Screen Time Exposure in Preschool Children with ADHD: A Cross-Sectional Exploratory Study from South India

Abstract

Background: Concern is mounting regarding screen exposure among young children and its association with mental health. Children with attention deficit hyperactivity disorder (ADHD) may be more vulnerable to its effects such as increased externalizing behaviors and problems with language and cognitive development and biological functions such as sleep. We aimed to assess screen exposure in preschool children with ADHD and to study the correlation of screen time with the severity of ADHD and parental stress levels. Methods: Children of age 2.5–6 years, diagnosed with ADHD (n = 56) were included, and details of the total duration of screen exposure, maximum continuous screen exposure time, and types of screen-based devices used, reasons for screen exposure were collected from primary caregivers. ADHD symptom severity was assessed on Conner's Abbreviated Rating Scale. Family interview for stress and coping, adapted for ADHD, was used to measure parental stress. Results: Total screen exposure time in preschool children with ADHD was more than the recommended standards in 80.4% of children, with a median of 140.00 minutes (range: 20–500 minutes). The most commonly used modality was television (98.2%), followed by mobile phones (87.3%), tablets (17.9%), and laptops (10.7%). The severity of ADHD ( r = 0.29, P = 0.02) and parent stress levels ( r = 0.29, P = 0.03) were positively correlated to increased screen time exposure in the child. Conclusions: Preschool children with ADHD have screen exposure above the recommended duration of one hour/day. Structured parent training programs for children with preschool ADHD and providing developmentally appropriate interventions are essential in curtailing screen time exposure and also to address parental stress.

Association between screen time and hyperactive behaviors in children under 3 years in China

“…Our research has found that screen time increases as children age. Low parental education is an important risk factor for screen exposure, which is consistent with previous studies ( 27 , 28 ). This suggests that the most important intervention group to reduce screen time in children is the population with low educational level.…”

Investigation of the relationships between ADHD risk and digital screen exposure in children aged 4–11: A large population study in Turkey

“…On the other hand, it is known that environmental and upbringing processes will affect ADHD positively or negatively, regardless of upbringing‐related problems. In this respect, an intense increase in the screen exposure of the child especially with hereditary predisposition to ADHD, which means that the diversity of social stimuli decreases considerably in the process, makes it possible for ADHD symptoms to become severe or to be difficult to treat (Swing et al, 2010; Vaidyanathan et al, 2021).…”

“…Over time, there might be a bidirectional relationship between attention problems and the digital screen. In other words, the attention of a child with an attention deficit can be kept alive by the digital screen, while a child exposed to bombardment with stimuli on the digital screen for a while may easily experience attention problems in his/her real life out of the screen, and his/her existing ADHD symptoms may become severe (Swing et al, 2010; Vaidyanathan et al, 2021).…”

Excess Screen Time - Impact on Childhood Development and Management: A Review

“…19 A study on screen exposure in pre-schoolers in India found that parent related reasons for screen exposure were more common than child related reasons and the common reasons for screen exposure were a) to do household chores b) severity of child's ADHD c) to manage tantrums d) due to poor knowledge attitude and practices e) sibling care f) working primary care giver g) meal times h) recreational, break times i) educational and j) reinforcement. 20 Parents play a central role in regulating children's screen use. However, they often find it challenging to adhere to the recommended guidelines when it comes to restraining their children's screen use.…”