Department of Psychology, National University of Singapore, Singapore.
Department of Child Development, KK Women's and Children's Hospital, Singapore.
J Dev Behav Pediatr. 2019 Sep;40(7):519-529. doi: 10.1097/DBP.0000000000000683.
Despite evidence that excessive screen use may contribute to negative health, developmental, emotional, and behavioral outcomes, more children are engaging in increasing amounts of screen-related activities. For children with neurodevelopmental conditions, increased screen use could exacerbate emotional/behavioral difficulties (EBDs) by interfering with sleep quantity and quality.
This study examined the possible mediating role of sleep in the relationship between screen use and EBDs in preschool children with neurodevelopmental disorders (NDDs) clinically referred to a child development center in Singapore.
A screen use questionnaire developed for the purposes of the present study, the Children's Sleep Habits Questionnaire, and the Strengths and Difficulties Questionnaire were completed by 367 caregivers of 2- to 5-year-old children with NDDs (39.5% autism spectrum disorder; 36.8% speech-language disorders; 23.7% others).
Average daily screen use duration was 3.98 hours, with 93.9% exceeding 1 hour of screen time daily. 57.7% of children had screen devices in their bedrooms, while 52% commenced screen use at the age of 18 months or earlier. Sleep problems fully mediated the relationship between the number of bedroom screen devices and children's EBDs, as well as between the age of first screen use and EBDs, but not between hours of screen use and EBDs. Controlling for age, developmental level, and family income, children who started using screens earlier than 18 months and who had screen devices in their bedrooms had significantly more sleep problems and EBDs than those without.
Children with neurodevelopmental conditions may have more difficulties disengaging from screen devices in their bedrooms, and an earlier age of screen exposure may contribute to more chronic disruption of sleep.
尽管有证据表明过度使用屏幕可能会对健康、发育、情绪和行为产生负面影响，但越来越多的儿童正在参与越来越多的与屏幕相关的活动。对于患有神经发育障碍的儿童来说，增加屏幕使用可能会通过干扰睡眠的数量和质量，从而加剧情绪/行为障碍（EBD）。
本研究旨在探讨屏幕使用与神经发育障碍（NDD）学龄前儿童情绪/行为障碍（EBD）之间的关系中，睡眠可能发挥的中介作用，这些儿童是新加坡一家儿童发展中心临床转诊的。
为本次研究开发了一份屏幕使用问卷、儿童睡眠习惯问卷和长处和困难问卷，由 367 名 2-5 岁患有 NDD 的儿童（自闭症谱系障碍 39.5%；言语语言障碍 36.8%；其他 23.7%）的照顾者填写。
平均每天的屏幕使用时间为 3.98 小时，93.9%的儿童每天使用屏幕时间超过 1 小时。57.7%的儿童卧室有屏幕设备，52%的儿童在 18 个月或更早开始使用屏幕。睡眠问题完全中介了卧室屏幕设备数量与儿童 EBD 之间的关系，以及首次使用屏幕的年龄与 EBD 之间的关系，但与屏幕使用时间之间的关系则不然。控制年龄、发育水平和家庭收入后，18 个月前开始使用屏幕且卧室有屏幕设备的儿童与没有这些设备的儿童相比，睡眠问题和 EBD 更多。
患有神经发育障碍的儿童可能更难从卧室的屏幕设备上脱离，并且更早的屏幕暴露可能会导致更频繁的睡眠中断。
