Evaluation of problematic screen exposure in pre-schoolers using a unique tool called "seven-in-seven screen exposure questionnaire": cross-sectional study

S Songül Yalçin, Özlem Tezol, Nilgün Çaylan, Meryem Erat Nergiz, Deniz Yildiz, Şeyma Çiçek, Ayşe Oflu, S Songül Yalçin, Özlem Tezol, Nilgün Çaylan, Meryem Erat Nergiz, Deniz Yildiz, Şeyma Çiçek, Ayşe Oflu

Abstract

Background: Screen media exposure has been increasing in the preschool years. Risky aspects of screen exposure have many potential negative effects on children's health. We aimed to evaluate problematic screen exposure in Turkish preschool children by using a unique tool called the "Seven-in-Seven Screen Exposure Questionnaire" and to investigate factors associated with problematic screen exposure.

Methods: A questionnaire form was designed including general descriptive questions in the first part. In the second part, a questionnaire we designed called the "Seven-in-Seven Screen Exposure Questionnaire" was conducted to evaluate problematic screen exposure characteristics. The questionnaire included seven items: daily screen time, viewing with parent(s), setting screen limits, screen exposure during meals and in the hour before bedtime, age of onset of screen exposure, and viewing low-quality content. The total problematic screen exposure score (range 0-13) was generated by summing scores from the seven items. Total scores are classified into two categories: low (< 7) and high (≥ 7). Logistic regression was performed to search for independent parameters associated with problematic screen exposure.

Results: One thousand two hundred forty-five mother-child pairs participated in this study. The median age of the children was 3.9 (IQR: 2.9-4.7) years and 51% were males. Overall, 280 children (22.5%) had a problematic screen exposure score of ≥7 (high). The median problematic screen exposure score was 4 (IQR: 3-6). Maternal age of < 30 years; paternal age of ≥30 years; maternal educational level of ≤12 years; the age of 24-48 months; home-based daycare; postponing eating, toileting, or sleeping while using a screen; and using touchscreen devices were found to be associated with an increased risk of having a high problematic screen exposure score.

Conclusion: Developing national scales to monitor problematic screen use in children would be more effective than monitoring screen time alone. All of the screen use characteristics not recommended in children would be evaluated using problematic screen exposure scales. The "Seven-in-Seven Screen Exposure Questionnaire" may serve as an example for further studies.

Keywords: Pre-schoolers; Problematic screen exposure; Questionnaire; Unique.

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

© 2021. The Author(s).

