Department of Education, Ben-Gurion University, Beer-Sheva, Israel.
Department of Ophthalmology, Drexel University College of Medicine, Philadelphia, PA.
J Dev Behav Pediatr. 2019 May;40(4):303-311. doi: 10.1097/DBP.0000000000000654.
Previous studies suggest that psychiatric disorders are associated with problematic use of screen media. This article systematically reviews the literature on the associations between screen media and autism spectrum disorder (ASD). The review uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Electronic databases were searched from inception to April 2018, using the term "ASD/autism" along with one of the following terms: "screen time"/"media"/"computer"/"phone"/"television"/"video game."
A total of 16 studies met the inclusion criteria. The studies support the view that children and adolescents with ASD are exposed to more screen time than their typically developing peers or other clinical groups and that the exposure starts at a younger age. The content and context of screen use (e.g., with parents vs alone) may affect the behaviors associated with media exposure. Correlates and long-term consequences of early screen exposure (before the age of 3 years) remain largely unexamined.
The current review provides important information about how ASD is associated with screen use and exposure. Future longitudinal research should examine the impact of early screen exposure on child development while accounting for potential moderating environmental factors (e.g., socioeconomic status, parent-child relationship). This will help determine whether-and if so, how much-exposure is detrimental and allow appropriate recommendations and interventions related to screen time among children with ASD.
既往研究表明，精神障碍与屏幕媒体的不当使用有关。本文系统地综述了屏幕媒体与自闭症谱系障碍（ASD）之间关联的文献。该综述使用了系统评价和荟萃分析的首选报告项目指南。
从建库起至 2018 年 4 月，我们在电子数据库中检索了以下术语：“ASD/自闭症”，并结合以下术语之一：“屏幕时间”/“媒体”/“计算机”/“电话”/“电视”/“视频游戏”。
共有 16 项研究符合纳入标准。这些研究支持这样一种观点，即 ASD 儿童和青少年比其正常发育的同龄人或其他临床群体接触更多的屏幕时间，并且这种接触开始于更年幼的年龄。屏幕使用的内容和情境（例如，与父母一起还是独自使用）可能会影响与媒体接触相关的行为。早期屏幕暴露（3 岁之前）的相关性和长期后果在很大程度上仍未得到检验。
目前的综述提供了有关 ASD 与屏幕使用和暴露之间关联的重要信息。未来的纵向研究应该在考虑潜在的环境调节因素（例如，社会经济地位、亲子关系）的情况下，研究早期屏幕暴露对儿童发育的影响。这将有助于确定暴露是否有害以及有害程度，从而为 ASD 儿童的屏幕时间制定适当的建议和干预措施。
