski
- Faculty of Data and Decision Sciences, Technion–Israel Institute of Technology, Haifa, Israel
| | - Shani Dalyot
- Communications Department, Sapir Academic College, Hof Ashkelon, Israel
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Yamamoto M, Mezawa H, Sakurai K, Mori C. Screen Time and Developmental Performance Among Children at 1-3 Years of Age in the Japan Environment and Children's Study. JAMA Pediatr 2023; 177:1168-1175. [PMID: 37721733 PMCID: PMC10507594 DOI: 10.1001/jamapediatrics.2023.3643] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/24/2023] [Indexed: 09/19/2023]
Abstract
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.
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Affiliation(s)
- Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Hidetoshi Mezawa
- Medical Support Center for Japan Environment and Children’s Study, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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Takahashi I, Obara T, Ishikuro M, Murakami K, Ueno F, Noda A, Onuma T, Shinoda G, Nishimura T, Tsuchiya KJ, Kuriyama S. Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years. JAMA Pediatr 2023; 177:1039-1046. [PMID: 37603356 PMCID: PMC10442786 DOI: 10.1001/jamapediatrics.2023.3057] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/22/2023] [Indexed: 08/22/2023]
Abstract
Importance Whether some domains of child development are specifically associated with screen time and whether the association continues with age remain unknown. Objective To examine the association between screen time exposure among children aged 1 year and 5 domains of developmental delay (communication, gross motor, fine motor, problem-solving, and personal and social skills) at age 2 and 4 years. Design, Participants, and Setting This cohort study was conducted under the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Pregnant women at 50 obstetric clinics and hospitals in the Miyagi and Iwate prefectures in Japan were recruited into the study between July 2013 and March 2017. The information was collected prospectively, and 7097 mother-child pairs were included in the analysis. Data analysis was performed on March 20, 2023. Exposure Four categories of screen time exposure were identified for children aged 1 year (<1, 1 to <2, 2 to <4, or ≥4 h/d). Main Outcomes and Measures Developmental delays in the 5 domains for children aged 2 and 4 years were assessed using the Japanese version of the Ages & Stages Questionnaires, Third Edition. Each domain ranged from 0 to 60 points. Developmental delay was defined if the total score for each domain was less than 2 SDs from its mean score. Results Of the 7097 children in this study, 3674 were boys (51.8%) and 3423 were girls (48.2%). With regard to screen time exposure per day, 3440 children (48.5%) had less than 1 hour, 2095 (29.5%) had 1 to less than 2 hours, 1272 (17.9%) had 2 to less than 4 hours, and 290 (4.1%) had 4 or more hours. Children's screen time was associated with a higher risk of developmental delay at age 2 years in the communication (odds ratio [OR], 1.61 [95% CI, 1.23-2.10] for 1 to <2 h/d; 2.04 [1.52-2.74] for 2 to <4 h/d; 4.78 [3.24-7.06] for ≥4 vs <1 h/d), fine motor (1.74 [1.09-2.79] for ≥4 vs <1 h/d), problem-solving (1.40 [1.02-1.92] for 2 to <4 h/d; 2.67 [1.72-4.14] for ≥4 vs <1 h/d), and personal and social skills (2.10 [1.39-3.18] for ≥4 vs <1 h/d) domains. Regarding risk of developmental delay at age 4 years, associations were identified in the communication (OR, 1.64 [95% CI, 1.20-2.25] for 2 to <4 h/d; 2.68 [1.68-4.27] for ≥4 vs <1 h/d) and problem-solving (1.91 [1.17-3.14] for ≥4 vs <1 h/d) domains. Conclusions and Relevance In this study, greater screen time for children aged 1 year was associated with developmental delays in communication and problem-solving at ages 2 and 4 years. These findings suggest that domains of developmental delay should be considered separately in future discussions on screen time and child development.
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Affiliation(s)
- Ippei Takahashi
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Taku Obara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Fumihiko Ueno
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Aoi Noda
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Tomomi Onuma
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Genki Shinoda
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomoko Nishimura
- United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kenji J. Tsuchiya
- United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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10
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Marriage JE, Keshavarzi M, Moore BCJ. An association between auditory responsiveness of children and duration of entertainment screen time in the early years of life. Int J Audiol 2023:1-7. [PMID: 37750302 DOI: 10.1080/14992027.2023.2260097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE To examine whether the responsiveness of young children to simple sounds was associated with entertainment screen time (EST), opportunities for social interaction, and social and communication skills. DESIGN Parents completed a questionnaire covering, for years one and two, the number of times the child met with other children; the number of words the child spoke; and the daily amount of EST. Social, attention and communication skills were assessed. STUDY SAMPLE Participants were 118 children, aged 15 to 46 months. They were initially assessed behaviourally using simple sounds. Children who responded to such sounds were denoted the Responsive group. Children who did not were assessed using familiar songs and denoted the Unresponsive group. RESULTS The two groups did not differ significantly in mean age or the number of opportunities to meet other children. The Unresponsive group had significantly fewer words than the Responsive group at 12 and 24 months and had significantly higher EST than the Responsive group for years 1 and 2. The Unresponsive group showed lower social, attention and communication skills than the Responsive group. CONCLUSIONS High EST was associated with poorer auditory and social skills. Hence, it may be wise to limit the EST of young children.
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Affiliation(s)
| | - Mahmoud Keshavarzi
- Centre for Neuroscience in Education, Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, UK
| | - Brian C J Moore
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, UK
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11
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Takahashi N, Tsuchiya KJ, Okumura A, Harada T, Iwabuchi T, Rahman MS, Kuwabara H, Nomura Y, Nishimura T. The association between screen time and genetic risks for neurodevelopmental disorders in children. Psychiatry Res 2023; 327:115395. [PMID: 37574599 DOI: 10.1016/j.psychres.2023.115395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Abstract
Whether longer screen time in infancy increases risk of neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD) and ADHD has long been debated, but no causal relationship between the two remains has been established. Using ongoing longitudinal cohort data, we found that in children 24 to 40 months of age, the genetic risk of ASD was associated with longer screen time and that of ADHD with an increase in screen time over time. These data suggest that prolonged screen time may not be a cause of the genetic risk for NDD, but an early sign of NDDs.
