Infant screen exposure links to toddlers' inhibition, but not other EF constructs: A propensity score study

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

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

Maternal COVID-19 Distress and Chinese Preschool Children's Problematic Media Use: A Moderated Serial Mediation Model

Introduction

Maternal distress increased during the COVID-19 pandemic, significantly impacting children's media use. The purpose of this study was to explore the influence mechanism of maternal COVID-19 distress on preschoolers' problematic media us through a moderated mediation model; specifically, we examined the possible mediating roles of parenting stress and negative instrumental use of media in parenting and the moderating role of supportive co-parenting.

Methods

An online survey was conducted in a sample of 1357 children (M_age = 4.01, SD = 1.06; 47.4% boys) and their parents from six public kindergartens in Shanghai, China. The mothers provided information by completing measures on their levels of distress related to COVID-19, parenting stress levels, digital parenting practices, and perception of supportive co-parenting from their partners. Additionally, both parents rated their children's problematic media use.

Results

(1) maternal COVID-19 distress was significantly and positively related to children's problematic media use; (2) this relationship was sequentially mediated by parenting stress and parents' negative instrumental use of media in parenting; and (3) supportive co-parenting moderated the serial mediation path by reducing the effect of maternal COVID-19 distress on parenting stress.

Conclusion

The findings provide some support and guidance for preventing children's problematic media use and enhancing parental adaptation during the COVID-19 pandemic or in potentially adverse situations.

Exposure to screens during meals in infants with functional gastrointestinal disorders

BACKGROUND

Since meals are a special moment in the parent-infant relationship and functional gastrointestinal disorders (FGD) are frequent in infants, this study mainly aimed to describe the frequency of exposure to screens during meals in infants with FGD.

METHODS

This French non-interventional, cross-sectional, and multicenter study was conducted with FGD infants (aged 1-12 months), consecutively included by private pediatricians and general practitioners. Descriptive analysis was performed.

RESULTS

Data from 816 infants, included by 246 physicians, were analyzed: mean age: 4.8 ± 2.9 months; FGD: regurgitation (81%), colic (61%), constipation (30%), and/or diarrhea (12%). Overall, 465 infants (57.0%, 95% CI [45.6%-60.4%]) were regularly exposed to screens during meals. Of these exposed infants, 131 (28.2%, 95% CI [24.1%-32.3%]) were directly exposed. Explicative factors of the overall screen exposure during meals were the following: >2 children in the household (p = 0.0112), infant meals in the living room (p < 0.0001) or the dining room (p = 0.0001), and mother or father being blue-collar workers, white-collar workers, or without employment (mother: p = 0.0402; father: p = 0.0375).

CONCLUSION

This real-world French study showed the high proportion of FGD infants under 12 months of age who are exposed to screens during meals. Our data suggest that information to parents on the potential adverse effects of screen exposure should be reinforced, including for infants.

Universality and context-specificity in early executive function development

A renewed interest in early executive function (i.e., EF or the conscious control of thought and behavior) development has led several research groups to suggest that EF may be emerging and is less coordinated (e.g., showing few relations between tasks) in the first few years (Devine et al., 2019; Gago Galvagno et al., 2021; Johansson et al., 2016; Miller & Marcovitch, 2015; Ribner et al., 2022). This potentially universal development in EF does not exclude the possibility that EF may also differ across context (e.g., Gago Galvagno et al., 2021; Lohndorf et al., 2019; Tran et al., 2015) reflecting unique strengths and development built within one's sociocultural environment. The present paper explores potential universal and context-specific early EF developments by focusing on three aims: (1) reviewing work on EF within the first two years of life that may speak to potential universality in the measurement, structure, growth, stability, and conceptualization of early EF (2) reviewing research that may speak to how the sociocultural context may play a role in context-specific development within early EF and (3) examining potential developmental EF frameworks for understanding universal and context-specific developments of early EF within context.

