Abstract
Objective: To investigate the current status of screen time in children with ASD, its correlation with autistic symptoms and developmental quotient (DQ), and the factors affecting screen time.Method: One hundred ninety-three Chinese children with ASD were recruited. We collected the demographic and screen time data using a questionnaire. The ASD core symptoms and developmental quotient (DQ) were measured by the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), Griffiths Development Scales-Chinese Language Edition (GDS-C), and Chinese Children's Parent-Child Relationship Questionnaire (CPCIS). Then, we analyzed the correlations between the screen time of children with ASD and the ABC, CARS, ADOS, GDS-C DQs, and CPCIS scores. Linear regression was used to analyze the risk factors that affect screen time.Results: The children's average daily screen time was 2.64 ± 2.24 h. Forty eight percent children were exposed to two or more types of electronic devices. Their favorite activity of screen time was watching cartoons. Only 34% children spent screen time accompanied by parents and with communication. 50.26% children had no screen time before sleeping. The screen time of children with ASD had a negative correlation with the GDS-C CQ (r = −0.234, P = 0.001) and the CPCIS score (r = −0.180, P = 0.012) and a positive correlation with the CARS score (r = 0.192, P = 0.009). A low father's education level (P = 0.010), less restriction of the child's screen time by the guardian (P = 0.001), greater caregiver screen time (P < 0.001), the use of the screen as a tool for child rearing (P = 0.001), and the child's ownership of independent electronic equipment (P = 0.027) are risk factors for long screen time in children with ASD.Conclusion: The screen time of children with ASD in China is higher than the recommended standard, and the current situation is serious. The screen time of ASD children is related to their autism symptoms, DQ and parent-child interaction. Low paternal education levels, less restriction of children's screen time by guardians, greater guardian screen time, the use of screens in child rearing, and children's ownership of independent electronic equipment can lead to an increase in children's screen time. These findings may have implications for family intervention strategies.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and interaction and stereotyped or repetitive patterns of behavior, interests or activities
The results showed the following regarding the main activity during screen time: n = 160 (83%) children with ASD watched cartoons, n = 102 (53%) watched nursery rhymes, and n = 37 (19%) watched short videos on social platforms (TikTok, etc.)
Univariate Analysis Results of Factors Related to Screen Time The Spearman rank correlation results for continuous variables showed that the screen time of children with ASD was negatively correlated with the CQ of the Griffiths Development Scales-Chinese Language Edition (GDS-C) and the CPCIS score (Table 1), and there was no correlation between screen time and age (r = 0.025, P = 0.730)
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and interaction and stereotyped or repetitive patterns of behavior, interests or activities. In ASD patients, a potential environmental factor is electronic screen time [4]. Screen time has adverse effects on both children with ASD and children with typical development. These adverse effects include poor academic performance [5], sleep problems [6], attention problems [7], social behavior deficits [8], obesity [9], adverse cardiovascular events [10], language delay [11], mood disorder [12], and even autistic-like symptoms [13]
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