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Affiliation(s)
- Nagahide Takahashi
- Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Japan; Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Japan.
| | - Kenji J Tsuchiya
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Japan
| | - Akemi Okumura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Japan
| | - Taeko Harada
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Japan
| | - Toshiki Iwabuchi
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Japan
| | - Md Shafiur Rahman
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Japan
| | - Hitoshi Kuwabara
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Japan; Department of Psychiatry, Saitama Medical University, Moroyama-chou, Saitama, Japan
| | - Yoko Nomura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; Queens College and Graduate Center, City University of New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tomoko Nishimura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Japan
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12
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Miyake K, Horiuchi S, Shinohara R, Kushima M, Otawa S, Yui H, Akiyama Y, Ooka T, Kojima R, Yokomichi H, Mochizuki K, Yamagata Z. Maternal dietary fiber intake during pregnancy and child development: the Japan Environment and Children's Study. Front Nutr 2023; 10:1203669. [PMID: 37575329 PMCID: PMC10415901 DOI: 10.3389/fnut.2023.1203669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background Animal studies have shown that maternal low-fiber diets during pregnancy may impair brain development and function in offspring, but this has not been validated by epidemiological studies. The aim of this study was to investigate the link between maternal dietary fiber intake during pregnancy and neurodevelopmental delay in offspring using a large birth cohort. Methods A total of 76,207 mother-infant pairs were analyzed using data from the Japan Environment and Children's Study, a nationwide prospective cohort study. Maternal dietary fiber intake was estimated using the food frequency questionnaire in mid-pregnancy. Maternal dietary fiber intake was adjusted for energy and classified into quintiles. Developmental delay was assessed in five domains using the Japanese version of the Ages and Stages Questionnaire, Third Edition at the age of 3 years. The logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (CI) for the link between dietary fiber intake during pregnancy and developmental delay at the age of 3 years. Results The lowest intake group of total dietary fiber had a higher risk of delayed communication [adjusted OR (aOR), 1.51; 95% CI, 1.32-1.74], fine motor (aOR, 1.45; 95% CI, 1.32-1.61), problem-solving (aOR, 1.46; 95% CI, 1.32-1.61), and personal-social skills (aOR, 1.30; 95% CI, 1.12-1.50) than did the highest intake group. An analysis that excluded the effects of insufficient folic acid intake during pregnancy also showed a similar trend. Conclusion This study showed that maternal dietary fiber deficiency during pregnancy might influence an increased risk of neurodevelopmental delay in offspring.
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Affiliation(s)
- Kunio Miyake
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Sayaka Horiuchi
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
| | - Ryoji Shinohara
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
| | - Sanae Otawa
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
| | - Hideki Yui
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Yuka Akiyama
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Tadao Ooka
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Reiji Kojima
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Hiroshi Yokomichi
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Kazuki Mochizuki
- Department of Local Produce and Food Sciences, Faculty of Life and Environmental Sciences, University of Yamanashi, Kofu, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Japan
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13
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Sarfraz S, Shlaghya G, Narayana SH, Mushtaq U, Shaman Ameen B, Nie C, Nechi D, Mazhar IJ, Yasir M, Arcia Franchini AP. Early Screen-Time Exposure and Its Association With Risk of Developing Autism Spectrum Disorder: A Systematic Review. Cureus 2023; 15:e42292. [PMID: 37614255 PMCID: PMC10442849 DOI: 10.7759/cureus.42292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 07/22/2023] [Indexed: 08/25/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurological deficit in brain functions that prevents a child from having a normal social life like his peers. It results in the inability to interact and communicate with others. Unsurprisingly, the alarming increase in screen-time exposure in children has become even more of a concern. Electronic devices are a double-edged sword. Despite their benefits, they have many potential hazards to children's neurological development. Previous studies have investigated the effects of unsupervised screen time and its impact on white matter development during the early years of life of children. The white matter has an important role in the development of neurological functions. This systematic review aims to qualitatively analyze the literature available on early screen time exposure and its association with the risk of developing ASD. This systematic review implemented the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, PubMed Central (PMC), Google Scholar, and Cochrane Library databases were searched for data in the recent six years. A total of 27,200 articles were identified using the MeSH and keywords through four selected databases. Search results revealed 70 from PubMed, 17,700 from Google Scholar, zero from Cochrane Library, and 9,430 from PubMed Central. After applying filters and screening the results by title and abstract and then by full text, 11 studies fulfilled the criteria to be included in the review. We found that the longer the period of screen exposure, the higher the risk that the child may develop ASD. Further, the earlier the child is exposed to screens, the higher the risk of developing ASD in children compared to children exposed later.
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Affiliation(s)
- Saba Sarfraz
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Gandhala Shlaghya
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sri Harsha Narayana
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ujala Mushtaq
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Basim Shaman Ameen
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Chuhao Nie
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Daniel Nechi
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Iqra J Mazhar
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohamed Yasir
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ana P Arcia Franchini
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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14
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Metwally AM, Helmy MA, Salah El-Din EM, Saleh RM, Abdel Raouf ER, Abdallah AM, Khadr Z, Elsaied A, El-Saied MM, Bassiouni RI, Nagi DA, Shehata MA, El-Alameey IR, El-Hariri HM, Salama SI, Rabah TM, Abdel-Latif GA, El Etreby LA, Elmosalami DM, Sami SM, Eltahlawy E, Ibrahim NA, Elghareeb NA, Badawy HY, Dewdar EM, Ashaat EA. National screening for Egyptian children aged 1 year up to 12 years at high risk of Autism and its determinants: a step for determining what ASD surveillance needs. BMC Psychiatry 2023; 23:471. [PMID: 37381024 DOI: 10.1186/s12888-023-04977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/20/2023] [Indexed: 06/30/2023] Open
Abstract
This study aimed to provide a national estimate of the prevalence of the high risk of autism spectrum disorder (ASD) and their determinants. A national screening survey was conducted for 41,640 Egyptian children aged 1 to 12 years in two phases. Tools used were Vineland's Adaptive Behavior Scales, Modified Checklist for Autism in Toddlers, Gilliam Autism Rating scale, and Denver II Developmental screening test. The overall prevalence of children at high risk of ASD was 3.3% (95% CI:3.1%-3.5%). Children living without mothers in homes, suffered from convulsions (AOR = 3.67; 95%CI:2.8-4.8), a history of cyanosis after birth (AOR = 1.87; 95% CI:1.35-2.59) or history of LBW babies (AOR = 1.53; 95% CI:1.23-1.89) carried higher odds of being at high risk of ASD.
