{
  "https://pmc.ncbi.nlm.nih.gov/articles/PMC6830442/": {
    "status": 200,
    "final": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6830442/",
    "title": "Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children - PMC",
    "snippets": [
      {
        "term": "screen time",
        "snippet": "ollection, data entry, and quality control for this study, with no compensation outside of their normal salaries. \u2709 Corresponding author. Received 2019 Apr 23; Accepted 2019 Aug 4; Issue date 2020 Jan. Copyright 2019 American Medical Association. All Rights Reserved. PMC Copyright notice PMCID: PMC6830442 PMID: 31682712 This article has been corrected. See JAMA Pediatr. 2020 Mar 23;174(5):509 . This cross-sectional study examines the results of diffusion tensor imaging, cognitive testing, and a screen time survey to identify the implications of screen-based media use for the development of language and literacy skills in early childhood. Key Points Question Is screen-based media use associated with differences in the structural integrity of brain white matter tracts that support language and literacy skills in preschool-aged children? Findings In this cross-sectional study of 47 healthy prekindergarten children, screen use greater than that recommended by the American Academy of Pediatrics guidelines was associated with (1) lower measures of microstructural organization and myelination of brain white matter tracts that support language and emergent literacy skills and (2) corresponding cognitive assessments. Meaning These findings suggest a need for further study into the association between screen-based media use and the developing brain, particularly during early childhood. Abstract Importance The American Academy of Pediatrics (AAP) recommends limits on screen-based media use, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown. Objective To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged children. Design, Setting, and Participants This cross-sectional st"
      },
      {
        "term": "white matter",
        "snippet": "FF'/%3E%3CfeComposite in='SourceGraphic'/%3E%3C/filter%3E%3Ctext id='b' font-family='Helvetica' font-size='11pt' style='opacity:1;fill:%23005ea2;stroke:none;text-anchor:middle' x='175' y='14'%3E%3C/text%3E%3Cpath id='a' style='fill:%23005ea2' d='M0 8h350v3H0z'/%3E%3C/defs%3E%3Cuse xlink:href='%23a' transform='rotate(90 10 10)'/%3E%3Cuse xlink:href='%23b' transform='rotate(90 10 10)' filter='url(%23c)'/%3E%3C/svg%3E\"); padding-left: 3rem; } } Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Search Log in Dashboard Publications Account settings Log out Search\u2026 Search NCBI Primary site navigation Search Logged in as: Dashboard Publications Account settings Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide PERMALINK Copy As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice JAMA Pediatr . 2019 Nov 4;174(1):e193869. doi: 10.1001/jamapediatrics.2019.3869 Search in PMC Search in PubMed View in NLM Catalog Add to search Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children John S Hutton John S Hutton , MS, MD 1 Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio 2 Reading and Literacy Dis"
      },
      {
        "term": "MRI",
        "snippet": "ethods Participants A total of 69 parent-child dyads were recruited through advertisement at a children\u2019s medical center and surrounding primary care clinics. Inclusion criteria were as follows: children aged 3 to 5 years, born at at least 36 weeks\u2019 gestation, living in a household of native English speakers, without a history of neurodevelopmental disorder conferring risk of language delays, no previous or current kindergarten attendance, and no contraindications to magnetic resonance imaging (MRI), such as metal implants. Written informed consent was obtained from a custodial parent, and families were compensated for their time and travel expenses. This study was approved by the institutional review board of Cincinnati Children's Hospital Medical Center and was conducted from August 2017 to November 2018. Screen-Based Media Use Assessment Research coordinators administered the ScreenQ 35 survey to a custodial parent in a private room before or during the child\u2019s MRI, and responses were entered into a REDCap (Research Electronic Data Capture) database. 36 ScreenQ is a recently developed, 15-item composite measure of screen-based media use of children aged 3 to 9 years, reflecting the AAP recommendations for this age range. 5 , 6 The conceptual model for ScreenQ is derived from the 4 domains of the AAP recommendations: access to screens, frequency of use, content viewed, and interactivity or coviewing. A preliminary version of the ScreenQ was tested and psychometrically refined in a previous study. 37 Psychometric analyses for the current version included modern-theory Rasch methods and were favorable, including a range of item difficulty, reliability, internal consistency (Cronbach \u03b1 = .74), and criterion-related validity referenced to external standards of child cognitive skills and home cognitive environment (StimQ-P 38 ). 35 The ScreenQ scoring range was 0 to 26 p"
      },
      {
        "term": "diffusion tensor",
        "snippet": "g and Literacy Discovery Center, oversaw the data collection, data entry, and quality control for this study, with no compensation outside of their normal salaries. \u2709 Corresponding author. Received 2019 Apr 23; Accepted 2019 Aug 4; Issue date 2020 Jan. Copyright 2019 American Medical Association. All Rights Reserved. PMC Copyright notice PMCID: PMC6830442 PMID: 31682712 This article has been corrected. See JAMA Pediatr. 2020 Mar 23;174(5):509 . This cross-sectional study examines the results of diffusion tensor imaging, cognitive testing, and a screen time survey to identify the implications of screen-based media use for the development of language and literacy skills in early childhood. Key Points Question Is screen-based media use associated with differences in the structural integrity of brain white matter tracts that support language and literacy skills in preschool-aged children? Findings In this cross-sectional study of 47 healthy prekindergarten children, screen use greater than that recommended by the American Academy of Pediatrics guidelines was associated with (1) lower measures of microstructural organization and myelination of brain white matter tracts that support language and emergent literacy skills and (2) corresponding cognitive assessments. Meaning These findings suggest a need for further study into the association between screen-based media use and the developing brain, particularly during early childhood. Abstract Importance The American Academy of Pediatrics (AAP) recommends limits on screen-based media use, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown. Objective To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged children. Design"
      },
      {
        "term": "language",
        "snippet": "normal salaries. \u2709 Corresponding author. Received 2019 Apr 23; Accepted 2019 Aug 4; Issue date 2020 Jan. Copyright 2019 American Medical Association. All Rights Reserved. PMC Copyright notice PMCID: PMC6830442 PMID: 31682712 This article has been corrected. See JAMA Pediatr. 2020 Mar 23;174(5):509 . This cross-sectional study examines the results of diffusion tensor imaging, cognitive testing, and a screen time survey to identify the implications of screen-based media use for the development of language and literacy skills in early childhood. Key Points Question Is screen-based media use associated with differences in the structural integrity of brain white matter tracts that support language and literacy skills in preschool-aged children? Findings In this cross-sectional study of 47 healthy prekindergarten children, screen use greater than that recommended by the American Academy of Pediatrics guidelines was associated with (1) lower measures of microstructural organization and myelination of brain white matter tracts that support language and emergent literacy skills and (2) corresponding cognitive assessments. Meaning These findings suggest a need for further study into the association between screen-based media use and the developing brain, particularly during early childhood. Abstract Importance The American Academy of Pediatrics (AAP) recommends limits on screen-based media use, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown. Objective To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged children. Design, Setting, and Participants This cross-sectional study of healthy children aged 3 to 5 years (n = 47) was conducted from August 2017 to November 201"
      },
      {
        "term": "literacy",
        "snippet": "or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice JAMA Pediatr . 2019 Nov 4;174(1):e193869. doi: 10.1001/jamapediatrics.2019.3869 Search in PMC Search in PubMed View in NLM Catalog Add to search Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children John S Hutton John S Hutton , MS, MD 1 Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio 2 Reading and Literacy Discovery Center, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio Find articles by John S Hutton 1, 2, \u2709 , Jonathan Dudley Jonathan Dudley , PhD 2 Reading and Literacy Discovery Center, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio 3 Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio Find articles by Jonathan Dudley 2, 3 , Tzipi Horowitz-Kraus Tzipi Horowitz-Kraus , PhD 1 Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio 2 Reading and Literacy Discovery Center, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio 3 Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio 4 Educational Neuroimaging Center, Biomedical Engineering, Technion, Israel Find articles by Tzipi Horowitz-Kraus 1, 2, 3, 4 , Tom DeWitt Tom DeWitt , MD 1 Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio 2 Reading and Literacy Discovery Center, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio Find articles by Tom DeWitt 1, 2 , Scott K Holland Scott K Holland , PhD 2 Reading and Literacy Discovery Center, Cincinnati Childr"
      },
      {
        "term": "attention",
        "snippet": "acts attributable to nonuniform directionality of fiber tracts, such as crossing fibers. 28 However, the analyses involved well-defined tracts and a hypothesis-driven approach, and FA and RD findings were consistent with results in the current behavioral and neuroimaging literature and with each other. Diffusion-weighted images were acquired at the end of the MRI session, resulting in a lower success rate (68%) than from recent work, 17 possibly conferring bias toward older children with higher attention skills. However, DTI is a task-free paradigm that is not affected by performance factors. Although important, the cross-sectional nature of this study precludes the discernment of causation or whether the results are attributable to screen time or an indirect effect of differences in reading, language, or other constructive experiences. 3 , 28 This study also has strengths. The sample of preschool-aged children is remarkable given the difficulty of successfully conducting MRI at this age. The DTI results survived stringent correction for motion and multiple comparisons, controlling for child age and household income, and were concordant with behavioral results controlling for child age. Rather than apply a single screen time variable, such as minutes per day or violent content as is often the case, 84 , 85 ScreenQ incorporated domains of use into a coherent composite, providing a more holistic view of use. 35 The analyses were driven by a hypothesis based on recent neuroimaging evidence and AAP guidelines, including characterization of associations for a broad range of tracts supporting relevant cognitive abilities and focused analyses with increased statistical power. The DTI findings aligned with those on validated cognitive measures, providing compelling insights into the implications for child development, preschool education, and further research. Although prelim"
      },
      {
        "term": "sleep",
        "snippet": " hours per day in children younger than 9 years, aside from use during childcare and school. 3 Accompanying this rise are variables with potential risks and benefits, including access to screens (eg, in bedrooms), frequency of use, content, and grownup-child interaction (eg, coviewing). 5 , 6 The American Academy of Pediatrics (AAP) recommends limits on screen-based media, citing developmental and health risks with excessive and inopportune use. 3 These risks include language delay 7 , 8 ; poor sleep 2 , 9 ; impaired executive function 10 and general cognition 11 ; and decreased parent-child engagement, including reading together. 12 , 13 , 14 The World Health Organization recently released even more restrictive recommendations for children younger than 5 years, discouraging screen time and advocating greater study of its implications for health and development. 15 Recent evidence suggests that screen-based media use poses neurobiological risks in children, 16 , 17 , 18 , 19 yet its associations with early brain development are largely unknown, particularly during the dynamic span of development before kindergarten. 10 Although sensory networks mature relatively early, 11 those sensory networks for higher-order skills, such as language, 12 executive function, 20 , 21 multimodal association, 13 and reading, 22 , 23 exhibit protracted development 11 , 14 and are dependent on constructive stimulation in the home. Specifically, the organization and myelination of white matter tracts, which enhance the efficiency of signal conduction within and between these networks, are highly sensitive to environmental factors. 21 , 24 , 25 , 26 Diffusion tensor imaging (DTI) is a powerful means to quantify white matter integrity in the brain and its various factors. 27 Parameters of DTI include fractional anisotropy (FA) and radial diffusivity (RD), scalar values associated with micros"
      },
      {
        "term": "emotion",
        "snippet": "lor indicates the slope or magnitude of correlation (ie, change in the DTI parameter for every point increase in ScreenQ score). Table 2. Extent of Tracts With Statistically Significant Correlations Between ScreenQ Scores and Diffusion Tensor Imaging Parameters in Whole-Brain Analysis. White Matter Tract Regions Connected Major Functions FA Decrease, % RD Increase, % Left Right Left Right Anterior thalamic radiation Thalamus-prefrontal Executive 33 a 13 18 a 10 Cingulum (cingulate gyrus) Limbic Emotion, learning, memory 28 a 18 25 22 Cingulum (hippocampus) Limbic Emotion, learning, memory 4 20 a 4 27 a Corticospinal tract Cortex\u2013spinal cord Sensory-motor 29 21 26 a 15 Forceps major Occipital-occipital Visual processing/imagery 33 39 38 33 Forceps minor Frontal-frontal Executive 55 56 34 33 Inferior fronto-occipital fasciculus Frontal-occipital/temporal Association, language 51 44 48 a 24 Inferior longitudinal fasciculus Occipital-temporal Visual association/imagery, language 38 a 21 48 a 6 Superior longitudinal fasciculus Frontal-occipital-temporal-parietal Association, working memory, language 24 40 a 29 37 Arcuate fasciculus Frontal-temporal-parietal Language 35 a 10 44 a 6 Uncinate fasciculus Orbitofrontal-temporal Association, language (rapid naming) 55 a 35 53 a 20 Open in a new tab Abbreviations: FA, fractional anisotropy; RD, radial diffusivity. a Substantial lateralization of correlation (extent >50% greater than contralateral tract). In the hypothesis-driven analysis, higher ScreenQ scores were correlated with lower FA, covering 16% of the arcuate fasciculus, 29% of the inferior longitudinal fasciculus, and 55% of the uncinate fasciculus, controlling for child age and household income ( P < .05, FWE-corrected). Higher ScreenQ scores were correlated with higher RD, spanning 20% of the arcuate fasciculus, 36% of the inferior longitudinal fasciculus, and 39% of "
      },
      {
        "term": "development",
        "snippet": "tside of their normal salaries. \u2709 Corresponding author. Received 2019 Apr 23; Accepted 2019 Aug 4; Issue date 2020 Jan. Copyright 2019 American Medical Association. All Rights Reserved. PMC Copyright notice PMCID: PMC6830442 PMID: 31682712 This article has been corrected. See JAMA Pediatr. 2020 Mar 23;174(5):509 . This cross-sectional study examines the results of diffusion tensor imaging, cognitive testing, and a screen time survey to identify the implications of screen-based media use for the development of language and literacy skills in early childhood. Key Points Question Is screen-based media use associated with differences in the structural integrity of brain white matter tracts that support language and literacy skills in preschool-aged children? Findings In this cross-sectional study of 47 healthy prekindergarten children, screen use greater than that recommended by the American Academy of Pediatrics guidelines was associated with (1) lower measures of microstructural organization and myelination of brain white matter tracts that support language and emergent literacy skills and (2) corresponding cognitive assessments. Meaning These findings suggest a need for further study into the association between screen-based media use and the developing brain, particularly during early childhood. Abstract Importance The American Academy of Pediatrics (AAP) recommends limits on screen-based media use, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown. Objective To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged children. Design, Setting, and Participants This cross-sectional study of healthy children aged 3 to 5 years (n = 47) was conducted from August 2017 "
