[Effects on children's cognitive development of chronic exposure to screens]

Screen exposure time of children under 6 years old: a French cross-sectional survey in general practices in the Auvergne-Rhône-Alpes region

BACKGROUND

The advent of miniature, easy-to-use and accessible multimedia products is leading to screen exposure that begins in early childhood. Overexposure in preschool may lead to adverse effects. The main objective of this study was to determine the average daily time (ADT) spent by children under 6 years of age, followed in general practice, in front of television or interactive screens.

METHODS

A cross-sectional survey was conducted in the Auvergne-Rhône-Alpes region among randomly selected General Practitioners (GPs). The average daily screen time (ADST), regardless of the type of device (TVs, computers, tablets, smartphones, video game consoles), of the included children aged 0 to 2 years and 2 to 5 years was calculated from a self-questionnaire completed by the parents. A multivariate Poisson regression model was performed to analyse daily screen time, adjusted by factors selected on their clinical relevance and statistical significance.

RESULTS

The 26 participating GPs included 486 parents. They reported an ADST of 26 (± 44) minutes on weekdays and 30 (± 46) minutes on weekends for children under 2 years of age. For children over 2 years of age, the ADST was 66 (± 82) minutes on weekdays and 103 (±91) minutes on weekends. There was an association between the children's average screen time and certain sociodemographic and environmental factors. Children whose parents had higher levels of education, those living in a family without TV screens or those who were well informed about the possible adverse health consequences of overuse of screens had lower average screen time. On the other hand, children of parents who spent more than 2 hours a day in front of screens, were more exposed.

CONCLUSIONS

In our survey, the ADST of children under 6 years of age followed in general practice was higher than the current recommendations. GPs can warn parents of preschool children of the effects of overexposure to screens, particularly parents of at-risk children.

A comparative study of life skills, lifestyle habits and academic performance in health promoting and non-health promoting schools in the Autonomous Community of Aragon, Spain

Background

There is insufficient evidence about the impact of health promoting schools on the student's health and academic performance. The aim of this study was to compare the life skills, lifestyle habits and academic performance of 7^th and 8^th grade students registered in health promoting and non-health promoting schools in the Autonomous Community of Aragon.

Methods

An observational, descriptive, comparative study of the life skills, lifestyle habits and academic performance of 7^th and 8^th grade students registered in 43 randomly selected health promoting and non-health promoting schools was carried out. We used an adapted tool, which was validated through the expert panel technique, to evaluate the students' life skills (self-efficacy, social skills and affect balance), lifestyle habits (diet, sleep, physical exercise, use of screen and substance abuse) and academic performance.

Results

The socioeconomic level of the mothers and fathers of the students who attended non-health promoting schools was significantly higher than that of the parents of the adolescents who attended health promoting schools (p < 0.001). The students who attended non-health promoting schools had better self-efficacy, led a healthier life generally and achieved better academic results (p = 0.03).

Conclusions

As opposed to previous studies, which found a positive association between health promoting schools and life skills, lifestyle habits and academic performance, our findings suggest that the impact of these health programs on the students' health and academic performance is limited. We recommend that the degree of implementation of health promotion programs in health promoting schools is systematically evaluated, and the health promoting school accreditation process and requirements reviewed, in order to ensure that the health of school children and adolescents is safeguarded and promoted in the short, medium and long term.

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PURPOSE OF RESEARCH

To investigate upon the relationship between screen exposure time and graphic/fine motor skills of children aged 5 to 6 in Auvergne.

METHODS

A cross-sectional epidemiological study was carried out in 2019-2020 in 3 kindergarten classes in Clermont-Ferrand and 4 in Cantal, chosen according to different socio-demographic criteria. The main criteria for evaluating fine motor skills were 3 calibrated graphic/fine motor activities, carried out during an individual assessment at school. The weekly screen exposure time of the child was assessed during a parental interview.

RESULTS

127 children took part in the survey. The main results point out that children who spend more than 10 hours per school week (more than 20 hours a holiday school week) on screen have significantly lower graphic/fine motor skills. Regardless of screen exposure time, a child living with a single parent, and/or of low level of educational, and/or intermediate occupation/socio-professional category, has lower graphic/fine motor skills scores. The rural setting of the school seems to play a positive role in the level of graphic/fine motor skills, while the socio-demographic profile of the school and the attendance of the children do not seem to influence these skills.

CONCLUSIONS

Our survey shows a significant association between increased weekly screen time exposure and decreased graphic/fine motor skills in children aged 5-6 years. Further work will be required to explore this association. Health education programs implemented in school and health communities with parental involvement would be useful to improve screen usage and prevent learning disabilities.

Healthy Lifestyle and Academic Performance in Middle School Students from the Region of Aragón (Spain)

A healthy lifestyle is important to the present and future development and health of school age people. This study aims to analyze the relationship between daily lifestyle habits and academic performance in a sample of adolescents from the autonomous community of Aragon (Spain). We performed a cross-sectional study to analyze the lifestyle habits and academic performance of a total of 1745 7th and 8th grade middle school students during the academic year 2018–2019; the participants were selected from a random sample of 43 middle schools from the region of Aragon. The following data were collected through an anonymized, previously validated questionnaire: diet, sleep, physical activity, use of screens, use of toxic substances, and academic performance. We found a statistically significant association between all the lifestyle habits analyzed and academic performance (p < 0.001) in our sample. Based on our findings, we suggest that health promotion and education in healthy lifestyles should be integrated in middle school curricula to improve academic performance and, more importantly, to promote both present and future health outcomes of adolescents.

