Maximizing Thai Children's Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Division of Growth and Development, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Pediatr Res. 2020 Dec;88(6):894-902. doi: 10.1038/s41390-020-0831-8. Epub 2020 Mar 13.
Associations between screen media and child cognition are complex. This study aimed to examine whether age of onset of media exposure, cumulative effect of high media exposure, and verbal interaction during screen time in the first 2 years of life were associated with 4-year-old cognition by including parenting behaviors into the final construct.
There were 274 healthy participants who were followed up until age 4 years. Screen media data were collected at age 6, 12, 18 months, and 2 years. Cognition or early learning composite (ELC) was evaluated at age 2, 3, and 4 years, where the latter variable was the primary outcome. Positive parenting was obtained by Parenting Styles and Dimensions Questionnaire.
ELC at age 2 years was associated with later age of onset of media exposure (β = 0.113, p < 0.05), fewer months of high media exposure above the upper quartile (β = 0.282, p < 0.001), and more months of verbal interaction during screen time (β = 0.261, p < 0.001). ELC at age 4 years was associated with ELC and positive parenting at earlier ages.
Delayed introduction of screen media, appropriate screen time, and increased verbal interaction during media use in the first 2 years of life were associated with better cognitive development in preschoolers.
Associations between screen media exposure and children's cognitive development in existing literature mainly focused on duration of screen media viewing or the content of electronic media in which other factors are rarely explored. Earlier age of onset of media exposure, more months of excessive screen media exposure (>6.5 h/day), and fewer months of verbal interaction with children during media use in the first 2 years of life had associations with decreased preschool cognition. To mitigate undesirable effects of inappropriate screen media use on cognition, delayed introduction of screen media, appropriate electronic media exposure, and increased verbal interaction during media use with children should be recommended at health supervision visits. Lower positive parenting was a mediator for the relationship between cumulative months of high screen media exposure and decreased child cognition.
屏幕媒体与儿童认知之间的关联很复杂。本研究旨在通过纳入父母教养行为到最终结构中，检验生命最初 2 年内媒体暴露的起始年龄、高媒体暴露的累积效应以及屏幕时间内的言语互动是否与 4 岁时的认知有关。
共有 274 名健康参与者随访至 4 岁。在 6、12、18 个月和 2 岁时收集屏幕媒体数据。在 2、3 和 4 岁时评估认知或早期学习综合（ELC），后者是主要结果。采用父母教养方式和维度问卷获得积极的教养方式。
2 岁时的 ELC 与较晚的媒体暴露起始年龄（β=0.113，p<0.05）、高于四分位数上限的高媒体暴露月数较少（β=0.282，p<0.001）和屏幕时间内言语互动的月数较多（β=0.261，p<0.001）有关。4 岁时的 ELC 与较早年龄的 ELC 和积极的教养方式有关。
生命最初 2 年内延迟引入屏幕媒体、适当的屏幕时间以及增加媒体使用期间的言语互动与学龄前儿童更好的认知发展有关。
现有文献中屏幕媒体暴露与儿童认知发展之间的关联主要集中在屏幕媒体观看时间或电子媒体内容上，很少探讨其他因素。生命最初 2 年内较早的媒体暴露起始年龄、较高的过度屏幕媒体暴露月数（>6.5 小时/天）和较少的与儿童在媒体使用期间的言语互动月数与学龄前认知降低有关。为了减轻不适当的屏幕媒体使用对认知的不良影响，应在健康检查时建议延迟引入屏幕媒体、适当的电子媒体暴露以及增加与儿童在媒体使用过程中的言语互动。较低的积极教养是高屏幕媒体暴露月数与儿童认知降低之间关系的中介。