      },
      {
        "term": "executive function",
        "snippet": "e was 8.6 (4.8; 1-19) points. Mean (SD; range) CTOPP-2 score was 9.4 (3.3; 2-15) points, EVT-2 score was 113.1 (16.6; 88-144) points, and GRTR score was 19.0 (5.9; 5-25) points. ScreenQ scores were negatively correlated with EVT-2 ( F 2,43 = 5.14; R 2 = 0.19; P < .01), CTOPP-2 ( F 2,35 = 6.64; R 2 = 0.28; P < .01), and GRTR ( F 2,44 = 17.08; R 2 = 0.44; P < .01) scores, controlling for child age. Higher ScreenQ scores were correlated with lower FA and higher RD in tracts involved with language, executive function, and emergent literacy abilities ( P < .05, familywise error\u2013corrected), controlling for child age and household income. Conclusions and Relevance This study found an association between increased screen-based media use, compared with the AAP guidelines, and lower microstructural integrity of brain white matter tracts supporting language and emergent literacy skills in prekindergarten children. The findings suggest further study is needed, particularly during the rapid early stages of brain development. Introduction In a single generation, through what has been described as a vast \u201cuncontrolled experiment,\u201d 1 the landscape of childhood has been digitized, affecting how children play, learn, and form relationships. In addition to traditional programming, rapidly emerging technologies, particularly portable electronic devices, provide unprecedented access to a wide range of media. 2 , 3 Use begins in infancy 4 and increases with age, and it was recently estimated at more than 2 hours per day in children younger than 9 years, aside from use during childcare and school. 3 Accompanying this rise are variables with potential risks and benefits, including access to screens (eg, in bedrooms), frequency of use, content, and grownup-child interaction (eg, coviewing). 5 , 6 The American Academy of Pediatrics (AAP) recommends limits on screen-based media, citing developm"
      },
      {
        "term": "limitations",
        "snippet": "ted by a recent MRI study of children aged 8 to 12 years that found lower functional connectivity within the emerging reading network was correlated with higher screen time and higher functional connectivity was correlated with more reading time. 18 Given the prevalence of \u201clearning\u201d applications marketed for young children and the emphasis on technology in early childhood educational curricula, 3 multiyear studies of emergent literacy outcomes are warranted to determine long-term implications. Limitations and Strengths This study has several limitations. The sample largely comprised families with high socioeconomic status, yet household income was accounted for in the DTI analyses. Associations between ScreenQ survey and cognitive testing scores did not meet the threshold for statistical significance when income was included in the model, which may be associated with the moderate collinearity between income level and ScreenQ scores that negatively affected statistical power, particularly given the small sample size. Both behavioral and DTI findings may have been even more robust in families with higher socioeconomic status compared with families with lower socioeconomic status, for whom language, literacy, and other cognitive disparities are well documented. 82 , 83 Although exhibiting strong psychometric properties, 35 ScreenQ is a new measure reliant on parent reporting and thus is subject to social desirability bias. However, no similar composite measure or direct assessment currently exists, and ScreenQ reflects domains in the current AAP recommendations. 5 Although DTI is a powerful method for studying white matter in the brain, it is vulnerable to artifacts attributable to nonuniform directionality of fiber tracts, such as crossing fibers. 28 However, the analyses involved well-defined tracts and a hypothesis-driven approach, and FA and RD findings were consist"
      },
      {
        "term": "conclusion",
        "snippet": "TR score was 19.0 (5.9; 5-25) points. ScreenQ scores were negatively correlated with EVT-2 ( F 2,43 = 5.14; R 2 = 0.19; P < .01), CTOPP-2 ( F 2,35 = 6.64; R 2 = 0.28; P < .01), and GRTR ( F 2,44 = 17.08; R 2 = 0.44; P < .01) scores, controlling for child age. Higher ScreenQ scores were correlated with lower FA and higher RD in tracts involved with language, executive function, and emergent literacy abilities ( P < .05, familywise error\u2013corrected), controlling for child age and household income. Conclusions and Relevance This study found an association between increased screen-based media use, compared with the AAP guidelines, and lower microstructural integrity of brain white matter tracts supporting language and emergent literacy skills in prekindergarten children. The findings suggest further study is needed, particularly during the rapid early stages of brain development. Introduction In a single generation, through what has been described as a vast \u201cuncontrolled experiment,\u201d 1 the landscape of childhood has been digitized, affecting how children play, learn, and form relationships. In addition to traditional programming, rapidly emerging technologies, particularly portable electronic devices, provide unprecedented access to a wide range of media. 2 , 3 Use begins in infancy 4 and increases with age, and it was recently estimated at more than 2 hours per day in children younger than 9 years, aside from use during childcare and school. 3 Accompanying this rise are variables with potential risks and benefits, including access to screens (eg, in bedrooms), frequency of use, content, and grownup-child interaction (eg, coviewing). 5 , 6 The American Academy of Pediatrics (AAP) recommends limits on screen-based media, citing developmental and health risks with excessive and inopportune use. 3 These risks include language delay 7 , 8 ; poor sleep 2 , 9 ; impaired executiv"
      },
      {
        "term": "results",
        "snippet": "ital Reading and Literacy Discovery Center, oversaw the data collection, data entry, and quality control for this study, with no compensation outside of their normal salaries. \u2709 Corresponding author. Received 2019 Apr 23; Accepted 2019 Aug 4; Issue date 2020 Jan. Copyright 2019 American Medical Association. All Rights Reserved. PMC Copyright notice PMCID: PMC6830442 PMID: 31682712 This article has been corrected. See JAMA Pediatr. 2020 Mar 23;174(5):509 . This cross-sectional study examines the results of diffusion tensor imaging, cognitive testing, and a screen time survey to identify the implications of screen-based media use for the development of language and literacy skills in early childhood. Key Points Question Is screen-based media use associated with differences in the structural integrity of brain white matter tracts that support language and literacy skills in preschool-aged children? Findings In this cross-sectional study of 47 healthy prekindergarten children, screen use greater than that recommended by the American Academy of Pediatrics guidelines was associated with (1) lower measures of microstructural organization and myelination of brain white matter tracts that support language and emergent literacy skills and (2) corresponding cognitive assessments. Meaning These findings suggest a need for further study into the association between screen-based media use and the developing brain, particularly during early childhood. Abstract Importance The American Academy of Pediatrics (AAP) recommends limits on screen-based media use, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown. Objective To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged child"
      },
      {
        "term": "children",
        "snippet": "%3E%3C/filter%3E%3Ctext id='b' font-family='Helvetica' font-size='11pt' style='opacity:1;fill:%23005ea2;stroke:none;text-anchor:middle' x='175' y='14'%3E%3C/text%3E%3Cpath id='a' style='fill:%23005ea2' d='M0 8h350v3H0z'/%3E%3C/defs%3E%3Cuse xlink:href='%23a' transform='rotate(90 10 10)'/%3E%3Cuse xlink:href='%23b' transform='rotate(90 10 10)' filter='url(%23c)'/%3E%3C/svg%3E\"); padding-left: 3rem; } } Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Search Log in Dashboard Publications Account settings Log out Search\u2026 Search NCBI Primary site navigation Search Logged in as: Dashboard Publications Account settings Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide PERMALINK Copy As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice JAMA Pediatr . 2019 Nov 4;174(1):e193869. doi: 10.1001/jamapediatrics.2019.3869 Search in PMC Search in PubMed View in NLM Catalog Add to search Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children John S Hutton John S Hutton , MS, MD 1 Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio 2 Reading and Literacy Discovery Center, Cincinnati Children\u2019s Hosp"
      },
      {
        "term": "preschool",
        "snippet": "SourceGraphic'/%3E%3C/filter%3E%3Ctext id='b' font-family='Helvetica' font-size='11pt' style='opacity:1;fill:%23005ea2;stroke:none;text-anchor:middle' x='175' y='14'%3E%3C/text%3E%3Cpath id='a' style='fill:%23005ea2' d='M0 8h350v3H0z'/%3E%3C/defs%3E%3Cuse xlink:href='%23a' transform='rotate(90 10 10)'/%3E%3Cuse xlink:href='%23b' transform='rotate(90 10 10)' filter='url(%23c)'/%3E%3C/svg%3E\"); padding-left: 3rem; } } Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Search Log in Dashboard Publications Account settings Log out Search\u2026 Search NCBI Primary site navigation Search Logged in as: Dashboard Publications Account settings Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide PERMALINK Copy As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice JAMA Pediatr . 2019 Nov 4;174(1):e193869. doi: 10.1001/jamapediatrics.2019.3869 Search in PMC Search in PubMed View in NLM Catalog Add to search Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children John S Hutton John S Hutton , MS, MD 1 Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio 2 Reading and Literacy Discovery Center, Cincinnati "
      }
    ]
  },
  "https://pmc.ncbi.nlm.nih.gov/articles/PMC6439882/": {
    "status": 200,
    "final": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6439882/",
    "title": "Association Between Screen Time and Children\u2019s Performance on a Developmental Screening Test - PMC",
    "snippets": [
      {
        "term": "screen time",
        "snippet": "'c'%3E%3CfeFlood flood-color='%23FFF'/%3E%3CfeComposite in='SourceGraphic'/%3E%3C/filter%3E%3Ctext id='b' font-family='Helvetica' font-size='11pt' style='opacity:1;fill:%23005ea2;stroke:none;text-anchor:middle' x='175' y='14'%3E%3C/text%3E%3Cpath id='a' style='fill:%23005ea2' d='M0 8h350v3H0z'/%3E%3C/defs%3E%3Cuse xlink:href='%23a' transform='rotate(90 10 10)'/%3E%3Cuse xlink:href='%23b' transform='rotate(90 10 10)' filter='url(%23c)'/%3E%3C/svg%3E\"); padding-left: 3rem; } } Association Between Screen Time and Children\u2019s Performance on a Developmental Screening Test - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Search Log in Dashboard Publications Account settings Log out Search\u2026 Search NCBI Primary site navigation Search Logged in as: Dashboard Publications Account settings Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide PERMALINK Copy As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice JAMA Pediatr . 2019 Jan 28;173(3):244\u2013250. doi: 10.1001/jamapediatrics.2018.5056 Search in PMC Search in PubMed View in NLM Catalog Add to search Association Between Screen Time and Children\u2019s Performance on a Developmental Screening Test Sheri Madigan Sheri Madigan , PhD 1 Department of Psychology, University of Calgary, Calgary, Alberta, Canada 2 Department of Paediatrics, Alberta Children\u2019s Hosp"
      },
      {
        "term": "language",
        "snippet": "y support the directional association between screen time and child development. Recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use. This longitudinal cohort study examines children\u2019s performance on developmental tests at ages 24, 36, and 60 months and the amount of screen time exposure at those points. Introduction By school entry, 1 in 4 children shows deficits and delays in developmental outcomes such as language, communication, motor skills, and/or socioemotional health. 1 , 2 Thus, many children are beginning school inadequately prepared for learning and academic success. Gaps in development tend to widen vs shrink over time without intervention, 3 creating a burden on education and health systems in the form of greater government and public expenditures for remediation and special education. 4 , 5 Consequently, there have been efforts to identify factors, including children\u2019s screen time, 6 that may create or exacerbate disparities in early child development. Digital media and screens are now ubiquitous in the lives of children. Approximately 98% of US children aged 0 to 8 years live in a home with an internet-connected device and, on average, spend over 2 hours a day on screens. 7 This amount exceeds the recommended pediatric guideline that children spend no more than 1 hour per day viewing high-quality programming. 8 , 9 Although some benefits of high-quality and interactive screen time have been identified, 10 , 11 , 12 , 13 excessive screen time has been associated with a number of deleterious physical, behavioral, and cognitive outcomes. 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 While it is possible that screen time interferes with opportunities for learning and growth, it is also possible that children with delays receive more screen time to help modulate challenging behav"
      },
      {
        "term": "literacy",
        "snippet": "s of the Early Development Instrument (EDI): a measure of children\u2019s school readiness. Can J Behav Sci. 2007;39(1):1-22. doi: 10.1037/cjbs2007001 [ DOI ] [ Google Scholar ] 2. Browne DT, Wade M, Prime H, Jenkins JM. School readiness amongst urban Canadian families: risk profiles and family mediation. J Educ Psychol. 2018;110(1):133-146. doi: 10.1037/edu0000202 [ DOI ] [ Google Scholar ] 3. Stanovich KE. Matthew effects in reading\u2014some consequences of individual-differences in the acquisition of literacy. Read Res Q. 1986;21(4):360-407. doi: 10.1598/RRQ.21.4.1 [ DOI ] [ Google Scholar ] 4. Browne DT, Rokeach A, Wiener J, Hoch JS, Meunier JC, Thurston S. Examining the family-level and economic impact of complex child disabilities as a function of child hyperactivity and service integration. J Dev Phys Disabil. 2013;25(2):181-201. doi: 10.1007/s10882-012-9295-z [ DOI ] [ Google Scholar ] 5. Heckman JJ. Skill formation and the economics of investing in disadvantaged children. Science. 2006;312(5782):1900-1902. doi: 10.1126/science.1128898 [ DOI ] [ PubMed ] [ Google Scholar ] 6. Radesky JS, Christakis DA. Increased screen time: implications for early childhood development and behavior. Pediatr Clin North Am. 2016;63(5):827-839. doi: 10.1016/j.pcl.2016.06.006 [ DOI ] [ PubMed ] [ Google Scholar ] 7. Common Sense Media The Common Sense census: media use by kids age zero to eight 2017. Common Sense Media website. https://www.commonsensemedia.org/research/the-common-sense-census-media-use-by-kids-age-zero-to-eight-2017 . Accessed August 30, 2018. 8. American Academy of Pediatrics American Academy of Pediatrics announces new recommendations for children\u2019s media use. http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Announces-New-Recommendations-for-Childrens-Media-Use.aspx . Published October 21, 2016. Accessed August 30, 2018. 9. Rades"
      },
      {
        "term": "attention",
        "snippet": "0.01) a 0.08 (0.03 to 0.13) a Sleep (h/night) 0.11 (0.06 to 0.16) a \u22120.14 (\u22120.19 to \u22120.10) a Child in care 0.02 (\u22120.03 to 0.06) \u22120.03 (\u22120.09 to 0.00) R 2 0.15 (0.12 to 0.19) a 0.12 (0.08 to 0.15) a Open in a new tab a Estimates in which 95% CIs do not include 0. Discussion Screen time is common in the lives of modern families. Moreover, it is on the rise as technology becomes increasingly integrated across all domains of life. The consequences of excessive screen time have garnered considerable attention in research, health, and public debate over the past decade. 7 , 41 , 42 But what comes first: delays in development or excessive screen time viewing? One of the novelties of the current longitudinal, 3-wave study is that it can address this question using repeated measures. Results suggest that screen time is likely the initial factor: greater screen time at 24 months was associated with poorer performance on developmental screening tests at 36 months, and similarly, greater screen time at 36 months was associated with lower scores on developmental screening tests at 60 months. The obverse association was not observed. On average, children aged 24, 36, and 60 months in our study were watching approximately 17, 25, and 11 hours of television per week, which amounts to approximately 2.4, 3.6, and 1.6 hours of screen time per day, respectively. The amount of screen time in this sample is consistent with a recent report 7 that suggests that children across the United States are watching, on average, 2 hours and 19 minutes of programming per day. Although the reduction in screen time at 60 months would not affect cross-lag analyses as they pertain to rank-order stability vs mean change, this reduction is noteworthy. It may be a reflection of the children in our cohort commencing primary school, as well as before- and after-school care, which begins at age 5 years, resulti"
      },
      {
        "term": "sleep",
