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

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          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-score≥65).

          Results

          Screen-time was available for over 95% of children (2,322/2,427) with CBCL data. Mean screen-time was 1·4 hours/day (95%CI 1·4, 1·5) at five-years and 1·5 hours/day (95%CI: 1·5, 1·6) at three-years. Compared to children with less than 30-minutes/day screen-time, those watching more than two-hours/day (13·7%) had a 2·2-point increase in externalizing T-score (95%CI: 0·9, 3·5, p≤0·001); a five-fold increased odd for reporting clinically significant externalizing problems (95%CI: 1·0, 25·0, p = 0·05); and were 5·9 times more likely to report clinically significant inattention problems (95%CI: 1·6, 21·5, p = 0·01). 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 7·7-fold increased risk of meeting criteria for ADHD (95%CI: 1·6, 38·1, p = 0·01). 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.

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          Most cited references33

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          Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine.

          Sleep is essential for optimal health in children and adolescents. Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. The recommendations are summarized here. A manuscript detailing the conference proceedings and the evidence supporting these recommendations will be published in the Journal of Clinical Sleep Medicine.
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            Media Use in School-Aged Children and Adolescents

            Swanson (2016)
            This policy statement focuses on children and adolescents 5 through 18 years of age. Research suggests both benefits and risks of media use for the health of children and teenagers. Benefits include exposure to new ideas and knowledge acquisition, increased opportunities for social contact and support, and new opportunities to access health-promotion messages and information. Risks include negative health effects on weight and sleep; exposure to inaccurate, inappropriate, or unsafe content and contacts; and compromised privacy and confidentiality. Parents face challenges in monitoring their children's and their own media use and in serving as positive role models. In this new era, evidence regarding healthy media use does not support a one-size-fits-all approach. Parents and pediatricians can work together to develop a Family Media Use Plan (www.healthychildren.org/MediaUsePlan) that considers their children's developmental stages to individualize an appropriate balance for media time and consistent rules about media use, to mentor their children, to set boundaries for accessing content and displaying personal information, and to implement open family communication about media.
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              The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies.

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: Writing – original draft
                Role: Formal analysisRole: Writing – review & editing
                Role: InvestigationRole: Project administration
                Role: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: ResourcesRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: ResourcesRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: ResourcesRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: VisualizationRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: Writing – review & editing
                Role: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 April 2019
                2019
                : 14
                : 4
                : e0213995
                Affiliations
                [1 ] Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
                [2 ] Department of Medicine, McMaster University, Hamilton, Ontario, Canada
                [3 ] Department of Pediatrics & Child Health, Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
                [4 ] Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
                [5 ] Department of Pediatrics, Child & Family Research Institute, BC Children’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
                [6 ] Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
                [7 ] Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
                [8 ] Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
                International Telematic University Uninettuno, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                ¶ A complete list of active investigators in the CHILD study is provided in S1 File.

                Author information
                http://orcid.org/0000-0001-5835-7238
                Article
                PONE-D-18-27763
                10.1371/journal.pone.0213995
                6469768
                30995220
                20134b26-3651-49b5-90c4-6f6e16a9579f
                © 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.

                History
                : 24 September 2018
                : 5 March 2019
                Page count
                Figures: 1, Tables: 5, Pages: 15
                Funding
                Funded by: Canadian Institute of Health Research (CA)
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100002722, AllerGen;
                Funded by: funder-id http://dx.doi.org/10.13039/100010090, Women and Children’s Health Research Institute;
                This work was supported by: 1. The Allergy Genes and Environment Network of Centres of Excellence (AllerGen NCE). 2. Women’s and Children’s 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.
                Categories
                Research Article
                Biology and Life Sciences
                Psychology
                Behavior
                Social Sciences
                Psychology
                Behavior
                Biology and Life Sciences
                Neuroscience
                Developmental Neuroscience
                Neurodevelopmental Disorders
                Adhd
                Medicine and Health Sciences
                Neurology
                Neurodevelopmental Disorders
                Adhd
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                Mental Health and Psychiatry
                Neuropsychiatric Disorders
                Adhd
                Medicine and Health Sciences
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                Public and Occupational Health
                Physical Activity
                Biology and Life Sciences
                Psychology
                Behavior
                Parenting Behavior
                Social Sciences
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                Behavior
                Parenting Behavior
                People and Places
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                Biology and Life Sciences
                Physiology
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                Sleep
                Medicine and Health Sciences
                Physiology
                Physiological Processes
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                Medicine and Health Sciences
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                All relevant data are within the manuscript and its Supporting Information files.

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