Children's Screen Use Research Articles

The Role of Screen Time and Screen Activity in the Nonverbal Reasoning of 5-Year-Olds: Cross-Sectional Findings from a Large Birth Cohort Study.

Family and home environment factors have been outlined in previous literature as important variables that affect early reasoning development. However, little research has focused on the association between screen use in the home environment and nonverbal reasoning ability. The aim of this cross-sectional study is to examine the role of both screen time and various screen activities (e.g., television, video, or educational games) in nonverbal reasoning ability in 9,001 5-year-old children using a large birth cohort study (Growing Up in Ireland). Interviews conducted with parents related to the children's screen use and various family factors, while reasoning ability was measured using a standardized task (Picture Similarities Task, British Ability Scales II). A hierarchical multiple regression examined the role of screen use in nonverbal reasoning, while also statistically controlling for family factors such as parental education and employment status. Screen use variables made a significant contribution to the regression model, even after family factors were accounted for, although the effect sizes were very small. Playing educational games, video games, or engaging in over three hours screen use per day were all significant predictors of nonverbal reasoning scores in the final adjusted model. The results of this study suggest that screen use may play a small role in the development of nonverbal reasoning in young children. The findings highlight the need for further studies in this area and may have implications for current debates in screen time research.

Is there an association between children's screen use and cariogenic diet?

Data sources Databases searched included the International Database for Medical Research MEDLINE/Pubmed, ISI Web of Science, Scopus, Scientific Electronic Library Online (SciELO), and Latin American and Caribbean Health Sciences (LILACS).Study selection Studies of observational design that examined the association between any screen-time behaviour and dietary intake in preschool and school-aged children (younger than 12 years) were selected by two independent reviewers. If a consensus could not be reached, a third reviewer was consulted.Data extraction and synthesis Data were extracted independently by two reviewers using a pre-tested data extraction form. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies. A PRISMA flow chart was used to present the study selection results. The GRADE system was used to evaluate the strength of evidence. A qualitative synthesis was used to report the results. A meta-analysis was not conducted.Results Nineteen studies were included in the review, all of which were of cross sectional design or conducted cross-sectional analysis. Fourteen studies were assessed as high quality, three as moderate quality and two as low quality. All studies found a significant positive association between television and/or total screen-time viewing and poor quality diet including lower intake of fruit and vegetables and higher intake of unhealthy foods. Screen-based sedentary behaviour was positively associated with cariogenic foods consumption in 15 studies. Based on the GRADE rating, there was moderate evidence of an association between TV viewing and intake of potentially cariogenic diet.Conclusions Although there could be an association between TV viewing and poor quality cariogenic diet in preschool and school-aged children, the authors conclude that the strength of evidence is limited.

Is there an association between children's screen use and cariogenic diet?

Data sources Databases searched included the International Database for Medical Research MEDLINE/Pubmed, ISI Web of Science, Scopus, Scientific Electronic Library Online (SciELO), and Latin American and Caribbean Health Sciences (LILACS).Study selection Studies of observational design that examined the association between any screen-time behaviour and dietary intake in preschool and school-aged children (younger than 12 years) were selected by two independent reviewers. If a consensus could not be reached, a third reviewer was consulted.Data extraction and synthesis Data were extracted independently by two reviewers using a pre-tested data extraction form. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies. A PRISMA flow chart was used to present the study selection results. The GRADE system was used to evaluate the strength of evidence. A qualitative synthesis was used to report the results. A meta-analysis was not conducted.Results Nineteen studies were included in the review, all of which were of cross sectional design or conducted cross-sectional analysis. Fourteen studies were assessed as high quality, three as moderate quality and two as low quality. All studies found a significant positive association between television and/or total screen-time viewing and poor quality diet including lower intake of fruit and vegetables and higher intake of unhealthy foods. Screen-based sedentary behaviour was positively associated with cariogenic foods consumption in 15 studies. Based on the GRADE rating, there was moderate evidence of an association between TV viewing and intake of potentially cariogenic diet.Conclusions Although there could be an association between TV viewing and poor quality cariogenic diet in preschool and school-aged children, the authors conclude that the strength of evidence is limited.Commentary.

Screen time and the development of emotion understanding from age 4 to age 8: A community study.