        "snippet": "rom none (1) to 7 hours or more (7), and completed the Center for Epidemiologic Depression Scale. 35 When the child was 36 months, maternal educational level was collected using a scale of 1 (some elementary or high school) to 6 (completed graduate school), income was reported in increments of $10 000 CAD (1, \u226410 000 CAD$; 11, \u2265$100 000 CAD$), maternal positive interactions were assessed using the National Longitudinal Survey of Children and Youth Parenting Scales, 36 and the number of hours of sleep the child receives in a typical 24-hour period was recorded. At 60 months, mothers responded to \u201cHas your child been in nonparental childcare or daycare on a regular basis before this year?\u201d as either no (0) or yes (1). Statistical Analysis The longitudinal associations between child hours of screen time and developmental outcomes were examined using a random-intercepts, cross-lagged panel model (RI-CLPM), as defined by Hamaker and colleagues 37 ( Figure ). Compared with the standard CLPMs, the RI-CLPM addresses problems associated with residual confounding by statistically isolating the variance in repeated outcome measures that is stable (ie, between-person and time-invariant) vs dynamic (ie, within-person and time-varying). Simulation studies have indicated that this approach reduces bias in directional estimates of association and more closely approximates causal inference. 38 Figure. Random-Intercepts, Cross-Lagged Panel Model Illustrating Within-Person Association Between Developmental Outcomes (Ages and Stages Questionnaire, Third Edition [ASQ-3]) and Screen Time (Hours per Week) From Ages 24 to 60 Months, Controlling for Between-Person Differences. Open in a new tab Standardized estimates (95% CIs) are presented. Solid lines represent estimates where 95% CIs do not include zero. The central, blue-tinted part of the model connected by black solid and dashed lines i"
      },
      {
        "term": "emotion",
        "snippet": "n time and child development. Recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use. This longitudinal cohort study examines children\u2019s performance on developmental tests at ages 24, 36, and 60 months and the amount of screen time exposure at those points. Introduction By school entry, 1 in 4 children shows deficits and delays in developmental outcomes such as language, communication, motor skills, and/or socioemotional health. 1 , 2 Thus, many children are beginning school inadequately prepared for learning and academic success. Gaps in development tend to widen vs shrink over time without intervention, 3 creating a burden on education and health systems in the form of greater government and public expenditures for remediation and special education. 4 , 5 Consequently, there have been efforts to identify factors, including children\u2019s screen time, 6 that may create or exacerbate disparities in early child development. Digital media and screens are now ubiquitous in the lives of children. Approximately 98% of US children aged 0 to 8 years live in a home with an internet-connected device and, on average, spend over 2 hours a day on screens. 7 This amount exceeds the recommended pediatric guideline that children spend no more than 1 hour per day viewing high-quality programming. 8 , 9 Although some benefits of high-quality and interactive screen time have been identified, 10 , 11 , 12 , 13 excessive screen time has been associated with a number of deleterious physical, behavioral, and cognitive outcomes. 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 While it is possible that screen time interferes with opportunities for learning and growth, it is also possible that children with delays receive more screen time to help modulate challenging behaviors. For example, toddlers who struggle with self-"
      },
      {
        "term": "development",
        "snippet": "feComposite in='SourceGraphic'/%3E%3C/filter%3E%3Ctext id='b' font-family='Helvetica' font-size='11pt' style='opacity:1;fill:%23005ea2;stroke:none;text-anchor:middle' x='175' y='14'%3E%3C/text%3E%3Cpath id='a' style='fill:%23005ea2' d='M0 8h350v3H0z'/%3E%3C/defs%3E%3Cuse xlink:href='%23a' transform='rotate(90 10 10)'/%3E%3Cuse xlink:href='%23b' transform='rotate(90 10 10)' filter='url(%23c)'/%3E%3C/svg%3E\"); padding-left: 3rem; } } Association Between Screen Time and Children\u2019s Performance on a Developmental Screening Test - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Search Log in Dashboard Publications Account settings Log out Search\u2026 Search NCBI Primary site navigation Search Logged in as: Dashboard Publications Account settings Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide PERMALINK Copy As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice JAMA Pediatr . 2019 Jan 28;173(3):244\u2013250. doi: 10.1001/jamapediatrics.2018.5056 Search in PMC Search in PubMed View in NLM Catalog Add to search Association Between Screen Time and Children\u2019s Performance on a Developmental Screening Test Sheri Madigan Sheri Madigan , PhD 1 Department of Psychology, University of Calgary, Calgary, Alberta, Canada 2 Department of Paediatrics, Alberta Children\u2019s Hospital Research Institute, Calgary, Alberta, C"
      },
      {
        "term": "self-regulation",
        "snippet": "gh some benefits of high-quality and interactive screen time have been identified, 10 , 11 , 12 , 13 excessive screen time has been associated with a number of deleterious physical, behavioral, and cognitive outcomes. 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 While it is possible that screen time interferes with opportunities for learning and growth, it is also possible that children with delays receive more screen time to help modulate challenging behaviors. For example, toddlers who struggle with self-regulation have been shown to receive more screen time than those without difficulties. 22 However, most studies have used cross-sectional methods, limiting conclusions regarding the directionality of associations. Greater clarity on the directionality of associations may be informative for pediatricians and other health care practitioners seeking to guide parents on developmentally appropriate screen exposure as well as the potential consequences of excessive screen use. Using a 3-wave, random-intercepts, cross-lagged panel model including 2441 children followed up at age 24, 36, and 60 months, we investigated whether higher screen time affects performance on developmental screening tests and whether children with lower scores on those tests received more screen time. Methods Study Design and Population Participants included mothers and children from the All Our Families study, a large, prospective pregnancy cohort of 3388 mothers and children from Calgary, Alberta, Canada. 23 , 24 In this cohort, pregnant women were recruited between May 13, 2008, and December 13, 2010, through local primary health care offices, community advertising, and the local blood laboratory service. Inclusion criteria for the study were (1) age 18 years or older, (2) able to communicate in English, (3) gestational age less than 24 weeks, and (4) receiving local prenatal care. Mothers were followe"
      },
      {
        "term": "limitations",
        "snippet": "lans 50 to ensure that screen time is not excessive or interfering with face-to-face interactions or family time. Media plans can be customized to help meet each family\u2019s needs. The plans provide guidance on setting and enforcing rules and boundaries regarding media use based on child age, how to devise screen-free zones and device curfews in the home, and how to balance and allocate time for online and offline activities to ensure that physical activity and family interactions are prioritized. Limitations Longitudinal research designs are necessary for drawing conclusions regarding directionality and patterning of associations over time and across development. However, one of the most significant hurdles in longitudinal research involving screens is that technology development is rapidly evolving and outpacing research. 51 In our large, prospective cohort monitoring children between the ages of 24 and 60 months, data were collected between October 20, 2011, and October 6, 2016. It is possible that screen time behaviors may have shifted over this time period owing to advances in technologies. Another potential limitation is that the first assessment of study variables was at 24 months. It may be beneficial in future research to include an additional lag of data at 12 or 18 months to add further support to the pattern of results observed herein. The addition of an earlier lag of data may be especially pertinent given recent reports suggesting that screen time in infancy is on the rise. 7 , 17 A third limitation is the unidimensional focus on screen time. Future research should disaggregate the effect of media content quality (eg, online streaming of videos vs educational apps) on children\u2019s development. One further limitation is that the assessment of screen time and child development was taken from maternal reports. The advantage of collecting maternal reports via que"
      },
      {
        "term": "conclusion",
        "snippet": "esults Of the 2441 children included in the analysis, 1227 (50.2%) were boys. A random-intercepts, cross-lagged panel model revealed that higher levels of screen time at 24 and 36 months were significantly associated with poorer performance on developmental screening tests at 36 months (\u03b2, \u22120.06; 95% CI, \u22120.10 to \u22120.01) and 60 months (\u03b2, \u22120.08; 95% CI, \u22120.13 to \u22120.02), respectively. These within-person (time-varying) associations statistically controlled for between-person (stable) differences. Conclusions and Relevance The results of this study support the directional association between screen time and child development. Recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use. This longitudinal cohort study examines children\u2019s performance on developmental tests at ages 24, 36, and 60 months and the amount of screen time exposure at those points. Introduction By school entry, 1 in 4 children shows deficits and delays in developmental outcomes such as language, communication, motor skills, and/or socioemotional health. 1 , 2 Thus, many children are beginning school inadequately prepared for learning and academic success. Gaps in development tend to widen vs shrink over time without intervention, 3 creating a burden on education and health systems in the form of greater government and public expenditures for remediation and special education. 4 , 5 Consequently, there have been efforts to identify factors, including children\u2019s screen time, 6 that may create or exacerbate disparities in early child development. Digital media and screens are now ubiquitous in the lives of children. Approximately 98% of US children aged 0 to 8 years live in a home with an internet-connected device and, on average, spend over 2 hours a day on screens. 7 This amount exceeds the recommended pediatric guidelin"
      },
      {
        "term": "results",
        "snippet": "nada 2 Department of Paediatrics, Alberta Children\u2019s Hospital Research Institute, Calgary, Alberta, Canada 3 Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada Accepted for Publication: November 25, 2018. \u2709 Corresponding Author: Sheri Madigan, PhD, Department of Psychology, University of Calgary, 2500 University Ave, Calgary, AB T2N 1N4, Canada ( sheri.madigan@ucalgary.ca ). Correction: This article was corrected on March 25, 2019, to fix numeric errors in the Abstract, Results, and figure. Published Online: January 28, 2019. doi: 10.1001/jamapediatrics.2018.5056 Author Contributions: Drs Madigan and Browne had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Madigan, Browne, Racine, Tough. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: Madigan, Browne. Critical revision of the manuscript for important intellectual content: Browne, Racine, Mori, Tough. Statistical analysis: Madigan, Browne, Racine. Obtained funding: Tough. Administrative, technical, or material support: Browne, Tough. Supervision: Tough. Conflict of Interest Disclosures: Dr Tough reported grants from the Alberta Childrens Hospital Foundation, Alberta Innovates Health Solutions, the MaxBell Foundation, CanFASD, and the Canadian Institutes for Health Research during the conduct of the study. No other disclosures were reported. Funding/Support: The All Our Families study was supported by Alberta Innovates Health Solutions Interdisciplinary Team grant 200700595. The principal investigator of the All Our Families Study is Dr Tough. Research support was provided by the Alberta Children\u2019s Hospital Foundation and the Canada Research Chairs program (Dr Madigan). Role of the Funder/Sponsor: The funding sources had no role in the design and "
      },
      {
        "term": "children",
        "snippet": " flood-color='%23FFF'/%3E%3CfeComposite in='SourceGraphic'/%3E%3C/filter%3E%3Ctext id='b' font-family='Helvetica' font-size='11pt' style='opacity:1;fill:%23005ea2;stroke:none;text-anchor:middle' x='175' y='14'%3E%3C/text%3E%3Cpath id='a' style='fill:%23005ea2' d='M0 8h350v3H0z'/%3E%3C/defs%3E%3Cuse xlink:href='%23a' transform='rotate(90 10 10)'/%3E%3Cuse xlink:href='%23b' transform='rotate(90 10 10)' filter='url(%23c)'/%3E%3C/svg%3E\"); padding-left: 3rem; } } Association Between Screen Time and Children\u2019s Performance on a Developmental Screening Test - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Search Log in Dashboard Publications Account settings Log out Search\u2026 Search NCBI Primary site navigation Search Logged in as: Dashboard Publications Account settings Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide PERMALINK Copy As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice JAMA Pediatr . 2019 Jan 28;173(3):244\u2013250. doi: 10.1001/jamapediatrics.2018.5056 Search in PMC Search in PubMed View in NLM Catalog Add to search Association Between Screen Time and Children\u2019s Performance on a Developmental Screening Test Sheri Madigan Sheri Madigan , PhD 1 Department of Psychology, University of Calgary, Calgary, Alberta, Canada 2 Department of Paediatrics, Alberta Children\u2019s Hospital Research In"
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    "title": "Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study | PLOS One",
    "snippets": [
      {
        "term": "screen time",
        "snippet": "orbidity In a dose-response manner, children exposed to more screen-time, at either age three and five-years, showed significantly increased behavior problems at five-years in univariate analysis. Briefly, children who watched more than 2-hours of screen-time/day had increased externalizing , internalizing , and total behavior problems scores compared to children who watched less than 30-minutes. Univariate linear results for the CBCL composite scales are provided in S1 Table through S9 Table . Screen time remained significant in the linear multivariate results for total, internalizing, and externalizing behavior. Adjusted results for total behavior problems (secondary outcome) are presented in S3 File and S9 Table . CBCL externalizing behaviour multiple linear regression analyses (primary outcome). Children exposed to more than 2-hours of screen-time had a 2\u00b72-point increase in externalizing behavior problem T-score (95%CI: 0\u00b79, 3\u00b75, p \u22640\u00b7001; model 1, Table 2 ) when controlling for sleep duration, parent-reported SDB symptoms, gender, SES, marital status, parenting stress, and maternal depression. Children who spent two or more hours/week participating in organized physical activities showed a 1\u00b73-point reduction in externalizing behavior score (95%CI: -2\u00b71, -0\u00b76, p \u22640\u00b7001). There were no significant interactions between screen-time and gender, physical activity, school enrolled, sleep duration, SDB, or parenting stress (all p >0\u00b705). The association between screen-time at five-years and increased externalizing behavioral morbidity remained significant when controlling for daily reported hours of screen-time at three-years ( p \u22640\u00b705). Download: PNG larger image TIFF original image Table 2. Multiple regression analysis examining associations between screen-time and the CBCL externalizing behavior problem T-score at five-years of age (n = 2,427). https://doi.org/10.13"
      },
      {
        "term": "attention",
        "snippet": "ode.parentNode.insertBefore(gads, node); })(); } googletag.cmd.push(function() { googletag.defineSlot('/75507958/PONE_728x90_ATF', [728, 90], 'div-gpt-ad-1458247671871-0').addService(googletag.pubads()); googletag.defineSlot('/75507958/PONE_160x600_BTF', [160, 600], 'div-gpt-ad-1458247671871-1').addService(googletag.pubads()); googletag.pubads().enableSingleRequest(); googletag.enableServices(); }); dataLayer = [{ 'mobileSite': 'false', 'desktopSite': 'true' }]; Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study | PLOS One (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= '//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-TP26BH'); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= '//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-MQQMGF'); // from https://developers.hubspot.com/docs/reference/api/analytics-and-events/cookie-banner/cookie-banner-api#example-using-a-third-party-cookie-banner-to-control-hubspot-cookies window.disableHubSpotCookieBanner = true; window._hsp = window._hsp || []; window._hsp.push(['setHubSpotConsent', { analytics: window.plosCookieConsent?.hasConsented('analytics'), advertisement: window.plosCookieConsent?.hasConsented('advertising'), functionality: window.plosCookieConsent?.hasConsented('functionality') } ]); ;window.NREUM||(NREUM={});NREUM.init={distributed_tracing:{enabled:true},privacy:{cookies_enabled:true},ajax:{deny_list:[\"bam.nr-data."
