Chen Jing-Yi, Strodl Esben, Huang Li-Hua, Chen Ying-Jie, Yang Gui-You, Chen Wei-Qing
Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
School of Psychology and Counselling, Queensland University of Technology, Brisbane 4059, Queensland, Australia.
Children (Basel). 2020 Oct 28;7(11):200. doi: 10.3390/children7110200.
Research into early screen exposure has raised growing concerns about its impact upon children's neuropsychological well-being. However, possible pathways remain unclear. This study therefore aimed not only to evaluate the association between screen exposure during the ages of 0-3 years and preschoolers' autistic-like behaviors, but also the mediating roles of the frequency of caregiver-child interaction, sleep duration and level of participation in outdoor activities. Based on the 2017 survey of the Longhua Child Cohort Study, data of 29,595 child-caregiver dyads were obtained via a caregiver-reported questionnaire, with the data from 29,461 dyads included in the data analysis. Multiple linear and logistic regression models were employed to estimate the associations between screen exposure, caregiver-child interaction, sleep duration, outdoor activities, and children's autistic-like behaviors. The results indicated that screen exposure during 0-3 years of age was associated with the presence of autistic-like behaviors at preschool age, and the strength of the association was enhanced with the increase of average daily screen time (Odds Ratios (ORs) ranging from 1.358 to 4.026). The frequency of caregiver-child interaction and sleep duration mediated 5.32% and 1.19% of the variance of the association respectively, but outdoor activities did not mediate the association. Our findings indicate that preschoolers who are exposed to screens at aged 0-3 years might have an increased risk of autistic-like behaviors, and that, the frequency of caregiver-child interaction and sleep duration might function as potential mediators of this association.
对早期屏幕接触的研究引发了人们对其对儿童神经心理健康影响的日益担忧。然而，可能的影响途径仍不明确。因此，本研究不仅旨在评估0至3岁期间的屏幕接触与学龄前儿童自闭症样行为之间的关联，还旨在评估照顾者与儿童互动频率、睡眠时间和户外活动参与程度的中介作用。基于2017年龙华儿童队列研究的调查，通过照顾者报告的问卷获得了29595对儿童-照顾者二元组的数据，其中29461对二元组的数据纳入了数据分析。采用多元线性和逻辑回归模型来估计屏幕接触、照顾者与儿童互动、睡眠时间、户外活动和儿童自闭症样行为之间的关联。结果表明，0至3岁期间的屏幕接触与学龄前儿童自闭症样行为的存在有关，且随着平均每日屏幕时间的增加，这种关联的强度增强（优势比（OR）范围为1.358至4.026）。照顾者与儿童互动的频率和睡眠时间分别介导了该关联方差的5.32%和1.19%，但户外活动并未介导该关联。我们的研究结果表明，0至3岁接触屏幕的学龄前儿童可能患自闭症样行为的风险增加，且照顾者与儿童互动的频率和睡眠时间可能是这种关联的潜在中介因素。
