Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
Medical Support Center for Japan Environment and Children's Study, National Center for Child Health and Development, Tokyo, Japan.
JAMA Pediatr. 2023 Nov 1;177(11):1168-1175. doi: 10.1001/jamapediatrics.2023.3643.
It is unclear whether increased television (TV) and DVD viewing in early childhood from age 1 year decreases development or whether poor development increases TV/DVD viewing.
To investigate the directional association between TV/DVD screen time and performance on developmental screeners in children aged 1 to 3 years.
DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study analyzed data from 57 980 children and mothers from a national birth cohort, the Japan Environment and Children's Study. Data were collected in collaboration with 15 regional centers across Japan. The mothers were recruited between January 2011 and March 2014. Analyses using random intercept, cross-lagged panel models were performed for children aged 1, 2, and 3 years. Of 100 303 live births, children with missing developmental screening test scores and screen time data, those with congenital diseases or cerebral palsy, and those diagnosed with an autism spectrum disorder were excluded. Statistical analyses were conducted from October 2022 to July 2023.
TV and DVD screen time.
Child development at ages 1, 2, and 3 years was assessed via the mother's or guardian's report using the Ages and Stages Questionnaire, third edition.
Of 57 980 included children, 29 418 (50.7%) were male, and the mean (SD) maternal age at delivery was 31.5 (4.9) years. A negative association between screen time and developmental scores was observed. Increased TV/DVD screen times at age 1 and 2 years were associated with lower developmental scores at age 2 and 3 years, respectively (2 years: β = -0.05; 95% CI, -0.06 to -0.04; 3 years: β = -0.08; 95% CI, -0.09 to -0.06). An obverse association was observed from the Ages and Stages Questionnaires, third edition, score in the communication domain at age 1 and 2 years to subsequent screen time (2 years: γ = -0.03; 95% CI, -0.04 to -0.02; 3 years: γ = -0.06; 95% CI, -0.07 to -0.04).
In this study, increased TV/DVD screen time from age 1 year negatively affected later development. To reduce the negative consequences of excessive media use, researchers and health care professionals should encourage family media management and recommend social support for parents who tend to rely on the media.
目前尚不清楚儿童从 1 岁开始增加电视（TV）和 DVD 观看时间是否会导致发育迟缓，或者是发育不良导致更多地看电视/看 DVD。
研究儿童 1 至 3 岁时，电视/DVD 屏幕时间与发育筛查测试成绩之间的方向性关联。
设计、地点和参与者：本纵向队列研究分析了来自全国出生队列日本环境与儿童研究的 57980 名儿童及其母亲的数据。数据是与日本 15 个地区中心合作收集的。母亲于 2011 年 1 月至 2014 年 3 月间招募。对 1 岁、2 岁和 3 岁的儿童进行随机截距、交叉滞后面板模型分析。从 100303 例活产儿中排除了发育筛查测试分数和屏幕时间数据缺失、患有先天性疾病或脑瘫以及被诊断为自闭症谱系障碍的儿童。统计分析于 2022 年 10 月至 2023 年 7 月进行。
电视和 DVD 屏幕时间。
使用母亲或监护人报告的《年龄与阶段问卷》第 3 版评估儿童 1、2 和 3 岁时的发育情况。
在 57980 名纳入的儿童中，29418 名（50.7%）为男性，母亲分娩时的平均（SD）年龄为 31.5（4.9）岁。观察到屏幕时间与发育评分之间存在负相关。1 岁和 2 岁时的电视/DVD 屏幕时间增加与 2 岁和 3 岁时的发育评分较低相关（2 岁：β=-0.05；95%CI，-0.06 至-0.04；3 岁：β=-0.08；95%CI，-0.09 至-0.06）。从《年龄与阶段问卷》第 3 版的沟通领域的分数来看，1 岁和 2 岁时的分数与随后的屏幕时间呈反向关联（2 岁：γ=-0.03；95%CI，-0.04 至-0.02；3 岁：γ=-0.06；95%CI，-0.07 至-0.04）。
在这项研究中，1 岁时电视/DVD 屏幕时间的增加对后期发育产生负面影响。为了减少过度使用媒体的负面影响，研究人员和医疗保健专业人员应鼓励家庭媒体管理，并为倾向于依赖媒体的父母提供社会支持。
