Screen Time Linked to Inattentiveness, Behavior Problems in Children

Increased screen time in children could lead to behavioral issues and attentiveness issues in school, according to a recent study.

Investigators found that 2 hours or more of screen time per day resulted in children being 7 times more likely to meet criteria for attention-deficit/hyperactivity disorder and 5.9 times more likely to report clinically significant inattention problems.

Study included 3455 families recruited from Edmonton, Toronto, Vancouver, and Manitoba from the Canadian Healthy Infant Longitudinal Development (CHILD) study. The primary exposure variable for the study was screen-time, which was assessed at 3 and 5 years. The outcome variable for the study was preschool behavior.

Parents reported their child’s total screen-time per day, which included watching TV, using a computer, tablet, mobile phone, or playing video games. Investigators created three categories based upon recommendations from the Canadian 24-hour Movement Guidelines. Group 1 had less than 30 minutes of screen time per day, group 2 had between 30 minutes and 2 hours per day, and group 3 reported 2 or more hours of screen time. Investigators adjusted the upper-threshold for screen time at 3 years old to 1 hour per day, based upon the same movement guidelines.

The Child Behavior Checklist (CBCL) preschool version was completed by parents at 5 years at all CHILD sites. Of the 3455 families enrolled in the CHILD study, 2427 children had CBCL data at 5 years old. Authors noted that parents of children with CBCL data reported less screen-time per day than those without CBCL data.

Investigators found significant externalizing behavior problems in 1.2% (28) of children and 2.5% (61) of children exhibited clinical significant internalizing behavior problems. Data on screen time was available for 96% (2322 of 2427) of participants. At 5 years old, 317 (13.7%) children were exposed to 2 hours of screen-time per day and the remaining 2005 met the recommended guideline of less than 2 hours.

Investigators found that children who watched more than 2 hours of screen time per day had increased externalizing, internalizing, and total behavior problems scores compared to children who watched less than 30 minutes. The mean screen time reported was 1.4 hours per day at five years and 1.5 hours per day at 3 years.

The 13.7% of children who reportedly watched more than 2 hours each day were 5 times more likely to report clinically significant externalizing problems and were 5.9 times more likely to report clinically significant inattention problems. Additionally, children with more than 2 hours of screen time per day were 7 times more likely to meet criteria for attention-deficit/hyperactivity disorder.


"The two big takeaways from this study are that children exposed to more screen time, at either age three or five years, showed significantly greater behavioral and attention problems at age five, and that this association was greater than any other risk factor we assessed, including sleep, parenting stress, and socioeconomic factors," said Sukhpreet Tamana, PhD, study author and a postdoctoral fellow in the Department of Pediatrics at the University of Alberta.

Investigators noted several limitations within their study. First, because the screen time information was parent-reported it could not be validated against objective measures. The investigators were unable to determine if the media content, or screen type were important predictors of behavioral morbidity. More than 84% of the sample population met the recommended 10 to 13 hours of sleep guideline, which limited the investigators ability to examine the impact of sleep duration on behavior.

This study, “Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study,” is published in PLOS ONE.