Screen Time Exposure Research Articles

Knowledge is power: Relationship between professional recommendations, maternal attitudes, and screen time exposure of infants

PurposeThe American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend infants avoid screen media exposure, yet most infants are regularly exposed. This study aimed to explore screen exposure, maternal attitudes regarding screen media effects, and pediatricians' recommendations to better understand widespread screen media use with infants younger than 18 months of age in hopes of informing mitigation efforts. Design and methodsSurveys consisting of 10 Likert-style questions were distributed real-time to a purposive sample of 193 mothers with infants 18 months of age or younger in Georgia, Pennsylvania, and New York. ResultsSeventy-nine percent of infants exceeded AAP/WHO guidelines and 61% of respondents couldn't recall receiving pediatrician recommendations regarding screen exposure for their infant. Mothers with higher levels of education were associated with an accurate reflection of the adverse effects of screen usage on infant development (ANOVA; F = 10.122; df = 3; p < .001). Accurate maternal attitudes regarding adverse effects on infants was associated with less daily screen exposure (Spearman correlation; r = −0.428; p < .001). ConclusionsFindings suggest that knowledge about adverse side effects of screen media usage with infants is associated with less daily exposure; and, that pediatricians may not routinely review guidelines for infants with their families, underscoring the importance of other methods of knowledge dissemination. Practice implicationsNurses, as trusted healthcare providers, can provide counseling on infant screen media usage creating an opportunity for augmented knowledge dissemination across maternal demographics potentially leading to less screen exposure in this vulnerable population.

Predictors of screen exposure among infants under 2 years of age during the COVID-19 pandemic

Contradicting pediatric societies’ recommendations, studies show that screen exposure begins at the first year of life for many children worldwide, with parental needs, educational purposes, and parental stress emerging as associated factors. However, the COVID-19 pandemic has likely worsened this scenario. This study aims to: 1) estimate the average daily screen exposure time for Brazilian infants aged 0–23 months during the COVID-19 pandemic based on caregiver report; 2) analyze the correlation between average exposure time, parental motivations for exposure, parental burnout levels and infant age; and 3) test the predictive role of parental motivations, burnout, and infant age on infant screen exposure. For this purpose, 139 parents (living in Brazil) answered online to questionnaires on infant screen exposure, parental motivations for exposure (four subscales: Parental Needs; Educational; Child’s Desires/Family Routine; Behavioral Control), and parental burnout (Total score; four subscales: Emotional Exhaustion; Contrast; Feelings of Being Fed Up; Emotional Distancing). On average, infants were exposed to screens for 131 min/day. Higher scores on the four parental motivation subscales and higher parental burnout (specifically the Contrast subscale) correlated with longer exposure times. Furthermore, the motivation subscales Parental Needs and Child's Desires/family routine, the burnout subscale Contrast and infant age predicted greater screen exposure, while the burnout scale Feelings of Being Fed Up predicted less exposure. Our results suggest that infants in Brazil were exposed to substantial amounts of screen time during the pandemic. Interventions aiming to reduce screen time must consider parental motivations and parental burnout/mental health along with infant age.

Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years

Whether some domains of child development are specifically associated with screen time and whether the association continues with age remain unknown. To examine the association between screen time exposure among children aged 1 year and 5 domains of developmental delay (communication, gross motor, fine motor, problem-solving, and personal and social skills) at age 2 and 4 years. This cohort study was conducted under the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Pregnant women at 50 obstetric clinics and hospitals in the Miyagi and Iwate prefectures in Japan were recruited into the study between July 2013 and March 2017. The information was collected prospectively, and 7097 mother-child pairs were included in the analysis. Data analysis was performed on March 20, 2023. Four categories of screen time exposure were identified for children aged 1 year (<1, 1 to <2, 2 to <4, or ≥4 h/d). Developmental delays in the 5 domains for children aged 2 and 4 years were assessed using the Japanese version of the Ages & Stages Questionnaires, Third Edition. Each domain ranged from 0 to 60 points. Developmental delay was defined if the total score for each domain was less than 2 SDs from its mean score. Of the 7097 children in this study, 3674 were boys (51.8%) and 3423 were girls (48.2%). With regard to screen time exposure per day, 3440 children (48.5%) had less than 1 hour, 2095 (29.5%) had 1 to less than 2 hours, 1272 (17.9%) had 2 to less than 4 hours, and 290 (4.1%) had 4 or more hours. Children's screen time was associated with a higher risk of developmental delay at age 2 years in the communication (odds ratio [OR], 1.61 [95% CI, 1.23-2.10] for 1 to <2 h/d; 2.04 [1.52-2.74] for 2 to <4 h/d; 4.78 [3.24-7.06] for ≥4 vs <1 h/d), fine motor (1.74 [1.09-2.79] for ≥4 vs <1 h/d), problem-solving (1.40 [1.02-1.92] for 2 to <4 h/d; 2.67 [1.72-4.14] for ≥4 vs <1 h/d), and personal and social skills (2.10 [1.39-3.18] for ≥4 vs <1 h/d) domains. Regarding risk of developmental delay at age 4 years, associations were identified in the communication (OR, 1.64 [95% CI, 1.20-2.25] for 2 to <4 h/d; 2.68 [1.68-4.27] for ≥4 vs <1 h/d) and problem-solving (1.91 [1.17-3.14] for ≥4 vs <1 h/d) domains. In this study, greater screen time for children aged 1 year was associated with developmental delays in communication and problem-solving at ages 2 and 4 years. These findings suggest that domains of developmental delay should be considered separately in future discussions on screen time and child development.

Early Screen-Time Exposure and Its Association With Risk of Developing Autism Spectrum Disorder: A Systematic Review.

Autism spectrum disorder (ASD) is a neurological deficit in brain functions that prevents a child from having a normal social life like his peers. It results in the inability to interact and communicate with others. Unsurprisingly, the alarming increase in screen-time exposure in children has become even more of a concern. Electronic devices are a double-edged sword. Despite their benefits, they have many potential hazards to children's neurological development. Previous studies have investigated the effects of unsupervised screen time and its impact on white matter development during the early years of life of children. The white matter has an important role in the development of neurological functions. This systematic review aims to qualitatively analyze the literature available on early screen time exposure and its association with the risk of developing ASD. This systematic review implemented the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, PubMed Central (PMC), Google Scholar, and Cochrane Library databases were searched for data in the recent six years. A total of 27,200 articles were identified using the MeSH and keywords through four selected databases. Search results revealed 70 from PubMed, 17,700 from Google Scholar, zero from Cochrane Library, and 9,430 from PubMed Central. After applying filters and screening the results by title and abstract and then by full text, 11 studies fulfilled the criteria to be included in the review. We found that the longer the period of screen exposure, the higher the risk that the child may develop ASD. Further, the earlier the child is exposed to screens, the higher the risk of developing ASD in children compared to children exposed later.

The challenges of screen time in children with typical development and children with developmental disorders during COVID-19 pandemic.

The significant lifestyle changes that occurred during the lockdown period associated with the COVID-19 pandemic may have had many potential adverse effects on children, in particular, sedentary screen exposure among children, including those with developmental disorders. We conducted a cross-sectional study to investigate and compare the screen time and outdoor activity time of children with typically development (TD) and those with developmental disorders during and before the emergence of COVID-19, and identified the risk factors related to screen time during the COVID-19 pandemic. A total of 496 children were surveyed via online questionnaires. Parents or/and children filled in the online questionnaire, including basic characteristics, screen time, outdoor activity time, and other related factors. The Statistical Product and Service Solutions software was used to analyze all data. Children spent less time outdoors (t=14.774, P<0.001) and more time on electronic screens (t=-14.069, P<0.001) during the lockdown period of COVID-19, compared to the periods before COVID-19. Age (P=0.037), pre-COVID-19 screen time (P=0.005), screen time used for learning/education (P<0.001), screen time of siblings (P=0.007), and use of screen devices as electronic babysitters (P=0.005) were risk factors for screen time during the COVID-19 pandemic, while restrictive use of electronic devices by parents (P<0.05) was a protective factor. The screen time of children with autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) was significantly longer than children with TD before COVID-19 pandemic, but there is no statistical difference during the COVID-19 pandemic. During the COVID-19 pandemic, children's screen exposure time increased, and outdoor activities decreased significantly. This represents a significant challenge, and we should focus our efforts on managing children's screen time and promoting healthier lifestyles, including children with typical development, as well as those with developmental disorders.