Recent increase in children's screen activities has raised concerns that screen time may replace face-to-face interaction, and hence impair children's development of emotion understanding. This longitudinal community study of 960 Norwegian 4-year-olds, followed up at ages 6 and 8, examined bidirectional relations between screen use and emotion understanding. Results revealed that more screen time at age 4 predicted lower levels of emotion understanding at age 6. In addition, television in children's bedroom at age 6 forecasted lower levels of emotion understanding at age 8. The effect of TV watching on emotion understanding was gender moderated, with stronger effects of TV watching observed among girls, but no significant effects detected among boys. In contrast, gaming forecasted lower level of emotion understanding in boys, not girls. Results are discussed in the light of the importance of face-to-face interaction to preserve the development of social-emotional competence among young children. Statement of contribution What is already known on this subject? We know that children's screen activities correlate with poorer social competence and with decrease of the quantity and quality of interaction with parents and siblings. The capacity to understand emotions in others is primarily learned through interaction with primary caregivers, but little is known how children's screen use influences development of emotion understanding. What the present study adds? We found that more TV watching among girls at age 4 predicted lower levels of emotion understanding at age 6. Furthermore, TV in child's bedroom at age 6 forecasted lower levels of emotion understanding at age 8.

Parental strategies restricting screen use among children, screen home environment, and child screen use as predictors of child body fat: Aprospective parent-child study.

This study provides an insight into associations between: (1) parental and child perceptions of parental strategies restricting screen use among children, (2) child perceptions of the presence and availability of screen-based equipment at home, (3) child sedentary screen use behaviours, and (4) child body fat. A prospective study with two assessment periods (Time 1, T1; Time 2, T2), spanning 7-8months. At T1, 879 parent-child dyads (83.3% mothers; 52.3% girls) were enrolled and provided parental and child (5-11years old) self-report data. T2 data were obtained from 603 dyads. Child body fat was measured with bioimpedance method (T1 and T2). Path analysis was used to test models calculated with and without additional covariates, such as parental and child age and gender, parental education, and economic status. Path analysis indicated indirect effects of the presence and availability of screen-based equipment at home (T1) on child body fat (T2), with screen use among children (T1) mediating this association. Parental perceptions of restrictions (T1) were unrelated to child body fat (T2). In contrast, child perceptions of parental restrictions (T1) predicted child body fat (T2). Children who perceived that their parents applied a higher level of restrictions (T1) had a lower body fat at the 7- to 8-month follow-up. These associations were found after controlling for baseline levels of child body fat, across models calculated with and without additional covariates. Child, not parental perceptions of parental restrictions, predicted better obesity-related outcomes in children, such as lower body fat. Statement of contribution What is already known on this subject? Little is known about effects of parental restrictions of screen use on child body fat. Evidence is mostly cross-sectional, except from a recent investigation by Sleddens, Gubbels, Kremers, van der Plas, and Thijs (). To date, effects of parental (not children's) reports of screen use restrictions were investigated. What does this study add? Children reporting more parental restrictions of screen use have less body fat at a follow-up. Parental reports of screen use restrictions are unrelated to child screen use and body fat. Frequent screen use mediate between the number of screen devices at home and higher child body fat.

Sociodemographic, anthropometric and behavioural risk factors for ultra-processed food consumption in a sample of 2-9-year-olds in Brazil.

The present study aimed to identify food patterns among 2-9-year-olds and investigate sociodemographic, anthropometric and behavioural predictors of less healthy dietary patterns. Cross-sectional study. Parents of 2-9-year-olds completed an FFQ and factor analysis was applied to identify dietary patterns. Parents also completed questionnaires assessing sociodemographic, anthropometric and behavioural characteristics of parents and children, including parental feeding practices. Participants were recruited from private schools of Campinas and São Paulo, SP, Brazil, between April and June 2014. Parents of 2-9-year-olds (n 929). Two dietary patterns emerged: 'traditional food' and 'ultra-processed food'. Lower maternal education (OR=2·05, P=0·010) and higher maternal weight status (OR=1·43, P=0·044) were associated with a greater likelihood of the ultra-processed food pattern. Lower perceived parental responsibility for adequacy of food group intake (OR=2·41, P=0·020), and lower scores on the parental feeding practices of 'Healthy Eating Guidance' (OR=1·83, P<0·001) and 'Monitoring' (OR=2·52, P<0·001), were also associated with the presence of this pattern, as was higher child's screen use during mealtimes (OR=1·61, P=0·004). The present study is the first to evaluate associations between less healthy dietary patterns of Brazilian 2-9-year-olds and parental feeding practices. Our findings highlight sociodemographic, anthropometric and behavioural factors within families that could be used to target tailored policies to at-risk populations.