Screen technology exposure and infant cognitive development: A scoping review

PROBLEM

There has been some concern that screen exposure is harmful to an infant's cognitive development, but the effects of screen technologies on cognition are not fully understood. A scoping review was conducted to determine what evidence exists about screen exposure and cognitive development in children ages birth to 24 months.

ELIGIBILITY CRITERIA

Inclusion = 1) English language; 2) studies focusing on children under 24 months of age; 3) cognitive development; 4) screen exposure. Exclusion = 1) articles over 25 years old; 2) structure, function and physiology of the brain; 3) social development; 4) psychosocial development; 5) motor development; 6) abnormal development/mental health; 7) behavior; 8) content only, not screen exposure e.g., social media; 9) secondary sources.

SAMPLE

Ten studies met the inclusion criteria. Articles included one retrospective chart review, six longitudinal studies, two cross-sectional studies, and one prospective study.

RESULTS

Of the ten studies in this review, six reported correlations between screen exposure and cognitive delay, one study reported positive cognitive outcomes and three reported no significant positive or negative outcomes.

CONCLUSIONS

From the evidence in this scoping review, no causal relationship has been found between screen exposure and infant cognitive harm. Some correlations between screen exposure and cognitive delay were reported. Some positive cognitive outcomes were also reported.

IMPLICATIONS

Future research should focus on the context of screen viewing as opposed to dosage or exposure. More robust methodologies should be used to assess infant cognition and screen usage.

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

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

Mothers' and fathers' executive function both predict emergent executive function in toddlerhood

There are multivariate influences on the development of children's executive function throughout the lifespan and substantial individual differences can be seen as early as when children are 1 and 2 years of age. These individual differences are moderately stable throughout early childhood, but more research is needed to better understand their origins. To some degree, individual differences in executive function are correlated between mother and child, but no research to date has examined these associations prior to when children are preschool age, nor have any studies considered the role of fathers' and mothers' executive function in tandem. Here, we use a sample of 484 families (Mothers 89.2% white; Fathers 92.5% white) in three countries (UK, USA, Netherlands) to investigate the role of each parents' executive function on the development of children's (49.7% female) executive function from 14 (M = 14.42, SD = 0.57) to 24 (M = 24.47, SD = 0.78) months, as well as parenting practices that underlie these associations. Results of structural equation models suggest stability in some-but not all-components of executive function and growing unity between components as children age. We replicate extant findings such that mothers' executive function predicts children's executive function over and above stability and extend these findings to include associations between father and child skills. We find an additive role of fathers' EF, similar in magnitude to the role of mothers' EF. Finally, for both mothers and fathers we find that sensitivity and autonomy supportive practices mediate the relations between parents' and children's executive function.

Effects of screen exposure on young children's cognitive development: A review

The past decade has witnessed a rapid increase in the use of screen media in families, and infants are exposed to screens at younger ages than ever before. The objective of this review is twofold: (1) to understand the correlates and demographic factors determining exposure to screens, including interactive screens, when available, and (2) to study the effects of watching screens and using touchscreens on cognitive development, during the first 3 years of life. We argue that the effects of screen viewing depend mostly on contextual aspects of the viewing rather than on the quantity of viewing. That context includes the behavior of adult caregivers during viewing, the watched content in relation to the child's age, the interactivity of the screen and whether the screen is in the background or not. Depending on the context, screen viewing can have positive, neutral or negative effects on infants' cognition.