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Affiliation(s)
- Ammal M Metwally
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt.
| | - Mona A Helmy
- Environmental and Occupational Medicine Department, Environmental and Climate Change Research Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Ebtissam M Salah El-Din
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Rehan M Saleh
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Ehab R Abdel Raouf
- Child With Special Needs Dept./ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Ali M Abdallah
- Quantitative Methods Department - Aswan University, Tingar, Egypt
| | - Zeinab Khadr
- Department of Statistics, Faculty of Economics and Political Science, Cairo University, Giza, Egypt
- The Social Research Center of the American University in Cairo, Cairo, Egypt
| | - Amal Elsaied
- Child With Special Needs Dept./ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Mostafa M El-Saied
- Child With Special Needs Dept./ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Randa I Bassiouni
- Clinical Genetics Dept./ Human Genetics and Genome Research Institute, National Research Centre , Dokki, Cairo, 60014618, Egypt
| | - Dina A Nagi
- Clinical Genetics Dept./ Human Genetics and Genome Research Institute, National Research Centre , Dokki, Cairo, 60014618, Egypt
| | - Manal A Shehata
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Inas R El-Alameey
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Hazem M El-Hariri
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Somia I Salama
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Thanaa M Rabah
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Ghada A Abdel-Latif
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Lobna A El Etreby
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Dalia M Elmosalami
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Samia M Sami
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Eman Eltahlawy
- Environmental and Occupational Medicine Department, Environmental and Climate Change Research Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Nihad A Ibrahim
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Nahed A Elghareeb
- Disability Prevention General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Hala Y Badawy
- Disability Prevention General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Eman M Dewdar
- Disability Prevention General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Engy A Ashaat
- Clinical Genetics Dept./ Human Genetics and Genome Research Institute, National Research Centre , Dokki, Cairo, 60014618, Egypt
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15
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Metwally AM, Helmy MA, Salah El-Din EM, Saleh RM, Abdel Raouf ER, Abdallah AM, Khadr Z, Elsaied A, El-Saied MM, Bassiouni RI, Nagi DA, Shehata MA, El-Alameey IR, El-Hariri HM, Salama SI, Rabah TM, Abdel-Latif GA, El Etreby LA, Elmosalami DM, Sami SM, Eltahlawy E, Ibrahim NA, Elghareeb NA, Badawy HY, Dewdar EM, Ashaat EA. National screening for Egyptian children aged 1 year up to 12 years at high risk of Autism and its determinants: a step for determining what ASD surveillance needs. BMC Psychiatry 2023; 23:471. [DOI: https:/doi.org/10.1186/s12888-023-04977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/20/2023] [Indexed: 10/31/2023] Open
Abstract
AbstractThis study aimed to provide a national estimate of the prevalence of the high risk of autism spectrum disorder (ASD) and their determinants. A national screening survey was conducted for 41,640 Egyptian children aged 1 to 12 years in two phases. Tools used were Vineland's Adaptive Behavior Scales, Modified Checklist for Autism in Toddlers, Gilliam Autism Rating scale, and Denver II Developmental screening test. The overall prevalence of children at high risk of ASD was 3.3% (95% CI:3.1%–3.5%). Children living without mothers in homes, suffered from convulsions (AOR = 3.67; 95%CI:2.8–4.8), a history of cyanosis after birth (AOR = 1.87; 95% CI:1.35–2.59) or history of LBW babies (AOR = 1.53; 95% CI:1.23–1.89) carried higher odds of being at high risk of ASD.
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16
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Gangi DN, Aishworiya R, Hill MM, Nguyen DT, Ni R, Parikh C, Solis E, Ozonoff S. Case report: Transient symptoms of autism spectrum disorder in a 2-year-old boy. Clin Case Rep 2023; 11:e07345. [PMID: 37180323 PMCID: PMC10172454 DOI: 10.1002/ccr3.7345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/06/2023] [Accepted: 04/15/2023] [Indexed: 05/16/2023] Open
Abstract
Though early ASD diagnosis is highly stable, this case report describes a rare situation in which symptoms resolved without intervention over a 4 month period. We do not recommend delaying diagnosis in symptomatic children who meet criteria but when major behavioral changes are reported after diagnosis, reevaluation may be beneficial.
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Affiliation(s)
- Devon N. Gangi
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | - Ramkumar Aishworiya
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
- Khoo Teck Puat‐National University Children's Medical InstituteNational University Health SystemSingaporeSingapore
- Department of Pediatrics, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Monique Moore Hill
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | - Dan Thu Nguyen
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | - Rachel Ni
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | - Chandni Parikh
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
| | | | - Sally Ozonoff
- Department of Psychiatry & Behavioral SciencesMIND Institute, University of California‐DavisSacramentoCaliforniaUSA
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17
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Geng S, Wang W, Huang L, Xie J, Williams GJ, Baker C, Du W, Hua J. Association between screen time and suspected developmental coordination disorder in preschoolers: A national population-based study in China. Front Public Health 2023; 11:1152321. [PMID: 37050955 PMCID: PMC10083417 DOI: 10.3389/fpubh.2023.1152321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
IntroductionExcessive screen exposure (ESE) is a growing global public health concern. This study aims to investigate the potential association between ESE and suspected developmental coordination disorder (DCD) in Chinese pre-schoolers, with or without siblings.MethodA retrospective cohort study was conducted, involving 126,433 children from 551 cities in China. The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was employed to evaluate motor impairment in children, while parents provided information on their children’s screen time in the past year. A mixed and multi-level logistic regression model was used to analyze the associations of all screen exposure measurements from the past year with LDCDQ scores and the risk of suspected DCD.ResultsThe prevalence of excessive screen exposure was 67.6% (>1 h per day) and 28.9% (>2 h per day) in Chinese pre-schoolers. One hour’s increase in weekday daily screen time, weekend daily screen time, and screen time before sleep in the past year was associated with a decreased total score of the LDCDQ (β were −0.690, −0.398, and −1.587, p < 0.001) and an increased risk of suspected DCD by 15.3%, 9.1%, and 46.8% when adjusting for the child, family and maternal health characteristics. Excessive screen exposure decreased the total LDCDQ scores by 1.335 (>1 vs. ≤1 h) and 1.162 (>2 vs. ≤2 h) and increased risks of suspected DCD by 44.0% (>1 vs. ≤1 h) and 31.1% (>2 vs. ≤2 h) with statistical significance (each p < 0.05). The stratified analysis showed that the association between screen time and LDCDQ score was stronger in children without siblings than in those with siblings.ConclusionThe risk of suspected DCD was highest for screen time exposure before bed compared with average weekday and weekend exposures. Parents should be advised to prevent their children from using electronic screens unsupervised, especially in one-child families.
