In spite of guidance from organizations including the American Academy of Pediatrics (AAP), many young children have a fair amount of screen exposure. A new study in JAMA Network Open looks at what might be causing young children to have potentially excessive screen exposures.1
The researchers used TARGet Kids, a network of primary health care research settings found throughout Toronto, Ontario, to find parent-child participants for their cross-sectional, population-based study. The children included were aged 7 to 18 months. Participants could be excluded for health conditions affecting growth, severe developmental delay, chronic conditions, acute conditions, and families who could not communicate in English.
The investigators looked at both child screen exposure (CSE) and child screen exposure plus feeding (CSE+F). Child screen exposures included background screen exposure and engaged use of screens for televisions, video games, computers, and mobile devices over the course of a typical week. Child screen exposure plus feeding looked at the frequency of screen exposure occurring at the same time as breakfast, lunch, dinner, or snack time during a typical week. A parent-completed Nutrition and Health Questionnaire; Infant Behavior Questionnaire, Revised Very Short; and Parenting Stress Index, Short Form was used to assess CSE and CSE+F.
Income and parental stress connected to levels of exposure
The sample included 1085 children. All were assessed for CSE and 1083 were assessed for CSE+F. During the course of a typical week, 581 of 779 children reported having any CSE and 321 of 874 children reported some level of CSE+F. Both older child age (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.01-2.03; P=0.04) as well as higher parenting stress levels (OR, 1.01; 95% CI, 1.00-1.02; P=0.04) were linked with CSE. Increased CSE was tied to lower household outcome (incidence rate [IR], 1.26; 95% CI, 1.10-1.45; P=0.01) and higher parenting stress levels (IR, 1.00; 95% CI, 1.00-1.01; P=0.002). Looking at CSE+F, both older child age (OR, 1.79; 95% CI, 1.35-2.38; P<0.001) and lower household income (OR, 2.54; 95% CI, 1.72-3.74; P<0.001) were associated with CSE+F. Lower household income also was linked to increased CSE+F (IR, 1.21; 95% CI, 1.03-1.42; P =0.02).
The study did have 2 strong limitations. It used self-reporting, which the investigators believe could have been biased by social desirability. The sample also was made up of relatively high-income families that mostly included 2 parents who were highly educated. The researchers highlighted that the study may not represent all urban families, particularly single parents.
They concluded that the research illustrated how pervasive CSE is, with roughly 75% of children having screen exposures by the time they are aged 18 months and roughly 33% being exposed to screen time in addition to food. The investigators believe that understanding why parents use screens with their young children is key to developing interventions that are successful.
The researchers recommend the following interventions as possible ways to curb CSEs:
· Education about the risks of early screen time;
· Alternative stress reduction techniques and parenting strategies that do not involve screens;
· Increased social support and resources within the home; or
· More free community-based activities for parents and children.
1. Tombeau Cost K, Korczak D, Charach A, et al. Association of parental and contextual stressors with child screen exposure and child screen exposure combined with feeding. JAMA Netw Open. 2020;3(2):e1920557.