Ghosh Roy Manisha, Agrawal Amit, Patil Rajesh, Shrivastava Jyotsna
Pediatrics, Gandhi Medical College, Bhopal, Bhopal, IND.
Cureus. 2024 Oct 27;16(10):e72459. doi: 10.7759/cureus.72459. eCollection 2024 Oct.
Excessive screen time is associated with developmental (mainly socio-cognitive and language) and behavioral problems more in children below five years than in older children and adolescents. The present study was conducted to determine the prevalence and pattern of exposure to excessive screen time in children below five years of age. It was also aimed at determining the prevalence of the risk of behavioral problems in these children in relation to their average daily screen time.
This study was conducted as an observational descriptive study on children attending OPD in the Department of Pediatrics of a tertiary care medical college in central India over the study period of 12 months. Parents were enquired about their socio-demographic details, the daily average screen time of their child, details regarding screen time and exposures, associated factors, sleeping and eating habits, average time spent by parents with their children, and also the behavioral issues according to the preschool pediatric symptom checklist (PPSC). All these questions were asked of the parents and duly filled out by a single doctor. The IAP (Indian Academy of Pediatrics) screen time recommendation was used as a cut-off value for excessive screen time definition, which states screen time recommendations for children below two years and two to five years old.
The daily average screen time greater than one hour (exceeding the recommended guidelines) was found in 57.7% of children. Twenty-six percent of children were exposed to screen time before their first birthday. Among the study participants, 37.7% (n=95) of children were found to be at risk of behavioral problems as per PPSC score, with a mean PPSC score of 6.7±3.3 in these children. The daily average screen time of one to three hours was found in 39.3% of children, three to five hours in 13% of children, and more than five hours in 5.3% of children. The PPCS score was found to be significantly higher in children with higher average screen time, children using multiple devices as compared to single devices, children who preferred electronic devices or devices with toys as preferred sources of entertainment, children becoming restless when devices are not given, children having feeding and sleep issues, and children who spend less time with parents (p<0.05). Multivariate analysis revealed higher odds of behavioral problems in children having more screen time (1-3 hours OR: 1.536; 95% CI: 1.03-7.237; p=0.035, 3-5 hours OR: 2.022; 95% CI: 1.477-8.570; p=0.029, and >5 hours OR: 9.793; 95% CI: 2.065-46.447; p=0.004), children using multiple devices as compared to single devices (OR: 2.43; 95% CI: 1.194-4.95; p=0.014), and children whose parents spend less time with them (<3 hours OR:1.311; 95% CI: 1.02-2.77; p=0.012).
The present study found that almost all children below five years are exposed to digital devices, with the majority of children exceeding the recommended screen time guidelines, and they mostly use it for entertainment purposes. During this period, exposure of children to screens is significantly associated with the risk of behavioral problems. It was observed that excessive screen time, less time spent by parents with their children, and use of multiple devices are significant predictors of increasing risk of behavioral problems in children below five years.
与大龄儿童及青少年相比，五岁以下儿童的屏幕使用时间过长与发育问题（主要是社会认知和语言方面）及行为问题的关联更为紧密。本研究旨在确定五岁以下儿童屏幕使用时间过长的患病率及模式。同时，本研究还旨在确定这些儿童行为问题风险的患病率与其平均每日屏幕使用时间的关系。
本研究为一项观察性描述性研究，研究对象为印度中部一所三级医疗学院儿科门诊的儿童，研究时长为12个月。向家长询问其社会人口学细节、孩子的每日平均屏幕使用时间、屏幕使用时间及接触情况的细节、相关因素、睡眠和饮食习惯、家长陪伴孩子的平均时间，以及根据学龄前儿童症状清单（PPSC）得出的行为问题。所有这些问题均由家长回答，并由一名医生如实填写。印度儿科学会（IAP）的屏幕使用时间建议被用作定义屏幕使用时间过长的临界值，该建议规定了两岁以下及两至五岁儿童的屏幕使用时间建议。
57.7%的儿童每日平均屏幕使用时间超过一小时（超过推荐指南）。26%的儿童在一岁前就开始接触屏幕。在研究参与者中，根据PPSC评分，37.7%（n = 95）的儿童存在行为问题风险，这些儿童的PPSC平均评分为6.7±3.3。39.3%的儿童每日平均屏幕使用时间为一至三小时，13%的儿童为三至五小时，5.3%的儿童超过五小时。研究发现，平均屏幕使用时间较长的儿童、使用多种设备而非单一设备的儿童、更喜欢电子设备或带有玩具的设备作为娱乐首选来源的儿童、在未得到设备时变得烦躁不安的儿童、有喂养和睡眠问题的儿童，以及与父母相处时间较少的儿童，其PPCS评分显著更高（p<0.05）。多因素分析显示，屏幕使用时间较长的儿童（1 - 3小时：比值比[OR]：1.536；95%置信区间[CI]：1.03 - 7.237；p = 0.035，3 - 5小时：OR：2.022；95% CI：1.477 - 8.570；p = 0.029，>5小时：OR：9.793；95% CI：2.065 - 46.447；p = 0.004）、使用多种设备而非单一设备的儿童（OR：2.