Effects of screen exposure on language skills in children

Objective: To investigate the association between screen exposure and language skills in children aged 2-5 years. Methods: There were 299 children aged 2-5 years, recruited by convenience sampling from those who visited the Center of Children's Healthcare, Children's Hospital, Capital Institute of Pediatrics for routine physical examination from November 2020 to November 2021. Their development status were evaluated by the children neuropsychological and behavioral scale (revision 2016). A self-designed questionnaire for parents was conducted to collect demographic and socioeconomic information and screen exposure characteristics (time and quality). One-way ANOVA and independent sample t test were applied to compare the differences in language development quotient of children with different screen exposure time and quality. Multiple linear regression was used to analyze the correlation between screen exposure time and quality with language developmental quotient. Multivariate Logistic regression was used to analyze the risk of language underdevelopment in children with different screen exposure time and quality. Results: Among 299 children, 184 (61.5%) were boys and 115 (38.5%) were girls, with the age of (3.9±1.1) years. The number of children with daily screen time <60, 60-120 and>120 min was 163 children (54.5%), 86 children (28.8%) and 50 children (16.7%), respectively, with the language development quotients of 94±13, 90±13, 84±14, respectively, demonstrating a statistically significant difference (F=8.92, P<0.001). Logistic regression analysis revealed that screen exposure time of 60-120 and >120 min per day were both risk factors for children's language developmental quotients (OR=2.28, 95%CI 1.00-5.17, P=0.043; OR=3.96, 95%CI 1.86-9.17, P<0.001), and co-viewing and exposure to educational programs were both protective factors for children's language developmental quotients (OR=0.48, 95%CI 0.25-0.91, P=0.024, OR=0.36, 95%CI 0.19-0.70, P=0.003). Conclusions: Excessive exposure screen time and inappropriate screen exposure habits are associated with children's poorer language development. Screen exposure time should be limited and screen use should be rational to promote children's language skills.

Association between screen time and suspected developmental coordination disorder in preschoolers: A national population-based study in China.

Excessive screen exposure (ESE) is a growing global public health concern. This study aims to investigate the potential association between ESE and suspected developmental coordination disorder (DCD) in Chinese pre-schoolers, with or without siblings. A retrospective cohort study was conducted, involving 126,433 children from 551 cities in China. The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was employed to evaluate motor impairment in children, while parents provided information on their children's screen time in the past year. A mixed and multi-level logistic regression model was used to analyze the associations of all screen exposure measurements from the past year with LDCDQ scores and the risk of suspected DCD. The prevalence of excessive screen exposure was 67.6% (>1 h per day) and 28.9% (>2 h per day) in Chinese pre-schoolers. One hour's increase in weekday daily screen time, weekend daily screen time, and screen time before sleep in the past year was associated with a decreased total score of the LDCDQ (β were -0.690, -0.398, and -1.587, p < 0.001) and an increased risk of suspected DCD by 15.3%, 9.1%, and 46.8% when adjusting for the child, family and maternal health characteristics. Excessive screen exposure decreased the total LDCDQ scores by 1.335 (>1 vs. ≤1 h) and 1.162 (>2 vs. ≤2 h) and increased risks of suspected DCD by 44.0% (>1 vs. ≤1 h) and 31.1% (>2 vs. ≤2 h) with statistical significance (each p < 0.05). The stratified analysis showed that the association between screen time and LDCDQ score was stronger in children without siblings than in those with siblings. The risk of suspected DCD was highest for screen time exposure before bed compared with average weekday and weekend exposures. Parents should be advised to prevent their children from using electronic screens unsupervised, especially in one-child families.