References

    1. Radesky JS, Christakis DA. Increased screen time: implications for early childhood development and behavior. Pediatr Clin N Am. 2016;63(5):827–839. doi: 10.1016/j.pcl.2016.06.006.
    1. Saunders TJ, Vallance JK. Screen time and health indicators among children and youth: current evidence, limitations and future directions. Appl Health Econ Health Policy. 2017;15(3):323–331. doi: 10.1007/s40258-016-0289-3.
    1. Whiting S, Buoncristiano M, Gelius P, Abu-Omar K, Pattison M, Hyska J, et al. Physical activity, screen time, and sleep duration of children aged 6–9 years in 25 countries: an analysis within the WHO European childhood obesity surveillance initiative (COSI) 2015–2017. Obes Facts. 2021;14(1):32–44. doi: 10.1159/000511263.
    1. Yilmaz G, Demirli Caylan N, Karacan CD. An intervention to preschool children for reducing screen time: a randomized controlled trial. Child Care Health Dev. 2015;41(3):443–449. doi: 10.1111/cch.12133.
    1. Yalçin SS, Tugrul B, Naçar N, Tuncer M, Yurdakök K. Factors that affect television viewing time in preschool and primary school children. Pediatr Int. 2002;44(6):622–627. doi: 10.1046/j.1442-200x.2002.01648.x.
    1. Kaur N, Gupta M, Malhi P, Grover S. Screen time in under-five children. Indian Pediatr. 2019;56:773–788. doi: 10.1007/s13312-019-1638-8.
    1. Paudel S, Jancey J, Subedi N, Leavy J. Correlates of mobile screen media use among children aged 0–8: a systematic review. BMJ Open. 2017;7:e014585. doi: 10.1136/bmjopen-2016-014585.
    1. Xu H, Wen LM, Rissel C. Associations of parental influences with physical activity and screen time among young children: a systematic review. J Obes. 2015;2015:546925. doi: 10.1155/2015/546925.
    1. Carson V, Kuzik N. Demographic correlates of screen time and objectively measured sedentary time and physical activity among toddlers: a cross-sectional study. BMC Public Health. 2017;17(1):187. doi: 10.1186/s12889-017-4125-y.
    1. Assathiany R, Guery E, Caron FM, Cheymol J, Picherot G, Foucaud P. Gelbert N; Association française de pédiatrie ambulatoire; Groupe de pédiatrie générale. Children and screens: A survey by French pediatricians. Arch Pediatr. 2018;25(2):84–88. doi: 10.1016/j.arcped.2017.11.001.
    1. Canadian Paediatric Society, Digital Health Task Force, Ottawa, Ontario. Screen time and young children: promoting health and development in a digital world. Paediatr Child Health. 2017;22(8):461–77. 10.1093/pch/pxx123.
    1. Bozzola E, Spina G, Ruggiero M, Memo L, Agostiniani R, Bozzola M, et al. Media devices in pre-school children: the recommendations of the Italian pediatric Society. Ital J Pediatr. 2018;44:69. doi: 10.1186/s13052-018-0508-7.
    1. Department of Health and Aging . Get up and grow: healthy eating and physical activity for early childhood. Canberra, ACT: Australian Government; 2010.
    1. Council on Communications and Media Media and Young Minds. Pediatrics. 2016;138(5):e20162591. doi: 10.1542/peds.2016-2591.
    1. Türkiye İstatistik Kurumu (TUIK). İstatistik veri portalı. Available from: . Accessed 5 May 2021.
    1. Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version. , updated 2013/04/06. Available from: . Accessed 3 July 2021.
    1. WHO . WHO AnthroPlus software: software for assessing growth and development of the world’s children. Geneva: WHO; 2007.
    1. 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):1–3. doi: 10.1542/peds.2014-2251.
    1. Hawi NS, Samaha M, Griffiths MD. The digital addiction scale for children: development and validation. Cyberpsychol Behav Soc Netw. 2019;22(12):771–778. doi: 10.1089/cyber.2019.0132.
    1. Çaylan N, Yalçın SS, Erat Nergiz M, Yıldız D, Oflu A, Tezol Ö, Çiçek Ş, Foto-Özdemir D. Associations between parenting styles and excessive screen usage in preschool children. Turk Arch Pediatr. 2021;56(3):261–266.
    1. Oflu A, Tezol O, Yalcin S, Yildiz D, Caylan N, Ozdemir DF, Cicek S, Nergiz ME. Excessive screen time is associated with emotional lability in preschool children. Arch Argent Pediatr. 2021;119(2):106–113.
    1. Kourlaba G, Kondaki K, Liarigkovinos T, Manios Y. Factors associated with television viewing time in toddlers and preschoolers in Greece: the GENESIS study. J Public Health (Oxf) 2009;31(2):222–230. doi: 10.1093/pubmed/fdp011.
    1. Tandon PS, Zhou C, Lozano P, Christakis DA. Preschoolers’ total daily screen time at home and by type of child care. J Pediatr. 2011;158(2):297–300. doi: 10.1016/j.jpeds.2010.08.005.
