Screen time linked to ‘delayed development’ in young children

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“Letting a toddler spend lots of time using screens may delay their development of skills such as language and sociability,” BBC News reports.

Researchers followed over 2,000 children in Canada from birth up to the age of 5, with screen time assessments performed from age 2 years onwards.

Screen time was defined as time children spent watching or interacting with any type of screen-based devices, such as tablets, TVs or smartphones.

Overall they found that increased screen time was generally associated with poorer developmental test scores.

However, the study can’t prove that screen time is directly responsible for the child’s developmental test scores.

A child’s development is likely to be influenced by a complex interplay of factors. It is very difficult to pull these factors apart and work out the role of a single factor like screen time.

Recent advice published by the Royal College of Paediatrics and Child Health avoided making specific recommendations on screen time limits, citing a lack of evidence.

But they say that for younger children “face-to-face social interaction is vital to the development of language and other skills, and screen-based interaction is not an effective substitute for this”. They also advise “that screens are avoided for an hour before the planned bedtime”.

Where did the story come from?

The study was conducted by researchers from the University of Calgary and University of Waterloo in Canada. Funding for the cohort was provided by a grant from the Alberta Innovates Health Solutions Interdisciplinary Team. The study was published in the peer-reviewedmedical journal JAMA Pediatrics, and is free to read online.

The UK’s media reporting of the study was accurate. BBC News provided some useful additional information about the ongoing debate about screen time recommendations.

What kind of research was this?

This study used data collected from an ongoing cohort study of mothers and children in Canada, to see whether reported screen time was associated with child developmental delay. The authors report that 1 in 4 children show signs of developmental delay, such as communication problems, when they start school.

The main limitation of cohort studies is that they can’t prove for certain that too much screen time affects a child’s development. A child’s development is likely to be influenced by a wide range of factors (confounders).

What did the research involve?

The All Our Families study recruited over 3,000 pregnant women from Calgary in Canada between 2008 and 2010. They were followed up when their child was aged 4, 12, 24, 36 and 60 months.

Screen time assessments were made at the latter 3 assessments (from 24, 36 and 60 months). Mothers were asked how many hours on typical weekdays and weekends their child used certain devices/media, including watching TV, DVDs, gaming systems and other screen-based devices.

At these ages mothers also completed the Ages and Stages Questionnaire Third Edition (ASQ-3), which is said to be a widely used way to measure screen time. It also assessed development in 5 areas:

communication skills

gross motor skills (such as walking and running)

fine motor skills (such as picking up and then manipulating objects)

problem-solving skills

social interaction skills

In exploring links between the two, various confounding factors were taken into account:

how often children read/looked at books

how often they engaged in physical activity

how much sleep they had at night

mother-child relationship

use of childcare/daycare

mother’s educational level

household income

The study analysed 2,441 of the cohort who had completed questionnaires in at least 1 of the 3 follow-up times.

What were the basic results?

Average (mean) viewing times were 17 hours a week at 24 months; 25 hours at 36 months; and 11 hours at 60 months (5 years).

The statistical model used to analyse screen time against development was complex, but essentially showed that higher screen time was associated with poorer developmental assessments at all assessment points. They also showed, for example, that higher screen time at age 24 months was associated with poorer performance at 36 months. A similar pattern was found for higher screen time at 36 months with poorer development at 60 months.

How did the researchers interpret the results?

The researchers conclude that their results support a directional link between screen time and child development. They suggest that “recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use”.

Conclusion

This study adds to the growing body of literature exploring the potential effects of too much screen time usage on health and wellbeing.

But by its very nature, this study can’t prove that higher screen time definitely impairs development.

The main limitation remains the potential that other factors may be at play. The researchers have made careful attempts to take into account various environmental influences and other factors associated with child upbringing. But it’s likely to be a complex mix of hereditary factors, interpersonal relationships, environmental and lifestyle factors that ultimately affect a child’s development. It’s always going to be difficult to pull apart all of these influences and assess the direct effect of a single exposure such as screen time.