Risk factors for developmental quotients in ASD children: A cross-sectional study.

To analyze the risk factors for developmental quotients (DQs) of children with autism spectrum disorder (ASD) and to better understand the effects of screen time on neurodevelopment in children with ASD. We retrospectively analyzed the data of 382 children with ASD, including demographic profiles; socioeconomic status; score on the Chinese parent-child interaction scale (CPCIS); screen time questionnaire; ASD symptom rating scales, including the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule Second Edition (ADOS-2); and DQs using Griffiths Development Scales-Chinese Edition. Univariate analysis was carried out to analyze the factors related to the DQs of children with ASD, and then the linear regression model was used to identify the independent influencing factors of the DQs of children with ASD. Vitamin D (β = 0.180, p = 0.002), age (β = -0.283, p = 0.000) and CARS score (β = -0.347, p = 0.000) are risk factors related to DQ of locomotor in children with ASD. Vitamin D (β = 0.108, p = 0.034), CARS score (β = -0.503, p = 0.000), ADOS-2 severity score (β = -0.109, p = 0.045) and CPCIS score (β = 0.198, p = 0.000) are risk factors related to DQ of personal social skill in children with ASD. Vitamin D (β = 0.130, p = 0.018), CARS score (β = -0.469, p = 0.000), and CPCIS score (β = 0.133, p = 0.022) are risk factors related to DQ of hearing-speech in children with ASD. Vitamin D (β = 0.163, p = 0.003) and CARS score (β = -0.471, p = 0.000) are risk factors related to DQ of eye-hand coordination in children with ASD. Age (β = -0.140, p = 0.020), CARS score (β = -0.342, p = 0.000), ADOS-2 severity score (β = -0.133, p = 0.034) and CPCIS score (β = 0.193, p = 0.002) are risk factors related to DQ of performance in children with ASD. Vitamin D (β = 0.801, p = 0.000) and CPCIS score (β = 0.394, p = 0.019) are risk factors related to DQ of practical reasoning in children with ASD. Vitamin D status, the severity of autistic symptoms and parent-child interaction are risk factors for developmental quotients in children with ASD. Screen exposure time is negatively associated with DQs in children with ASD but is not an independent risk factor for DQs.

Screen exposure time of children under 6 years old: a French cross-sectional survey in general practices in the Auvergne-Rhône-Alpes region

BackgroundThe advent of miniature, easy-to-use and accessible multimedia products is leading to screen exposure that begins in early childhood. Overexposure in preschool may lead to adverse effects. The main objective of this study was to determine the average daily time (ADT) spent by children under 6 years of age, followed in general practice, in front of television or interactive screens.MethodsA cross-sectional survey was conducted in the Auvergne-Rhône-Alpes region among randomly selected General Practitioners (GPs). The average daily screen time (ADST), regardless of the type of device (TVs, computers, tablets, smartphones, video game consoles), of the included children aged 0 to 2 years and 2 to 5 years was calculated from a self-questionnaire completed by the parents. A multivariate Poisson regression model was performed to analyse daily screen time, adjusted by factors selected on their clinical relevance and statistical significance.ResultsThe 26 participating GPs included 486 parents. They reported an ADST of 26 (± 44) minutes on weekdays and 30 (± 46) minutes on weekends for children under 2 years of age. For children over 2 years of age, the ADST was 66 (± 82) minutes on weekdays and 103 (±91) minutes on weekends. There was an association between the children’s average screen time and certain sociodemographic and environmental factors. Children whose parents had higher levels of education, those living in a family without TV screens or those who were well informed about the possible adverse health consequences of overuse of screens had lower average screen time. On the other hand, children of parents who spent more than 2 hours a day in front of screens, were more exposed.ConclusionsIn our survey, the ADST of children under 6 years of age followed in general practice was higher than the current recommendations. GPs can warn parents of preschool children of the effects of overexposure to screens, particularly parents of at-risk children.

Screen time and suicidal behaviors among U.S. children 9–11 years old: A prospective cohort study

Suicide is a leading cause of death among adolescents. Emerging literature has described relationships between excessive screen time and suicidal behaviors, though findings have been mixed. The objective of this study is to determine the prospective associations between screen time and suicidal behaviors two-years later in a national (U.S.) cohort of 9–11-year-old-children. We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,633). Logistic regression analyses were estimated to determine the associations between baseline self-reported screen time (exposure) and suicidal behaviors (outcome) based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) at two-year-follow-up. Participants reported an average of 4.0 h of total screen time per day at baseline. At two-year-follow-up, 1.38% of the sample reported at least one suicidal behavior. Each additional hour of total screen time was prospectively associated with 1.09 higher odds of suicidal behaviors at 2-year-follow-up (95% CI 1.03–1.14), after adjusting for covariates. For specific screen time modalities, each additional hour of texting (aOR 1.36, 95% CI 1.06–1.74), video chatting (aOR 1.30, 95% CI 1.03–1.65), watching videos (aOR 1.21, 95% CI 1.04–1.39), and playing video games (aOR 1.18, 95% CI 1.01–1.38) was associated with higher odds of subsequent suicidal behaviors. Higher screen time is associated with higher odds of reporting suicidal behaviors at two-year-follow-up. Future research should seek to identify how specific screen time experiences may influence suicidal behaviors.

The Analyses of the Relationship between Physical Activity, Musculoskeletal System Problems, Sleep, and Screen Exposure Time in University students during the Distance Learning Process

Purpose: To investigate the relationship between physical activity, musculoskeletal system problems, sleep, and screen exposure time in university students during the distance learning process. &#x0D; Methods: Three hundred and one students (183 female, 118 male) participated in the study via online survey. The screen exposure time was recorded. The physical activity using Short Form International Physical Activity Questionnaire and pain using Visual Analog Scale were evaluated. Nordic Musculoskeletal System Questionnaire was used to evaluate musculoskeletal symptoms. The Pittsburg Sleep Quality Index was applied for the details of sleep quality. &#x0D; Results: The students had a low level of physical activity (58.8%) and poor sleep quality (70.8%). Musculoskeletal pain was reported in upper back (85%), lower back (85%), neck (79.4%), shoulder (71.4%). The pain was correlated with total sleep quality (r=0.320, p

Associations Between Infant Screen Use, Electroencephalography Markers, and Cognitive Outcomes

Research evidence is mounting for the association between infant screen use and negative cognitive outcomes related to attention and executive functions. The nature, timing, and persistence of screen time exposure on neural functions are currently unknown. Electroencephalography (EEG) permits elucidation of the neural correlates associated with cognitive impairments. To examine the associations between infant screen time, EEG markers, and school-age cognitive outcomes using mediation analysis with structural equation modeling. This prospective maternal-child dyad cohort study included participants from the population-based study Growing Up in Singapore Toward Healthy Outcomes (GUSTO). Pregnant mothers were enrolled in their first trimester from June 2009 through December 2010. A subset of children who completed neurodevelopmental visits at ages 12 months and 9 years had EEG performed at age 18 months. Data were reported from 3 time points at ages 12 months, 18 months, and 9 years. Mediation analyses were used to investigate how neural correlates were involved in the paths from infant screen time to the latent construct of attention and executive functioning. Data for this study were collected from November 2010 to March 2020 and were analyzed between October 2021 and May 2022. Parent-reported screen time at age 12 months. Power spectral density from EEG was collected at age 18 months. Child attention and executive functions were measured with teacher-reported questionnaires and objective laboratory-based tasks at age 9 years. In this sample of 437 children, the mean (SD) age at follow-up was 8.84 (0.07) years, and 227 children (51.9%) were male. The mean (SD) amount of daily screen time at age 12 months was 2.01 (1.86) hours. Screen time at age 12 months contributed to multiple 9-year attention and executive functioning measures (η2, 0.03-0.16; Cohen d, 0.35-0.87). A subset of 157 children had EEG performed at age 18 months; EEG relative theta power and theta/beta ratio at the frontocentral and parietal regions showed a graded correlation with 12-month screen use (r = 0.35-0.37). In the structural equation model accounting for household income, frontocentral and parietal theta/beta ratios partially mediated the association between infant screen time and executive functioning at school age (exposure-mediator β, 0.41; 95% CI, 0.22 to 0.59; mediator-outcome β, -0.38; 95% CI, -0.64 to -0.11), forming an indirect path that accounted for 39.4% of the association. In this study, infant screen use was associated with altered cortical EEG activity before age 2 years; the identified EEG markers mediated the association between infant screen time and executive functions. Further efforts are urgently needed to distinguish the direct association of infant screen use compared with family factors that predispose early screen use on executive function impairments.