    1. Wu CST, Fowler C, Lam WYY, Wong HT, Wong CHM, Loke AY. Parenting approaches and digital technology use of preschool age children in a Chinese community. Italian J Pediatr. 2014;40:44. doi: 10.1186/1824-7288-40-44.
    1. Barr-Anderson DJ, Fulkerson JA, Smyth M, Himes JH, Hannan PJ, Holy Rock B, et al. Associations of American Indian children’s screen-time behavior with parental television behavior, parental perceptions of children’s screen time, andmedia-related resources in the home. Prev Chronic Dis. 2011;8(5):A105.
    1. Birken CS, Maguire J, Mekky M, Manlhiot C, Beck CE, Jacobson S, Peer M, Taylor C, McCrindle BW, Parkin PC, TARGet Kids! collaboration Parental factors associated with screen time in pre-school children in primarycare practice: a TARGet kids! Study. Public Health Nutr. 2011;14(12):2134–2138. doi: 10.1017/S1368980011000516.
    1. Asplund KM, Kair LR, Arain YH, Cervantes M, Oreskovic NM, Zuckerman KE. Early childhood screen time and parental attitudes toward child television viewing in a low-income latino population attending the special supplemental nutrition program for women, infants, and children. Child Obes. 2015;11(5):590–599. doi: 10.1089/chi.2015.0001.
    1. Emond JA, Tantum LK, Gilbert-Diamond D, Kim SJ, Lansigan RK, Neelon SB. Household chaos and screen media use among preschool-aged children: a crosssectional study. BMC Public Health. 2018;18(1):1210. doi: 10.1186/s12889-018-6113-2.
    1. Christakis E. The importance of being little: what young children really need from grownups. New York: Penguin Books; 2017.
    1. Wolf C, Wolf S, Weiss M, Nino G. Children’s environmental health in the digital era: understanding early screen exposure as a preventable risk factor for obesity and sleep disorders. Children (Basel) 2018;5(2):31. doi: 10.3390/children5020031.
    1. Schary DP, Cardinal BJ, Loprinzi PD. Parenting style associated with sedentary behaviour in preschool children. Early Child Dev Care. 2012;182(8):1015–1026. doi: 10.1080/03004430.2012.678596.
    1. Vandewater EA, Rideout VJ, Wartella EA, Huang X, Lee JH, Shim MS. Digital childhood: electronic media and technology use among infants, toddlers, and preschoolers. Pediatrics. 2007;119(5):e1006–e1015. doi: 10.1542/peds.2006-1804.
    1. Hinkley T, Salmon J, Okely AD, Crawford D, Hesketh K. Preschoolers’ physical activity, screen time, and compliance with recommendations. Med Sci Sport Exerc. 2012;44(3):458–465. doi: 10.1249/MSS.0b013e318233763b.
    1. Pagani LS, Fitzpatrick C, Barnett TA, Dubow E. Prospective associations between early childhood television exposure and academic, psychosocial, and physical well-being by middle childhood. Arch Pediatr Adolesc Med. 2010;164(5):425–431. doi: 10.1001/archpediatrics.2010.50.
    1. Carson V, Janssen I. Associations between factors within the home setting and screen time among children aged 0-5 years: a cross-sectional study. BMC Public Health. 2012;12:539. doi: 10.1186/1471-2458-12-539.
    1. Chang HY, Park E-J, Yoo H-J, Lee JW, Shin Y. Electronic media exposure and use among toddlers. Psychiatry Investig. 2018;15(6):568–573. doi: 10.30773/pi.2017.11.30.2.
    1. Rideout V, Robb MB. The common sense census: media use by kids age zero to eight. San Francisco: Common Sense Media; 2020.
    1. Kabali HK, Irigoyen MM, Nunez-Davis R, Budacki JG, Mohanty SH, Leister K, et al. Exposure and use of Mobile media devices by young children. Pediatrics. 2015;136(6):1044–1050. doi: 10.1542/peds.2015-2151.
    1. Fang K, Mu M, Liu K, He Y. Screen time and childhood overweight/obesity: a systematic review and meta-analysis. Child Care Health Dev. 2019;45(5):744–753. doi: 10.1111/cch.12701.
    1. De Decker E, De Craemer M, De Bourdeaudhuij I, Wijndaele K, Duvinage K, Koletzko B, et al. Influencing factors of screen time in preschool children: an exploration of parents’ perceptions through focus groups in six European countries. Obes Rev. 2012;(Suppl 1):75–84. 10.1111/j.1467-789X.2011.00961.x.
    1. Jago R, Stamatakis E, Gama A, Carvalhal IM, Nogueira H, Rosado V, et al. Parent and child screen-viewing time and home media environment. Am J Prev Med. 2012;43(2):150–158. doi: 10.1016/j.amepre.2012.04.012.
    1. Duch H, Fisher EM, Ensari I, Harrington A. Screen time use in children under 3 years old: a systematic review of correlates. Int J Behav Nutr Phys Act. 2013;10:102. doi: 10.1186/1479-5868-10-102.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa