Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
PLoS One. 2019 Apr 17;14(4):e0213995. doi: 10.1371/journal.pone.0213995. eCollection 2019.
Pre-school children spend an average of two-hours daily using screens. We examined associations between screen-time on pre-school behavior using data from the Canadian Healthy Infant Longitudinal Development (CHILD) study.
CHILD participant parents completed the Child Behavior Checklist (CBCL) at five-years of age. Parents reported their child's total screen-time including gaming and mobile devices. Screen-time was categorized using the recommended threshold of two-hours/day for five-years or one-hour/day for three-years. Multiple linear regression examined associations between screen-time and externalizing behavior (e.g. inattention and aggression). Multiple logistic regression identified characteristics of children at risk for clinically significant externalizing problems (CBCL T-score≥65).
Screen-time was available for over 95% of children (2,322/2,427) with CBCL data. Mean screen-time was 1·4 hours/day (95%CI 1·4, 1·5) at five-years and 1·5 hours/day (95%CI: 1·5, 1·6) at three-years. Compared to children with less than 30-minutes/day screen-time, those watching more than two-hours/day (13·7%) had a 2·2-point increase in externalizing T-score (95%CI: 0·9, 3·5, p≤0·001); a five-fold increased odd for reporting clinically significant externalizing problems (95%CI: 1·0, 25·0, p = 0·05); and were 5·9 times more likely to report clinically significant inattention problems (95%CI: 1·6, 21·5, p = 0·01). Children with a DSM-5 ADHD T-score above the 65 clinical cut-off were considered to have significant ADHD type symptoms (n = 24). Children with more than 2-hours of screen-time/day had a 7·7-fold increased risk of meeting criteria for ADHD (95%CI: 1·6, 38·1, p = 0·01). There was no significant association between screen-time and aggressive behaviors (p>0.05).
Increased screen-time in pre-school is associated with worse inattention problems.
学龄前儿童每天平均有两小时的时间在使用屏幕。我们利用来自加拿大健康婴儿纵向发展（CHILD）研究的数据，检验了学龄前儿童屏幕时间与行为之间的关联。
CHILD 参与者的家长在孩子五岁时完成了儿童行为检查表（CBCL）。家长报告了他们孩子的总屏幕时间，包括游戏和移动设备。屏幕时间的分类使用了每天两小时（五岁）或每天一小时（三岁）的推荐阈值。多线性回归分析了屏幕时间与外化行为（如注意力不集中和攻击性）之间的关联。多逻辑回归确定了有临床显著外化问题风险的儿童特征（CBCL T 评分≥65）。
有超过 95%（2322/2427）的儿童的屏幕时间数据可用，且有 CBCL 数据。五岁时的平均屏幕时间为 1.4 小时/天（95%CI 1.4，1.5），三岁时为 1.5 小时/天（95%CI：1.5，1.6）。与每天屏幕时间少于 30 分钟的儿童相比，每天观看超过两小时（13.7%）的儿童外化 T 评分增加了 2.2 分（95%CI：0.9，3.5，p≤0.001）；报告临床显著外化问题的几率增加了五倍（95%CI：1.0，25.0，p=0.05）；报告临床显著注意力不集中问题的几率增加了 5.9 倍（95%CI：1.6，21.5，p=0.01）。具有 DSM-5 ADHD T 评分高于 65 临床临界值的儿童被认为具有显著的 ADHD 类型症状（n=24）。每天屏幕时间超过两小时的儿童患 ADHD 的风险增加了 7.7 倍（95%CI：1.6，38.1，p=0.01）。屏幕时间与攻击性行为之间没有显著关联（p＞0.05）。
学龄前儿童屏幕时间增加与注意力不集中问题更严重有关。