Association of screen exposure with psychosocial problems in primary school students.

This study aimed to investigate the current status of screen exposure and the factors related to screen exposure in primary school students and explore the relationship between screen exposure and psychosocial problems, which may provide evidence for the scientific use of electronic products and psychological interventions used in these children. The parents of 811 primary school students aged 6-12 years received a questionnaire survey in Beijing between January 13 and January 16, 2022. The demographic data and daily screen exposure time were collected, and the Strengths and Difficulties Questionnaire (SDQ) about their children was administered online. In 793 students, the average daily screen exposure of <2 h and ≥2 h was noted in 75.0% and 25% of patients, respectively. The mobile phone was the main medium for screen exposure (40.9%). The family's economic level, parental relationship, and main supervisor were related to screen exposure time (χ 2 = 44.8,14.5 and 12.4, P < 0.05). A low family economic level with a monthly income not meeting the basic living needs, poor parental relationship, and an elderly person responsible for supervision were related to increased screen exposure time. The abnormal emotional and behavioral symptoms, conduct problems, hyperactivity inattention, peer communication, prosocial behaviors, and a total difficulties score were found in 11.6%, 9.8%, 15.3%, 22.1%, 6.8%, and 13.4% of children, respectively. Excessive screen exposure was related to peer interaction and prosocial behaviors (χ 2 = 12.18 and 7.76, P < 0.05). The children with excessive screen exposure were more likely to have abnormal peer interaction (χ 2 = 12.09, P = 0.001) and prosocial behaviors (χ 2 = 7.76, P = 0.005). Excessive screen exposure was a risk factor for peer interaction problems (P < 0.05). In conclusion, the detection rate of excessive screen exposure is higher in primary school students, which is related to the family's economic level, parental relationship, and main supervisor. Excessive screen exposure is harmful to the psychosocial health of these children, which is characterized by abnormal peer intercommunion and prosocial behaviors. More attention should be paid to screen exposure time in primary school students.

Study on the Correlation Between Screen-Time and Mental Health among Private University Students in Shah Alam during Covid-19 Lockdown

This study aims to assess the correlation between screen time exposure and mental health during theCovid-19 pandemic lockdown among private university students in Shah Alam. Using a convenientsampling method, a cross-sectional study was conducted among 480 students in a private university inShah Alam using a self-administered online questionnaire. The data were analysed using SPSS software.Analysis was collected from 480 respondents (female 282 and males 198); showing 443 respondents(92.2%) spend more than two hours on screen despite the international guidelines recommending youngpeople limit their recreational screen time to less than 2 hours per day (Babic M J. et al. 2016) and 246respondents (51.2% ) spend more than 9 hours on screen. Among 480 respondents, 62.6 %, 69.4%, and46.5% experienced mild to extremely severe depression, anxiety, and stress. This research found that thereis no association between screen time with depression and stress. However, there is a significantassociation between screen time and anxiety, p-value &lt; 0.05. Post hoc analyses on anxiety revealed thereis no significant difference between the duration of screen exposure. This study has revealed theassociation between screen exposure and anxiety. However, the difference within the duration of theassociation is not significant. Therefore, the current generation needs to be aware of their risk towardanxiety irrespective of screen time exposure.

