Screen Media Use in Hospitalized Children.

Screen media (television, computers, and videogames) use has been linked to multiple child outcomes, including obesity. Parents can be an important influence on children's screen use. There has been an increase in the number of instruments available to assess parenting in feeding and physical activity contexts, however few measures are available to assess parenting practices regarding children's screen media use. A working group of screen media and parenting researchers convened at the preconference workshop to the 2012 International Society for Behavioral Nutrition and Physical Activity (ISBNPA) annual meeting, "Parenting Measurement: Current Status and Consensus Reports," to identify and prioritize issues in assessing screen media parenting practices. The group identified that screen media use can pose different risks for children, depending on their age and developmental stage, across physiologic, psychosocial, and development outcomes. With that in mind, a conceptual framework of how parents may influence their child's screen-viewing behaviors was proposed to include the screen media content, context of viewing, and amount viewed. A research agenda was proposed to prioritize a validation of the framework and enhance the ability of researchers to best assess parenting influences across the three domains of content, context and amount of children's screen media use.

Screen media serves an essential role in adolescents' lives, posing growth opportunities and mental health challenges. Family plays a crucial role in mitigating these challenges. This systematic review offers a comprehensive analysis of the family factors related to adolescent screen media use and mental health. A systematic search was conducted in PubMed, CINAHL, PsycINFO, Scopus, and Embase, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the following inclusion criteria: English, peer-reviewed, observational design, and published since 2013; adolescent samples aged 10-17 years; and examining screen media use, family factors, and internalizing problems. The role of family factors as predictors, moderators, and mediators was also examined. Of the 3587 records, 32 met the inclusion criteria. These studies, primarily cross-sectional, presented a global perspective of 14 countries. A heterogeneous range of family factors, screen media use, and mental health outcomes were examined, revealing significant associations between elevated screen media use and internalizing problems. Positive family processes and democratic media-specific parenting mitigate such association. A few studies underscored family socioeconomic status (SES), noting elevated screen media use and mental health risks among adolescents in families of low SES. Accumulating evidence supports the important role of positive family contexts in fostering balanced screen media use and mental health in adolescents, accentuating the need for professional screening and education to promote positive screen media use among adolescents and families. Further research requires refinement in measurement and methodology to better capture the intricate relationship between family dynamics, screen media use, and adolescent mental health.

Parental mediation of screen media (e.g., television, video games) is associated with better outcomes for children. Although much research has examined parental mediation of television (TV), there is a dearth of research examining communication about mobile media (e.g., Smartphones, tablets) in the digital age. This study seeks to identify themes of family communication around media and mobile devices using naturalistic observational methodology. The sample consisted of 21 toddlers (ages 12-24-months old), 31 preschool-age children (3-5 years old), and 23 school-age (10-13 years old) children and their families. Children wore Language ENvironment Analysis (LENA) audio recording devices, which recorded vocalizations and other sounds proximal to the child wearing the device in the home environment, as well as audible screen media use. ATLAS.ti was used to transcribe dialogue from the audio recordings that pertained to screen media. Experts from the fields of communication, clinical child psychology, and developmental-behavioral pediatrics independently analyzed the transcripts to identify common themes. Five main themes emerged. First, parental mediation of screen media was primarily restrictive, reactive, and focused on technology functionality. Second, active mediation was child-driven. Third, siblings played a more dominant role in mediation than parents. Fourth, parents and children negotiated screen time limits. Finally, parallel family media use was common. Multiple family members engaged with their own mobile devices while simultaneously being exposed to background screen media (i.e., media multitasking). Assessing media use in the naturalistic home environment elucidated current patterns of family media use and communication about media in the digital age.

ObjectiveThis study is a systematic review of the peer-reviewed literature to identify the correlates of mobile screen media use among children aged 8 years and less.SettingHome or community-based studies were...

