自闭症儿童以及与肥胖相关的儿童的被动和社交屏幕时间。
Passive and social screen time in children with autism and in association with obesity.
作者信息
Must Aviva, Eliasziw Misha, Stanish Heidi, Curtin Carol, Bandini Linda G, Bowling April
机构信息
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States.
Department of Exercise and Health Sciences, Manning College of Nursing and Health Sciences, University of Massachusetts-Boston, Boston, MA, United States.
出版信息
Front Pediatr. 2023 Jul 10;11:1198033. doi: 10.3389/fped.2023.1198033. eCollection 2023.
BACKGROUND
Screen time has been identified as a risk factor for childhood obesity, but the media landscape has evolved rapidly. Children with autism tend to be heavy users of screens and have an elevated prevalence of obesity. We know little about screen use patterns among children with autism vs. typically developing (TD) peers and in association with obesity.
METHODS
Baseline data from 10,842 participants in the Adolescent Brain Cognition Development Study was used to characterize time spent with child-reported passive screen use (television/movies/watching videos), playing video games, and using social media. Duration of screen time by autism status and gender was summarized as mean time per day; obesity was defined using CDC/WHO criteria. A propensity score analysis was used to create a matched dataset for analysis.
RESULTS
Overall, 1.7% of children were was identified as having autism. Significant mean differences were observed by autism status and gender for both passive viewing and playing video games. Compared to TD children, boys with autism spent more time (2.9 vs. 2.3 h, < 0.001) watching TV, movies or videos, as did girls (3.0 vs. 2.0 h, = 0.002). Compared to TD peers, boys with autism reported more video game time (102.7 vs. 77.5 min, = 0.001), as did girls with autism (64.4 vs. 37.9 min, = 0.03); girls with autism also spent more time on social media sites or video chat (45.5 vs. 21.9 min, = 0.04). Overall, obesity prevalence increased with increasing screen time duration, significantly for passive screen time (-value = 0.002) and texting (-value = 0.02). Associations between obesity and screen time duration did not differ by autism status.
DISCUSSION
Children with autism spend more time playing video games and on passive and social screen activities than their TD peers, with some variations by gender. High rates of social media use among girls with autism and multiplayer video game use among both boys and girls with autism may challenge the notion that the high levels of screen time reflect social isolation in the group. Given potential positive aspects of screen time in children with autism movement to focus on content and context is appropriate.
背景
屏幕使用时间已被确定为儿童肥胖的一个风险因素，但媒体格局已迅速演变。自闭症儿童往往是屏幕的重度使用者，肥胖患病率较高。我们对自闭症儿童与发育正常（TD）的同龄人之间的屏幕使用模式以及与肥胖的关系了解甚少。
方法
使用青少年大脑认知发展研究中10842名参与者的基线数据来描述儿童报告的被动屏幕使用（电视/电影/观看视频）、玩电子游戏和使用社交媒体所花费的时间。按自闭症状态和性别汇总的屏幕使用时间以每天的平均时间表示；肥胖按照美国疾病控制与预防中心/世界卫生组织的标准定义。使用倾向得分分析创建一个匹配数据集进行分析。
结果
总体而言，1.7%的儿童被确定为患有自闭症。在被动观看和玩电子游戏方面，按自闭症状态和性别观察到显著的平均差异。与发育正常的儿童相比，患有自闭症的男孩看电视、电影或视频的时间更多（2.9小时对2.3小时，<0.001），女孩也是如此（3.0小时对2.0小时，=0.002）。与发育正常的同龄人相比，患有自闭症的男孩报告玩电子游戏的时间更多（102.7分钟对77.5分钟，=0.001），患有自闭症的女孩也是如此（64.4分钟对37.9分钟，=0.03）；患有自闭症的女孩在社交媒体网站或视频聊天上花费的时间也更多（45.5分钟对21.9分钟，=0.04）。总体而言，肥胖患病率随着屏幕使用时间的增加而上升，被动屏幕使用时间（-值=0.002）和发短信（-值=0.02）的情况显著。肥胖与屏幕使用时间之间的关联在自闭症状态方面没有差异。
讨论
自闭症儿童玩电子游戏以及进行被动和社交屏幕活动的时间比他们发育正常的同龄人更多，且存在一些性别差异。患有自闭症的女孩使用社交媒体的比例较高，患有自闭症的男孩和女孩玩多人电子游戏的比例较高，这可能会挑战屏幕使用时间长反映该群体社交隔离的观点。鉴于屏幕使用时间对自闭症儿童可能有积极方面，转向关注内容和背景是合适的。
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