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        "term": "inattention",
        "snippet": " node.parentNode.insertBefore(gads, node); })(); } googletag.cmd.push(function() { googletag.defineSlot('/75507958/PONE_728x90_ATF', [728, 90], 'div-gpt-ad-1458247671871-0').addService(googletag.pubads()); googletag.defineSlot('/75507958/PONE_160x600_BTF', [160, 600], 'div-gpt-ad-1458247671871-1').addService(googletag.pubads()); googletag.pubads().enableSingleRequest(); googletag.enableServices(); }); dataLayer = [{ 'mobileSite': 'false', 'desktopSite': 'true' }]; Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study | PLOS One (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= '//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-TP26BH'); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= '//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-MQQMGF'); // from https://developers.hubspot.com/docs/reference/api/analytics-and-events/cookie-banner/cookie-banner-api#example-using-a-third-party-cookie-banner-to-control-hubspot-cookies window.disableHubSpotCookieBanner = true; window._hsp = window._hsp || []; window._hsp.push(['setHubSpotConsent', { analytics: window.plosCookieConsent?.hasConsented('analytics'), advertisement: window.plosCookieConsent?.hasConsented('advertising'), functionality: window.plosCookieConsent?.hasConsented('functionality') } ]); ;window.NREUM||(NREUM={});NREUM.init={distributed_tracing:{enabled:true},privacy:{cookies_enabled:true},ajax:{deny_list:[\"bam.nr-dat"
      },
      {
        "term": "sleep",
        "snippet": " of Excellence (AllerGen NCE). 2. Women\u2019s and Children\u2019s Health Research Institute. 3. The Canadian Institutes of Health Research (CIHR). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Introduction Childhood screen-time has increased over the years[ 1 \u2013 4 ]. Increased screen-time has been associated with unhealthy dietary patterns, poor sleep quality, cardiovascular disease, and obesity[ 5 ] in children. In 2016, the new Canadian 24-hour Movement Guidelines[ 6 , 7 ] recommend that children aged five and over should have less than two-hours of screen-time/day, while limiting screen-time to less than one-hour/day for two-four year olds. It has been estimated that children between three to five years old are exposed to an average of two-hours of screen-time per day[ 8 \u2013 13 ] in Canada. There has been a significant increase in screen options in recent years, from device choices to streaming content, with rising concern that screen-time may have negative consequences for mental health[ 14 ]. Studies of school-aged children have shown associations between increased television viewing time and attention problems[ 15 \u2013 17 ]. The Dunedin Study found that increased television viewing from five to eleven years old was associated with attention problems in adolescence[ 18 ]. In their study sample, children reportedly watched an average of 2-hours of television each day between[ 18 ]. Recent study examining adolescent sedentary behaviors among suggested that screen-time should be considered a risk factor for attention deficit hyperactivity disorder (ADHD) symptoms[ 19 ]. Swing et al[ 20 ] reported that television viewing time greater than 2-hours per day was associated with increased attention problems among older children"
      },
      {
        "term": "emotion",
        "snippet": "red a risk factor for attention deficit hyperactivity disorder (ADHD) symptoms[ 19 ]. Swing et al[ 20 ] reported that television viewing time greater than 2-hours per day was associated with increased attention problems among older children. A meta-analysis concluded that television viewing or gaming among 4\u201317 years old children was modestly associated with later ADHD symptoms[ 4 ]. Reports in toddlers and preschoolers have linked television viewing time above 1.5 hours to later behavioral and emotional problems[ 8 ]. There is less research examining associations between screen-time exposure and behavioral development in the preschool years. Most studies have focused on school-aged children, only considered traditional screen sources such as television viewing, or did not allow for many potential confounders. We analyzed data from the population-based Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study to determine associations between screen-time and behavioral outcomes at age 5 years. Prolonged screen-time may displace time spent in other activities such as active play; important to promoting development in young children[ 21 , 22 ]. The extensive CHILD Study assessment allowed us to examine major determinants of mental health including movement behaviors (e.g. screen-time, sleep, physical activity) in addition to important covariates such as parenting stress, socioeconomic status, marital status, and breastfeeding. We investigated whether parents of children exposed to more screen-time reported more externalizing and internalizing behavior problems at 5 years of age. We sought to determine if increased screen-time above the Canadian recommended guideline is associated with clinically significant behavior problems in young children. We hypothesized that children exposed to screen-time above the 2-hour threshold would exhibit clinically signi"
      },
      {
        "term": "development",
        "snippet": "ts Media Coverage Reader Comments Figures Sukhpreet K. Tamana Victor Ezeugwu ... Piush J. Mandhane \u00a0 \"> \" /> \"> Reset zoom 1) { %> All Figures Next Previous \"> \u00a0\u00a0 show more \" > \u00a0\u00a0 show less \">Show in Context Download: \" title=\"original image\"> TIFF \" title=\"large image\"> PNG Figures Abstract Background Pre-school children spend an average of two-hours daily using screens. We examined associations between screen-time on pre-school behavior using data from the Canadian Healthy Infant Longitudinal Development (CHILD) study. Methods CHILD participant parents completed the Child Behavior Checklist (CBCL) at five-years of age. Parents reported their child\u2019s total screen-time including gaming and mobile devices. Screen-time was categorized using the recommended threshold of two-hours/day for five-years or one-hour/day for three-years. Multiple linear regression examined associations between screen-time and externalizing behavior (e.g. inattention and aggression). Multiple logistic regression identified characteristics of children at risk for clinically significant externalizing problems (CBCL T-score\u226565). Results Screen-time was available for over 95% of children (2,322/2,427) with CBCL data. Mean screen-time was 1\u00b74 hours/day (95%CI 1\u00b74, 1\u00b75) at five-years and 1\u00b75 hours/day (95%CI: 1\u00b75, 1\u00b76) at three-years. Compared to children with less than 30-minutes/day screen-time, those watching more than two-hours/day (13\u00b77%) had a 2\u00b72-point increase in externalizing T-score (95%CI: 0\u00b79, 3\u00b75, p\u22640\u00b7001); a five-fold increased odd for reporting clinically significant externalizing problems (95%CI: 1\u00b70, 25\u00b70, p = 0\u00b705); and were 5\u00b79 times more likely to report clinically significant inattention problems (95%CI: 1\u00b76, 21\u00b75, p = 0\u00b701). Children with a DSM-5 ADHD T-score above the 65 clinical cut-off were considered to have significant ADHD type symptoms ( n = 24). Children with more than 2-"
      },
      {
        "term": "limitations",
        "snippet": "ns between early television viewing and ADHD symptoms[ 18 , 34 , 35 ]. Behavioral problems identified in this study are unlikely to reflect a referral bias as CHILD study families were recruited from the general population. We used an empirically validated outcome to measure behavior and mental health problems in young children. The large sample size allowed us to observe associations between screen-time and clinically significant behavioral morbidity while controlling for multiple confounders. Limitations One of the limitations of this current study is that screen-time, sleep, and physical activity, were parent-reported and not validated against objective measures. We only had repeated screen-time and behavior data available for a sub-sample of our cohort (n = 367) which limited our ability to determine directionality. As such, it is possible parents may respond to children who exhibit externalizing behavior difficulties by offering more screen-time or using increased opportunity for screen-time as a self-soothing strategy. Although we identified prior studies in school-aged children[ 18 , 34 , 36 , 37 ] that have shown a significant association between screen-time and inattention while controlling for earlier attention problems. We were also not able to determine if the media content (e.g. educational, video gaming, social media), or screen type (television, computer, tablet) were important predictors of behavioral morbidity. For example, the UK Millennium Cohort Study[ 20 ] showed that television exposure (but not gaming) above three-hours/day at age five was significantly associated with conduct behavior problems by age seven years. The sample of 2,447 children included in our analysis, overall, represented a higher SES, an older maternal age, were more likely to be of Caucasian compared to the general population[ 38 ]. As a result, our findings may not be general"
      },
      {
        "term": "conclusion",
        "snippet": "0, 25\u00b70, p = 0\u00b705); and were 5\u00b79 times more likely to report clinically significant inattention problems (95%CI: 1\u00b76, 21\u00b75, p = 0\u00b701). Children with a DSM-5 ADHD T-score above the 65 clinical cut-off were considered to have significant ADHD type symptoms ( n = 24). Children with more than 2-hours of screen-time/day had a 7\u00b77-fold increased risk of meeting criteria for ADHD (95%CI: 1\u00b76, 38\u00b71, p = 0\u00b701). There was no significant association between screen-time and aggressive behaviors ( p >0.05). Conclusion Increased screen-time in pre-school is associated with worse inattention problems. Citation: Tamana SK, Ezeugwu V, Chikuma J, Lefebvre DL, Azad MB, Moraes TJ, et al. (2019) Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study. PLoS ONE 14(4): e0213995. https://doi.org/10.1371/journal.pone.0213995 Editor: Luca Cerniglia, International Telematic University Uninettuno, ITALY Received: September 24, 2018; Accepted: March 5, 2019; Published: April 17, 2019 Copyright: \u00a9 2019 Tamana et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: All relevant data are within the manuscript and its Supporting Information files. Funding: This work was supported by: 1. The Allergy Genes and Environment Network of Centres of Excellence (AllerGen NCE). 2. Women\u2019s and Children\u2019s Health Research Institute. 3. The Canadian Institutes of Health Research (CIHR). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Introduction Childhood screen-time has increased over the years[ 1 "
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        "term": "children",
        "snippet": "atrics, University of Alberta, Edmonton, Alberta, Canada \u2a2f Joyce Chikuma, Roles Investigation, Project administration Affiliation Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada \u2a2f Diana L. Lefebvre, Roles Investigation, Project administration, Writing \u2013 review & editing Affiliation Department of Medicine, McMaster University, Hamilton, Ontario, Canada \u2a2f Meghan B. Azad, Roles Investigation, Writing \u2013 review & editing Affiliation Department of Pediatrics & Child Health, Children\u2019s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada \u2a2f Theo J. Moraes, Roles Investigation, Writing \u2013 review & editing Affiliation Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada \u2a2f Padmaja Subbarao, Roles Conceptualization, Funding acquisition, Investigation, Resources, Writing \u2013 review & editing Affiliation Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada \u2a2f Allan B. Becker, Roles Conceptualization, Funding acquisition, Investigation, Resources, Writing \u2013 review & editing Affiliation Department of Pediatrics & Child Health, Children\u2019s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada \u2a2f Stuart E. Turvey, Roles Conceptualization, Funding acquisition, Investigation, Methodology, Resources, Writing \u2013 review & editing Affiliation Department of Pediatrics, Child & Family Research Institute, BC Children\u2019s Hospital, University of British Columbia, Vancouver, British Columbia, Canada \u2a2f Malcolm R. Sears, Roles Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Visualization, Writing \u2013 review & editing Affiliation Department of Medicine, McMaster University, Hamilton, Ontario, Canada \u2a2f Bruce D. Dick, Roles Supervision, "
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    "title": "Screen time exposure and executive functions in preschool children | Scientific Reports",
    "snippets": [
      {
        "term": "screen time",
        "snippet": "Screen time exposure and executive functions in preschool children | Scientific Reports window.dataLayer = [{\"content\":{\"category\":{\"contentType\":\"article\",\"legacy\":{\"webtrendsPrimaryArticleType\":\"research\",\"webtrendsSubjectTerms\":\"paediatric-research;preventive-medicine\",\"webtrendsContentCategory\":null,\"webtrendsContentCollection\":null,\"webtrendsContentGroup\":\"Scientific Reports\",\"webtrendsContentGroupType\":null,\"webtrendsContentSubGroup\":\"Article\",\"status\":null}},\"article\":{\"doi\":\"10.1038/s41598-024-79290-6\"},\"attributes\":{\"cms\":null,\"deliveryPlatform\":\"oscar\",\"copyright\":{\"open\":true,\"legacy\":{\"webtrendsLicenceType\":\"http://creativecommons.org/licenses/by-nc-nd/4.0/\"}},\"articleInPress\":\"false\"},\"contentInfo\":{\"authors\":[\"Nemanja Lakicevic\",\"Marko Manojlovic\",\"Elena Chichinina\",\"Patrik Drid\",\"Yury Zinchenko\"],\"publishedAt\":1736726400,\"publishedAtString\":\"2025-01-13\",\"title\":\"Screen time exposure and executive functions in preschool children\",\"legacy\":null,\"publishedAtTime\":null,\"documentType\":\"aplusplus\",\"subjects\":\"Paediatric research,Preventive medicine\"},\"journal\":{\"pcode\":\"srep\",\"title\":\"scientific reports\",\"volume\":\"15\",\"issue\":\"1\",\"id\":41598,\"publishingModel\":\"Open Access\"},\"authorization\":{\"status\":true},\"features\":[{\"name\":\"furtherReadingSection\",\"present\":false}],\"collection\":null},\"page\":{\"category\":{\"pageType\":\"article\"},\"attributes\":{\"template\":\"mosaic\",\"featureFl"
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        "term": "language",
        "snippet": "ontent that requires no interaction or no input from the user and active ST involves interactive engagement with a media (e.g., videogaming, exergaming, messaging, using learning and creative applications) 2 . Children might be particularly vulnerable to ST exposure because their regulatory mechanisms are underdeveloped, which consequently leads to increased ST on a daily basis 3 . However, greater ST comes at a cost in children, particularly relative to poor academic performance 4 , inadequate language performance 5 and behavior problems 6 . A global analysis of ST in ~ 90,000 children revealed that only a quarter of children younger than 2 years met the guidelines to avoid ST, and only one third of children aged 2 to 5 years met the guidelines of no more than 1 h daily of ST 7 . In a rather older sample of schoolchildren aged 6 to 14, the average ST was 2.77 h per day, with nearly half of them spending \u2265 2 h per day 8 . A growth trend could be detected by analyzing studies in the same countries and regions pre vs. post the COVID-19 outbreak with average rates of school-aged children who spent \u2265 2 h per day on screens were 41.3% and 59.4% respectively before and after January 2020 8 . The most recent data (May 2024) from the American Academy of Child and Adolescent Psychiatry found that US children ages 8\u201312 have ST of 4\u20136 h per day, and teens spend up to 9 h daily 9 . Considering that children\u2019s goal-oriented behavior is driven by executive functions (EFs) 10 , the importance of EFs has been addressed by a handful of previous investigations suggesting that ST might harm EFs in toddlerhood 11 and preschool children 12 and cause decreased attention in children 13 , 14 , but overall, it appears that the available data in this field (specifically in preschool children) are rather scarce and necessitate further investigation. Executive functions are defined as goal-orien"
      },
      {
        "term": "literacy",