This prospective observational study quantified screen media use within the night-time pre-sleep period in a pediatric intensive care unit and postulated possible implications. Seventy-five patients between the ages of newborn to 19 years old were observed 5 evenings per week for 3 weeks. Trained observers documented the patient’s screen use, type of screen used, screen engagement, sleep state, light level, and parental presence. Patients in the ICU had on average 65 minutes of screen media use, per evening. The total screen media use averaged 59 minutes for the 0 to18-month age group; 83 minutes for the 18 to 24-month age group; 66 minutes for 2 to 6 year olds; 72 minutes for 6 to 13 year olds; and 74 minutes for those above 13. This research demonstrates that children are engaging in more screen time during the night hours than is recommended by the AAP.

Children's exposure to unhealthy food marketing contributes to poor diets by influencing the foods that children like, request, buy and consume. This study aimed to use confirmatory mediational analyses to test a hypothetical model of marketing effects, to better understand the mechanisms behind food marketing's impacts on children. Children responded to a cross-sectional online survey about their attitudes towards, and purchase and consumption behaviours of, ten frequently promoted food/beverage brands and their media use. Structural equation modelling tested a priori potential pathways for the effects of food marketing exposure on children's diets. 10-16-year-old children (n 400). Australia. There was a significant positive correlation between children's commercial screen media use and their attitudes towards brands (related to perceived social norms) and their brand purchasing behaviours, including their own purchases and requests to parents. The use of strategies to avoid advertising in commercial screen media reduced but did not remove the association between media use and brand purchases. Other brand exposures (on clothing, outdoor advertising, sponsorships) had a positive association with children's perceived social norms about brands and their brand purchases and requests. Non-commercial screen media use was not associated with any brand-related outcomes. Commercial screen media use and other brand exposures were strongly positively associated with children's perceptions and purchasing behaviours of frequently marketed food/beverages. Regulations to restrict children's exposures to food marketing on-screen and through other media are required to reduce the effect of marketing exposure on children's food purchasing behaviours.

BackgroundA large percentage (68%) of children under age 3 use screen media, such as television, DVDs and video games, on a daily basis. Research suggests that increased screen time in young children is linked to negative health outcomes, including increased BMI, decreased cognitive and language development and reduced academic success. Reviews on correlates of screen time for young children have included preschool age children and children up to age 7; however, none have focused specifically on correlates among infants and toddlers. As research suggests that screen media use increases with age, examining correlates of early media exposure is essential to reducing exposure later in life. Thus, this paper systemically reviews literature published between January 1999 and January 2013 on correlates of screen time among children between 0 and 36 months of age.MethodsTwo methods were used to conduct this review: (1) Computerized searches of databases (PubMed, PsycINFO, ERIC, Medline); and (2) Reference sections of existing reviews and primary studies. Inclusion criteria were: (1) The article included separate data for children 36 months and younger, (2) English language, (3) peer reviewed article, (4) analysis reported for screen viewing as a dependent variable, (5) original research article and, (6) examined correlates or associations between screen time and other demographic, contextual or behavioral variables. Articles were compiled between 2011 and 2013 and evaluation occurred in 2012 and 2013.ResultsThe literature search identified 29 studies that met inclusion criteria. These studies investigated a total of 33 potential correlates, which were examined in this review. Findings suggest demographic variables most commonly correlated with high screen time among infants and toddlers are child’s age (older) and race/ethnicity (minority). Child BMI, maternal distress/depression, television viewing time of the mother and cognitive stimulation in the home environment were also associated with screen media use. Studies reported that child sex, first born status, paternal education, non-English speaking family, two-parent household, number of children in the home and non-parental childcare were not associated with screen time among children aged 0–36 months. Associations were unclear (fewer than 60% of studies report an association) for maternal age, maternal education and household income. The remaining correlates were investigated in fewer than three studies and thus not coded for an association.ConclusionsThe correlates identified in this study point to avenues for intervention to reduce screen time use in young children. However, further research is necessary to explore a number of environmental, socio-cultural and behavioral correlates that are under-examined in this population and may further inform prevention and intervention strategies.

This study examined the association between screen media use, media content, and language development among 119 Hispanic infants and toddlers. Children and their caregivers were recruited through an urban, Early Head Start program. Duration and content of screen media exposure was measured through a 24-hour recall questionnaire, and language development was measured at baseline and at 1-year follow up. Children in the sample spent an average of 3.29 hours engaged with screen media (median 2.5 hours per day). In both cross-sectional and longitudinal analyses, children who watched over 2 hours of television per day had increased odds of low communication scores. Whereas child-directed media was associated with low language scores, adult-directed media was not. Our findings support the mounting literature on the deleterious impacts of screen media in toddler's language development. Guidance and alternatives to screen media use should be available to families in pediatric practices and early childhood centers.