Case-control study found that primary language disorders were associated with screen exposure

AIM

We explored the associations between childhood exposure to screens, including televisions, computers, game consoles, tablets and smartphones and primary language disorders.

METHODS

This multi-centre case-control study comprised 167 children aged 3.5-6.5 years, who were born in 2010-2012 and diagnosed with primary language disorders, and 109 matched controls without language disorders. Questionnaires were completed by their parents who were recruited by 16 family doctors and 27 speech and language therapists in the Ille-et-Vilaine region of France. The data were analysed using a multivariate logistic regression model and presented as adjusted odds ratios (aOR) and 95% confidence intervals (95% CI).

RESULTS

We found that cases (44.3%) and controls (22.0%) exposed to screens in the morning before nursery or primary school were three times more likely to develop primary language disorders (aOR 3.40, 95% CI 1.60-7.23). When this risk was combined with rarely or never discussing screen content with their parents (aOR 2.14, 95% CI 1.01-4.54) they were six times more likely to have language problems (aOR 5.86, 95% CI 1.44-23.95).

CONCLUSION

Being exposed to screens in the morning before school, and rarely or never discussing screen content with parents, meant children were six times more likely to develop primary language disorders.

Children and screens: Groupe de Pédiatrie Générale (Société française de pédiatrie) guidelines for pediatricians and families

The Groupe de Pédiatrie Générale (General Pediatrics Group), a member of the Société française de pédiatrie (French Pediatrics Society), has proposed guidelines for families and doctors regarding children's use of digital screens. A number of guidelines have already been published, in particular by the French Academy of Sciences in 2013 and the American Academy of Pediatrics in 2016. These new guidelines were preceded by an investigation into the location of digital screen use by young children in France, a survey of medical concerns on the misuse of digital devices, and a review of their documented benefits. The Conseil Supérieur de l'Audiovisuel (Higher Council on Audiovisual Technology) and the Union Nationale de Associations Familiales (National Union of Family Associations) have taken part in the preparation of this document. Five simple messages are proposed: understanding without demonizing; screen use in common living areas, but not in bedrooms; preserve time with no digital devices (morning, meals, sleep, etc.); provide parental guidance for screen use; and prevent social isolation.

[Prevalence of teenage sleeping disorders]

Teenage sleeping disorders can have short- and long-term consequences such as learning disorders, accidents, depression, and type 2 diabetes.

OBJECTIVE

To assess the prevalence of sleeping disorders in high school students in the southwest of Brittany (Finistère), France. To search for family and social factors causing these disorders and drug use.

METHOD

Observational multicenter study that took place in May, 2015, asking high school students to anonymously complete a questionnaire during school time. A variable was created: sleep disorders (TrS+) when teenagers responded "often" or "very often" to at least one of the six questions concerning sleeping disorders.

RESULTS

The prevalence of TrS+ was 73 % (4170/5556). These teenagers had difficulty falling asleep (36 %), woke up during the night (33 %), or had nightmares (10 %). Their sleep routine was disrupted (35 %), they did not feel rested the following day (49 %): 9 % were late for class related to their sleeping disorders. TrS+ were more recurrent among females (OR: 2.64; P<0.0001). A negative atmosphere in high school (OR: 2.64; P<0.0001), tobacco use (>10 cigarettes per a day) (OR: 2.39; P<0.0001), alcohol (OR: 1.4, P=0.009), marijuana (<1 time per day; OR: 2.05; P=0.009), and time spent using a computer or watching television (>8h per a day; OR: 2.7; P<0.0001) had an impact on their sleep quality. Ten percent of TrS+ individuals consume medications and 9 % cannabis to help them fall asleep.

CONCLUSION

Technology, drugs, and well-being at school have an impact on sleep quality. Screening of teenagers with sleeping disorders and information programs for teenagers must be provided by the teaching and medical staff.

Temporal trends in the diagnosis and management of childhood obesity/overweight in primary care

OBJECTIVE

To determine the temporal trends in diagnosis and management of pediatric overweight/obesity by primary care providers at a single medical center.

PATIENTS

Children 2 to 18 years old undergoing a general medical examination during 3 calendar years (2003, 2006, and 2009). The number of visits for general medical examination were 6390 in 2003, 6646 in 2006, and 7408 in 2009.

METHODS

We performed a retrospective review of the electronic medical records for weight related diagnostic and/or management terms and laboratory screening in children with body mass index at or greater than the 85th percentile (n = 1630 in 2003, 1495 in 2006, and 1730 in 2009).

RESULTS

There was a significant increase in the diagnosis of obesity among obese children seen in 2009 (53.3%) compared with 2006 (36%, P < .001) and 2003 (24.3%, P < .001). Weight-related counseling was documented in a higher proportion of obese children in 2009 (49.4%) compared with 2006 (34.8%) and 2003 (26.6%). There was a significant increase in counseling regarding screen time in 2009 compared with 2006. A significant increase in screening for nonalcoholic fatty liver disease was also noted (30.5% in 2009 vs 21.9% in 2006, P = .018).

CONCLUSIONS

There has been steady improvement in the rates of obesity diagnosis and obesity-related counseling by primary care providers. However, continued efforts to increase awareness of these issues are needed as nearly half of obese children remained undiagnosed and recommended laboratory screening for obesity-related comorbidities was performed in only a third of obese children.