        "snippet": "gence in preschool children: A systematic review and meta-analysis. Psychol. Bull. 148 , 337\u2013369 (2022). Article Google Scholar McHarg, G., Ribner, A. D., Devine, R. T. & Hughes, C. Screen time and executive function in toddlerhood: A longitudinal study. Front. Psychol. 11 , 570392 (2020). Article PubMed PubMed Central Google Scholar Horowitz-Kraus, T. et al. Executive functions abilities in preschool-age children are negatively related to parental EF, screen-time and positively related to home literacy environment: An EEG study. Child Neuropsychol. A J. Norm. Abnorm. Dev. Child. Adolesc. https://doi.org/10.1080/09297049.2023.2272339 (2023). Santos, R. M. S., Mendes, C. G., Marques Miranda, D. & Romano-Silva, M. A. The association between screen time and attention in children: A systematic review. Dev. Neuropsychol. 47 , 175\u2013192 (2022). Article PubMed Google Scholar Jourdren, M., Bucaille, A. & Ropars, J. The impact of screen exposure on attention abilities in young children: A systematic review. Pediatr. Neurol. 142 , 76\u201388 (2023). Article PubMed MATH Google Scholar Paschen, L., Lehmann, T., Kehne, M. & Baumeister, J. Effects of acute physical exercise with low and high cognitive demands on executive functions in children: A systematic review. Pediatr. Exerc. Sci. 31 , 267\u2013281 (2019). Article PubMed Google Scholar Miyake, A. & Friedman, N. P. The nature and organization of individual differences in executive functions: Four general conclusions. Curr. Dir. Psychol. Sci. 21 , 8\u201314 (2012). Article PubMed PubMed Central MATH Google Scholar Diamond, A. The evidence base for improving school outcomes by addressing the whole child and by addressing skills and attitudes, not just content. Early Educ. Dev. 21 , 780\u2013793 (2010). Article PubMed PubMed Central MATH Google Scholar Diamond, A. Executive functions. Annu. Rev. Psychol. 64 , 135\u2013168 (2013). Article PubMed MATH Google "
      },
      {
        "term": "attention",
        "snippet": "ely before and after January 2020 8 . The most recent data (May 2024) from the American Academy of Child and Adolescent Psychiatry found that US children ages 8\u201312 have ST of 4\u20136 h per day, and teens spend up to 9 h daily 9 . Considering that children\u2019s goal-oriented behavior is driven by executive functions (EFs) 10 , the importance of EFs has been addressed by a handful of previous investigations suggesting that ST might harm EFs in toddlerhood 11 and preschool children 12 and cause decreased attention in children 13 , 14 , but overall, it appears that the available data in this field (specifically in preschool children) are rather scarce and necessitate further investigation. Executive functions are defined as goal-oriented behavior that consists of competencies such as goal setting, time management, project monitoring, and organizing and prioritizing materials, all of which are key for successful learning and are thus prerequisites for academic success 15 , 16 . Three components of EFs are working memory (WM) (also called updating), cognitive flexibility (CF) (also called shifting or switching) and inhibition (also called inhibitory control) 17 . Working memory relates to short-term maintenance and usage of task-pertinent information, whereas inhibition is characterized by intentional suppression of distracting stimuli to manage attention, behavior, thoughts, and emotions 18 . Cognitive flexibility pertains to adjusting the focus of attention in a rapid manner to switch perspectives and promptly adapt to new task-determined needs such as demands, rules, or priorities 18 . Given that EFs significantly predict academic achievement in children 19 , 20 , it is highly important to cultivate the development of EFs at an early age. Two approaches that have been shown to successfully increase EFs in preschool children are physical activity (PA) 21 , 22 and cognitive train"
      },
      {
        "term": "inattention",
        "snippet": "r P, Boer C & Schwarte LA. Correlation Coefficients: Appropriate Use and Interpretation. Anesth Analg. 126 (5), 1763-1768. https://doi.org/10.1213/ANE.0000000000002864 (2018). Bustamante, J. C., Fern\u00e1ndez-Castilla, B. & Alcaraz-Iborra, M. Relation between executive functions and screen time exposure in under 6 year-olds: A meta-analysis. Comput. Human Behav. 145 , 107739 (2023). Article MATH Google Scholar Corkin, M. T. et al. Preschool screen media exposure, executive functions and symptoms of inattention/hyperactivity. J. Appl. Dev. Psychol. 73 , 101237 (2021). Article MATH Google Scholar Beaugrand, M., Muehlematter, C., Markovic, A., Camos, V. & Kurth, S. Sleep as a protective factor of children\u2019s executive functions: A study during COVID-19 confinement. PLoS One 18 , e0279034 (2023). Article PubMed PubMed Central Google Scholar Philbrook, L. E., Becker, L. E. & Linde, J. Sleep disturbances moderate the association between effortful control and executive functioning in early childhood. J. Exp. Child Psychol. 220 , 105421 (2022). Article PubMed MATH Google Scholar Mer\u00edn, L., Nieto, M., S\u00e1nchez-Arias, L., Ros, L. & Latorre, J. M. Actigraphy-assessed sleep duration and quality and executive function in a sample of typically developing preschoolers. Eur. Child Adolesc. Psychiatry https://doi.org/10.1007/s00787-024-02558-9 (2024). Article PubMed PubMed Central Google Scholar Wang, J. et al. Comparative efficacy of physical activity types on executive functions in children and adolescents: A network meta-analysis of randomized controlled trials. J. Sci. Med. Sport 27 , 187\u2013196 (2024). Article CAS PubMed MATH Google Scholar Egbert, A. H., Creber, C., Loren, D. M. & Bohnert, A. M. Executive function and dietary intake in youth: A systematic review of the literature. Appetite 139 , 197\u2013212 (2019). Article PubMed Google Scholar Ko\u015fkulu-Sancar, S., van de Weijer-Bergsma, E., "
      },
      {
        "term": "sleep",
        "snippet": "etermine the overall effect of ST on EF in children 34 . Also, longitudinal studies showed that the effects of ST do not have to be immediate and can affect children\u2019s EFs several years after initial exposure 35 . Thus, it is important to go beyond total ST duration and content, consider type (active or passive), and context to get a better picture of the overall effect of ST on EFs and broader cognitive function 11 . Time spent away from device should be considered given that variables such as sleep 36 , 36 , 38 , daily physical activity 39 , diet 40 and general upbringing 41 can impact cognitive performance in children. With respect to differences in EFs between sexes, functional neuroimaging studies have revealed sex differences in the neural networks underlying certain EFs tasks, suggesting that male and female adults engage in different strategies depending on task demands 42 . However, due to the rather significant methodological heterogeneity of neuroimaging studies and the engagement of multiple neural networks, a simple overarching statement with respect to sex differences in EFs has been precluded to date. However, objective assessment of EFs was related to greater self-rated health in males than in females, while better subjective perception of EFs was significantly associated with greater self-rated health scores in both male and female adults 43 . In adolescents (i.e., 13\u201316 years), subjective reporting has shown that females evaluate their attention more than males do, and they report higher levels of self-control and self-monitoring 44 . In children, emerging evidence indicates that, when preschool children were given an EF task and patterns of activation in the lateral prefrontal regions were measured by functional near-infrared spectroscopy, there were no behavioral differences between children of either sex, although girls showed stronger prefrontal "
      },
      {
        "term": "emotion",
        "snippet": " are key for successful learning and are thus prerequisites for academic success 15 , 16 . Three components of EFs are working memory (WM) (also called updating), cognitive flexibility (CF) (also called shifting or switching) and inhibition (also called inhibitory control) 17 . Working memory relates to short-term maintenance and usage of task-pertinent information, whereas inhibition is characterized by intentional suppression of distracting stimuli to manage attention, behavior, thoughts, and emotions 18 . Cognitive flexibility pertains to adjusting the focus of attention in a rapid manner to switch perspectives and promptly adapt to new task-determined needs such as demands, rules, or priorities 18 . Given that EFs significantly predict academic achievement in children 19 , 20 , it is highly important to cultivate the development of EFs at an early age. Two approaches that have been shown to successfully increase EFs in preschool children are physical activity (PA) 21 , 22 and cognitive training (CT) 23 . For this reason, some scholars have suggested that when used jointly, PA and CT can produce greater effects in enhancing EFs than when any of these approaches are applied alone 22 . Indeed, many studies have adopted this approach and detected a significant effect of cognitively enhanced PA on cognitive function in various populations 24 , 25 , 26 . Unfortunately, preschool children spend the majority of their waking hours in sedentary behavior (approximately 73%) 27 , while almost half of their time in childcare is spent sitting (48.4%) 28 . Although there are exceptions, ST in preschool children can generally be described as a sedentary behavior, and recent studies indicate that there is a dose\u2012response relationship relative to child development. Namely, compared to preschool children who had \u2264 1 h per day, children who had ST for several hours per day had an inc"
      },
      {
        "term": "development",
        "snippet": "ong preschool children is becoming a matter of concern globally. Although gadgets such as phones, tablets and computers might be of educational use in this population, excessive ST might impair cognitive function among preschoolers. As data on this topic in preschool children are scarce, this study sought to investigate the relationship between ST and executive functions (EFs) in this population. A total of 1016 preschool children aged 5\u20136 years (M = 70.8 months, SD = 4.5) were tested using the Developmental Neuropsychological Assessment (NEPSY-II) and the Dimensional Change Card Sort tests for cognitive flexibility (CF), visual working memory (WM), verbal WM, inhibition and motor persistence with parental consent, while ST was reported via a questionnaire completed by their mothers. Participants spent approximately 2 h in both active and passive ST per day, with boys spending much more time in active ST than girls. There was a very weak negative correlation between CF and both active and passive ST, and a weak negative correlation between verbal WM and both active and passive ST. Additionally, there was a very weak negative correlation between inhibition and passive ST on weekday. To ensure proper development of EFs in preschool children, ST should be limited to \u2264 1 h per day of high-quality educational/interactive content as previously determined by eminent pediatric institutions worldwide. Proven remedies that enhance EFs in children, such as physical activity and cognitive training, should be practiced regularly.\",\"datePublished\":\"2025-01-13T00:00:00Z\",\"dateModified\":\"2025-02-27T00:00:00Z\",\"pageStart\":\"1\",\"pageEnd\":\"9\",\"license\":\"http://creativecommons.org/licenses/by-nc-nd/4.0/\",\"sameAs\":\"https://doi.org/10.1038/s41598-024-79290-6\",\"keywords\":[\"Paediatric research\",\"Preventive medicine\",\"Working memory\",\"Cognitive flexibility\",\"Inhibition\",\"Kindergarten\",\"Phones\""
      },
      {
        "term": "executive function",
        "snippet": "Screen time exposure and executive functions in preschool children | Scientific Reports window.dataLayer = [{\"content\":{\"category\":{\"contentType\":\"article\",\"legacy\":{\"webtrendsPrimaryArticleType\":\"research\",\"webtrendsSubjectTerms\":\"paediatric-research;preventive-medicine\",\"webtrendsContentCategory\":null,\"webtrendsContentCollection\":null,\"webtrendsContentGroup\":\"Scientific Reports\",\"webtrendsContentGroupType\":null,\"webtrendsContentSubGroup\":\"Article\",\"status\":null}},\"article\":{\"doi\":\"10.1038/s41598-024-79290-6\"},\"attributes\":{\"cms\":null,\"deliveryPlatform\":\"oscar\",\"copyright\":{\"open\":true,\"legacy\":{\"webtrendsLicenceType\":\"http://creativecommons.org/licenses/by-nc-nd/4.0/\"}},\"articleInPress\":\"false\"},\"contentInfo\":{\"authors\":[\"Nemanja Lakicevic\",\"Marko Manojlovic\",\"Elena Chichinina\",\"Patrik Drid\",\"Yury Zinchenko\"],\"publishedAt\":1736726400,\"publishedAtString\":\"2025-01-13\",\"title\":\"Screen time exposure and executive functions in preschool children\",\"legacy\":null,\"publishedAtTime\":null,\"documentType\":\"aplusplus\",\"subjects\":\"Paediatric research,Preventive medicine\"},\"journal\":{\"pcode\":\"srep\",\"title\":\"scientific reports\",\"volume\":\"15\",\"issue\":\"1\",\"id\":41598,\"publishingModel\":\"Open Access\"},\"authorization\":{\"status\":true},\"features\":[{\"name\":\"furtherReadingSection\",\"present\":false}],\"collection\":null},\"page\":{\"category\":{\"pageType\":\"article\"},\"attributes\":{\"template\":\"mosaic\",\"featureFlags\":[{\"name\":\"download-c"
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      {
        "term": "self-regulation",
        "snippet": "s in executive control: A systematic review of functional neuroimaging studies. Eur. J. Neurosci. 53 , 2592\u20132611 (2021). Article CAS PubMed MATH Google Scholar Jung, M. S., Lee, K. S., Kim, M. & Yun, H. Gender-specific relationship between executive function and self-rated health. Osong Public Health Res. Perspect. 10 , 93\u2013101 (2019). Article PubMed PubMed Central MATH Google Scholar van Tetering, M. A. J., van der Laan, A. M., de Kogel, C. H., de Groot, R. H. M. & Jolles, J. Sex differences in self-regulation in early, middle and late adolescence: A large-scale cross-sectional study. PLoS One 15 , e0227607 (2020). Article CAS PubMed PubMed Central Google Scholar Shinohara, I. & Moriguchi, Y. Are there sex differences in the development of prefrontal function during early childhood?. Dev. Psychobiol. 63 , 641\u2013649 (2021). Article PubMed MATH Google Scholar Silverman, I. W. Gender differences in inhibitory control as assessed on simple delay tasks in early childhood: A meta-analysis. Int. J. Behav. Dev. 45 , 533\u2013544 (2021). Article Google Scholar Ribeiro, F., Cavaglia, R. & Rato, J. R. Sex differences in response inhibition in young children. Cogn. Dev. 58 , 101047 (2021). Article Google Scholar Kerai, S., Almas, A., Guhn, M., Forer, B. & Oberle, E. Screen time and developmental health: Results from an early childhood study in Canada. BMC Public Health 22 , 310 (2022). Article PubMed PubMed Central Google Scholar Xie, G., Deng, Q., Cao, J. & Chang, Q. Digital screen time and its effect on preschoolers\u2019 behavior in China: Results from a cross-sectional study. Ital. J. Pediatr. 46 , 9 (2020). Article PubMed PubMed Central MATH Google Scholar Tamana, S. K. et al. Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study. PLoS One 14 , e0213995 (2019). Article CAS PubMed PubMed Central Google Scholar van den Heuvel, M. et"
      },
      {
        "term": "limitations",
        "snippet": "ildren for the development of EFs and their overall health cannot be overestimated. Studies have indicated that the more time preschool children spend performing moderate-to-vigorous intensity PA and the greater their cardiorespiratory fitness is, the better their EFs outcomes are 66 , even if increased PA levels are practiced for only 24 h 67 , 68 . Notably, interventions that aim to increase PA levels are simultaneously effective at reducing ST in preschool children 69 . The present study has limitations. First, our study is cross-sectional in nature; therefore, we could only detect a relationship between the main variables observed, namely, ST and EFs. Thus, due to the absence of a randomized controlled trial design, we could not determine causality between these two variables and tried to eliminate as many confounding factors as possible. Next, unlike EFs, which were assessed objectively in a natural setting to include kindergarteners, weekly ST was reported via questionnaires by mothers. As this input requires recall and is highly subjective and prone to social desirability, the obtained data on ST are subject to question. One of the strengths of the current study was that we succeeded in recruiting a fairly large sample of preschool children from different ethnic, economic and social backgrounds. Furthermore, we had almost the same number of boys and girls in this study, thereby equally representing both sexes in our study. Finally, we used tools to assess EFs that are globally recognized as valid and reliable in the measurement of WM, CF and inhibition. Future studies on ST should elaborate on how children spend time away from screens and use wearable devices 70 to investigate factors such as sleep (using sleep trackers), daily physical activity (using accelerometers) and diet (using dietary diaries that would be filled out by parents) all of which are known to"
      },
      {
        "term": "conclusion",