Children's electronic screen time exposure and its relationship to dental anxiety and behavior

ObjectivesThe purpose of this study was to assess the association between electronic screen time and dental anxiety and behaviour among children aged six to twelve years during dental examination, prophylaxis, and topical fluoride application. Material and methodsThis was a cross-sectional study which included 402 paediatric dental patients aged six to twelve years who came to King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. The data was collected from September 2020 to December 2021. Self-constructed questionnaire was used to collect data from the patient and his/her guardian. It was comprised of eight demographic questions as well as 13 multiple-choice questions regarding the patients' screen time. Child dental anxiety was assessed by using Abeer Children Dental Anxiety Scale (ACDAS). Assessment of child's behaviour was done by using Frankl Behavioural Rating Scale. ResultsThis study had a response rate of 100%. Out of the 402 participants, 248 (61.7%) were found to have anxiety while 154 (38.3%) were not. Of all participants 274 (68.2%) were cooperative and 128 (31.8%) were not. A Significant relationship between anxiety and behavioural problems during a dental visit and the participant's total exposure hours to electronic devices was found (p < 0.001). Children exposed to electronics at the age of two years or before displayed more anxiety and uncooperative behaviour (p < 0.001). Conclusionsearly exposure to electronic screens, especially for entertainment purposes and longer exposure can be associated with increased dental anxiety and uncooperative behaviour in children age 6–12 years. RecommendationsParents should be educated about the risks of permitting their children to use electronic devices and encouraged to replace such devices with activities that incorporate physical activity.

The correlation of screen time with sleep quality: A cross-sectional study on undergraduate medical students

Background: Continuous and long-term exposure to the screens of electronic devices, especially smartphones, cell phones, and tablets, is associated with poor quality of sleep. Aim and Objectives: The study was undertaken to correlate screen time exposure and the quality of sleep in undergraduate medical students and to find out the effects of increased screen time exposure on the health of students. Materials and Methods: The study was carried out on 200 undergraduate medical students at Smt. B. K. Shah Medical Institute and Research Centre, Piparia, Vadodara, Gujarat with the help of an online pre-validated questionnaire constructed on Google Form after obtaining ethical approval. The questionnaire was comprised demographic profiles, screen time exposure, and Pittsburgh sleep quality index (PSQI) statements. Data were entered into an Microsoft Excel sheet. For the descriptive statistical part, means, standard deviations, and frequency tables were used. A Chi-square test was applied to detect the strength of the association. P &lt; 0.05 was considered statistically significant. Results: The prevalence of increased screen time among the study population was found 79%. The prevalence of PSQI scores &gt;5 observed in the present study was 73%. There was a significant association observed between increased screen time exposure and PSQI score &gt;5. Conclusion: Increased screen time was significantly associated with poor sleep quality. The most common effect of increased screen time exposure among students found was a headache.

Frequency of Screen Time Exposure During COVID-19 Pandemic and its Impact on patients wellbeing in Saudi Arabia: A Questionnaire-Based Study

Background and Aims: Ever since the declaration of COVID-19 pandemic, the usage of digital devices has increased, whether in the educational field, entertainment or for communication and social purposes. In our study, we aim to investigate the influence of digital devices usage in health-related problems during COVID-19 and its correlation to headache. Methods: This questionnaire-based cross-sectional study was conducted from August 2021 to December 2021at of Imam Mohammad Ibn Saud Islamic University in Riyadh city, Kingdom of Saudi Arabia. An electronic self-administered questionnaire distributed via student’s emails to assess the characteristics of headache. Results: 384 students were recruited; the most common age group was 18-21 years old. Most of the students reported increased use of digital devices during the pandemic. Additionally, it revealed that 71% of the students reported experiencing a headache for the last year during lockdown period, and more than half (52.2%) of them reported an increase in the frequency of headaches which usually lasted for hours (71%) with a medium severity (75.4%). The commonest associated headache triggers were loud noises (61%), followed by difficulty concentrating (58.8%). Conclusions: The pandemic had a general negative impact on patients’ health, and an increase in frequency of headaches due to increased exposure to screen time. Several risk factors for these negative results have been distinguished. It is therefore critical to establish long-term strategies to reduce severity and frequency of headache in order to improve the quality of life of patients.

