Early childhood screen time as a predictor of emotional and behavioral problems in children at 4 years: a birth cohort study in China

Abstract

Background Previous studies have suggested that screen time (ST) has a negative effect on children’s emotional and behavioral health, but there are few longitudinal studies that have been conducted with infants and toddlers. This study sought to examine the effect of ST in early childhood on emotional and behavioral problems in children aged 4 years, based on a birth cohort study in China. Methods A total of 2492 children aged 4 years were enrolled in this study. The parents and guardians of each child completed a questionnaire that included items eliciting information on children’s birth information, socio-demographic information at baseline, and ST at each follow-up. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) at 4 years of age. Multivariate logistic analysis was used to explore the effects of ST on emotional and behavioral problems. Results The percentages of children with ST > 0 h/day at age 0.5 years, ST > 2 h/day at age 2.5 years, and ST > 2 h/day at age 4 years were 45.7, 55.5, and 34.5% respectively. The prevalence of emotional and behavioral problems was 10.8%. ST at 6 months was a risk factor for emotional symptoms and hyperactivity at the age of 4 years. ST at age 2.5 years was a risk factor for hyperactivity at the age of 4 years. However, ST at age 4 years was a risk factor for total difficulties, conduct problems, peer problems, hyperactivity, and prosocial behavior. Conclusions Higher ST exposure at early childhood is associated with later emotional and behavioral problems. In particular, sustained high ST exposure is a risk factor for behavioral problems. These findings suggested the importance of controlling ST to prevent the occurrence of emotional and behavioral problems in the early years.

Associations Between Movement Behaviors and Emotional Changes in Toddlers and Preschoolers During Early Stages of the COVID-19 Pandemic in Chile

“…Our study showed that during the early stages of the pandemic child's and caregiver's characteristics were more consistently associated with emotional changes in toddlers and preschoolers than family, home and geographic characteristics. As shown in other studies (29)(30)(31)(32)(33), physical activity, screen time and sleep duration and quality were associated with emotions in children, highlighting the importance of ensuring opportunities to maintain healthy movement behaviors. These results capture early stages of the pandemic.…”

“…For example, physical activity is positively associated with psychosocial health ( 29 ) and with sociability ( 30 ). High levels of sedentary screen time during infancy has been shown to be associated with greater emotional and behavioral problems at age 4 ( 31 ) while preschoolers who met the WHO guideline for screen time had fewer emotional problems than preschoolers who did not meet the guideline ( 32 ). Shorter sleep duration has also been associated with poorer emotional regulation ( 33 ).…”

Digital Devices and Cognitive Functions in Children

“…Согласно результатам работы с поправкой на социально-демографические факторы (за исключением стиля воспитания), высокая экспозиция экранного времени в возрасте 6 мес является фактором риска эмоциональных симптомов и гиперактивности в возрасте 4 лет, в возрасте 2,5 лет -фактором риска гиперактивности в возрасте 4 лет. Высокая экспозиция экранного времени в возрасте 4 лет была связана с общими поведенческими проблемами, проблемами в отношениях со сверстниками, гиперактивностью и просоциальным поведением [11].…”

“…Имеются данные о высоком риске гиперактивности в возрасте 4 лет при продолжительном просмотре контента с экрана в возрасте 6 мес и 2,5 лет в Китае [11]. В новозеландском когортном исследовании выявлена ассоциация между экранным временем перед телевизо-ром в будний день в возрасте 2 лет и низкими исполнительными функциями в 4,5 года, а также связь приема пищи перед телевизором в 4 года с низкими исполнительными функциями в 4,5 года [69].…”

HelperFriend, a Serious Game for Promoting Healthy Lifestyle Behaviors in Children: Design and Pilot Study

“…However, there are mixed opinions about this strategy. One concern is related to screen time—screen time is considered to be a risk factor for several health, emotional, and psychological problems in children [ 25 , 26 ]. However, it appears that screen time for playing video games does not represent as high a risk when compared with that for watching television [ 27 ].…”