University of Calgary, Calgary, Alberta, Canada.
Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
JAMA Pediatr. 2020 Jul 1;174(7):665-675. doi: 10.1001/jamapediatrics.2020.0327.
There is considerable public and scientific debate as to whether screen use helps or hinders early child development, particularly the development of language skills.
To examine via meta-analyses the associations between quantity (duration of screen time and background television), quality (educational programming and co-viewing), and onset of screen use and children's language skills.
Searches were conducted in MEDLINE, Embase, and PsycINFO in March 2019. The search strategy included a publication date limit from 1960 through March 2019.
Inclusion criteria were a measure of screen use; a measure of language skills; and statistical data that could be transformed into an effect size. Exclusion criteria were qualitative studies; child age older than 12 years; and language assessment preverbal.
The following variables were extracted: effect size, child age and sex, screen measure type, study publication year, and study design. All studies were independently coded by 2 coders and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Based on a priori study criteria, quantity of screen use included duration of screen time and background television, quality of screen use included co-viewing and exposure to educational programs, and onset of screen use was defined as the age children first began viewing screens. The child language outcome included assessments of receptive and/or expressive language.
Participants totaled 18 905 from 42 studies included. Effect sizes were measured as correlations (r). Greater quantity of screen use (hours per use) was associated with lower language skills (screen time [n = 38; r = -0.14; 95% CI, -0.18 to -0.10]; background television [n = 5; r = -0.19; 95% CI, -0.33 to -0.05]), while better-quality screen use (educational programs [n = 13; r = 0.13; 95% CI, 0.02-0.24]; co-viewing [n = 12; r = 0.16; 95% CI, 0.07-.24]) were associated with stronger child language skills. Later age at screen use onset was also associated with stronger child language skills [n = 4; r = 0.17; 95% CI, 0.07-0.27].
The findings of this meta-analysis support pediatric recommendations to limit children's duration of screen exposure, to select high-quality programming, and to co-view when possible.
公众和科学界对于屏幕使用是否有助于或阻碍儿童早期发展，尤其是语言技能的发展，存在相当大的争议。
通过荟萃分析研究屏幕使用的数量（屏幕时间和背景电视的持续时间）、质量（教育节目和共同观看）以及屏幕使用开始的时间与儿童语言技能之间的关联。
2019 年 3 月在 MEDLINE、Embase 和 PsycINFO 中进行了检索。搜索策略包括从 1960 年到 2019 年 3 月的发布日期限制。
纳入标准是屏幕使用的测量；语言技能的测量；以及可以转换为效应大小的统计数据。排除标准是定性研究；儿童年龄大于 12 岁；语言评估在言语之前。
提取了以下变量：效应大小、儿童年龄和性别、屏幕测量类型、研究发表年份和研究设计。所有研究均由 2 名编码员独立进行，并按照系统评价和荟萃分析的首选报告项目指南进行。
根据事先设定的研究标准，屏幕使用的数量包括屏幕时间和背景电视的持续时间，屏幕使用的质量包括共同观看和接受教育节目，以及儿童开始观看屏幕的年龄。儿童语言结局包括接受性和/或表达性语言的评估。
来自 42 项研究的 18905 名参与者被纳入。效应大小以相关系数 (r) 表示。屏幕使用时间（使用时间/小时）越高，语言技能越低（屏幕时间[n=38; r=-0.14;95%置信区间：-0.18 至 -0.10]；背景电视[n=5; r=-0.19;95%置信区间：-0.33 至 -0.05]），而高质量的屏幕使用（教育节目[n=13; r=0.13;95%置信区间：0.02-0.24]；共同观看[n=12; r=0.16;95%置信区间：0.07-0.24]）与儿童语言技能较强相关。屏幕使用开始的年龄较晚也与儿童语言技能较强相关（n=4; r=0.17;95%置信区间：0.07-0.27）。
这项荟萃分析的结果支持儿科建议，即限制儿童的屏幕暴露时间，选择高质量的节目，并尽可能共同观看。
