Association between screen time and developmental and behavioral problems among children in the United States: evidence from 2018 to 2020 NSCH

Associations between screen time and emotional and behavioral problems among children and adolescents in US, National Health Interview Survey (NHIS), 2022

BACKGROUND

Excessive screen time is associated with physical health, behavior, and cognitive development. Recognizing childhood and adolescence as crucial periods for mental health development, we examine the association of screen time with mental health in children and adolescents.

METHOD

This cross-sectional study included 4932 children and adolescents aged 6-17 years. Information on screen time and mental health was obtained through questionnaires reported by a parent or guardian. The Strengths and Difficulties Questionnaire (SDQ) was used to evaluate children's mental health, followed by categorization into normal and abnormal groups.

RESULTS

3742 participants(weighted prevalence was 70.05 % CI 68.44 %-71.67 %) had more than two hours of screen time. After adjusting for confounders, excessive screen time was significantly associated with emotional symptoms, conduct problems, peer relationship issues, and higher total difficulties in children and adolescents. The odds ratios were 1.75 (95 % CI, 1.29-2.37; P < 0.001) for emotional symptoms, 1.73 (95 % CI, 1.19-2.52; P = 0.004) for conduct problems, 1.46 (95 % CI, 1.11-1.93; P = 0.009) for peer relationships, and 1.72 (95 % CI, 1.17-2.52; P = 0.006) for total difficulties score.

LIMITATIONS

Cross-sectional analyses cannot establish causality of the associations.

CONCLUSIONS

Significant association were found between excessive screen time and emotional problems, conduct problems, peer relationships, and total difficulties. Children and adolescents need wise guidance in using electronic devices, and timely attention should be given to the potential challenges associated with excessive screen time. Further investigation is deemed necessary to assess causality and elucidate potential mechanisms.

Study protocol: Mixed-methods evaluation of a cluster-randomized trial on preventing dysregulated screen use in children under 3

BACKGROUND

Screen media use in early childhood is associated with increased risk for health and developmental problems. A preventive intervention during a regular examination in pediatric practices aims to prevent dysregulated screen time by children under three years of age. This protocol describes a process evaluation with the aim of understanding how to implement most effectively a complex intervention to prevent dysregulated screen time in childhood. For this purpose, the process evaluation combines two frameworks to identify both the implementation process and the relevant contextual factors.

METHODS

The focus of this process evaluation is a nation-wide, cluster-randomized controlled trial with a complex intervention. Two-thirds of all pediatric practices registered with Professional Association of Pediatricians in Germany received the intervention materials with the option to participate in May 2022, while one-third maintain as usual. Since than an app has been collecting children's screen time and developmental diagnostic parameters using a longitudinal parent survey. The process evaluation will examine the implementation process following the RE-AIM scheme (Reach, Effectiveness, Adoption, Implementation, and Maintenance) as well as the relevant contextual factors influencing the effectiveness of the implementation process following the Consolidated Framework for Implementation Research. Data collection will include quantitative and qualitative methods. Measurement points are at the start of the intervention, several times during the ongoing intervention and after two years. The two groups of people will be interviewed: Pediatricians who use the intervention in their practice and parents who have received the intervention.

DISCUSSION

This protocol illustrates the process evaluation of a complex, app-based intervention in pediatric practices. It combines the two frameworks RE-AIM and CFIR and thus covers all aspects of the evaluation of the implementation process of a complex intervention.

TRIAL REGISTER NUMBER

DRKS00032258; https://drks.de/search/en/trial/DRKS00032258.

Screen use in children - two sides of the coin: a critical narrative review

Like a coin, the impacts of screens on children's development have two sides, as reflected in current scientific knowledge. This narrative review aimed to explore the dual-faceted state of the art regarding screen use, highlighting both positive and negative aspects on neurodevelopment, intervention proposals, and future perspectives for appropriate screen use. Recent scientific findings emphasize two central points: on the one hand, the benefits of appropriate use, such as co-viewing and the use of educational content; on the other hand, the negative impacts of excessive screen use, passive, and non-educational use on the development of neural networks. In this sense, with the advent of the digital age and in light of current scientific results, it is clear that eliminating screens from daily life is unrealistic. Therefore, implementing strategies to ensure a healthy balance between screen time and other activities important for child development is essential.