Another thing to consider is that the results only show an overall trend for lower test scores with higher screen time. They don’t actually show that any children have a noticeable “impairment” or were at any disadvantage compared to other children. Despite lower test scores they may function and develop perfectly normally.

The questionnaire is said to be a valid method of assessing media use, but these are still estimates and there may be some inaccuracies.

Finally, this is a very specific population sample from one region of Canada, of mostly white ethnicity and from higher income households. The same results may not be seen in other samples.

The overall message would still seem to be that it’s better for children to have a balance and perhaps limited used of screen time combined with other activities like play, reading, interaction with others and physical activity. This advice corresponds to the recent advice for parents provided by the Royal College of Paediatrics and Child Health (PDF, 191kb).

Analysis by Bazian
Edited by NHS Website

More sleep and limiting screen time may improve children’s mental abilities

"Limiting children's screen time linked to better cognition," reports BBC News.

“Limiting children’s screen time linked to better cognition,” reports BBC News.

“Limiting children’s screen time linked to better cognition,” reports BBC News.

A study of 4,524 children in the US found those who used screens recreationally for less than 2 hours a day did better on tests of mental functioning.

The study was designed to assess whether Canadian recommendations on screen time, sleep and physical activity for children aged 8 to 11 were linked to better mental function, which was assessed using a series of tests.

The recommendations are:

restrict screen time (including TV, smartphones, tablets and video games) to less than 2 hours a day

sleep 9 to 11 hours a night

do at least 1 hour of moderate to vigorous physical activity a day

The children who did best on testing were those who followed all 3 recommendations.

But only 5% of children met all 3 recommendations, which could reduce the strength of the association.

And we can’t be sure that meeting the recommendations was the cause of the improved test performance.

Screen time and sleep accounted for around 22% of the variation between test results, while physical activity alone didn’t seem to be linked to mental functioning.

Other differences, such as children’s school grade and ethnic background, were also strongly linked to test results.

The researchers say parents should consider limiting screen time and ensuring adequate regular sleep for children, as well as encouraging physical activity.

UK guidelines on screen time and sleep for children are expected to be published in 2019.

Where did the story come from?

The study was carried out by researchers from the Children’s Hospital of Eastern Ontario Research Institute, the University of Ottawa and Carleton University, all in Canada.

It was funded by the US National Institutes of Health.

The study was published in the peer-reviewed journal The Lancet Child and Adolescent Health.

UK media reports were reasonably balanced. Most included warnings that the observational nature of the study means we can’t be sure that screen time is directly linked to cognitive function.

The Sun and The Times ignored this by both reporting that limiting screen time “boosts brains”.

What kind of research was this?

This was a cross-sectional observational study. These types of studies are fine when researchers are looking for links between factors (such as screen time and mental function).

But cross-sectional studies can’t show that one thing causes another. That’s because they look at just one point in time, so can’t account for changes in brain function or variability in factors like screen time. Also, other factors could influence the results.

What did the research involve?

Researchers used baseline data from a study of US children that began in 2016.

Children from 21 study sites across the US were invited to take part in cognitive tests.

Children and parents also filled out a series of questionnaires about the child’s lifestyle.

For this study, researchers looked at answers to questions about:

physical activity (how many days in the past week they did at least 1 hour of exercise)

how many hours they typically spent each day on screen-related leisure activities such as watching TV, playing video games or using social media

how many hours on average they slept each night (this question was answered by parents)

Researchers adjusted their figures to take account of some potential confounding factors known to affect cognitive test results:

household income

parent and child education level

ethnic background

body mass index (BMI)

head injury

What were the basic results?

Researchers found only 5% of children studied met all 3 recommendations.

Children did an hour of physical activity on average 3.7 days a week, used screens on average 3.6 hours a day and slept for an average 9.1 hours a night.

Just over half of children met the sleep recommendations, while 37% met the screen time recommendation and only 18% met the physical activity recommendations.

Children who met all 3 recommendations scored highest on the cognitive tests.