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Affiliation(s)
- Shanshan Geng
- The Women’s and Children’s Health Care Department of Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Weijie Wang
- The Women’s and Children’s Health Care Department of Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Liping Huang
- The Women’s and Children’s Health Care Department of Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jinhong Xie
- The Women’s and Children’s Health Care Department of Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Gareth J. Williams
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Charlie Baker
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Wenchong Du
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
- *Correspondence: Wenchong Du,
| | - Jing Hua
- The Women’s and Children’s Health Care Department of Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Jing Hua,
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18
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Christakis DA. JAMA Pediatrics-The Year in Review, 2022. JAMA Pediatr 2023; 177:452-453. [PMID: 36939713 DOI: 10.1001/jamapediatrics.2023.0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Affiliation(s)
- Dimitri A Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
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Dong HY, Miao CY, Zhang Y, Shan L, Feng JY, Jia FY, Du L. Risk factors for developmental quotients in ASD children: A cross-sectional study. Front Psychol 2023; 14:1126622. [PMID: 36993893 PMCID: PMC10040800 DOI: 10.3389/fpsyg.2023.1126622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveTo analyze the risk factors for developmental quotients (DQs) of children with autism spectrum disorder (ASD) and to better understand the effects of screen time on neurodevelopment in children with ASD.MethodsWe retrospectively analyzed the data of 382 children with ASD, including demographic profiles; socioeconomic status; score on the Chinese parent–child interaction scale (CPCIS); screen time questionnaire; ASD symptom rating scales, including the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule Second Edition (ADOS-2); and DQs using Griffiths Development Scales–Chinese Edition. Univariate analysis was carried out to analyze the factors related to the DQs of children with ASD, and then the linear regression model was used to identify the independent influencing factors of the DQs of children with ASD.ResultsVitamin D (β = 0.180, p = 0.002), age (β = −0.283, p = 0.000) and CARS score (β = −0.347, p = 0.000) are risk factors related to DQ of locomotor in children with ASD. Vitamin D (β = 0.108, p = 0.034), CARS score (β = −0.503, p = 0.000), ADOS-2 severity score (β = −0.109, p = 0.045) and CPCIS score (β = 0.198, p = 0.000) are risk factors related to DQ of personal social skill in children with ASD. Vitamin D (β = 0.130, p = 0.018), CARS score (β = −0.469, p = 0.000), and CPCIS score (β = 0.133, p = 0.022) are risk factors related to DQ of hearing-speech in children with ASD. Vitamin D (β = 0.163, p = 0.003) and CARS score (β = −0.471, p = 0.000) are risk factors related to DQ of eye-hand coordination in children with ASD. Age (β = −0.140, p = 0.020), CARS score (β = −0.342, p = 0.000), ADOS-2 severity score (β = −0.133, p = 0.034) and CPCIS score (β = 0.193, p = 0.002) are risk factors related to DQ of performance in children with ASD. Vitamin D (β = 0.801, p = 0.000) and CPCIS score (β = 0.394, p = 0.019) are risk factors related to DQ of practical reasoning in children with ASD.ConclusionVitamin D status, the severity of autistic symptoms and parent-child interaction are risk factors for developmental quotients in children with ASD. Screen exposure time is negatively associated with DQs in children with ASD but is not an independent risk factor for DQs.
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20
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Qu G, Hu W, Meng J, Wang X, Su W, Liu H, Ma S, Sun C, Huang C, Lowe S, Sun Y. Association between screen time and developmental and behavioral problems among children in the United States: evidence from 2018 to 2020 NSCH. J Psychiatr Res 2023; 161:140-149. [PMID: 36924568 DOI: 10.1016/j.jpsychires.2023.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/15/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
Excessive digital media use has become the common phenomenon among children's lifestyle, and its influences on the plausible accompanying psychological and behavioral problems are gradually investigated. This study aimed to examine the association between screen time and developmental and behavioral problems of children in the United States (US). A secondary analysis based on the data from the 2018 to 2020 National Survey of Children's Health (NSCH) was conducted. Seven types of developmental and behavioral problems and screen time on weekdays of children were collected through parents/caregivers' recall. Logistic regression models were constructed to determine the associations. Overall, 101,350 children aged between 0 and 17 years old were included in this study and 70.3% of preschoolers aged 0-5 years old and 80.2% of children and adolescents aged 6-17 years old had excessive screen time. Excessive screen time was positively associated with behavioral and conduct problem, developmental delay, speech disorder, learning disability, autism spectrum disorders (ASD), and attention deficit hyperactivity disorder (ADHD) and there were significant dose-response relationships. The association between excessive screen time and developmental and behavioral problems was stronger among preschoolers than among children and adolescents. Boys with excessive screen time showed high odds of most types of developmental and behavioral problems. It can be concluded that children with excessive screen time are at high odds of developmental and behavioral problems, especially for preschoolers and boys. Early intervention of digital media use is urgent and essential for children in the US.
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Affiliation(s)
- Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wenjing Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jia Meng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xingyue Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wenqi Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, 60657, Illinois, USA
| | - Christy Huang
- Santa Clara University, 500 El Camino Real, Santa Clara, CA, 95053, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238000, Anhui, China.