Ethical considerations in AI for child health and recommendations for child-centered medical AI

There does not exist any previous comprehensive review on AI ethics in child health or any guidelines for management, unlike in adult medicine. This review describes ethical principles in AI for child health and provides recommendations for child-centered medical AI. We also introduce the Pediatrics EthicAl Recommendations List for AI (PEARL-AI) framework for clinicians and AI developers to ensure ethical AI enabled systems in healthcare for children.

Excessive screen time and problem behaviours among school-age children in Fujian, China: a cross-sectional study

BACKGROUND

Screen time encompasses activities conducted on digital devices, including traditional devices such as televisions and computers, as well as modern devices like smartphones, tablets, and other digital screens. Excessive screen time among children has been linked to a heightened likelihood of engaging in high-risk problem behaviours. This study aimed to quantify the prevalence of excessive screen time and delve into its correlation with problem behaviours among school-aged children in Fujian, thereby gaining insight into the prevalence and trends within this region.

METHODS

From October to November 2022, we used cluster sampling and invited 891 school-age children from Fujian as participants. Parents recorded children's screen time for a week, taking the average value of seven days, and the unit is minutes. The Child Behaviour Checklist was used to assess their problem behaviours. Correlation analysis, Propensity Score Matching, Single-factor analysis, and Multi-factor analysis were used to explore the influencing factors and correlation.

RESULTS

Screen exposure time of school-age children was 34.29 (17.14, 55.71) min/day. Then, 17.06% were exposed to excessive video. The total CBCL score of school-age children was 10.00 (3.00, 22.00), and 10.00% had problem behaviours. After matching the propensity score, the total score of problem behaviours in the daily over-exposure group was higher than that in the non-over-exposure group (Z = 5.466, p < 0.001). Generalized linear model analysis showed that after controlling confounding variables, daily video exposure time or daily excessive screening could affect problem behaviours (p < 0.05).

CONCLUSIONS

The incidence of problem behaviours among school-age children is low in Fujina. The daily screen time, weekday screen time, and weekend screen time were positively associated with problem behaviours. We suggested family members shift to more serious and cautious attitudes toward children's screen exposure and adopt appropriate digital-related parenting practices, such as accompanying children when they inevitably need to watch electronic devices, to better understand and manage their screen time.

Digital Device Usage and Childhood Cognitive Development: Exploring Effects on Cognitive Abilities

The increasing ubiquity of digital devices in childhood had outpaced the understanding of their effects on cognitive development, creating a significant research gap regarding their long-term impact.

OBJECTIVE

The present narrative overview explored the complex relationship between digital device usage and cognitive development in childhood.

METHODS

We conducted a comprehensive literature search across multiple databases, including PubMed, Embase, Scopus, and Web of Science, to critically assess cognitive domains such as attention, memory, executive functions, problem-solving skills, and social cognition. Incorporating over 157 peer-reviewed studies published between 2001 and 2024, we used strict inclusion and exclusion criteria to ensure scientific rigor.

RESULTS

The review integrated empirical findings with established theoretical frameworks, particularly from cognitive development and media psychology, to highlight both the advantages and risks of early, frequent exposure to technology. The potential for digital devices to enhance cognitive skills, such as multitasking and information processing, was weighed against risks such as cognitive overload, diminished attention spans, and impaired social skills. We also examined psychological and behavioral outcomes, including identity formation, emotional regulation, and maladaptive behaviors associated with excessive screen time. Additionally, we identified strategies to mitigate negative effects, emphasizing structured digital engagement and parental involvement to support healthy cognitive and psychological growth. Our findings provided actionable recommendations for parents, educators, and policymakers, promoting optimal digital practices that enhanced cognitive development while safeguarding against potential harms.

CONCLUSIONS

The review offered essential insights for stakeholders in child development, education, and policy-making, highlighting the need for balanced integration of digital tools in childhood learning environments.

Associating prenatal antibiotics exposure with attention deficit hyperactivity disorder symptoms in preschool children: The role of maternal vitamin D

BACKGROUND

The associations between prenatal antibiotics exposure and attention-deficit/hyperactivity disorder (ADHD) in preschoolers, and the role of maternal vitamin D in these associations, remain to be explored.