Background:Physical activity (PA) and screen media use are key behaviors for healthy development in early childhood. This study aimed to investigate 12-month trajectories of PA and screen time among toddlers and examine their associations with parenting practices.Methods:The Child and Mother PA Study (CAMPAS) recruited toddler-mother dyads in the US Chicago area from 2022–2024. Assessments were conducted at approximately 12, 18, and 24 months of age (Waves 1–3). Toddlers’ PA was measured using hip-worn ActiGraph accelerometers and their screen time was mother-reported. The PA Parenting Practices for Preschoolers (PAPPP) questionnaire was used to assess PA-encouraging and screen time-limiting parenting practices. Mixed-effects models were fit to model trajectories of moderate and vigorous-intensity PA (MVPA) and screen time over age. Multivariable regression models examined the associations between toddlers’ MVPA and screen time and their parents’ parenting practice scores.Results:The CAMPAS included 139 toddler participants (74 females). At Waves 1–3, average age was 13.6 (SD=1.7), 19.9 (SD=1.6), and 26.9 (SD=2.1) months, respectively. Average MVPA was 74 (95%CI=70–79), 73 (95%CI=69–77), and 80 (95%CI=75–85) minutes/day, respectively, with no significant change over time (p=0.13). Average screen time was 27 (95%CI=21–33), 46 (95%CI=38–55), and 59 (95%CI=50–69) minutes/day, respectively, significantly increasing over time (p<0.01). Every one-point higher PA-encouraging parenting practice score was associated with 9 additional minutes of daily MVPA (95%CI=2–15). For every one-point higher screen time-limiting parenting practice score was associated with 45 fewer minutes of daily screen time (95%CI=38–52).Conclusion:During the second year of life, toddlers exhibited a substantial increase in screen time but minimal changes in MVPA. Parenting practices were associated with toddlers’ MVPA and screen time. Findings suggest that promoting parenting practices that encourage PA and limit screen time may be an effective intervention strategy to support healthy PA and screen use development during this critical developmental period.

Introduction More than 1/3 of US children do not sleep adequately. Our previous work has shown that during summer, 5-8-year-old children go to bed later, obtain less sleep, have a lower Entrainment Sleep Regularity Index (ESRI), and have lower sleep efficiency compared to the school year. Good sleep hygiene helps support adequate sleep. We hypothesized that school year-summer differences in the family environment would explain differences in children’s sleep timing, efficiency, and ESRI. Methods 119 parents of 5-8-year-olds completed measures of child temperament, sleep hygiene, and parenting practices. Child sleep was measured for 8 days using wrist actigraphs in the summer and school year. Sleep timing was determined using the Sadeh algorithm and sleep diaries. Paired samples t-tests examined school year-summer differences in family variables. Multivariate analyses were performed to calculate predictors of sleep midpoint, total sleep time, sleep efficiency, and ESRI. Results Compared to the school year, during summer parents reported less consistent bedtime routines (t(108)=3.388, p&amp;lt;.001), increased average daily screen use (t(107)=-3.194, p=.001), less parent-child sleep conflict (t(108)=3.388, p&amp;lt;.001) and greater child surgency (impulsivity) (t(108)=-2.960, p=.004). During the school year, chronotype (β=3.639, p&amp;lt;.001), greater sleep reinforcement (β=-2.005, p=.041), greater caffeine use (β=5.312, p=.02), lower negative affect (β=-10.156, p=.039), and greater effortful control (β=14.253, p=.014) predicted later sleep midpoint. Greater bedtime routine consistency predicted lower sleep efficiency (β=-0.154, p=.032). During the summer, chronotype (β=5.542, p&amp;lt;.001) and decreased bedtime routine consistency predicted later sleep midpoints (β=-2.438, p=.016). Greater maladaptive bedtime activities (β=-.009, p=.004), greater sleep reinforcement (β=-.007, p=.036), and greater screen media use (β=-.003, p=.019) predicted lower ESRI. Conclusion Concerningly, maladaptive bedtime behaviors and screen media use predicted lower ESRI during the summer, which has been associated with increases in children’s BMI over the summer. Overall, these results suggest factors that contribute to unhealthy sleep habits differ during the school year and summer. During the school year, it may be important to encourage families to limit caffeine while during summer, promoting consistent bedtime routines and limiting screen media may help improve children’s sleep, with potential BMI effects. Support (if any) Texas Children’s Pediatric Pilot Award

