Yuan Guojing, Zhu Zhihui, Guo Haiyun, Yang Huayu, Zhang Jianghui, Zhang Kexin, Zhang Xueqing, Lu Xiaoyan, Du Jun, Shi Haiyan, Jin Guifang, Hao Jiahu, Sun Ying, Su Puyu, Zhang Zhihua
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, China.
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China.
J Autism Dev Disord. 2024 Dec 3. doi: 10.1007/s10803-024-06665-z.
The relationship between autism spectrum disorder (ASD) and screen time (ST) has been extensively studied; but the evidence remains inconsistent, and a comprehensive quantitative synthesis of this association is lacking. This study aims to provide a robust quantitative assessment of the relationship between ASD and ST by consolidating and analyzing available evidence to offer a more precise understanding of this complex association. This systematic review followed PRISMA 2020 statement, and applied a quality assessment tool for quantitative studies to identity best available evidence. A comprehensive search was conducted in PubMed, Web of Science, Embase, and Scopus, covering literature published from January 1, 2006 to June 12, 2024. In total, 30 studies involving 356,666 participants met the inclusion criteria. The findings revealed a significant association between screen exposure in preschool children and the development of ASD, with a longer duration of screen exposure correlating with an increased likelihood of being diagnosed with autism. Furthermore, autistic people tend to have longer daily screen use and are at a higher risk of screen addiction compared to non-autistic individuals. These findings emphasize the importance of limiting ST for preschoolers and autistic people. However, the level of evidence supporting these conclusions is very low. Future studies should focus on controlling for confounding factors, using more objective measures, and further investigate the relationship between screen engagement styles (active or passive), screen use patterns (screen devices and content), and ASD.
自闭症谱系障碍（ASD）与屏幕使用时间（ST）之间的关系已得到广泛研究；但证据仍不一致，且缺乏对这种关联的全面定量综合分析。本研究旨在通过整合和分析现有证据，对ASD与ST之间的关系进行强有力的定量评估，以便更精确地理解这种复杂的关联。本系统评价遵循PRISMA 2020声明，并应用定量研究质量评估工具来确定最佳可用证据。在PubMed、科学网、Embase和Scopus中进行了全面检索，涵盖2006年1月1日至2024年6月12日发表的文献。共有30项研究涉及356,666名参与者符合纳入标准。研究结果显示，学龄前儿童的屏幕暴露与ASD的发展之间存在显著关联，屏幕暴露时间越长，被诊断为自闭症的可能性就越大。此外，与非自闭症个体相比，自闭症患者往往每天的屏幕使用时间更长，且屏幕成瘾风险更高。这些发现强调了限制学龄前儿童和自闭症患者屏幕使用时间的重要性。然而，支持这些结论的证据水平非常低。未来的研究应侧重于控制混杂因素，使用更客观的测量方法，并进一步研究屏幕参与方式（主动或被动）、屏幕使用模式（屏幕设备和内容）与ASD之间的关系。