OBJECTIVES

To evaluate the relationships between multiple maternal urinary antibiotics levels and preschoolers' ADHD symptoms, and to identify the potential modifying effects of maternal vitamin D.

METHODS

Based on a prospective birth cohort, the present study included 2033 motherchild pairs. Maternal urine and serum samples were collected during all three trimesters to measure the urinary concentrations of 43 antibiotics (including two metabolites) and the serum vitamin D levels. The ADHD symptoms of preschoolers were assessed using the Diagnostic and Statistical Manual-oriented ADHD problems scale in the Achenbach Child Behavior Checklist. Multiple informant models in the form of logistic regression were conducted to investigate the associations between prenatal antibiotics exposure and preschooler ADHD symptoms, and these associations were stratified by child sex and maternal vitamin D status.

RESULTS

Compared with the lowest tertile concentrations, maternal exposure to the middle tertile concentrations of doxycycline and human antibiotics/preferred as human antibiotics (HAs/PHAs), and the highest tertile concentrations of doxycycline during the first trimester were associated with an increased risk of ADHD symptoms in children. An increased risk of ADHD symptoms was observed in girls exposed to the highest tertile levels of sulfamethazine during the second trimester. Furthermore, pregnant women with vitamin D deficiency have a greater risk of ADHD symptoms in their offspring after exposure to doxycycline in the first trimester.

CONCLUSIONS

Maternal exposure to doxycycline and HAs/PHAs during the first trimester increases the risk of ADHD symptoms in preschoolers. Mid-pregnancy sulfamethazine exposure increases the risk of ADHD symptoms in girls. Maternal vitamin D deficiency during pregnancy may exacerbate the adverse effects of doxycycline exposure on ADHD symptoms.

Assessment of Risk of Behavioral Problems in Children Below Five Years in Relation to Screen Time: A Cross-Sectional Study

BACKGROUND

Excessive screen time is associated with developmental (mainly socio-cognitive and language) and behavioral problems more in children below five years than in older children and adolescents. The present study was conducted to determine the prevalence and pattern of exposure to excessive screen time in children below five years of age. It was also aimed at determining the prevalence of the risk of behavioral problems in these children in relation to their average daily screen time.

METHODOLOGY

This study was conducted as an observational descriptive study on children attending OPD in the Department of Pediatrics of a tertiary care medical college in central India over the study period of 12 months. Parents were enquired about their socio-demographic details, the daily average screen time of their child, details regarding screen time and exposures, associated factors, sleeping and eating habits, average time spent by parents with their children, and also the behavioral issues according to the preschool pediatric symptom checklist (PPSC). All these questions were asked of the parents and duly filled out by a single doctor. The IAP (Indian Academy of Pediatrics) screen time recommendation was used as a cut-off value for excessive screen time definition, which states screen time recommendations for children below two years and two to five years old.

RESULTS

The daily average screen time greater than one hour (exceeding the recommended guidelines) was found in 57.7% of children. Twenty-six percent of children were exposed to screen time before their first birthday. Among the study participants, 37.7% (n=95) of children were found to be at risk of behavioral problems as per PPSC score, with a mean PPSC score of 6.7±3.3 in these children. The daily average screen time of one to three hours was found in 39.3% of children, three to five hours in 13% of children, and more than five hours in 5.3% of children. The PPCS score was found to be significantly higher in children with higher average screen time, children using multiple devices as compared to single devices, children who preferred electronic devices or devices with toys as preferred sources of entertainment, children becoming restless when devices are not given, children having feeding and sleep issues, and children who spend less time with parents (p<0.05). Multivariate analysis revealed higher odds of behavioral problems in children having more screen time (1-3 hours OR: 1.536; 95% CI: 1.03-7.237; p=0.035, 3-5 hours OR: 2.022; 95% CI: 1.477-8.570; p=0.029, and >5 hours OR: 9.793; 95% CI: 2.065-46.447; p=0.004), children using multiple devices as compared to single devices (OR: 2.43; 95% CI: 1.194-4.95; p=0.014), and children whose parents spend less time with them (<3 hours OR:1.311; 95% CI: 1.02-2.77; p=0.012).