        "snippet": "s 70 to investigate factors such as sleep (using sleep trackers), daily physical activity (using accelerometers) and diet (using dietary diaries that would be filled out by parents) all of which are known to influence EFs in children and adults. In addition, if possible, researchers should also elaborate on type and content of ST consumed by children. By taking into account multiple variables affecting EFs in children, we could distill more concisely on the exact effect of ST on EF in children. Conclusion Our findings indicate that Russian preschool children spend about 2 h in front of various types of screens per day. However, acquired data is based on the parental reporting and is therefore subject to criticism due to high likelihood of bias. Consistent with the message of renowned pediatrics institutions worldwide, we support current guidelines stating that screen time in preschool children should be restricted to \u2264 1 h per day of high-quality educational/interactive content. Preschool children should engage in daily physical activity and cognitive training to ensure proper development of executive functions and increase the likelihood of later academic success. Data availability The authors confirm that the data supporting the findings of this study are available within the study and its supplementary materials. Change history 27 February 2025 A Correction to this paper has been published: https://doi.org/10.1038/s41598-025-91348-7 References Kalabina, I. A. & Progackaya, T. K. Defining digital competence for older preschool children. Psychol. Russ. 14 , 169 (2021). Article PubMed PubMed Central Google Scholar Sweetser, P., Johnson, D., Ozdowska, A. & Wyeth, P. Active versus passive screen time for young children. Australas. J. Early Child. 37 , 94\u201398 (2012). Article Google Scholar Brauchli, V. et al. Screen time vs. scream time: Developmental interrelations betwe"
      },
      {
        "term": "results",
        "snippet": "eviously shown. For each trial, points are scored separately for four parameters: (1) the content score assesses the child\u2019s ability to recall which designs were shown for each trial; (2) the spatial score assesses the child\u2019s ability to recall where a design was shown for the trial; (3) the bonus score reflects the child\u2019s ability to recall which designs were in which locations for that trial; and (4) the total score for each trial is the sum of the content, spatial and bonus scores. The final results of this subtest are the sum of each kind of score (the maximum for all trials is 120). Verbal WM was tested through the NEPSY-II subtest \u201cSentence Repetition\u201d for individuals aged 3\u20136 years 32 . The stimuli included 17 sentences of increasing complexity and length. The children read one sentence and were asked to recall it immediately after it was presented. There are the following types of errors: omitting a word, changing a word, adding a word, and changing a word order. Children received 0 points for 3 or more errors in one sentence, 1 point for 1 or 2 errors, and 2 points for correct repetition of the sentence (maximum 34 points). The procedure was stopped when the child received 0 points three times consecutively. Inhibition was assessed via the NEPSY-II subtest \u201cInhibition\u201d for ages 5\u20136 years 32 . The subtest consists of two blocks: a series of white and black figures (circles and squares) and a series of arrows with different directions (upward and downward). Two tasks were carried out with each series of pictures: the task of naming figures (in this case, a child has to name the figures that he or she saw as quickly as possible) and the task of inhibition (in this case, a child is supposed to say the opposite of what he or she saw; for example, if the child saw a square, he or she has to say \u201ccircle\u201d, etc.). Three indicators in each task are recorded: (1) the nu"
      },
      {
        "term": "children",
        "snippet": "Screen time exposure and executive functions in preschool children | Scientific Reports window.dataLayer = [{\"content\":{\"category\":{\"contentType\":\"article\",\"legacy\":{\"webtrendsPrimaryArticleType\":\"research\",\"webtrendsSubjectTerms\":\"paediatric-research;preventive-medicine\",\"webtrendsContentCategory\":null,\"webtrendsContentCollection\":null,\"webtrendsContentGroup\":\"Scientific Reports\",\"webtrendsContentGroupType\":null,\"webtrendsContentSubGroup\":\"Article\",\"status\":null}},\"article\":{\"doi\":\"10.1038/s41598-024-79290-6\"},\"attributes\":{\"cms\":null,\"deliveryPlatform\":\"oscar\",\"copyright\":{\"open\":true,\"legacy\":{\"webtrendsLicenceType\":\"http://creativecommons.org/licenses/by-nc-nd/4.0/\"}},\"articleInPress\":\"false\"},\"contentInfo\":{\"authors\":[\"Nemanja Lakicevic\",\"Marko Manojlovic\",\"Elena Chichinina\",\"Patrik Drid\",\"Yury Zinchenko\"],\"publishedAt\":1736726400,\"publishedAtString\":\"2025-01-13\",\"title\":\"Screen time exposure and executive functions in preschool children\",\"legacy\":null,\"publishedAtTime\":null,\"documentType\":\"aplusplus\",\"subjects\":\"Paediatric research,Preventive medicine\"},\"journal\":{\"pcode\":\"srep\",\"title\":\"scientific reports\",\"volume\":\"15\",\"issue\":\"1\",\"id\":41598,\"publishingModel\":\"Open Access\"},\"authorization\":{\"status\":true},\"features\":[{\"name\":\"furtherReadingSection\",\"present\":false}],\"collection\":null},\"page\":{\"category\":{\"pageType\":\"article\"},\"attributes\":{\"template\":\"mosaic\",\"featureFlags\":[{\"name\":\"download-collection-test\",\"active\":false},{"
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        "term": "preschool",
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  "https://cps.ca/en/documents/position/screen-time-and-preschool-children": {
    "status": 200,
    "final": "https://cps.ca/en/documents/position/screen-time-and-preschool-children",
    "title": "Screen time and preschool children: Promoting health and development in a digital world | Canadian Paediatric Society",
    "snippets": [
      {
        "term": "screen time",
        "snippet": "Screen time and preschool children: Promoting health and development in a digital world | Canadian Paediatric Society #page-wrapper,.no-js body{background-color:#f7f7f7}body,h1,p,span{font-display:swap;line-height:1.5}.button,body,h1,p,span{line-height:1.5}*{-webkit-font-smoothing:subpixel-antialiased;box-sizing:border-box}html{overflow:scroll!important;scroll-behavior:smooth!important}body{background-color:#003478;counter-reset:count count2}#page-wrapper{background-attachment:fixed;background-image:url(\"data:image/svg+xml;charset=utf-8,%3Csvg xmlns='http://www.w3.org/2000/svg' viewBox='0 0 1600 900'%3E%3Cpath fill='%23fcfcfc' d='M0 504v395h1600V120z'/%3E%3Cpath fill='%23f7f7f7' d='M1600 567v332H0V165z'/%3E%3Cpath fill='%23f5f5f5' d='M0 680v219h1600V300z'/%3E%3Cpath fill='%23f2f2f2' d='M1600 719v180H0V353z'/%3E%3Cpath fill='%23f5f5f5' d='M0 788v111h1600V625z'/%3E%3C/svg%3E\");background-position:50%;background-size:cover;overflow:visible}.main-body{padding-bottom:20px}body,p,span{color:#000;font-family:Muli,sans-serif;font-size:1.125rem;font-weight:300}.header .tagline__h1,h1{color:#003478;font-family:Merriweather,serif}h1{font-weight:400}a{border-bottom:2px solid #007d58;font-weight:500;word-wrap:break-word}a,a:visited{color:#007d58}a:not(.btn){border-bottom:1px solid #007d58}a:not(.mm-btn-next){border-bottom:none}ul{margin-left:2.25rem}@media screen and (min-width:75em){body,p"
      },
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        "term": "white matter",
        "snippet": "ehav 2019;94:92\u201399. Pew Research Center. Parenting Children in the Age of Screens: 1. Children\u2019s engagement with digital devices, screen time . July 28, 2020 (Accessed March 8, 2022). Zivan M, Bar S, Jing X, Hutton J, Farah R, Horowitz-Kraus T. Screen-exposure and altered brain activation related to attention in preschool children: An EEG study. Trends Neurosci Educ 2019;17:100117. Hutton JS, Dudley J, Horowitz-Kraus T, DeWitt T, Holland SK. Associations between screen-based media use and brain white matter integrity in preschool-aged children. JAMA Pediatr 2020;174(1):e193869. Rodriguez-Ayllon M, Derks IPM, van den Dries MA, et al. Associations of physical activity and screen time with white matter microstructure in children from the general population. Neuroimage 2020;205:116258. Courage ML, Frizzell LM, Walsh CS, Smith M. Toddlers using tablets: They engage, play, and learn. Front Psychol 2021;12:564479. Gerwin RL, Kaliebe K, Daigle M. The interplay between digital media use and development. Child Adolesc Psychiatric Clin N Am 2018;27(2):345-55. Wartella EA, Richert RA, Robb MB. Babies, television and videos: How did we get here? Developmental Rev 2010;30(2):116\u201327. Wartella EA, Lauricella AR. Should babies be watching television and DVDs? Pediatr Clin North Am 2012;59(3):613\u201321,vii. Lin LY, Cherng RJ, Chen YJ, Chen YJ, Yang HM. Effects of television exposure on developmental skills among young children. Infant Behav Dev 2015;38:20\u201326. Radesky JS, Schumacher J, Zuckerman B. Mobile and interactive media use by young children: The good, the bad, and the unknown. Pediatrics 2015;135(1):1\u20133. Dynia JM, Dore RA, Bates RA, Justice LM. Media exposure and language for toddlers from low-income homes. Infant Behav Dev 2021;63:101542. Courage ML, Howe ML. To watch or not to watch: Infants and toddlers in a brave new electronic world. Dev Rev 2010;30(2):101\u201315. Klein-Radukic S,"
      },
      {
        "term": "language",
        "snippet": " in an environment of relationships [ 5 ] , and increasingly these relationships include screens. A child\u2019s earliest screen encounters are formative because patterns of exposure and use [ 6 ] - [ 8 ] \u00a0are habit-forming and known to track into later life [ 8 ] - [ 12 ] . Because screens are largely controlled by parents, children\u2019s exposure is more easily modifiable at this age than later on [ 8 ] [ 13 ] . Limits are essential because babies and toddlers attend to screens in ways that can impact language acquisition, cognitive development, and socio-emotional health [ 6 ] - [ 10 ] . Among the trends in early childhood viewing patterns: Increasing use of screens in young children is\u00a0linked to changing levels of physical activity, sedentary behaviour, and sleep\u00a0 [ 14 ] . Nearly all children in Canada are exposed to screens by the age of 2 [ 15 ] \u00a0and only 15% of Canadian children aged 3 to 4 years meet screen time guidelines of <1 h/day [ 16 ] . Even before COVID, the average parent-reported screen time for this age group was 1.9 h/day [ 17 ] [ 18 ] . TVs, tablets, and video portals like YouTube dominate total screen time for this age group [ 19 ] - [ 23 ] . A 2018 Alberta study showed children at 2, 3, and 5 years old watching about 17, 25, and 11 h of TV per week respectively (or about 2.4, 3.6, and 1.6 h per day) [ 24 ] . Many preschoolers use screens at home and in child care [ 9 ] [ 25 ] . In the United States, most 2-year-olds use a digital device daily, and 9 of every 10 children are introduced to a device before their first birthday [ 26 ] . One recent study reported a 60% rate of touchscreen device use in children younger than 3 [ 27 ] [ 28 ] . A 2020 U.S. survey found that nearly 4 in 10 parents (39%) say the television is either \u201calways\u201d on (10%), or on \u201cmost of the time\u201d (29%). In those households, young children also consistently watch far more TV than other"
      },
      {
        "term": "literacy",
        "snippet": "throughout the COVID-19 pandemic, renewing concerns about how screen time impacts children and family relationships. This updated statement re-examines the potential benefits and risks of screen exposure and use on children younger than 5 years old. Screen time is the time spent with any screen, including television, computers, and gaming or mobile devices (smartphones, tablets). Digital media includes all content transmitted over the Internet or computer networks, on all devices. Digital media literacy is the ability to critically, effectively, and responsibly access, use, understand, and engage with media of all\u00a0kinds [ 1 ] . Health care professionals (HCPs) and others working with families and young children are increasingly asked for evidence-based guidance on digital media in four main areas: duration of use (how much is too much?) [ 2 ] , limit-setting, effects on health and well-being, and quality content. A literature search [ 3 ] \u00a0into the effects of screen media on children younger than 5 years was undertaken in 2021, with focus on studies and guidelines published since 2017. Recommendations are based on evidence and expert consensus. For information on screen time in older children and adolescents, see the CPS statement published in 2019 [ 4 ] . THE IMPORTANCE OF EARLY CHILDHOOD EXPERIENCES Young children develop in an environment of relationships [ 5 ] , and increasingly these relationships include screens. A child\u2019s earliest screen encounters are formative because patterns of exposure and use [ 6 ] - [ 8 ] \u00a0are habit-forming and known to track into later life [ 8 ] - [ 12 ] . Because screens are largely controlled by parents, children\u2019s exposure is more easily modifiable at this age than later on [ 8 ] [ 13 ] . Limits are essential because babies and toddlers attend to screens in ways that can impact language acquisition, cognitive development, and socio-"
      },
      {
        "term": "attention",
        "snippet": "en their age [ 23 ] , with developmental risks described below.\u00a0 IMPACTS OF SCREEN MEDIA ON DEVELOPMENT Evidence for neuroanatomical and physiological changes to the developing brain related to early, intensive exposure to screen media remains mixed [ 29 ] - [ 31 ] , but research on how (and how much) children younger than 5 years of age actually learn from screens has advanced in recent years [ 32 ] - [ 38 ] . Although babies cannot absorb screen content, digital media can catch and hold their attention. Children under 2 years old can remember brief sequences and imitate screen behaviours and emotions [ 23 ] [ 33 ] . While toddlers are beginning to understand TV content by the end of their second year [ 9 ] [ 39 ] , they still have difficulty transferring what they see from screens to real life, and do not learn efficiently from screen media [ 23 ] [ 40 ] - [ 42 ] . By contrast, they learn intensely through face-to-face interaction with parents and caregivers: Early learning is easiest, most enriching, and most efficient developmentally when experienced live, interactively, in real time and space, and with real people [ 43 ] - [ 47 ] . Potential benefits for development The pandemic highlighted two beneficial screen activities for babies, toddlers, and families: interactive video-chats and virtual story times. Parents and children can share experiences involving digital devices by singing along with songs on YouTube, playing games, or exploring apps together [ 48 ] . A recent study showed that when measured on vocabulary and story comprehension, preschool children understood and learned equally well from dialogic reading over video chat compared with traditional book sharing [ 49 ] . For children 2 to 4 years old, quality screen media\u2014well-designed, age-appropriate content with specific educational goals\u2014can provide an additional route to early language and literacy "
      },
      {
        "term": "sleep",
        "snippet": " 12 ] . Because screens are largely controlled by parents, children\u2019s exposure is more easily modifiable at this age than later on [ 8 ] [ 13 ] . Limits are essential because babies and toddlers attend to screens in ways that can impact language acquisition, cognitive development, and socio-emotional health [ 6 ] - [ 10 ] . Among the trends in early childhood viewing patterns: Increasing use of screens in young children is\u00a0linked to changing levels of physical activity, sedentary behaviour, and sleep\u00a0 [ 14 ] . Nearly all children in Canada are exposed to screens by the age of 2 [ 15 ] \u00a0and only 15% of Canadian children aged 3 to 4 years meet screen time guidelines of <1 h/day [ 16 ] . Even before COVID, the average parent-reported screen time for this age group was 1.9 h/day [ 17 ] [ 18 ] . TVs, tablets, and video portals like YouTube dominate total screen time for this age group [ 19 ] - [ 23 ] . A 2018 Alberta study showed children at 2, 3, and 5 years old watching about 17, 25, and 11 h of TV per week respectively (or about 2.4, 3.6, and 1.6 h per day) [ 24 ] . Many preschoolers use screens at home and in child care [ 9 ] [ 25 ] . In the United States, most 2-year-olds use a digital device daily, and 9 of every 10 children are introduced to a device before their first birthday [ 26 ] . One recent study reported a 60% rate of touchscreen device use in children younger than 3 [ 27 ] [ 28 ] . A 2020 U.S. survey found that nearly 4 in 10 parents (39%) say the television is either \u201calways\u201d on (10%), or on \u201cmost of the time\u201d (29%). In those households, young children also consistently watch far more TV than other children their age [ 23 ] , with developmental risks described below.\u00a0 IMPACTS OF SCREEN MEDIA ON DEVELOPMENT Evidence for neuroanatomical and physiological changes to the developing brain related to early, intensive exposure to screen media remains mixed [ 29 ]"
      },
      {
        "term": "emotion",