Psychometric validity of the parent's outcome expectations for children's television viewing (POETV) scale.

BackgroundTV and other screen use are common among elementary school aged children with both potential benefits and harms. It is not clear why some parents restrict their children’s screen use and others do not. Parent’s outcome expectations for allowing their child to watch TV and other screen media, i.e. the perceived ‘costs’ and ‘benefits,’ may be influential. Our objective was to develop a measure of Parent’s Outcome Expectations for Children’s TV Viewing (POETV) and test the psychometrics of the resulting instrument among parents with children 6-12 years old.MethodsAn ethnically diverse sample (n = 311) of parents from Harris County, Texas completed measures for POETV, demographics, and parent and child TV viewing and other screen media use via an internet survey. The sample was randomly split and an exploratory factor analysis (EFA) was conducted among the first half of the sample separately for Positive and Negative POETV. A confirmatory factor analysis (CFA) assessed the fit of the resulting factors with the data in the second half of the sample. Internal reliabilities and Spearman partial correlations (controlling for confounders) of children’s TV and other screen use with the resulting POETV factors were calculated for the full sample.ResultsEFA identified two factors for Positive POETV (Parent Centered; Child Centered) and two factors for Negative POETV (TV & Content Exposure; Prevent Other Activities). Follow up CFA confirmed moderate to good psychometric properties for both factor structures with the addition of four correlated errors in the Positive POETV model. Internal reliabilities were appropriate (Cronbach’s alpha >0.7). Parent Centered Positive POETV and Child Centered Positive POETV were correlated with children’s TV viewing on weekdays (0.14, p < 0.05) and weekends (0.17, p < 0.01) respectively. Both also correlated with other screen media use on weekends (0.20 and 0.21, p < 0.001). Prevent Other Activities Negative POETV was negatively correlated with children’s TV viewing on weekdays (-0.16, p < 0.01), weekends (-0.14, p < 0.05) and other screen media on weekends (-0.14, p < 0.05).ConclusionsThe Positive and Negative POETV scales offer a new tool to better define predictors of screen media parenting practices and child screen media use behaviors.

The role of family-related factors in the effects of the UP4FUN school-based family-focused intervention targeting screen time in 10- to 12-year-old children: the ENERGY project.

BackgroundScreen-related behaviours are highly prevalent in schoolchildren. Considering the adverse health effects and the relation of obesity and screen time in childhood, efforts to affect screen use in children are warranted. Parents have been identified as an important influence on children’s screen time and therefore should be involved in prevention programmes. The aim was to examine the mediating role of family-related factors on the effects of the school-based family-focused UP4FUN intervention aimed at screen time in 10- to 12-year-old European children (n child–parent dyads = 1940).MethodsA randomised controlled trial was conducted to test the six-week UP4FUN intervention in 10- to 12-year-old children and one of their parents in five European countries in 2011 (n child–parent dyads = 1940). Self-reported data of children were used to assess their TV and computer/game console time per day, and parents reported their physical activity, screen time and family-related factors associated with screen behaviours (availability, permissiveness, monitoring, negotiation, rules, avoiding negative role modeling, and frequency of physically active family excursions). Mediation analyses were performed using multi-level regression analyses (child-school-country).ResultsAlmost all TV-specific and half of the computer-specific family-related factors were associated with children’s screen time. However, the measured family-related factors did not mediate intervention effects on children’s TV and computer/game console use, because the intervention was not successful in changing these family-related factors.ConclusionFuture screen-related interventions should aim to effectively target the home environment and parents’ practices related to children’s use of TV and computers to decrease children’s screen time.Trial registrationThe study is registered in the International Standard Randomised Controlled Trial Number Register (registration number: ISRCTN34562078).

The family context of low-income parents who restrict child screen time.