Longitudinal Associations of Children’s Hyperactivity/Inattention, Peer Relationship Problems and Mobile Device Use

Children with emotional, behavioral or relationship problems may be more inclined to use mobile touchscreen devices (MTSDs: mobiles and tablets) to regulate their emotions or compensate for the lack of social relationships, which, in turn, may affect their symptoms. Bi-directional longitudinal associations between behavioral difficulties and MTSD use were analyzed. Participants were parents of children aged 4–6 years old at first data collection (n = 173), and 7–9 years old at second data collection (n = 98). They reported on their child’s MTSD use and behavioral difficulties at two time points (T1 and T2). It was analyzed whether T1 MTSD use predicts T2 behavioral difficulties (controlling for demographics and T1 behavioral difficulties); and whether T1 behavioral difficulties predict T2 MTSD use (controlling for demographics and T1 MTSD use). Additionally, cross-sectional associations between behavioral difficulties and MTSD use were analyzed. Children’s T1 hyperactivity/inattention score positively associated with T2 MTSD use, and peer relationship problems and MTSD use positively associated in T2. Pre-schoolers with more hyperactive inattentive symptoms may use MTSDs more to regulate their emotions. The association between peer relationship problems and MTSD use in T2 is consistent with poorer socio-cognitive skills in MTSD user children and may be bi-directional.

Children aged 3-4 years were more likely to be given mobile devices for calming purposes if they had weaker overall executive functioning

AIM

Young children with weaker self-regulation use more digital media, but studies have been limited by parent-reported screen time measures. We examine associations between early childhood executive functioning and objective mobile device usage.

METHODS

The parents of 368 American children (51.6% male) aged 3-4 years of age completed standardised measures of executive functioning, parenting stress and household chaos. They provided mobile sampling data for 1 week in 2018-2019 and reported how often the children used mobile devices to calm themselves.

RESULTS

The children's mean age was about 3.8 years. A third of the children who were given devices to calm them down had weaker executive functioning in the overall and multivariable models, including working memory, planning and organisation. So did 39.7% of the children who used educational apps. Streaming videos, using age-inappropriate apps and using the mobile device for more than1 h per day were not associated with executive functioning levels. Parenting stress and household chaos did not moderate the associations.

CONCLUSION

This study confirms previous studies that suggesting that children with weaker overall executive functioning used devices more for calming purposes. It also raises questions about whether children with weaker executive functioning should use educational apps.

Demographic Correlates of Movement Behaviors in Infants: A Longitudinal Study

BACKGROUND

Demographic correlates of movement behaviors in infants are unclear. This study examined the longitudinal associations between demographic correlates and movement behaviors in infants.

METHODS

Participants were 411 parents of infants from the Early Movers project in Edmonton, Canada. Movement behaviors, infant and parental age, and nonparental care time were assessed using a parental questionnaire at 2, 4, and 6 months of age. Other infant and parental demographic variables were assessed at 2 months of age. Linear and generalized linear mixed models were conducted.

RESULTS

Infant age was associated with all movement behaviors except for restrained time. White infants and those with older parents had less tummy time but increased odds of having reading time. Infants of the most educated parents also had lower tummy time. Higher parental education and more siblings were associated with no screen time and longer infant sleep time. Infants with immigrant parent(s) were less likely to have reading time. No associations were found for infant sex, time spent in nonparental care, and parental marital status.

CONCLUSION

Since no single demographic group demonstrated healthy patterns for all movement behaviors, promotion of a healthy balance of movement behaviors may be needed universally for all infants.

Not all babies are in the same boat: Exploring the effects of socioeconomic status, parental attitudes, and activities during the 2020 COVID-19 pandemic on early Executive Functions

Early executive functions (EFs) lay the foundations for academic and social outcomes. In this parent‐report study of 575 UK‐based 8‐ to 36 month olds (218 followed longitudinally), we investigate how variation in the home environment before and during the 2020 pandemic relates to infants’ emerging EFs. Parent‐infant enriching activities were positively associated with infant Cognitive Executive Function (CEF) (encompassing inhibitory control, working memory, cognitive flexibility). During the most‐restrictive UK lockdown—but not subsequently—socioeconomic status (SES) was positively associated with levels of parent‐infant enriching activities. Parents who regard fostering early learning, affection, and attachment as important were more likely to engage in parent‐infant enriching activities, yet there was no significant pathway from parental attitudes or SES to CEF via activities. Infant screen use was negatively associated with CEF and Regulation. Screen use fully mediated the effect of SES on CEF, and partially mediated the effect of SES on regulation. Parental attitudes toward early learning, affection, and attachment did not significantly influence screen use. These results indicate that although parental attitudes influence the development of early EFs, interventions targeting attitudes as a means of increasing enriching activities, and thus EF are likely to be less effective than reducing barriers to engaging in enriching activities.