        "snippet": "ingly these relationships include screens. A child\u2019s earliest screen encounters are formative because patterns of exposure and use [ 6 ] - [ 8 ] \u00a0are habit-forming and known to track into later life [ 8 ] - [ 12 ] . Because screens are largely controlled by parents, children\u2019s exposure is more easily modifiable at this age than later on [ 8 ] [ 13 ] . Limits are essential because babies and toddlers attend to screens in ways that can impact language acquisition, cognitive development, and socio-emotional health [ 6 ] - [ 10 ] . Among the trends in early childhood viewing patterns: Increasing use of screens in young children is\u00a0linked to changing levels of physical activity, sedentary behaviour, and sleep\u00a0 [ 14 ] . Nearly all children in Canada are exposed to screens by the age of 2 [ 15 ] \u00a0and only 15% of Canadian children aged 3 to 4 years meet screen time guidelines of <1 h/day [ 16 ] . Even before COVID, the average parent-reported screen time for this age group was 1.9 h/day [ 17 ] [ 18 ] . TVs, tablets, and video portals like YouTube dominate total screen time for this age group [ 19 ] - [ 23 ] . A 2018 Alberta study showed children at 2, 3, and 5 years old watching about 17, 25, and 11 h of TV per week respectively (or about 2.4, 3.6, and 1.6 h per day) [ 24 ] . Many preschoolers use screens at home and in child care [ 9 ] [ 25 ] . In the United States, most 2-year-olds use a digital device daily, and 9 of every 10 children are introduced to a device before their first birthday [ 26 ] . One recent study reported a 60% rate of touchscreen device use in children younger than 3 [ 27 ] [ 28 ] . A 2020 U.S. survey found that nearly 4 in 10 parents (39%) say the television is either \u201calways\u201d on (10%), or on \u201cmost of the time\u201d (29%). In those households, young children also consistently watch far more TV than other children their age [ 23 ] , with developmental risks d"
      },
      {
        "term": "anger",
        "snippet": "ements This statement was reviewed by the Community Paediatrics Committee, the Early Years Task Force, and the Mental Health and Developmental Disabilities Committee of the Canadian Paediatric Society. Special thanks are due to Professor Mary L. Courage, of Memorial University of Newfoundland and Labrador. Thanks also to Jennie Strickland for statement drafting, and to Roxana Barbu for reviewing the literature. CANADIAN PAEDIATRIC SOCIETY DIGITAL HEALTH TASK FORCE (2021-2022) Members: Stacey B\u00e9langer MD, Ruth Grimes MD (CPS Board Representative), Janice Cohen MD, Janice Heard MD, Michelle Jackman MD, Matthew Johnson (MediaSmarts), Katherine Matheson MD, Michelle Ponti MD (Chair), Alyson Shaw MD, Richard Stanwick MD, Jennifer Strickland (CPS Senior Editor), Jackie Van Lankveld (Manager, Speech Services, Niagara Children\u2019s Centre), Elizabeth (Lisette) Yorke MD References MediaSmarts. Digital Media Literacy Fundamentals (Accessed November 14, 2022). Statistics Canada. The Social and Economic Impacts of COVID-19: A Six-Month Update , October 2020 (Accessed January 7, 2022). Barbu R. Literature review on screen use in children aged 0-5 years (synthesis). Prepared for the Canadian Paediatric Society\u2019s Digital Health Task Force, June 2021. Ponti M; Canadian Paediatric Society, Digital Health Task Force. Digital media: Promoting healthy screen use in school-aged children and adolescents . Paediatr Child Health 2019;24(6):402\u20138 Williams RC, Biscaro A, Clinton J; Canadian Paediatric Society, Early Years Task Force. Relationships matter: How clinicians can support positive parenting in the early years . Paediatr Child Health 2019;24(5):340\u201347 Kostyrka-Allchorne K, Cooper NR, Simpson A. The relationship between television exposure and children\u2019s cognition and behaviour: A systematic review. Develop Rev 2017;44:19\u201358. Hoyos Cillero I, Jago R. Systematic review of correlates of scr"
      },
      {
        "term": "development",
        "snippet": "Screen time and preschool children: Promoting health and development in a digital world | Canadian Paediatric Society #page-wrapper,.no-js body{background-color:#f7f7f7}body,h1,p,span{font-display:swap;line-height:1.5}.button,body,h1,p,span{line-height:1.5}*{-webkit-font-smoothing:subpixel-antialiased;box-sizing:border-box}html{overflow:scroll!important;scroll-behavior:smooth!important}body{background-color:#003478;counter-reset:count count2}#page-wrapper{background-attachment:fixed;background-image:url(\"data:image/svg+xml;charset=utf-8,%3Csvg xmlns='http://www.w3.org/2000/svg' viewBox='0 0 1600 900'%3E%3Cpath fill='%23fcfcfc' d='M0 504v395h1600V120z'/%3E%3Cpath fill='%23f7f7f7' d='M1600 567v332H0V165z'/%3E%3Cpath fill='%23f5f5f5' d='M0 680v219h1600V300z'/%3E%3Cpath fill='%23f2f2f2' d='M1600 719v180H0V353z'/%3E%3Cpath fill='%23f5f5f5' d='M0 788v111h1600V625z'/%3E%3C/svg%3E\");background-position:50%;background-size:cover;overflow:visible}.main-body{padding-bottom:20px}body,p,span{color:#000;font-family:Muli,sans-serif;font-size:1.125rem;font-weight:300}.header .tagline__h1,h1{color:#003478;font-family:Merriweather,serif}h1{font-weight:400}a{border-bottom:2px solid #007d58;font-weight:500;word-wrap:break-word}a,a:visited{color:#007d58}a:not(.btn){border-bottom:1px solid #007d58}a:not(.mm-btn-next){border-bottom:none}ul{margin-left:2.25rem}@media screen and (min-width:75em){body,p,span{font-size:1.125rem}ul{margin-left:3.25rem}}.grid-x{"
      },
      {
        "term": "executive function",
        "snippet": "62 ] [ 63 ] . One recent Canadian study found a significant negative association between mobile media device use and expressive language use in children 18 months old [ 64 ] . Evidence of an association between screen time and attentional difficulties remains mixed [ 23 ] [ 65 ] , but a recent study of cumulative media use has related exposure to multiple media forms with decreasing focused attention during toddlerhood [ 66 ] . Focused attention is considered foundational for the development of executive function abilities in later childhood [ 66 ] , and toddlerhood may be a critical period for establishing these skills [ 67 ] . High exposure to background TV is known to negatively affect language use and acquisition, cognitive development, and foundational executive function skills (i.e., attention, working memory, impulse-control) in children younger than 5 years. Background TV has also been shown to reduce the amount and quality of parent\u2013child interaction and distract children from play [ 23 ] [ 39 ] [ 61 ] [ 68 ] [ 69 ] . Despite some evidence for increasing children\u2019s reading engagement, parents appear to interact less about story elements with children when reading from e-books. Emerging evidence appears to show that interactive screens diminish rather than enhance opportunities for parent-child interactions [ 62 ] [ 70 ] . Further, e-book sound effects and animation can interfere with story comprehension and event sequencing in preschoolers, when compared with printed book sharing [ 37 ] [ 71 ] - [ 74 ] . Prolonged screen exposure and use is associated with decreasing a child\u2019s opportunities to develop optimally [ 24 ] \u00a0and with lower cognitive abilities, specifically attention, early reading skills, and language development [ 20 ] [ 25 ] [ 36 ] [ 62 ] [ 64 ] - [ 66 ] [ 71 ] [ 75 ] - [ 77 ] . A longitudinal study related higher screen use per week at 24 months"
      },
      {
        "term": "self-regulation",
        "snippet": "Setting meaningful limits when children are young and sharing them as a family is far easier than cutting back screen time later on. Studies have found that parents\u2019 comfort level with saying \u2018no\u2019 to their children\u2019s requests for screen time, along with their own media-related beliefs, intentions, and attitudes, are key components of constructive, positive limit-setting [ 8 ] [ 13 ] [ 87 ] [ 97 ] . For children\u2014and parents\u2014off-screen time is critical for developing essential life skills such as self-regulation [ 98 ] , creativity, and learning through physical and imaginative play. Psychosocial risks There is a strong association between parents\u2019 screen time and that of their children, suggesting that media use displaces or interferes with quality, face-to-face parent\u2013child interactions [ 13 ] [ 25 ] [ 99 ] - [ 101 ] . \u2018Technoference\u2019\u2014the frequent interruption of routines, play, or interactions by digital media use (frequently a parent\u2019s device)\u2014has emerged as a risk factor [ 20 ] . Studies have linked time spent by parents on their mobile devices with the frequency of attention-getting behaviours, \u2018acting out\u2019, and negative interactions with children [ 23 ] [ 102 ] . Frequent use of a phone to reward or distract 1- to 4-year-olds can lead to children asking for phones\u2014and becoming upset if refused\u2014more often [ 93 ] [ 103 ] . However, the highest cost of too much screen time for young children is the loss of opportunities for social learning and practice [ 89 ] . The routine use of devices to distract or calm may preclude self-soothing strategies and lead to overdependence on screens for emotion regulation [ 89 ] [ 104 ] . Lower child self-regulation has been associated with increased screen exposure at 2 years of age [ 98 ] . Higher amounts of screen time in preschoolers have also been shown to increase externalizing behaviours and psychosocial difficulties. Children"
      },
      {
        "term": "children",
        "snippet": "Screen time and preschool children: Promoting health and development in a digital world | Canadian Paediatric Society #page-wrapper,.no-js body{background-color:#f7f7f7}body,h1,p,span{font-display:swap;line-height:1.5}.button,body,h1,p,span{line-height:1.5}*{-webkit-font-smoothing:subpixel-antialiased;box-sizing:border-box}html{overflow:scroll!important;scroll-behavior:smooth!important}body{background-color:#003478;counter-reset:count count2}#page-wrapper{background-attachment:fixed;background-image:url(\"data:image/svg+xml;charset=utf-8,%3Csvg xmlns='http://www.w3.org/2000/svg' viewBox='0 0 1600 900'%3E%3Cpath fill='%23fcfcfc' d='M0 504v395h1600V120z'/%3E%3Cpath fill='%23f7f7f7' d='M1600 567v332H0V165z'/%3E%3Cpath fill='%23f5f5f5' d='M0 680v219h1600V300z'/%3E%3Cpath fill='%23f2f2f2' d='M1600 719v180H0V353z'/%3E%3Cpath fill='%23f5f5f5' d='M0 788v111h1600V625z'/%3E%3C/svg%3E\");background-position:50%;background-size:cover;overflow:visible}.main-body{padding-bottom:20px}body,p,span{color:#000;font-family:Muli,sans-serif;font-size:1.125rem;font-weight:300}.header .tagline__h1,h1{color:#003478;font-family:Merriweather,serif}h1{font-weight:400}a{border-bottom:2px solid #007d58;font-weight:500;word-wrap:break-word}a,a:visited{color:#007d58}a:not(.btn){border-bottom:1px solid #007d58}a:not(.mm-btn-next){border-bottom:none}ul{margin-left:2.25rem}@media screen and (min-width:75em){body,p,span{font-size:1.125rem}u"
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        "term": "preschool",
        "snippet": "Screen time and preschool children: Promoting health and development in a digital world | Canadian Paediatric Society #page-wrapper,.no-js body{background-color:#f7f7f7}body,h1,p,span{font-display:swap;line-height:1.5}.button,body,h1,p,span{line-height:1.5}*{-webkit-font-smoothing:subpixel-antialiased;box-sizing:border-box}html{overflow:scroll!important;scroll-behavior:smooth!important}body{background-color:#003478;counter-reset:count count2}#page-wrapper{background-attachment:fixed;background-image:url(\"data:image/svg+xml;charset=utf-8,%3Csvg xmlns='http://www.w3.org/2000/svg' viewBox='0 0 1600 900'%3E%3Cpath fill='%23fcfcfc' d='M0 504v395h1600V120z'/%3E%3Cpath fill='%23f7f7f7' d='M1600 567v332H0V165z'/%3E%3Cpath fill='%23f5f5f5' d='M0 680v219h1600V300z'/%3E%3Cpath fill='%23f2f2f2' d='M1600 719v180H0V353z'/%3E%3Cpath fill='%23f5f5f5' d='M0 788v111h1600V625z'/%3E%3C/svg%3E\");background-position:50%;background-size:cover;overflow:visible}.main-body{padding-bottom:20px}body,p,span{color:#000;font-family:Muli,sans-serif;font-size:1.125rem;font-weight:300}.header .tagline__h1,h1{color:#003478;font-family:Merriweather,serif}h1{font-weight:400}a{border-bottom:2px solid #007d58;font-weight:500;word-wrap:break-word}a,a:visited{color:#007d58}a:not(.btn){border-bottom:1px solid #007d58}a:not(.mm-btn-next){border-bottom:none}ul{margin-left:2.25rem}@media screen and (min-width:75em){body,p,span{font-size:"
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  "https://www.who.int/news/item/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-more": {
    "status": 200,
    "final": "https://www.who.int/news/item/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-more",
    "title": "To grow up healthy, children need to sit less and play more",
    "snippets": [
      {
        "term": "screen time",
        "snippet": " ealthy physical activity, sedentary behaviour and sleep habits are established early in life, this helps shape habits through childhood, adolescence and into adulthood. \u201cWhat we really need to do is bring back play for children,\u201d says Dr Juana Willumsen, WHO focal point for childhood obesity and physical activity. \u201cThis is about making the shift from sedentary time to playtime, while protecting sleep. \u201c The pattern of overall 24-hour activity is key: replacing prolonged restrained or sedentary screen time with more active play, while making sure young children get enough good-quality sleep. Quality sedentary time spent in interactive non-screen-based activities with a caregiver, such as reading, storytelling, singing and puzzles, is very important for child development. The important interactions between physical activity, sedentary behaviour and adequate sleep time, and their impact on physical and mental health and wellbeing, were recognized by the Commission on Ending Childhood Obesity , which called for clear guidance on physical activity, sedentary behaviour and sleep in young children. Applying the recommendations in these guidelines during the first five years of life will contribute to children\u2019s motor and cognitive development and lifelong health.\u00a0 \u00a0 Recommendations at a glance: Infants (less than 1 year) should: \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n\\r\\n\\r\\n \\r\\n \\r\\n Normal \\r\\n 0 \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n false \\r\\n false \\r\\n false \\r\\n \\r\\n EN-GB \\r\\n ZH-CN \\r\\n AR-SA \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r\\n \\r"
      },
      {
        "term": "language",
        "snippet": "ut' .split(','), i, o = function (n) { return 'function' == typeof n ? o.l.push([arguments]) && o : function () { return o.l.push([n, arguments]) && o } }, t = d.getElementsByTagName(s)[0], j = d.createElement(s); j.async = !0; j.src = 'https://cdn.fundraiseup.com/widget/' + a + ''; t.parentNode.insertBefore(j, t); o.s = Date.now(); o.v = 5; o.h = w.location.href; o.l = []; for (i = 0; i var lang = document.documentElement.lang; window.dataLayer = window.dataLayer || []; window.dataLayer.push({'language': lang }); window.dataLayer.push({ \"pagetype\": \"news\", \"targetaudience\": \"general-audience\", \"targetcountry\": \"global\", \"publishingoffice\": \"maternal-health\", \"healthtopic\": \"Obesity\" }); (function() { function deleteCookie(cookieName,domain) { document.cookie = cookieName + '=;expires=Mon Jan 01 1900 00:00:00 ; path=/; domain=' + domain; } function loadAndTrack(canTrack) { if (!canTrack) { var domain = location.hostname.replace(/^www\\./i, '.'); //GA deleteCookie('_ga', domain); deleteCookie('_gat', domain); deleteCookie('_gid', domain); //Clarity deleteCookie('_clck', domain); deleteCookie('_clsk', domain); //Google Adsense deleteCookie('_gcl_au', domain); } else{ //Fire GTM //Google Tag Manager (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-5QFSQRT'); //End Google Tag Manager } return; } if (window.TrackingConsentManager) { TrackingConsentManager.addEventListener('ConsentChanged', loadAndTrack); loadAndTrack(TrackingConsentManager.canTrackCurrentUser()); } else { loadAndTrack(true); } })(); .embed-responsive { position: relative; display: block; height: 0; padding: 0; overflow: hidden; } "
      },
      {
        "term": "sleep",
        "snippet": ",\"position\":4,\"item\":{\"@id\":\"\",\"name\":\"To grow up healthy, children need to sit less and play more\"}}],\"itemListOrder\":\"ItemListOrderAscending\",\"@context\":\"http://schema.org\",\"@type\":\"BreadcrumbList\"} A.Keenan \u00a9 Credits var imageCreditClass = document.getElementsByClassName(\"sf-image-credit\"); var preventFunction = function () { event.preventDefault() }; for (var i = 0; i To grow up healthy, children need to sit less and play more New WHO guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age 24 April 2019 News release Geneva Reading time: document.addEventListener('DOMContentLoaded', (event) => { new ReadingTime(270, 'min', 'words', 'Less than a minute'); }) {\"author\":{\"@type\":\"Organization\",\"name\":\"World Health Organization: WHO\",\"logo\":{\"@type\":\"ImageObject\",\"url\":\"https://www.who.int/Images/SchemaOrg/schemaOrgLogo.jpg\",\"width\":250,\"height\":60}},\"headline\":\"To grow up healthy, children need to sit less and play more\",\"description\":\" Children under five must spend less time sitting watching screens, or restrained in prams and seats, get better quality sleep and have more time for active play if they are to grow up healthy, according to new guidelines issued by the World Health Organization (WHO). \u201cAchieving health for all means doing what is best for health right from the beginning of people\u2019s lives,\u201d says WHO Director-General Dr Tedros Adhanom Ghebreyesus. \u201cEarly childhood is a period of rapid development and a time when family lifestyle patterns can be adapted to boost health gains.\u201d The new guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age were developed by a WHO panel of experts. They assessed the effects on young children of inadequate sleep, and time spent sitting watching screens or restrained in chairs and prams. They also reviewed evidence around the benefits of increas"