These higher test results seemed most strongly associated with meeting screen time recommendations alone, or a combination of screen time and sleep recommendations.

Meeting the physical activity recommendations alone didn’t seem to be linked to cognition test performance.

How did the researchers interpret the results?

The researchers said: “These findings highlight the importance of limiting recreational screen time and encouraging healthy sleep to improve cognition in children.”

They say doctors, parents, teachers and policymakers “should promote limiting recreational screen time and prioritising healthy sleep routines throughout childhood and adolescence”.

Conclusion

The suggestion that children should have limited screen time, enough sleep and plenty of physical activity isn’t particularly controversial.

This study adds to evidence that these might be sensible lifestyle adaptations for children.

But this type of study can’t prove that any one of these is directly responsible for children’s mental abilities.

The study has other limitations. These include:

It looks at just one snapshot in time, so we can’t tell whether children’s activities or abilities changed over time.

Children self-reported their time spent on physical activity and screen-based activity, which may not have been accurate and possibly prone to both under- and overestimating.

While the researchers tried to adjust for the effects of other confounding factors, it’s impossible to account for them all as so many things affect cognitive functioning.

It’s interesting that the study found the strongest link with sleep and screen time combined.

It’s possible that overuse of devices like mobile phones at night could be affecting children’s sleep, rather than the screen time directly affecting mental functioning.

What’s perhaps more interesting is how few children met all the recommendations.

Even the recommendation that children aged 8 to 11 should have 9 to 11 hours sleep a night was only met by 51% of children, while only 18% of children met the recommendation of an hour a day of physical activity.

While the study doesn’t give us definitive answers about the effects of screen time, it does provide further evidence to suggest that adequate sleep and limited screen time may improve mental function.

Similarly, frequent physical activity improves physical and mental health.

Analysis by Bazian
Edited by NHS Website

Children at Risk of Drowning: Who are They?

The Infographic: Home pool and spa safety steps accurately pointed out the alarming numbers of children drowning, the swimming pools involved and the preventive measures to be done. It also focuses on naming the ages involved for the parents to be careful with their child.

Here are the factors why these children are at risk of drowning:
• Inability to swim: Studies have proven that one of the main reasons for drowning is that the children can’t swim. And other studies show that there is a decrease in the incidence of drowning for children who know how to swim.
• The barriers are not present: Pool fencing prevents children’s access to the pool, and without it, children will not receive adult supervision that in turn can cause drowning.
• No or decrease in close supervision: A heightened peripheral vision of parents is essential and not just their presence in preventing children from drowning.
• The location: CDC’s research proved that children mostly drown in home swimming pools, and the Infographic has the breakdown of the incidence in the different kinds of a pool.
• Presence of Disease, such as cardiovascular, respiratory and seizure disorders: Hindrances like these, most especially for febrile seizures, increases the risk of that child in drowning. Children with congenital diseases of the heart need a doctor’s approval to swim. Also, pediatricians recommend a check-up for children with respiratory asthma. A febrile seizure is common in 6 months to 5 years, which is near the age bracket of the victims of drowning.
Now that you have an idea of whom they are, it is right that an utmost importance be given in caring for a child belonging to that age bracket. The safety measures/steps presented in the Infographic is very important to make sure that children will not be left alone or be allowed to go near the pool.

Children at Risk of Drowning: Who are They?

The reality of teen depression

Teen depression is a mental and emotional disorder that can cause persistent feelings of sadness and lack of interest in school and other activities, which can affect your teens daily thoughts and behavior. Knowing the signs and possible causes of teen depression can prepare you to help your teen as they battle this mental illness.

Teens have a lot going on their lives that can play a role in developing teen depression including peer pressure, academic expectations and changing bodies.

The major depressive disorder is the leading cause of disability among Americans age 15 to 44 (addressing teen depression early can help stop it from becoming an issue).

The infographic explores the long-term effects of untreated teen depression and provides tips for talking with a depressed teen.

The Reality of Teen Depression