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Sugiyama M, Tsuchiya KJ, Okubo Y, Rahman MS, Uchiyama S, Harada T, Iwabuchi T, Okumura A, Nakayasu C, Amma Y, Suzuki H, Takahashi N, Kinsella-Kammerer B, Nomura Y, Itoh H, Nishimura T. Outdoor Play as a Mitigating Factor in the Association Between Screen Time for Young Children and Neurodevelopmental Outcomes. JAMA Pediatr 2023; 177:303-310. [PMID: 36689245 PMCID: PMC9871942 DOI: 10.1001/jamapediatrics.2022.5356] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Importance Whether the association between higher screen time in infancy and later suboptimal neurodevelopment can be mitigated by frequency of outdoor play is unknown. Objective To investigate whether higher screen time at age 2 years is associated with neurodevelopmental outcomes at age 4 years and whether this association is mediated by frequency of outdoor play at age 2 years 8 months. Design, Setting, and Participants Participants were a subsample of the Hamamatsu Birth Cohort Study for Mothers and Children (HBC Study, N = 1258). Children were born between December 2007 and March 2012 and followed up from 1 year 6 months to 4 years. The analysis was conducted from April 2021 to June 2022. Exposures Screen time longer than 1 hour a day at age 2 years was coded as higher screen time. Main Outcomes and Measures Standardized scores for communication, daily living skills, and socialization domains of the Vineland Adaptive Behavior Scale, second edition, at age 4 years were used (mean [SD], 100 [15]). The mediating factor was frequency of outdoor play at age 2 years 8 months, with 6 or 7 days per week coded as frequent outdoor play. Results Of 885 participants, 445 children (50%) were female; mean (SD) screen time per day was 2.6 (2.0) hours. Causal mediation analyses revealed that higher screen time at age 2 years was associated with lower scores in communication at age 4 years (nonstandardized coefficient b = -2.32; 95% CI, -4.03 to -0.60), but the association was not mediated by frequency of outdoor play. Higher screen time was also associated with lower scores in daily living skills (b = -1.76; 95% CI, -3.21 to -0.31); 18% of this association was mediated by frequency of outdoor play. Frequency of outdoor play was associated with socialization (b = 2.73; 95% CI, 1.06 to 4.39), whereas higher screen time was not (b = -1.34; 95% CI, -3.05 to 0.36). Conclusions and Relevance Higher screen time at age 2 years was directly associated with poorer communication at age 4 years. It was also associated with daily living skills, but frequency of outdoor play at age 2 years 8 months alleviated it, suggesting outdoor play mitigated the association between higher screen time and suboptimal neurodevelopment. Future research should specify the nature of the associations and intervention measures, enabling targeted interventions that reduce the potential risk in screen time.
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Affiliation(s)
- Mika Sugiyama
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan
| | - Kenji J Tsuchiya
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yusuke Okubo
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Mohammad Shafiur Rahman
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Satoshi Uchiyama
- Rupiro, the Center for Consultation of Child Development, Hamamatsu, Japan
| | - Taeko Harada
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Toshiki Iwabuchi
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Akemi Okumura
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Chikako Nakayasu
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuko Amma
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Haruka Suzuki
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Nagahide Takahashi
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Barbara Kinsella-Kammerer
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Queens College and Graduate Center, City University of New York, New York
| | - Yoko Nomura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Queens College and Graduate Center, City University of New York, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York
| | - Hiroaki Itoh
- Department of Obstetric and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoko Nishimura
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
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22
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Rozaini MAN, Sariman S, Abd Rashed A, Shari N. The association of screen time with physical activity and weight status of autistic children in Kuala Lumpur, Malaysia. NFS 2023; 53:549-563. [DOI: 10.1108/nfs-02-2022-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Purpose
The purpose of this study was to evaluate the screen time used by Autism Spectrum Disorder (ASD) children and its association with their physical activity and weight status.
Design/methodology/approach
This cross-sectional study was conducted among 100 purposive sampled children registered under the National Autism Society of Malaysia centres in Kuala Lumpur. Parents-administered questionnaire composed of socio-demographic, anthropometric data (height and weight of the children), Autism Severity Questionnaire, Screen Time Questionnaire and Physical Activity Questionnaire for Older Children (PAQ-C) was used in this study.
Findings
Respondents in this study were categorised as having mild ASD (55%). Most of the respondents had higher screen time (78%), with average (4.14 ± 3.19) h spent using the devices. The respondents had low physical activity level (54%), with average PAQ-C scores of (2.38 ± 0.79). Average BMI-for-age z-scores was 1.06 ± 2.15, which was in the normal category. Approximately, 34% of the respondents were overweight and obese. BMI-for-age was positively associated with screen time during weekdays (χ2 = 11.06; p < 0.05) but not during weekend (χ2 = 3.14; p > 0.05). Spearman correlation test showed negative relationships between screen time on weekdays (rs = −0.30 and p < 0.01) and weekend (rs = −0.21 and p < 0.05) with PAQ-C of this group of ASD children.
Practical implications
Screen time was directly associated with the BMI-for-age z-score but was inversely associated with physical activity. Future studies could implement a structured physical activity intervention among children with ASD, which may increase physical activity and decrease screen time behaviours while addressing the overweight/obesity and cognitive aspects of these ASD children.
Originality/value
This study measured the amount of screen time, level of physical activity and weight status but not dietary intake of autistic children.
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Sadeghi S, Pouretemad HR, Badv RS, Brand S. Associations between Symptom Severity of Autism Spectrum Disorder and Screen Time among Toddlers Aged 16 to 36 Months. Behav Sci (Basel) 2023; 13:208. [PMID: 36975233 PMCID: PMC10045374 DOI: 10.3390/bs13030208] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
There is growing evidence that prevalence rates of autism spectrum disorder (ASD) are increasing. A number of factors appear to contribute to this increase, including excessive screen time. Screen time seems to be linked to the severity of the symptoms of ASD. Given this, the aim of the present cross-sectional study was to investigate the association between early screen time and ASD symptoms severity in the first 36 months of life. To this end, sixty-eight Iranian toddlers (mean age: 27.09 months; 22.1% females) with ASD were recruited. Parents completed the modified checklist for autism in toddlers (M-CHAT), the Repetitive Behavior Scale-Revised (RBS-R), and a lifestyle checklist. Next, parents rated children’s daily exposure to content specifically designed (foreground media) and not specifically designed (background media) for children, along with their daily exposure to social interaction. Per day, toddlers spent 5.12 h (±3.77) with foreground media, 3.72 h (±3.57) with background media, and 2.89 h (±2.74) in interaction with other people (parents). To test the hypotheses, we performed a series of Pearson’s correlations and multiple regression analyses. Toddlers’ higher severity scores for ASD symptoms were associated with longer foreground (r = 0.234, p = 0.001) and longer background (r = 0.180, p = 0.012) media duration, and with shorter duration of interaction with others (r = 0.192, p = 0.009). Toddlers spending 1 h more in foreground screen time and background screen time have 0.38 and 0.29 more units in the ASD symptom severity scale, respectively, while toddlers spending 1 h more in social interactions have 0.42 fewer units in the ASD symptom severity scale. The screen time and interaction duration are related to ASD symptoms severity of toddlers. The cross-sectional study design precludes causal associations, although bi-directional relationships appear plausible.