CONCLUSIONS

The present study found that almost all children below five years are exposed to digital devices, with the majority of children exceeding the recommended screen time guidelines, and they mostly use it for entertainment purposes. During this period, exposure of children to screens is significantly associated with the risk of behavioral problems. It was observed that excessive screen time, less time spent by parents with their children, and use of multiple devices are significant predictors of increasing risk of behavioral problems in children below five years.

Association between maternal antibiotic exposure and emotional and behavioural problems in children at four years of age: A biomonitoring-based prospective study

BACKGROUND

Maternal exposure to multiple antibiotics exposure during pregnancy has attracted extensive attention, but biomonitoring studies linking prenatal antibiotic exposure to emotional and behavioural problems in children are limited.

METHODS

A total of 2475 pregnant women from the Ma'anshan Birth Cohort were included, and the Strengths and Difficulties Questionnaire was completed when their children turned four years of age. The levels of 41 maternal urinary antibiotics and two metabolites were measured during the first, second and third trimesters. Generalized estimating equations and binary logistic regression models were applied to analyse the associations between maternal antibiotic exposure and emotional and behavioural problems in children and to determine the sensitive period, respectively. A quantile-based g-computation (QGC) approach was employed to examine the combined effects of multiple antibiotics on emotional and behavioural problems in children.

RESULTS

Overall, florfenicol and preferred-as-veterinary antibiotic (PVA) exposure during pregnancy increased the risk of emotional problems in children, and ofloxacin exposure increased the risk of hyperactivity-inattention. Maternal exposure to trimethoprime, ciprofloxacin, florfenicol, other antibiotics and PVA exposure during the first trimester was positively associated with emotional problems in children. Second-trimester trimethoprime concentrations and third-trimester ciprofloxacin concentrations were positively associated with hyperactivity-inattention. Third-trimester veterinary antibiotic (VA) exposure was negatively associated with hyperactivity-inattention, and second-trimester VA and PVA exposure was negatively associated with peer problems. The QGC model revealed that mixed antibiotic exposure in the first trimester exacerbated the risk of childhood emotional problems (the contribution of ciprofloxacin is prominent), and mixed antibiotic exposure in the second trimester increased the risk of hyperactivity-inattention (the contribution of trimethoprime is prominent).

CONCLUSION

Maternal mixed antibiotic exposure during the first and second trimesters increases the risk of emotional problems and hyperactivity-inattention in children at four years of age.

Lifestyle Behaviors of Childhood and Adolescence: Contributing Factors, Health Consequences, and Potential Interventions

In this narrative review, we summarized evidence from peer-reviewed articles, published before February 2024, that investigated lifestyle behaviors among children (≤12 years) and adolescents (13-18 years) representing different geographic descents. These behaviors included dietary patterns, screen time, physical activity, smoking, alcohol consumption, oral hygiene, unsafe sex, and sleep duration and quality. We documented the significant impacts of parental, school, and sociodemographic factors on the adoption of numerous lifestyle behaviors in this age category. Several health consequences could be attributed to unhealthy lifestyle behaviors during childhood and adolescence. For example, poor dietary habits can lead to a higher risk of obesity and cardiovascular disease. Physical inactivity contributes to the development of musculoskeletal and psychological disorders. Excessive screen time is associated with visual acuity problems, poor sleep, and psychological and behavioral problems. Tobacco use poses a significant risk for severe respiratory and cardiovascular diseases. Risky sexual behaviors are related to sexually transmitted infections and exposure to violence. Short sleep duration is associated with a lack of physical fitness and poor cognitive function. However, potential interventions, such as school-based health programs, community outreach initiatives, and national health policies and regulations, can improve lifestyle behaviors among children and adolescents.

Screen Time, Sociodemographic Factors, and Psychological Well-Being Among Young Children

Importance

Young children's screen time increased during the COVID-19 lockdown in 2020, but it is unknown whether their screen time returned to prepandemic levels in 2021. Knowledge of the relationship between screen time and child development and health will inform prevention and intervention targets and strategies.

