Department of Pediatrics, University of Michigan Medical School, Ann Arbor.
Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor.
JAMA Pediatr. 2023 Jan 1;177(1):62-70. doi: 10.1001/jamapediatrics.2022.4793.
Mobile devices are often used to keep young children occupied or calm, but it is not known whether this practice influences child development.
To examine the longitudinal, bidirectional associations between the parent-reported frequency of using mobile devices to calm young children and children's executive functioning (EF) and emotional reactivity, testing moderation by child sex and temperament.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included a community-based convenience sample of English-speaking parents of typically developing children aged 3 to 5 years. The study duration was from August 2018 to January 2020, with baseline (T1), 3-month follow-up (T2), and 6-month follow-up (T3) waves.
Parent-reported frequency of use of mobile devices to calm children when upset (5-point Likert scale).
At each wave, the child's EF was assessed with the Behavior Rating Inventory of Executive Function-Preschool Version Global Executive Composite and emotional reactivity with the Child Behavior Checklist Emotional Reactivity subscale. Structural equation models were built to examine cross-lagged associations of the use of devices for calming, EF, and emotional reactivity, testing for moderation by child sex or temperament (Child Behavior Questionnaire-Very Short Form surgency score, median split).
Of 422 eligible parents with data at T1, 375 (88.9%) provided data at T2 and 366 (86.7%) at T3. At baseline, the mean (SD) age of the 422 children was 3.8 (0.5) years, the number of boys in the sample was 224 (53.1%), the number of individuals of non-Hispanic White race and ethnicity was 313 (74.2%), and among the parents, 254 (60.2%) had a college degree or higher. Among the boys, the use of devices to calm at T2 was associated with higher emotional reactivity at T3 (r [standardized regression coefficient] = 0.20; 95% CI, 0.10-0.30), while higher emotional reactivity at T2 had a nonsignificant association with increased device use for calming at T3 (r = 0.10; 95% CI, -0.01 to 0.21). Among children with high temperamental surgency, the use of devices to calm at T2 was associated with increased emotional reactivity at T3 (r = 0.11; 95% CI, 0.01-0.22), while higher emotional reactivity at T2 was associated with increased device use for calming at T3 (r = 0.13; 95% CI, 0.02-0.24).
The findings of this study suggest that the frequent use of mobile devices for calming young children may displace their opportunities for learning emotion-regulation strategies over time; therefore, pediatric health care professionals may wish to encourage alternate calming approaches.
移动设备常被用来让幼儿保持专注或平静，但目前尚不清楚这种做法是否会影响儿童的发展。
研究父母报告的使用移动设备安抚幼儿的频率与儿童执行功能（EF）和情绪反应之间的纵向、双向关联，并检验儿童性别和气质的调节作用。
设计、地点和参与者：这是一项基于社区的便利样本的前瞻性队列研究，包括年龄在 3 至 5 岁之间的、英语为母语的、发育正常的儿童的父母。研究时间为 2018 年 8 月至 2020 年 1 月，基线（T1）、3 个月随访（T2）和 6 个月随访（T3）。
父母报告使用移动设备安抚孩子时的频率（5 分李克特量表）。
在每个时间点，使用行为评定量表中的执行功能学前版综合执行功能和儿童行为检查表情绪反应分量表评估儿童的 EF 和情绪反应。建立结构方程模型来检验设备使用镇静、EF 和情绪反应之间的交叉滞后关联，并检验儿童性别或气质（儿童行为问卷-非常短形式的活泼性评分，中位数分割）的调节作用。
在符合 T1 数据条件的 422 位合格父母中，375 位（88.9%）在 T2 时提供了数据，366 位（86.7%）在 T3 时提供了数据。在基线时，422 名儿童的平均（SD）年龄为 3.8（0.5）岁，样本中男孩的数量为 224 名（53.1%），非西班牙裔白人和西班牙裔的数量为 313 名（74.2%），父母中 254 名（60.2%）拥有大学学历或更高学历。在男孩中，T2 时使用设备镇静与 T3 时的情绪反应更高相关（r [标准化回归系数] = 0.20；95%置信区间，0.10-0.30），而 T2 时的情绪反应更高与 T3 时增加使用设备镇静之间没有显著关联（r = 0.10；95%置信区间，-0.01 至 0.21）。在高气质活泼性的儿童中，T2 时使用设备镇静与 T3 时的情绪反应增加相关（r = 0.11；95%置信区间，0.01-0.22），而 T2 时的情绪反应增加与 T3 时使用设备镇静增加相关（r = 0.13；95%置信区间，0.02-0.24）。
本研究结果表明，随着时间的推移，频繁使用移动设备安抚幼儿可能会取代他们学习情绪调节策略的机会；因此，儿科保健专业人员可能希望鼓励替代的镇静方法。
