Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, CA, USA.
Merrimack College School of Health Sciences, North Andover, MA, USA.
Child Obes. 2021 Jul;17(5):329-341. doi: 10.1089/chi.2020.0335. Epub 2021 Apr 20.
Children with neurodevelopmental and mental health disorders (N/MHD), such as autism spectrum, mood disorders, and anxiety, are more likely to engage in excessive screen time, receive insufficient sleep, and to have obesity than neurotypical peers. However, little is known about how parents of these children approach promoting sleep and balanced screen time. We conducted semistructured interviews with 24 parents of children aged 8-15 years with a diagnosis of N/MHD to assess barriers and facilitators to promoting sleep and balanced screen time. Interviews were transcribed, double-coded using constant comparative methods, and summarized into themes using NVivo 11. Many parents described children's chronic sleep challenges, often compounded by screen use and no clear solutions. When feeling overwhelmed, some parents reluctantly reported co-sleeping or allowing gaming devices in bed. Nearly all participants reported chronic, occasionally severe, conflict when managing children's screen time, with some parents experiencing opposition and physical aggression. Parents struggled to weigh the benefits of screen use (, behavior management, learning, and social connection) with the costs (, reduced self-care and limited physical activity). To combat barriers, parents described firm routines (, "screens off" time and consistent bedtime on weekdays and weekends), moderating access (, shutting down internet and no device in bedroom), verbal priming, and coping strategies (, music and books). Parents of children with N/MHD face unique challenges in promoting sleep and balanced screen time. Given these behaviors may impact weight status and mental health, future interventions should examine ways to support parents in reducing conflict while promoting healthy habits.
患有神经发育和精神健康障碍（N/MHD）的儿童，如自闭症谱系障碍、情绪障碍和焦虑症，比神经典型同龄人更有可能过度使用屏幕、睡眠不足和肥胖。然而，对于这些孩子的父母如何促进睡眠和平衡屏幕时间，我们知之甚少。
我们对 24 名 8-15 岁患有 N/MHD 诊断的儿童的父母进行了半结构化访谈，以评估促进睡眠和平衡屏幕时间的障碍和促进因素。访谈记录被转录，使用恒定比较方法进行双重编码，并使用 NVivo 11 汇总为主题。
许多父母描述了孩子长期存在的睡眠问题，这些问题常常因屏幕使用而加剧，且没有明确的解决方案。当感到不知所措时，一些父母勉强报告说会让孩子陪睡或允许孩子在床上使用游戏设备。几乎所有的参与者都报告说在管理孩子的屏幕时间时经常会出现慢性、偶尔严重的冲突，有些父母会遭遇反对和身体攻击。父母们在权衡屏幕使用的好处（例如行为管理、学习和社交联系）和成本（例如减少自我保健和有限的身体活动）方面感到困难。
为了克服障碍，父母们描述了严格的日常生活规律（例如“关闭屏幕”时间和工作日和周末的一致睡眠时间）、适度控制使用（例如关闭互联网和不在卧室使用设备）、口头引导以及应对策略（例如音乐和书籍）。
患有 N/MHD 的儿童的父母在促进睡眠和平衡屏幕时间方面面临独特的挑战。鉴于这些行为可能会影响体重状况和心理健康，未来的干预措施应该研究如何在促进健康习惯的同时减少冲突，以支持父母。