Associations between touchscreen exposure and hot and cool inhibitory control in 10-month-old infants

Touchscreen use amongst young children has proliferated in recent years, yet little is known about the association between daily touchscreen exposure and inhibitory control in the first year of life. Previous research has found a negative association between the amount of television viewing and inhibitory control in early childhood, but it is unclear whether negative associations with screen use extend to touchscreens. The current study presents an exploratory analysis of the cross-sectional associations between inhibitory control and the amount of touchscreen use amongst 10-month-olds (n = 128-156). Touchscreen exposure was assessed via parent-report. In order to include a range of "hot" and "cool" aspects of inhibitory control, these skills were assessed using lab-based response inhibition and prohibition tasks as well as parent-reported observations of infants' inhibitory control abilities and broader regulatory behaviors. A "Cognitive Executive Function (EEFQ-CEF)" score (encompassing Inhibitory Control, Flexibility, and Working Memory items) was included as a secondary broader executive function construct to examine whether effects showed specificity to inhibitory control rather than executive functions more generally. Correlation analyses indicated no association between touchscreen exposure and the four indices of IC. However, a positive association was found for the amount of touchscreen exposure and EEFQ-CEF once accounting for sociodemographic variables. The implications of these findings and future directions are discussed.

Associations among average parental educational attainment, maternal stress, and infant screen exposure at 6 months of age

Evidence suggests that increased use of screens early in life may have negative developmental consequences for children. However, little is known concerning parental factors that predict initial screen exposure in infancy. The primary goal of this study was to examine whether parental educational attainment and maternal stress were associated with infant screen exposure by 6 months of age. A diverse sample of mothers (N = 93) was recruited prenatally. In a follow-up visit when the infants were six months of age (N = 82), we examined factors that may be associated with initial infant exposure to screens. First, mothers reported whether they had already exposed their infants to screens. Thereafter, those mothers who reported already having exposed their infants to screens were further queried to determine the extent of infant screen use. Results demonstrated that among infants exposed to screens, mothers reported an average of nearly 3 h of daily screen use. Average parental educational attainment, but not maternal stress, was significantly associated with initial infant exposure. Of those families who endorsed screen exposure by 6 months, 70 % reported a screen in the room where the child sleeps, nearly half reported using screens to help calm the infant, and about a third reported using a screen at least sometimes during meals, when going to sleep, and while waiting. Parental education around infant screen use behaviors may be important to help promote child development and outcomes.

Development and validation of the Early Executive Functions Questionnaire: A carer-administered measure of Executive Functions suitable for 9- to 30-month-olds

Executive functions (EFs) enable us to control our attention and behavior in order to set and work toward goals. Strong EF skills are linked to better academic performance, and greater health, wealth, and happiness in later life. Research into EF development has been hampered by a lack of scalable measures suitable for infancy through to toddlerhood. The 31-item Early Executive Functions Questionnaire (EEFQ) complements temperament measures by targeting cognitive and regulatory capabilities. Exploratory Factor Analysis (n = 486 8- to 30-month-olds) and Confirmatory Factor Analysis (n = 317 9- to 30-month-olds) indicate Inhibitory Control, Flexibility, and Working Memory items load onto a common "Cognitive Executive Function (CEF)" factor, while Regulation items do not. The CEF factor shows strong factorial measurement invariance for sex, and partial strong factorial measurement invariance for age. CEF and Regulation scores show limited floor and ceiling effects, good internal consistency, short-term stability, and convergent validity with carer-report measures of attentional control. The EEFQ is sensitive to developmental change. Results indicate that the widely overlooked period between late infancy and early toddlerhood may be a sensitive period for EF development. The low-resource demands of the EEFQ afford the possibility to study emergent EFs at scale; opening up new opportunities in basic developmental and intervention research.