Objective

To evaluate screen time by family income and race and ethnicity in the prepandemic (ie, 2018, 2019) and pandemic (ie, 2020, 2021) periods and to examine the relationship between screen time and psychological well-being among young children in the US.

Design, Setting, and Participants

Cross-sectional population-based web or mail survey study of 2018-2021 National Survey of Children's Health participants aged 6 months to 5 years.

Exposure

Daily screen time (<1, 1, 2, 3, or ≥4 h/d) reported by participants' primary caregivers.

Main outcomes and Measures

Flourishing and externalizing behaviors, as indicators of psychological well-being. All analyses were weighted, accounting for the complex survey sample design.

Results

Of the 48 775 participants (50.7% female), the proportion of those with high screen time (defined as ≥1 h/d for children aged 6 months-1 year and ≥2 h/d for children aged 2-5 years) was 48.5% (95% CI, 46.3%-50.7%) in 2018, 49.2% (95% CI, 47.0%-51.5%) in 2019, 55.3% (95% CI, 53.4%-57.2%) in 2020, and 50.0% (95% CI, 48.3%-51.6%) in 2021. Among children living in poverty (federal poverty level <100%), the proportion of those with high screen time was 48.7% (95% CI, 42.8%-54.6%) in 2018, 52.0% (95% CI, 45.4%-58.6%) in 2019, 60.9% (95% CI, 55.4%-66.4%) in 2020, and 58.9% (53.7%-64.1%) in 2021. Adjusted odds ratio of flourishing was 0.66 (95% CI, 0.51-0.85), 0.81 (95% CI, 0.66-0.99), 0.68 (95% CI, 0.52-0.88), and 0.53 (95% CI, 0.42-0.69) for less than 1, 2, 3, and 4 or more hours per day vs 1 hour per day of screen time, respectively, among children aged 3 to 5 years. No association between screen time and flourishing was found among children aged 6 months to 2 years. An adjusted externalizing behavior score was higher by 0.2 points (95% CI, -0.1 to 0.5), 0.5 points (95% CI, 0.3 to 0.8), 1.3 points (95% CI, 1.0 to 1.6), and 2.1 points (95% CI, 1.7 to 2.5) for less than 1, 2, 3, and 4 or more hours per day vs 1 hour per day of screen time, respectively, among children aged 3 to 5 years.

Conclusions and Relevance

In this multiyear cross-sectional study of a representative sample of young children in the US, the increased prevalence of high screen time in 2020 returned to prepandemic levels in 2021; however, it remained elevated in children living in poverty. Two hours or more of daily screen time was associated with lower psychological well-being among preschool-aged children.

Associations between Parental Educational Attainment, Children's 24-h Behaviors and Children's Hyperactivity Behavior in the COVID-19 Pandemic

BACKGROUND

Parental Educational Attainment and children's 24-h behaviors significantly influenced children's hyperactivity symptoms. This study aimed to examine the mediating role of children's 24-h behavior changes due to the COVID-19 pandemic between Parental Educational Attainment and children's hyperactivity index. It also aimed to investigate the associations between Children's Physical Activity, digital media use, sleep, and hyperactivity index between two clusters of Parental Educational Attainments. The goal was to provide targeted behavioral optimization recommendations for caregivers to reduce the risk of children's hyperactivity.

METHODS

The study was a collaborative extension of the International iPreschooler Surveillance Study Among Asians and otheRs project and the Chinese Children and Adolescent Sports Health Promotion Action Project. The Parent-Surveillance of Digital Media in Childhood Questionnaire® and the Abbreviated Rating Scales from the Conners Parent Symptom Questionnaire were used to measure Parental Educational Attainment, children's behavior changes during the COVID-19 pandemic, and hyperactivity indexes. A total of 11,190 parents of 6-to-12-year-old children completed the online surveys in mainland China. A structural equation model was established by using Smart-PLS, and the linear regression model, and isotemporal substitution models were established by using a Compositional Data Analysis package with R program to achieve the research objectives.

