Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study

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’s 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-score65). Results Screen-time was available for over 95% of children (2,322/2,427) with CBCL data. Mean screen-time was 14 hours/day (95%CI 14, 15) at five-years and 15 hours/day (95%CI: 15, 16) at three-years. Compared to children with less than 30-minutes/day screen-time, those watching more than two-hours/day (137%) had a 22-point increase in externalizing T-score (95%CI: 09, 35, p0001); a five-fold increased odd for reporting clinically significant externalizing problems (95%CI: 10, 250, p = 005); and were 59 times more likely to report clinically significant inattention problems (95%CI: 16, 215, p = 001). 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 77-fold increased risk of meeting criteria for ADHD (95%CI: 16, 381, p = 001). 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.