Brief report: Association between socio-demographic factors, screen media usage and physical activity by type of day in Spanish adolescents

The struggle to thrive as a productive student researcher, an attentive parent, and a caring partner can be difficult, particularly for international student parents who are far from home and also possibly burdened with complex cultural expectations, interpersonal dynamics, and institutional biases. Using uses and gratifications theory as a framing mechanism, we describe interviews with twelve international student mothers in the United States who are primary caregivers of children between six months to five years old, focusing on the context of their use of screen media content and devices, the gratifications they seek from their children's use of screen media devices, and the differences in their perceptions about the use of screen media as an educated, non-US parent. Our findings give an initial account of the role of screen based technology in their domestic life with young children, and the limitations of their technological experience. We present four opportunities for designing for this population including technologies for positive distraction, interactive language aids, playful acquaintance tools, and anonymous peer networks for parent support. We conclude by formulating future promising avenues of research in this design space.

Screen media are ubiquitous in human life across all age, cultural and socioeconomic groups. The ceaseless and dynamic growth of technological possibilities has given rise to questions regarding their effect on the well-being of children. Research in this area largely consists of cross-sectional studies; experimental and randomized studies are rare, which makes drawing causative conclusions difficult. However, the prevailing approach towards the use of screen media by children has focused on time limitations. The emerging evidence supports a more nuanced perspective. It appears that the older the child, the more important how the screen media are used becomes. Concentrating on the quality of the screen, time has become increasingly relevant in the recent COVID-19 pandemic, which necessitated a transfer of educational and social functioning from real-life to the digital world. With this review, we aimed at gathering current knowledge on the correlations of different screen media use and development outcomes, as well as providing an overview of potential benefits that new technologies may provide to the pediatric population. To summarize, if one cannot evade screen time in children, how can we use it for children’s maximum advantage?

Media use in children has increased significantly over the past decades, particularly screen media use, raising concerns as emerging research has suggested that children's media use might be associated with self‐esteem. This entry provides an overview of the theoretical frameworks that account for such an association as well as the empirical work on the topic. Media use in childhood may be related to self‐esteem both through exposure to media‐promoted stereotypes regarding self‐worth that may impact self‐esteem, as well as through the sedentary nature of most media use, and lost opportunities for engaging in activities and peer interactions that promote social skills and competencies. The extant data are still inconsistent, although evidence has been found for an overall cross‐sectional relationship between media use and lower self‐esteem, particularly among girls. Importantly, this relationship may be qualified by the individual characteristics of children, the media content and format, as well as the dose. Further longitudinal research to better characterize this relationship, and help identify children most vulnerable to media influences is critical to advance our understanding and inform practices and guidelines.

In the area of early language development, understanding links between screen media, vocabulary, and grammar in 5-year-old children is crucial yet complex. While previous studies have exposed a negative association between screen use and vocabulary, the roles of content and context remain less explored, especially within the Swedish context. This study aims to address these factors. This study examined 89 5-year-old Swedish children and their parents. Language assessments of vocabulary and grammar were administered with the child by a clinician, and parents completed the Media Assessment Questionnaire (MAQ 2.3) online. Results indicate a negative association between screen time and both grammar and vocabulary skills at age 5, suggesting that increased screen media exposure during early childhood might hinder language development. Screen content quality, particularly educational and prosocial content, was positively associated with vocabulary development, but not grammar. Exposure to non-Swedish content was linked to lower vocabulary and grammar scores. In conclusion, this study underscores the significant association between screen media use and language development in children, highlighting the importance of considering content and duration. It contributes to a deeper understanding of the complex dynamics between screen media and language development, offering insights into media practices for fostering language skills at the time of school entry.