      },
      {
        "term": "development",
        "snippet": "nd play more\",\"description\":\" Children under five must spend less time sitting watching screens, or restrained in prams and seats, get better quality sleep and have more time for active play if they are to grow up healthy, according to new guidelines issued by the World Health Organization (WHO). \u201cAchieving health for all means doing what is best for health right from the beginning of people\u2019s lives,\u201d says WHO Director-General Dr Tedros Adhanom Ghebreyesus. \u201cEarly childhood is a period of rapid development and a time when family lifestyle patterns can be adapted to boost health gains.\u201d The new guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age were developed by a WHO panel of experts. They assessed the effects on young children of inadequate sleep, and time spent sitting watching screens or restrained in chairs and prams. They also reviewed evidence around the benefits of increased activity levels. \u201cImproving physical activity, reducing sedentary time and ensuring quality sleep in young children will improve their physical, mental health and wellbeing, and help prevent childhood obesity and associated diseases later in life,\u201d says Dr Fiona Bull, programme manager for surveillance and population-based prevention of noncommunicable diseases, at WHO. Failure to meet current physical activity recommendations is responsible for more than 5 million deaths globally each year across all age groups.\u00a0 Currently, over 23% of adults and 80% of adolescents are not sufficiently physically active. If h ealthy physical activity, sedentary behaviour and sleep habits are established early in life, this helps shape habits through childhood, adolescence and into adulthood. \u201cWhat we really need to do is bring back play for children,\u201d says Dr Juana Willumsen, WHO focal point for childhood obesity and physical activity. \u201cThis is about making the"
      },
      {
        "term": "results",
        "snippet": "donate-div { display: inline-block !important; right: 60px !important; padding: 0 !important; } } @media (min-width: 1020px) { .row.flex-ar {display: flex;flex-direction: row;align-content: stretch;} .row.flex-ar .sf_colsIn.col-sm-6.col-md-3{display:flex;flex-grow:1;;margin-bottom:2em;} } .flex-ar img.mdc-card__media--4-3 { aspect-ratio: 1/1; } Skip to main content Global Regions WHO Regional websites Africa Americas South-East Asia Europe Eastern Mediterranean Western Pacific When autocomplete results are available use up and down arrows to review and enter to select. Select language Select language English \u0627\u0644\u0639\u0631\u0628\u064a\u0629 \u4e2d\u6587 Fran\u00e7ais \u0420\u0443\u0441\u0441\u043a\u0438\u0439 Espa\u00f1ol Portugu\u00eas li.slicknav_addition.sf-lang-selector { width: 100%; position: relative } li.slicknav_addition.sf-lang-selector select { min-width: 100% } #search-form label { visibility: hidden } .language-selector label { width: 0 !important; height: 0; display: inline-block; overflow: hidden } Home Health Topics All topics A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Resources Fact sheets Facts in pictures Multimedia Podcasts Publications Questions and answers Tools and toolkits Popular Dengue Endometriosis Excessive heat Herpes Mental disorders Mpox Countries All countries A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Regions Africa Americas Europe Eastern Mediterranean South-East Asia Western Pacific WHO in countries Data by country Country presence\u00a0 Country cooperation strategies\u00a0 Country office profiles Strengthening country offices\u00a0 Newsroom Newsroom News releases Statements Campaigns Events Feature stories Speeches Commentaries Photo library Headlines #: Title # #: FormatedDate # #: NewsType # window.onload = function () { var remoteDataSource = new kendo.data.DataSource({ type: \"odata-v4\", transport: { read: \"/api/news/newsitems?sf_provider=OpenAccessDataProvider&sf_culture=en&$top=3&$orderby=PublicationDateAndT"
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        "snippet": "To grow up healthy, children need to sit less and play more (function (w, d, s, n, a) { if (!w[n]) { var l = 'call,catch,on,once,set,then,track,openCheckout' .split(','), i, o = function (n) { return 'function' == typeof n ? o.l.push([arguments]) && o : function () { return o.l.push([n, arguments]) && o } }, t = d.getElementsByTagName(s)[0], j = d.createElement(s); j.async = !0; j.src = 'https://cdn.fundraiseup.com/widget/' + a + ''; t.parentNode.insertBefore(j, t); o.s = Date.now(); o.v = 5; o.h = w.location.href; o.l = []; for (i = 0; i var lang = document.documentElement.lang; window.dataLayer = window.dataLayer || []; window.dataLayer.push({'language': lang }); window.dataLayer.push({ \"pagetype\": \"news\", \"targetaudience\": \"general-audience\", \"targetcountry\": \"global\", \"publishingoffice\": \"maternal-health\", \"healthtopic\": \"Obesity\" }); (function() { function deleteCookie(cookieName,domain) { document.cookie = cookieName + '=;expires=Mon Jan 01 1900 00:00:00 ; path=/; domain=' + domain; } function loadAndTrack(canTrack) { if (!canTrack) { var domain = location.hostname.replace(/^www\\./i, '.'); //GA deleteCookie('_ga', domain); deleteCookie('_gat', domain); deleteCookie('_gid', domain); //Clarity deleteCookie('_clck', domain); deleteCookie('_clsk', domain); //Google Adsense deleteCookie('_gcl_au', domain); } else{ //Fire GTM //Google Tag Manager (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm."
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    "status": 200,
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    "title": "Understanding the New AAP Digital Media Guidelines for Screen Time and Social Media",
    "snippets": [
      {
        "term": "screen time",
        "snippet": "html { visibility: hidden; opacity: 0; } Understanding the New AAP Digital Media Guidelines for Screen Time and Social Media function OptanonWrapper() { } (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window, document, 'script', 'dataLayer', 'GTM-N2RV28J'); var googletag = googletag || {}; googletag.cmd = googletag.cmd || []; googletag.cmd.push(function() { var AAPorg = googletag.sizeMapping(). addSize([730, 0], [728, 90]) //desktop .build(); var gptAdSlots = []; gptAdSlots[0] =googletag.defineSlot('/22410314033/aap_leadert', [728, 90], 'div-gpt-ad-1633540336787-0').defineSizeMapping(AAPorg).addService(googletag.pubads()); googletag.pubads().enableSingleRequest(); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); (function(w,d,s,n,a){if(!w[n]){var l='call,catch,on,once,set,then,track'.split(','),i,o=function(n){return'function'==typeof n?o.l.push([arguments])&&o:function(){return o.l.push([n,arguments])&&o}},t=d.getElementsByTagName(s)[0],j=d.createElement(s);j.async=!0;j.src='https://cdn.fundraiseup.com/widget/'+a; t.parentNode.insertBefore(j,t);o.s=Date.now();o.v=4;o.h=w.location.href;o.l=[];for(i=0;i com.realmagnet.MagnetLeads.init('hXdIOUQOZEy77inoSnCQWg'); com.realmagnet.MagnetLeads.visitPage(); function mo"
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      {
        "term": "literacy",
        "snippet": " play a role in supporting healthy social media use and shaping environments where young people can thrive. And social media companies have a responsibility for making sure healthy development is at the center of their designs. When we include young people\u2019s perspectives in social media design, we can build online environments that strengthen mental health for everyone.\u00a0 \u00a0 \u00a0 \u00a0 What Youth and Parents Can Do Tech design shapes how we use social media. Parents can build their tweens/teens\u2019 digital literacy through regular conversation. Conversations build awareness about engagement-based designs that want our attention and clicks. Here are some conversation starters and questions to try :\u00a0 \u201cWhen does social media feel inspiring to you, and when does it feel like a bunch of ads and clickbait?\u201d\u00a0 \u201cWhat accounts do you follow that are authentic and supportive, and which ones seem like the creators are competing for attention? How can you tell the difference?\u201d\u00a0 \u201cWhat ads do you see on social media? What do you think the social media platform knows about you, and why it sends you those ads?\u201d\u00a0 \u201cWhat pulls you back to social media? What reminds you to put it down?\u201d\u00a0 Experiment with small changes. Researchers found that a 1-week break from social media can help reset mood and sleep. But it\u2019s important to make small changes that are sustainable for you . Here are some small changes to help build healthier relationships with social media:\u00a0 What attention-grabbing features can you turn off? Reducing notifications and setting downtimes are available on most phones.\u00a0 Plan out times when you will check social media, like at lunchtime or after dinner, instead of letting it fill your downtime or boredom.\u00a0 Find other chill activities to fill downtime, such as listening to music, reading, or coloring.\u00a0 The goal is to be in control of your attention and direct it to what matters to you \u2013 yo"
      },
      {
        "term": "attention",
        "snippet": "ts: Helping Kids Thrive in a Digital World - AAP Policy Explained The 5 Cs of Media Use VIDEO: Explaining the 5 Cs of Media Use Framework for Parents Glossary of Digital Media Platforms Early Childhood Development and Screen Time Toolkit AAP Family Media Plan Child-centered design: How digital products can support or undermine youth well-being\u00a0 Design matters. When social media platforms use features that encourage endless scrolling, they can interfere with sleep, which in turn affects mood and attention. \u00a0 Design changes to social media\u2014like reducing public \u2018like\u2019 counts or building in reminders to get more sleep\u2014can ease pressures on younger users and support healthier use. Better policies and accountability will help us achieve that. \u00a0 Healthy digital spaces are a shared responsibility. Practitioners, policymakers, and communities all play a role in supporting healthy social media use and shaping environments where young people can thrive. And social media companies have a responsibility for making sure healthy development is at the center of their designs. When we include young people\u2019s perspectives in social media design, we can build online environments that strengthen mental health for everyone.\u00a0 \u00a0 \u00a0 \u00a0 What Youth and Parents Can Do Tech design shapes how we use social media. Parents can build their tweens/teens\u2019 digital literacy through regular conversation. Conversations build awareness about engagement-based designs that want our attention and clicks. Here are some conversation starters and questions to try :\u00a0 \u201cWhen does social media feel inspiring to you, and when does it feel like a bunch of ads and clickbait?\u201d\u00a0 \u201cWhat accounts do you follow that are authentic and supportive, and which ones seem like the creators are competing for attention? How can you tell the difference?\u201d\u00a0 \u201cWhat ads do you see on social media? What do you think the social media platform k"
      },
      {
        "term": "sleep",
        "snippet": " and the media industry.\u00a0 The Center of Excellence approaches social media the same way . We encourage clinicians and parents to think about:\u00a0 How does your unique child experience social media? Young people are active problem-solvers, we need to listen to them to figure out limits and alternative activities that will stick. \u00a0 How parents use media shapes how kids and teens use media! Make your own boundaries so that you are role-modeling healthy use and making uninterrupted time for family and sleep\u00a0 What offline community opportunities can give your teen social connection, such as a creative, sports, or volunteering activity? \u00a0 In other words, social media use doesn\u2019t occur in a vacuum . Relationships play a central role in social media use and youth mental health. When young people have strong, supportive relationships both offline and online, they are more likely to use social media in a healthy way.\u00a0 Quick Links: Related Resources Read the New AAP Digital Media Policy Statement For Parents: Helping Kids Thrive in a Digital World - AAP Policy Explained The 5 Cs of Media Use VIDEO: Explaining the 5 Cs of Media Use Framework for Parents Glossary of Digital Media Platforms Early Childhood Development and Screen Time Toolkit AAP Family Media Plan Child-centered design: How digital products can support or undermine youth well-being\u00a0 Design matters. When social media platforms use features that encourage endless scrolling, they can interfere with sleep, which in turn affects mood and attention. \u00a0 Design changes to social media\u2014like reducing public \u2018like\u2019 counts or building in reminders to get more sleep\u2014can ease pressures on younger users and support healthier use. Better policies and accountability will help us achieve that. \u00a0 Healthy digital spaces are a shared responsibility. Practitioners, policymakers, and communities all play a role in supporting healthy social me"
      },
      {
        "term": "development",
        "snippet": " and Social Media Home \u00a0/\u00a0 Patient Care \u00a0/\u00a0 Media and Children \u00a0/\u00a0 Center of Excellence on Social Media and Youth Mental Health \u00a0/\u00a0 Understanding the New AAP Digital Media Guidelines for Screen Time and Social Media Connecting policy to practice: How to implement the new AAP digital media guidelines By: Dr. Jenny Radesky, MD, FAAP, Co-Medical Director, Center of Excellence on Social Media & Youth Mental Health Dr. Radesky served as Chair of the AAP Council on Communications and Media during the development of the new policy statement. Below, Dr. Radesky highlights the updated policy guidance and explains what parents can do now to build healthier media habits. The American Academy of Pediatrics (AAP) has released a new version of what are often called the \u201cscreen time guidelines.\u201d Except this time, the focus goes way beyond the amount of time children, teens, and parents spend on screens. The policy statement and technical report emphasize two new concepts that shape how digital media impacts children\u2019s well-being: Socio-ecological systems and Child-centered design.\u00a0 Let\u2019s unpack those concepts and how they relate to social media. Jump to what youth and parents can do Circles of care: The socio-ecological systems around children\u00a0 The new policy uses a model called the socioecological framework to explain how different layers of a child\u2019s world affect their experiences with digital media. Think of it like a set of circles around the child:\u00a0 The innermost circle is the child\u2014their personality, age, and needs.\u00a0 The next circle includes their family, school, and neighborhood.\u00a0 The outer circles represent bigger influences like culture, laws, and the media industry.\u00a0 The Center of Excellence approaches social media the same way . We encourage clinicians and parents to think about:\u00a0 How does your unique child experience social media? Young people are active problem-solvers,"
      },
      {
        "term": "self-regulation",
        "snippet": " by clinicians, educators and other professionals who support teens and families. Center of Excellence on Social Media and Youth Mental Health | July 10, 2024 Activity Cards for Children 10 and Younger (Available in English and Spanish) Children build media habits and preferences from a very young age, so it\u2019s important to set them up for a healthy relationship with media before they grow into teens and young adults. Our activity cards suggest practical ways to build balance, critical thinking, self-regulation, and safety skills for toddlers through elementary school-aged children. Many clinicians keep these in their exam rooms for parents to read while waiting. Center of Excellence on Social Media and Youth Mental Health | July 20, 2024 Last Updated 01/20/2026 Source American Academy of Pediatrics window.searchBox = { searchBoxText: 'Search All AAP', searchButtonText: 'Search', findIndexUrl: 'https://es-us-api01.episerver.com/3fu1nB75NF5xwBMuzJdHOF0KFePbaflM/aaop_index00214/', vertexSearchPageUrl: '/en/search/', shopSearchBoxText: 'Search shopAAP' }; window.GoogleAnalyticsBootstrap = { sendUserInformationtoGA: 'False', lockedContentUniqueUserId: '', userVisitorGroupName: '', } window.errorText = { dismissButtonText: 'Dismiss', requiredErrorText: 'This is a required field', invalidErrorText: 'This field is invalid', invalidPasswordText: 'Password must be at least 10 characters long', passwordMatchErrorText: 'Passwords must match', } window.passwordValidation = { passwordRequiredLength: 10, passwordRequireNonLetterOrDigit: false, passwordRequireDigit: false, passwordRequireUpperCase: false, passwordRequireLowerCase: false, } window.loginInfo = { loginUrl: '/en/my-account/login/' } We're 67\u200b,000 pediatricians committed to the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults. AAP Home Policy Advocacy Pedi"
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      {
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