An exploration of the correlates of screen time in early childhood

In a recent study published in the Preventive Medicine Reports Journal, researchers examined the correlates of screen time in early childhood.

Study: Correlates of Screen Time in the Early Years (0-5 years): A systematic review. Image Credit: CroMary/Shutterstock.com

Background

Screens, such as televisions, mobile phones, etc., are ubiquitous, leading to a substantial increase in screen time in children. The World Health Organization (WHO) recommends zero screen time for infants/toddlers up to two years and less than one hour per day for those aged 2-4.

However, many children currently exceed these recommendations. The impact of screen time on child health and development is concerning, given the increasing levels of screen time.

Research suggests that increased screen time is associated with higher adiposity, sleep problems, and poor scores on cognitive/motor development measures and psychosocial health, underscoring the need for early-age interventions.

While prior studies assessed specific contexts and age groups, focusing mainly or only on television screen time, there is a need for an updated overview of the correlates of screen time.

About the study

In the present study, researchers performed a systematic review to identify the correlates of screen time in children. Using relevant keywords, they performed a comprehensive literature search on PubMed, SPORTDiscus, PsycINFO, and Embase databases.

Longitudinal and cross-sectional studies were eligible for inclusion if they quantitatively investigated the association between a potential correlate and screen time in healthy children under five years and were published after 2000.

Studies were excluded if they presented data on preterm children, examined potential prenatal correlate(s), and used guideline adherence as the sole assessment.

Titles and abstracts were screened after duplicate removal, followed by full-text screening. The team extracted data on methodology, participants, screen time, correlate(s), and findings. Correlates were grouped into two categories – individual and environmental.

Individual correlates were sub-stratified into biological, cognitive or psychosocial, and behavioral attributes or skills. Likewise, environmental correlates were sub-categorized into physical, economic, sociocultural, and political factors.

Methodological quality was assessed using the quality assessment tool for quantitative studies and classified as high, moderate, or weak. The team synthesized evidence based on the number of studies, methodological quality, and consistency of results.

Findings

After removing duplicates, the authors identified 6,618 records and included 53 studies for analysis. The sample size in included studies ranged between 62 and 10,700. Eighteen studies had 500-1,000 participants, while 17 had over 1,000 participants. Overall, 91 distinct correlates of screen time were examined.

Eight correlates were biological, six were behavioral attributes and skills, one was cognitive/psychosocial, 61 were sociocultural, seven were economic, one was political, and seven were physical.

Two studies were of high quality, one was of high-to-moderate quality, nine were of moderate quality, and 43 were of low or moderate-to-low quality.

Biological correlates were examined in 24 studies, where sex, age, and ethnicity/race were the most frequently examined. Most studies did not observe a significant association between screen time and sex.

There were inconsistent results for race/ethnicity and age. Two studies reported a negative association between screen time and sleep duration, while two observed no associations between screen time and physical activity.

Three studies found no association between a child’s personality or temperament and screen time. Having an electronic device in the child’s bedroom was associated with increased screen time.

Household income and parental income were negatively associated with screen time. Maternal employment was associated with increased screen time. Parents’ marital status and socioeconomic level indicators were not associated with screen time.

Seventeen studies observed a positive association between parents and children’s screen time. Being in childcare was associated with less screen time.

Monitoring screen time was associated with less screen time. Children of authoritarian/permissive mothers had higher screen time in one study, whereas authoritative parenting in another was associated with less time.

A less concerned attitude of parents towards screen time was associated with higher screen time. Having a television on in the house was associated with increased screen time.

Moreover, parents finding increased television time suitable was associated with more screen time. Higher parental stress was associated with increased screen time.

Conclusions

The researchers found no or moderate evidence for the association of correlates with screen time and could not firmly conclude because the evidence was insufficient or inconsistent for most correlates.

Overall, they recommend future interventions focusing on physical and sociocultural factors and emphasize the need for more high-quality research.