The American Academy of Pediatrics recommends that parents restrict child screen time to two hours per day, but many preschool-aged children exceed this viewing recommendation. Modifying children's viewing habits will require collaborating with parents, but little is known about the factors that influence parents' capacity for effective screen-related parenting. This study aimed to identify the demographic, family and community contextual factors associated with low-income parents' restriction of child screen time. Parents (N=146) of children (age 2-5 years) attending Head Start centers in the United States completed a self-report survey in 2010 assessing parent and child screen use (television, DVD, video, video games, and leisure-time computer use), parent restriction of child screen time, and family (parent stress, social support, and life pressures) and community (neighborhood safety and social capital) factors. Children were more likely to meet the American Academy of Pediatrics screen time recommendation if their parent reported high restriction of child screen time. Parent and child demographic characteristics were not associated with parents' restriction of child screen time. In multivariate analysis, less parent screen time, fewer parent life pressures, and greater social support were associated with parents' high restriction of screen time. Family contextual factors may play an important role in enabling low-income parents to restrict their children's screen time. When counseling low-income parents about the importance of restricting child screen time, practitioners should be sensitive to family contextual factors that may influence parents' capacity to implement this behavior change.

Conceptual understanding of screen media parenting: report of a working group.

Screen media (television, computers, and videogames) use has been linked to multiple child outcomes, including obesity. Parents can be an important influence on children's screen use. There has been an increase in the number of instruments available to assess parenting in feeding and physical activity contexts, however few measures are available to assess parenting practices regarding children's screen media use. A working group of screen media and parenting researchers convened at the preconference workshop to the 2012 International Society for Behavioral Nutrition and Physical Activity (ISBNPA) annual meeting, "Parenting Measurement: Current Status and Consensus Reports," to identify and prioritize issues in assessing screen media parenting practices. The group identified that screen media use can pose different risks for children, depending on their age and developmental stage, across physiologic, psychosocial, and development outcomes. With that in mind, a conceptual framework of how parents may influence their child's screen-viewing behaviors was proposed to include the screen media content, context of viewing, and amount viewed. A research agenda was proposed to prioritize a validation of the framework and enhance the ability of researchers to best assess parenting influences across the three domains of content, context and amount of children's screen media use.

Social–Cognitive Predictors of Low-Income Parents’ Restriction of Screen Time Among Preschool-Aged Children

Parents' rules regarding child television, DVD, video game, and computer use (screen time) have been associated with lower screen use in children. This study aimed to identify modifiable correlates of this behavior by examining social-cognitive predictors of parents' restriction of child screen time. Low-income parents (N = 147) of preschool-aged children (2-6 years) completed self-administered questionnaires examining parent and child screen time, parent restriction of screen time, self-efficacy to restrict screen time, and beliefs about screen time. Structural equation modeling results indicated that greater self-efficacy to restrict screen time (β = .29, p = .016) and greater perceived importance of restricting child screen use (β = .55, p < .001) were associated with greater restriction of child screen use, after controlling for parent screen time. Family-based interventions that consider broader attitudinal factors around child screen time may be necessary to engage parents in restricting screen use.

Screen-related Sedentary Behaviors: Children's and Parents' Attitudes, Motivations, and Practices

Objective To investigate school-aged children's and parents' attitudes, social influences, and intentions toward excessive screen-related sedentary behavior (S-RSB). Design A cross-sectional study using a survey methodology. Setting Elementary schools in London, Ontario, Canada. Participants All grades 5 and 6 students, their parents, and their teachers in the participating schools were invited to voluntarily participate; 508 student–parent pairs completed the surveys. Main Outcome Measure Children's screen-related behaviors. Analysis Data were analyzed using the Independent Student t test to compare differences of continuous variables and the chi-square test to test for differences of categorical variables. Results Children spent 3.3 ± 0.15 (standard error) hours per day engaged in screen-related activities. Entertainment, spending time with family, and boredom were cited as the top 3 reasons for television viewing and video game playing. Compared to “low-screen users” (ie, < 2 hours/day), “high-screen users” (ie, ≥ 2 hours/day) had a less negative attitude toward excessive S-RSB and perceived loosened parental rules on screen use. Parents of high-screen users had a less negative attitude toward children's S-RSB, had fewer rules about their children's screen use, and were more likely to be sedentary themselves. Conclusions and Implications Intervention strategies aimed at reducing S-RSB should involve both parents and children and should focus on fostering behavioral changes and promoting parental role modeling.