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24
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Kong C, Chen A, Ludyga S, Herold F, Healy S, Zhao M, Taylor A, Müller NG, Kramer AF, Chen S, Tremblay MS, Zou L. Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder. J Sport Health Sci 2023; 12:73-86. [PMID: 36029958 PMCID: PMC9923433 DOI: 10.1016/j.jshs.2022.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND The Canadian 24-hour movement behavior (24-HMB) guidelines suggest that a limited amount of screen time use, an adequate level of physical activity (PA), and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life (QoL) of children and adolescents. However, this topic has yet to be examined for children and adolescents with autism spectrum disorder (ASD) specifically. The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoL-related indicators among a national sample of American children and adolescents with ASD. METHODS Data were taken from the 2020 U.S. National Survey of Children's Health dataset. Participants (n = 956) aged 6-17 years and currently diagnosed with ASD were included. The exposure of interest was adherence to the 24-HMB guidelines. Outcomes were QoL indicators, including learning interest/curiosity, repeating grades, adaptive ability, victimization by bullying, and behavioral problems. Categorical variables were described with unweighted sample counts and weighted percentages. Age, sex, race, preterm birth status, medication, behavioral treatment, household poverty level, and the educational level of the primary caregivers were included as covariates. Odds ratio (OR) and 95% confidence interval (95%CI) were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators. RESULTS Overall, 452 participants (45.34%) met 1 of the 3 recommendations, 216 (22.65%) met 2 recommendations, whereas only 39 participants (5.04%) met all 3 recommendations. Compared with meeting none of the recommendations, meeting both sleep duration and PA recommendations (OR = 3.92, 95%CI: 1.63-9.48, p < 0.001) or all 3 recommendations (OR = 2.11, 95%CI: 1.03-4.35, p = 0.04) was associated with higher odds of showing learning interest/curiosity. Meeting both screen time and PA recommendations (OR = 0.15, 95%CI: 0.04-0.61, p < 0.05) or both sleep duration and PA recommendations (OR = 0.24, 95%CI: 0.07-0.87, p < 0.05) was associated with lower odds of repeating any grades. With respect to adaptive ability, participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing (OR = 0.11, 95%CI: 0.02-0.66, p < 0.05) than those who did not. For participants who met all 3 recommendations (OR = 0.38, 95%CI: 0.15-0.99, p = 0.05), the odds of being victimized by bullying was lower. Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems (OR = 0.17, 95%CI: 0.04-0.71, p < 0.05) than those who did not meet those guidelines. CONCLUSION Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators. These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.
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Affiliation(s)
- Chuidan Kong
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518061, China
| | - Aiguo Chen
- College of Physical Education, Yangzhou University, Yangzhou 225127, China
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany
| | - Sean Healy
- Community Health Academic Group, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin 9, Ireland
| | - Mengxian Zhao
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518061, China
| | - Alyx Taylor
- School of Rehabilitation, Sport and Psychology, AECC University College, Bournemouth, BH5 2DF, UK
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany; Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg 39120, Germany; Center for Behavioral Brain Sciences (CBBS), Magdeburg 39118, Germany
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA 02115, USA; Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario K1H8L1, Canada; Department of Pediatrics, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518061, China.
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25
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Kerbl R. [Pediatrics up to date-Brief notes on research]. Monatsschr Kinderheilkd 2023; 171:5-6. [PMID: 36467862 DOI: 10.1007/s00112-022-01652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/27/2022]
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26
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Mansouri M, Pouretemad H, Bigdeli M, Ardalan M. Excessive audio-visual stimulation leads to impaired social behaviour with an effect on amygdala: Early life excessive exposure to digital devices in male rats. Eur J Neurosci 2022; 56:6174-6186. [PMID: 36215127 DOI: 10.1111/ejn.15837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 12/29/2022]
Abstract
Today, the effect of extreme early-life exposure to digital devices is suggested as a risk factor for neurodevelopmental disorders. However, the multitude of factors that influence brain development with subsequent behavioural abnormalities have not been fully elucidated. Herein, we simulated extreme early-life exposure to digital devices in rats by audio and visual stimulation and investigated its effects on autism-related behaviours and brain structural alteration. Male rat pups were exposed to excessive audio-visual stimulation (EAVS) from PND (post-natal day) 12 to PND 35, with and without maternal separation (MS). Autism-related behaviours including abnormal sociability, stereotype behaviours, anxiety and locomotor dysfunction were tested at PND 42. Brain structural alternation was examined by considering the amygdala, mPFC (medial prefrontal cortex) and hippocampal regions while performing 3D quantitative stereological analysis. We found that EAVS led to social behaviour deficit and higher locomotion in rats, which were associated with increases in the number of neurons and volume of the amygdala. We also showed that MS did not exaggerate the effect of extreme sensory stimulation on behaviour and the structure of the brain. This study proposed EAVS in rats as an animal model of early exposure to digital devices for investigating possible neurobiological alternations underlying autistic-like behaviours with an emphasis on the amygdala area.
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Affiliation(s)
- Monireh Mansouri
- Department of Cognitive Psychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hamidreza Pouretemad
- Department of Cognitive Psychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran.,Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Mohammadreza Bigdeli
- Department of Cognitive Psychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran.,Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Maryam Ardalan
- Centre for Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Translational Neuispschiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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27
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Shima M, Tokuda N, Hasunuma H, Kobayashi Y, Tanaka H, Sawai H, Shibahara H, Takeshima Y, Hirose M. Association of epidural analgesia during labor with neurodevelopment of children during the first three years: the Japan Environment and Children's Study. Environ Health Prev Med 2022; 27:37. [PMID: 36171117 PMCID: PMC9556973 DOI: 10.1265/ehpm.22-00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Epidural analgesia relives pain during labor. However, the long-term effects on neurodevelopment in children remain unclear. We explored associations between exposure to epidural analgesia during labor and childhood neurodevelopment during the first 3 years of life, in the Japan Environment and Children's Study (JECS), a large-scale birth cohort study. METHODS Pregnant women were recruited between January 2011 and March 2014, and 100,304 live births of singleton children born at full-term by vaginal delivery, and without congenital diseases were analyzed. Data on mothers and children were collected using a self-administered questionnaires and medical record transcripts. The children's neurodevelopment was repeatedly assessed for five domains (communication, gross motor, fine motor, problem solving, and personal-social), using the Ages and Stages Questionnaires, Third Edition, at six time points from age 6 to 36 months. After adjusting for potential confounders, the associations between exposure to epidural analgesia during labor and children's neurodevelopment at each time point were assessed. RESULTS Of the 42,172 children with valid data at all six time points, 938 (2.4%) were born to mothers who received epidural analgesia during labor. Maternal exposure to epidural analgesia was associated with neurodevelopmental delays during the first 3 years after birth. Delay risks in gross and fine motor domains were the greatest at 18 months (adjusted odds ratio (aOR) [95% confidence interval (CI)]: 1.40 [1.06, 1.84] and 1.54 [1.17, 2.03], respectively), subsequently decreasing. Delay risks in communication and problem-solving domains were significantly high at 6 and 24 months, and remained significant at 36 months (aOR [95% CI]: 1.40 [1.04, 1.90] and 1.28 [1.01, 1.61], respectively). Exposure to epidural analgesia was also associated with the incidence of problem solving and personal-social delays from 18 to 24 months old. Neurodevelopmental delay risks, except for communication, were dominant in children born to mothers aged ≥30 years at delivery. CONCLUSIONS This study showed that maternal exposure to epidural analgesia during labor was associated with neurodevelopmental delays in children during the first 3 years after birth.
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Affiliation(s)
- Masayuki Shima
- Hyogo Regional Center for the Japan Environment and Children's Study, Hyogo Medical University.,Department of Public Health, School of Medicine, Hyogo Medical University
| | - Narumi Tokuda
- Hyogo Regional Center for the Japan Environment and Children's Study, Hyogo Medical University
| | - Hideki Hasunuma
- Hyogo Regional Center for the Japan Environment and Children's Study, Hyogo Medical University.,Department of Public Health, School of Medicine, Hyogo Medical University
| | - Yoshiko Kobayashi
- Hyogo Regional Center for the Japan Environment and Children's Study, Hyogo Medical University.,Department of Anesthesiology and Pain Medicine, School of Medicine, Hyogo Medical University
| | - Hiroyuki Tanaka
- Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University
| | - Hideaki Sawai
- Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University
| | - Hiroaki Shibahara
- Hyogo Regional Center for the Japan Environment and Children's Study, Hyogo Medical University.,Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University
| | - Yasuhiro Takeshima
- Hyogo Regional Center for the Japan Environment and Children's Study, Hyogo Medical University.,Department of Pediatrics, School of Medicine, Hyogo Medical University
| | - Munetaka Hirose
- Hyogo Regional Center for the Japan Environment and Children's Study, Hyogo Medical University.,Department of Anesthesiology and Pain Medicine, School of Medicine, Hyogo Medical University
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28
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Lin YH, Lin SH, Gau SSF. Screen Timing May Be More Likely Than Screen Time to Be Associated With the Risk of Autism Spectrum Disorder. JAMA Pediatr 2022; 176:824-825. [PMID: 35604677 DOI: 10.1001/jamapediatrics.2022.1516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Yu-Hsuan Lin
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Sheng-Hsuan Lin
- Institute of Statistics, National Yang-Ming Chiao-Tung University, Hsinchu, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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29
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Wilmshurst J. The hazards of screen time: Are we practicing what we preach? Dev Med Child Neurol 2022; 64:930. [PMID: 35778551 DOI: 10.1111/dmcn.15254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
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30
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Kushima M, Yamagata Z. Screen Timing May Be More Likely Than Screen Time to Be Associated With the Risk of Autism Spectrum Disorder-Reply. JAMA Pediatr 2022; 176:825. [PMID: 35604655 DOI: 10.1001/jamapediatrics.2022.1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, University of Yamanashi, Chuo, Yamanashi, Japan
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31
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Soler Artigas M, Sánchez-Mora C, Rovira P, Vilar-Ribó L, Ramos-Quiroga JA, Ribasés M. Mendelian randomization analysis for attention deficit/hyperactivity disorder: studying a broad range of exposures and outcomes. Int J Epidemiol 2022; 52:386-402. [PMID: 35690959 PMCID: PMC10114062 DOI: 10.1093/ije/dyac128] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/26/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder caused by a combination of genetic and environmental factors and is often thought as an entry point into a negative life trajectory, including risk for comorbid disorders, poor educational achievement or low income. In the present study, we aimed to clarify the causal relationship between ADHD and a comprehensive range of related traits. METHODS We used genome-wide association study (GWAS) summary statistics for ADHD (n = 53 293) and 124 traits related to anthropometry, cognitive function and intelligence, early life exposures, education and employment, lifestyle and environment, longevity, neurological, and psychiatric and mental health or personality and psychosocial factors available in the MR-Base database (16 067 ≤n ≤766 345). To investigate their causal relationship with ADHD, we used two-sample Mendelian randomization (MR) with a range of sensitivity analyses, and validated MR findings using causal analysis using summary effect estimates (CAUSE), aiming to avoid potential false-positive results. RESULTS Our findings strengthen previous evidence of a causal effect of ADHD liability on smoking and major depression, and are consistent with a causal effect on odds of decreased average total household income [odds ratio (OR) = 0.966, 95% credible interval (CrI) = (0.954, 0.979)] and increased lifetime number of sexual partners [OR = 1.023, 95% CrI = (1.013, 1.033)]. We also found evidence for a causal effect on ADHD for liability of arm predicted mass and weight [OR = 1.452, 95% CrI = (1.307, 1.614) and OR = 1.430, 95% CrI = (1.326, 1.539), respectively] and time spent watching television [OR = 1.862, 95% CrI = (1.545, 2.246)], and evidence for a bidirectional effect for age of first sexual intercourse [beta = -0.058, 95% CrI = (-0.072, -0.044) and OR = 0.413, 95% CrI = (0.372, 0.457), respectively], odds of decreased age completed full-time education [OR = 0.972, 95% CrI = (0.962, 0.981) and OR = 0.435, 95% CrI = (0.356, 0.533), respectively] and years of schooling [beta = -0.036, 95% CrI = (-0.048, -0.024) and OR = 0.458, 95% CrI = (0.411, 0.511), respectively]. CONCLUSIONS Our results may contribute to explain part of the widespread co-occurring traits and comorbid disorders across the lifespan of individuals with ADHD and may open new opportunities for developing preventive strategies for ADHD and for negative ADHD trajectories.