RESULTS

Changes in children's 24-h behaviors due to the COVID-19 pandemic had a significant mediation effect on the negative associations between Parental Educational Attainment and children's hyperactivity index (β = 0.018, T = 4.521, p < 0.001) with a total effect (β = -0.046, T = 4.521, p < 0.001) and a direct effect (β = -0.064, T = 6.330, p < 0.001). Children's Digital Media use was significantly and negatively associated with hyperactivity index among all children. Reallocated time from digital media use to both sleep and physical activity decreased the hyperactivity index, and vice-versa. For parents without tertiary education (R2 = 0.09, p < 0.001), sleep was significantly and negatively associated with the hyperactivity index (βilr-CSL = -0.06, p < 0.001); for parents with tertiary education (R2 = 0.07, p < 0.001), physical activity was significantly and negatively associated with the hyperactivity index (βilr-CPA = -0.05, p < 0.001), and sleep was significantly and positively associated with the hyperactivity index (βilr-CSL = 0.03, p < 0.001). A significant increase in the hyperactivity index was detected when physical activity time was reallocated to sleep, with a significant decrease in the opposite direction.

CONCLUSIONS

Parental Educational Attainment and children's 24-h behaviors directly influenced children's hyperactivity index. However, a purposeful and targeted optimization of children's 24-h behaviors-namely, physical activity, digital media use, and sleep-could assist parents with different educational attainments to reduce their children's hyperactivity index and mitigate the risk of hyperactivity.

Screen Time and Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

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.

Screen time of toddlers in Paris suburbs: Quantitative and qualitative analysis

BACKGROUND

Our aim was to describe the exposure of French children aged 12-36 months to screens (time, content, age of first exposure) and to analyze different moderating factors: sociodemographic data, parents' screen time, and other factors (childcare arrangements, language spoken at home, book reading).

POPULATION AND METHODS

We conducted an observational, cross-sectional, descriptive and analytical study based on 171 questionnaires from parents of children aged 12-36 months who consulted different hospitals in the Paris region during the summer of 2020.

RESULTS

The median screen time was 1 h per day and was essentially television time. The median age of first exposure for children was 12 months. Among the most-watched sites, YouTube was in first place. One third of the children chose the content they watched alone, and the majority did so without any parental guidance (66%). Children watched a screen during mealtime every day in 25% of cases, before bedtime in 12.3% of cases, and 8.8% had a screen in their bedroom. More than one third of families left the television on in the background most of the time. In the multivariate analysis, a high level of screen time was notably linked to the child's age, the parents' screen time, and background television. However, the parental reason for exposure "to calm the child" was the most strongly correlated factor with significant child screen time. Reading books appeared to be a determining factor for less screen exposure.

CONCLUSION

These results emphasize the importance of raising parents' awareness about the potential negative effects of screen exposure (particularly on children's cognitive and emotional development) as early as possible during the maternity period. Implementing this prevention in the maternity wards could be an effective way of informing and educating parents about the potential negative effects of screen time on their child's development.

Screen media activity in youth: A critical review of mental health and neuroscience findings

This review has two primary objectives: (1) to offer a balanced examination of recent findings on the relationship between screen media activity (SMA) in young individuals and outcomes such as sleep patterns, mood disturbances, anxiety-related concerns, and cognitive processes; and (2) to introduce a novel multi-level system model that integrates these findings, resolves contradictions in the literature, and guides future studies in examining key covariates affecting the SMA-mental health relationship. Key findings include: (1) Several meta-analyses reveal a significant association between SMA and mental health issues, particularly anxiety and depression, including specific negative effects linked to prolonged screen time; (2) substantial evidence indicates that SMA has both immediate and long-term impacts on sleep duration and quality; (3) the relationship between SMA and cognitive functioning is complex, with mixed findings showing both positive and negative associations; and (4) the multifaceted relationship between SMA and various aspects of adolescent life is influenced by a wide range of environmental and contextual factors. SMA in youth is best understood within a complex system encompassing individual, caregiver, school, peer, and environmental factors, as framed by Bronfenbrenner's ecological systems theory, which identifies five interrelated systems (microsystem, mesosystem, exosystem, macrosystem, and chronosystem) that influence development across both proximal and distal levels of the environment. This model provides a framework for future research to examine these interactions, considering moderating factors, and to develop targeted interventions that can mitigate potential adverse effects of SMA on mental well-being.