A cross-sectional study to find out association between smartphone addiction and dry eye disease among medical students in Jamnagar

Background: In the recent times, use of smart phone and multimedia devices is extensive. With prolonged use of smart phones, multimedia devices and social media ophthalmic and psychiatric complications are rising in young population. Aim and Objectives: The aim of the study was to find out prevalence of smartphone addiction and dry eye disease and association between smartphone addiction and dry eye disease in medical students. Material and Methods: This study was conducted in M.P. Shah Government Medical College and included 201 medical students. This was analytical survey-based study. Data collection was done through Google form and the survey included demographic questions, pre-structured smartphone addiction scale-short version, and ocular surface disease index questionnaire. Results: The prevalence of dry eye disease in medical students was 52.73% and the prevalence of smartphone addiction was 20%. In our study, dry eye disease was present in 45% of subjects with smartphone addiction. Conclusion: The prolonged usage of smartphone leads to increased screen exposure time which may be causative factor for ophthalmic problems and dry eye disease. More awareness in adolescent and young population about potential hazards of prolonged screen exposure and smartphone is necessary nowadays.

Assessing visual symptoms related to dry eye and refractive error in school students before and after online classes during COVID-19 pandemic

Background: During the COVID-19 pandemic, there was a major change in the mode of education from offline to online classes for the school students. Objectives: To determine if school students have developed symptoms related to dry eye. Methodology: Its descriptive cross-sectional study. This study was conducted in a reputed school in the city and 1000 students who had attended online classes during the covid-19 pandemic by the Department of Ophthalmology, Chettinad hospital and research institute, Kelambakkam, Tamil nadu, India Results: About 41% experienced redness of eye, 38% experienced blurring of vision, 36.6% had eye pain, 32% had burning sensation of eyes signs of dryness of eye. 50.2% had adequate distance between your gadget and eyes, 36.1 % had too close to eyes and 13.7 % had too far from eyes. Regarding the eye checkup, 43.7% never checked up their eyes, 11.6% does annual examination and 44.7% does rarely. Comparison between duration of Electronic Gadget usage per day during online class and offline class was significantly reduced after the offline class commencement. P value is 0.000001. Conclusion: There is significant Digital screen exposure time difference is observed during online and in offline classes. And its impact in visual refractive errors and computer vision syndrome

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

BackgroundBoth excessive screen time and early screen exposure have been linked to children’s health outcomes, but few studies considered these two exposures simultaneously. The aim of this study was to explore the independent and interactive associations of excessive screen time and early screen exposure with health-related quality of life (HRQOL) and behavioral problems among Chinese children attending preschools.MethodsA cross-sectional study of 4985 children aged between 3 and 6 years was conducted in Chengdu, China. Each parent has finished an online questionnaire regarding their children’s screen use, HRQOL, and behavioral problems. Children with screen time over 1 h/day were considered as having excessive screen time. Early screen exposure was defined if the children had started using screen-based media before the age of 2 years. HRQOL was assessed by the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0), while behavioral problems were confirmed with the 48-item Conners’ Parent Rating Scale (CPRS-48).ResultsOf the 4985 children (2593 boys and 2392 girls) included, the mean age was 4.6 (SD: 1.0) years. After adjustment for confounders and early screen exposure, excessive screen time was significantly associated with worse HRQOL scores in all dimensions and summary scales, as well as each type of behavioral problems (all p values < 0.05). We also found that compared to children with later initiation of screen exposure, those with screen use before the age of 2 years had significantly lower emotional functioning score (β: − 2.13, 95%CI: − 3.17, − 1.09) and psychosocial health summary score (β: − 0.82, 95%CI: − 1.54, − 0.10) of HRQOL, as well as higher risks of conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, and hyperactivity index, which were independent of excessive screen use. Furthermore, there were significant interactive effects of excessive screen time and early screen exposure on emotional functioning domain of HRQOL scores and conduct problems.ConclusionExcessive screen time and early screen exposure are two independent and interactive factors to children’s HRQOL and behavioral problems. Our findings support current guidelines to limit screen exposure in children. Appropriate screen use may represent an important intervention target to improve children’s HRQOL and reduce their behavioral problems.