Infant media use: A harm reduction approach

There are a myriad of potentially harmful developmental outcomes associated with infant digital media use. Studies revealing risk associated with early media use have informed the current American Academy of Pediatrics (AAP) recommendations that discourage most digital media use among children under 18 months of age. Recent research advances, however, suggest potential benefits of technology engagement in this age group. Additionally, surveys of parents reveal that most infants engage with digital media for at least 30 min a day, exceeding the AAP recommendations. In response to these discoveries and cultural trends, some scholars have made compelling cases to adapt the AAP guidelines for infants. A helpful model for developing infant digital media use guidelines for families may be the harm reduction approach. The intent of this review is to suggest adaptations to the AAP guidelines for infant media engagement using a harm reduction framework. This review describes the challenge of restrictive guidelines, briefly summarizes the harm reduction approach, provides a review of risks and benefits associated with infant media use in each developmental domain (physical, cognitive, and socioemotional), summarizes correlates of infant screen media use, and examines intervention strategies for reducing screen time. The paper concludes with examples of possible adaptations to current AAP infant media use recommendations using harm reduction and bioecological frameworks.

Screens across the pond: Findings from longitudinal screen time research in the US and UK

Digital media are increasingly pervasive in the lives of young children. This increase in the availability of digital media might have long-run implications for child development; however, it is too soon to definitively conclude the direction of effects. In part due to this lack of certainty, leading health organizations have chosen to make different recommendations to parents of young children: Many international health organizations (e.g., the American Academy of Pediatrics, World Health Organization) recommend very young children be limited to under one hour of screen time daily, whereas others (e.g., Royal College of Paediatrics and Child Health) have intentionally opted not to make recommendations about specific limits. These guidelines might contribute to parents in different countries making meaningfully different choices about children's use of digital media. Using a sample of N = 303 families recruited in Cambridgeshire, England and New York City prior to the birth of couples' first child, we explore predictors of digital media use across the first two years of life. Data were collected when children were 4, 14, and 24 months of age. Results of latent growth curve analyses show that generally, children spend more time engaging with digital media as they grow older; however, growth mixture models reveal most children fit into one of two classes: One group of children (High Media Users; 52.2 %) engages with a substantial amount of digital media, whereas the other (Low Media Users; 48.8 %) engages with relatively little. Children in the US were approximately 30 % more likely to be in the Low Media Users group and there were no differences in group membership on the basis of parents' psychosocial wellbeing. While these differences could be due to a number of factors, these findings may reflect the power of pediatric recommendations.

Links between television exposure and toddler dysregulation: Does culture matter?

Television exposure in early childhood has increased, with concerns raised regarding adverse effects on social-emotional development, and emerging self-regulation in particular. The present study addressed television exposure (i.e., amount of time watching TV) and its associations with toddler behavioral/emotional dysregulation, examining potential differences across 14 cultures. The sample consisted of an average of 60 toddlers from each of the 14 countries from the Joint Effort Toddler Temperament Consortium (JETTC; Gartstein & Putnam, 2018). Analyses were conducted relying on the multi-level modeling framework (MLM), accounting for between- and within-culture variability, and examining the extent to which TV exposure contributions were universal vs. variable across sites. Effects of time watching TV were evaluated in relation to temperament reactivity and regulation, as well as measures of emotional reactivity, attention difficulties, and aggression. Results indicated that more time spent watching TV was associated with higher ratings on Negative Emotionality, emotional reactivity, aggression, and attention problems, as well as lower levels of soothability. However, links between TV exposure and both attention problems and soothability varied significantly between cultures. Taken together, results demonstrate that increased time spent watching television was generally associated with dysregulation, although effects were not consistently uniform, but rather varied as a function of culturally-dependent contextual factors.