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Affiliation(s)
- María Soler Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Cristina Sánchez-Mora
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Paula Rovira
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Vicerectorat de Recerca, postdoctoral researcher Margarita Salas, Universitat de Barcelona, Barcelona, Spain.,Departament of Psychiatry, Faculty of Medicine, Universidad de Granada, Spain
| | - Laura Vilar-Ribó
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
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Melchior M, Barry K, Cohen D, Plancoulaine S, Bernard JY, Milcent K, Gassama M, Gomajee R, Charles MA. TV, computer, tablet and smartphone use and autism spectrum disorder risk in early childhood: a nationally-representative study. BMC Public Health 2022; 22:865. [PMID: 35490214 PMCID: PMC9055369 DOI: 10.1186/s12889-022-13296-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Screen media use in early childhood has largely increased in recent years, even more so during the COVID-19 epidemic, and there is much discussion regarding its influence on neurodevelopment, including Autism Spectrum Disorder (ASD). Methods We examined the relationship between use of TV, computer, tablet and smartphone at age 2 years and risk of ASD assessed in telephone-based questionnaires among 12,950 children participating in the nationally representative ELFE (‘Etude Longitudinale Française sur les Enfants’) birth cohort study in France. Results In inverse-probability weighted (IPW) multinomial regression analyses, children’s weekly or daily screen media use was associated with an increased likelihood of an intermediate risk of ASD (IPW-controlled OR for weekly use:1.07, 95% CI 1.02—1.12; IPW-controlled OR for daily use:1.05, 95% CI 1.02—1.08) but inversely associated with a high risk (IPW-controlled OR for weekly use: 0.60, 95% CI 0.50—0.73; IPW-controlled OR for daily use: 0.75, 95% CI 0.62—0.91), as ascertained by the M-CHAT. This was confirmed when studying TV as well as computer/tablet exposure separately. Conclusions Overall, our nationally-representative study conducted among a large sample of 2-year-old children, indicates a complex relationship between screen exposure and ASD risk.
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Affiliation(s)
- Maria Melchior
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie Et de Santé Publique (IPLESP), Paris, France.
| | - Katharine Barry
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie Et de Santé Publique (IPLESP), Paris, France
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France.,CNRS UMR 7222, Institute for Intelligent Systems and Robotics, Sorbonne University, Paris, France
| | - Sabine Plancoulaine
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inrae, 16 Av Paul Vaillant-Couturier, 75004, Paris, France
| | - Jonathan Y Bernard
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inrae, 16 Av Paul Vaillant-Couturier, 75004, Paris, France.,Agency for Science, Technology and Research (A*STAR), Singapore Institute for Clinical Sciences (SICS), Singapore, Singapore
| | - Karen Milcent
- UMS Elfe Team, Ined, Inserm, EFS, Aubervilliers, France
| | | | - Ramchandar Gomajee
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie Et de Santé Publique (IPLESP), Paris, France
| | - Marie-Aline Charles
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inrae, 16 Av Paul Vaillant-Couturier, 75004, Paris, France.,UMS Elfe Team, Ined, Inserm, EFS, Aubervilliers, France
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Berard M, Peries M, Loubersac J, Picot MC, Bernard JY, Munir K, Baghdadli A. Screen time and associated risks in children and adolescents with autism spectrum disorders during a discrete COVID-19 lockdown period. Front Psychiatry 2022; 13:1026191. [PMID: 36532191 PMCID: PMC9751585 DOI: 10.3389/fpsyt.2022.1026191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/04/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic may affect the screen time of children and adolescents with Autism Spectrum Disorders (ASD). This study aimed to examine the screen time of children and adolescents with ASD during a discrete lockdown period in France and identify risk factors for excessive screen time. METHODS The study sample consisted of 249 ASD subjects, 3-17 years of age, enrolled in the ELENA cohort. Information about the screen time was collected using the COVID-19 questionnaire specially created for this study. The clinical, socio-demographic and familial characteristics were collected from the last ELENA follow-up visit. RESULTS More than one third of subjects exceeded recommended levels of screen time and almost half of parents reported that their child spent more time using screen since COVID-19 pandemic beginning. Excessive screen time was significantly related to age with higher screen time in adolescents. Risk factors for excessive screen time were high withdrawn behaviors and low socioeconomic status for children, and older age and male gender for adolescents. CONCLUSION These results imply to adapt the recommendations already formulated in general population concerning the good use of screens in youth with ASD. Specific recommendations and suitable guidance are needed to help children and adolescents with ASD and their parents implement the more optimal use of screen time activities for educational, therapeutic and social goals. TRIAL REGISTRATION NUMBER NCT02625116.
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Affiliation(s)
- Mathilde Berard
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Marianne Peries
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Julie Loubersac
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Marie-Christine Picot
- Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Clinical Research and Epidemiology Unit, Department of Medical Information, University Hospital, CHU Montpellier, Montpellier, France
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre de Recherche en Épidémiologie et Statistiques, Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France
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34
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Heffler KF, Frome LR, Garvin B, Bungert LM, Bennett DS. Screen time reduction and focus on social engagement in autism spectrum disorder: A pilot study. Pediatr Int 2022; 64:e15343. [PMID: 36348519 DOI: 10.1111/ped.15343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/21/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is growing concern regarding early screen media exposure and its potential effects on developmental delays including autism spectrum disorder (ASD). However, there is little research examining whether interventions can decrease screen media exposure and ASD behaviors among children with ASD. METHODS Participants were nine children, 18 to 40 months old, with an ASD diagnosis who watched screens at least 2 h per day. Screen viewing history and weekly screen viewing and social interaction were assessed. The intervention involved a parent education program followed by weekly 1 h in-home support visits aimed at replacing screen time with social engagement time over a 6 month period. Child autism symptoms (Brief Observation of Social Communication Change), functional behavior (Vineland Adaptive Behavior Scales), and development (Mullen Scales of Early Learning) were assessed before and after intervention; parents completed questionnaires on parental stress (Autism Parenting Stress Index) and their perceptions of the intervention. RESULTS Children's screen viewing decreased from an average of 5.6 h/day prior to intervention to 5 min/day during the study. Significant improvements were observed in core autism symptoms and parental stress from pre- to post-intervention. CONCLUSIONS Parent education and training/support to minimize screen time and increase social interaction for young children with ASD was tolerated well by parents and children. These promising preliminary results suggest that further research on early screen media viewing, ASD, and screen reduction intervention is warranted.
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Affiliation(s)
- Karen Frankel Heffler
- Department of Psychiatry, Drexel University College of Medicine and Tower Health, Philadelphia, Pennsylvania, USA.,Tower Health, West Reading, Pennsylvania, USA
| | - Lori R Frome
- INVO Healthcare Services, Jamison, Pennsylvania, USA
| | - Brigid Garvin
- AJ Drexel Autism Institute of Drexel University, Philadelphia, Pennsylvania, USA
| | - Lindsay M Bungert
- AJ Drexel Autism Institute of Drexel University, Philadelphia, Pennsylvania, USA
| | - David S Bennett
- Department of Psychiatry, Drexel University College of Medicine and Tower Health, Philadelphia, Pennsylvania, USA
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