A longitudinal examination of daily amounts of screen time and technoference in infants aged 2-11 months and associations with maternal sociodemographic factors

This study aimed to examine longitudinal developmental patterns in the daily amounts of screen time and technoference in infants aged 2, 4, 7, and 11 months and to examine associations with maternal sociodemographic factors across all age groups. The results showed that the amount of screen time varied between 6 and 17 min a day, while interruptions in mother-infant interactions due to maternal use of digital technology occurred between 5 and 6 times a day. There was a significant increase in infant screen time from 2 to 4 months, from 4-7 months, and from 7-11 months, and in technoference from 2 to 4 months and from 4-7 months. Maternal age and household income were not associated with infant screen time, but maternal educational level was negatively associated with infant screen time throughout the first year. No associations were found between technoference and maternal age, maternal educational level, or household income. Future research focusing on infant screen time and technoference should aim at including samples that reflect the general population, include measures of screen time and technoference that do not rely on parental report, and include measures of the effects of early infant screen time and technoference on later development.

Testing Reliability of Biophilic Design Matrix Within Urban Residential Playrooms

Playtime in urban cities has become an indoor activity for children due to limited access to natural outdoor environments. This product of urbanization makes the case for the introduction of biophilic design. However, playrooms are often neglected as a possibility in designing a natural space indoors. Interior designers and other specialists lack a reliable tool to identify and incorporate biophilic features into the design of these indoor environments in urban settings. The Biophilic Interior Design Matrix (BID-M) developed by McGee and Marshall-Baker quantifies 52 of Kellert’s biophilic design attributes to assess their presence and absence within interior spaces. We expanded its use by testing the matrix in a new type of space, urban playrooms, and coded images of 45 children’s playrooms within Manhattan residential buildings in New York City, including assessing a larger sample and reliability rate compared to McGee and Marshall-Baker’s research. Inter-rater reliability of the overall design matrix and individual matrix items was measured with percent agreement and free-marginal multirater kappa. Reliability testing showed overall good reliability of the overall design matrix. Several matrix items had low reliability between raters. Our findings show that the BID-M needs to be modified to better assess urban interior spaces for children.

Infant screen media usage and social-emotional functioning

There has been little research on whether and how screen media usage affects social-emotional (SE) function prior to two years of age, even though early SE development is understood to be nurtured through interpersonal experience, mainly withthe primary caregiver. This study sought to characterise infant screen media usage and understand how it may link with concurrent SE function by testing associated effects on reducing parent-infant interaction and of parent psychological factors. Questionnaire responses from 327 UK-based parents of infants aged 6-24 months showed diverse usage in the amount of time spent on screen media ('screen time') and amount of parental involvement (co-sharing and co-referencing). Infants with possible SE delay experienced more screen time than those at low risk. The study tested three mediation models and found support for the displacement and not distancing hypothesis based on this community sample. While screen time predicted both SE competence and SE problems, reduced parent-infant play partially mediated the effect on SE competence. Parent depressed mood was positively linked with infant SE problems, but there was little evidence that increased screen time mediated this effect. Also, parent reflective function and attitudes toward parent-infant play were unrelated to screen time. Though longitudinal study is warranted, the findings implicate screen media usage as potentially directly and indirectly relevant when addressing infant mental health.

Screen Time and Executive Function in Toddlerhood: A Longitudinal Study

Technology is pervasive in homes with young children. Emerging evidence that electronic screen-based media use has adverse effects on executive functions may help explain negative relations between media use and early academic skills. However, longitudinal investigations are needed to test this idea. In a sample of 193 British toddlers tracked from age 2 to 3 years, we test concurrent and predictive relations between screen use and children’s executive function. We find no concurrent association between screen use and executive function; however, screen time at age 2 is negatively associated with the development of executive functions in toddlerhood from age 2 to 3, controlling for a range of covariates including verbal ability. Implications for parenting, education, and pediatric recommendations are discussed.