J Korean Med Sci.  2023 Sep;38(36):e283. 10.3346/jkms.2023.38.e283.

Emotional and Behavioral Correlates of Exposure to Electronic Media in School-Aged Children: A Prospective Study

• Kim KM
• Chung US

• KMID: 2545785
• DOI: http://doi.org/10.3346/jkms.2023.38.e283

Abstract

Background
Exposure to electronic media is increasing from early childhood. This study aimed to examine the association between screen time and behavioral outcomes in schoolaged children with a prospective birth-cohort.
Methods
We examined the association between screen time and behavioral outcomes in school-aged children with a Korean birth-cohort study. Participants were 2,150 children, recruited during their fetal period, assessed annually for developmental outcomes. Media exposure was assessed at T4 (3.2 y/o), T8 (7.3 y/o), and T10 (9.4 y/o). After exclusions for missing data, 1,368 children were categorized into four groups (Low-Low, Low-High, HighLow, and High-High) based on average daily media time in early childhood and during schooldays, respectively. Children's temperament was assessed from T1 (0.5 y/o) to T4. Emotional and behavioral outcomes were assessed using the Child Behavior Checklist (DSMoriented subscales) at T8 and T10.
Results
We found that early-years temperament was generally similar between the mediatime groups: they only differed significantly on Activity at T1 and Emotionality at T2 (1.2 y/o). However, compared to the Low-Low group, the Low-High group had significantly higher odds of high-risk scores for Conduct Problems (increased odds ratios [ORs] of 1.82 at T8 and 1.83 at T10) and Anxiety Problems (increased ORs of 1.60 at T8 and 1.82 at T10). Self-rated self-esteem and overall happiness at T10 also significantly differed among the four groups.
Conclusion
Our findings suggest the negative impacts of media exposure on the emotional and behavioral development of school-aged children, which substantiates the guidelines that restrict media exposure during childhood.

Keyword

Screen Media; Behavior; Emotion; Childbirth Cohort; School-Aged Children

Reference

1. Zimmerman FJ, Christakis DA, Meltzoff AN. Television and DVD/video viewing in children younger than 2 years. Arch Pediatr Adolesc Med. 2007; 161(5):473–479. PMID: 17485624.

2. Christakis DA. The effects of infant media usage: what do we know and what should we learn? Acta Paediatr. 2009; 98(1):8–16. PMID: 18793294.

3. Rideout V, Robb MB. The Common Sense Census: Media Use by Kids Age Zero to Eight. San Francisco, CA, USA: Common Sense Media;2017. p. 283.

4. Nunez-Smith M, Wolf E, Huang H, Emanuel D, Gross C. Media and Child and Adolescent Health: a Systematic Review. Washington, D.C., USA: Common Sense Media;2008.

5. Strasburger VC, Jordan AB, Donnerstein E. Health effects of media on children and adolescents. Pediatrics. 2010; 125(4):756–767. PMID: 20194281.

6. Anderson DR, Pempek TA. Television and very young children. Am Behav Sci. 2005; 48(5):505–522.

7. Christakis DA, Gilkerson J, Richards JA, Zimmerman FJ, Garrison MM, Xu D, et al. Audible television and decreased adult words, infant vocalizations, and conversational turns: a population-based study. Arch Pediatr Adolesc Med. 2009; 163(6):554–558. PMID: 19487612.

8. Duch H, Fisher EM, Ensari I, Font M, Harrington A, Taromino C, et al. Association of screen time use and language development in Hispanic toddlers: a cross-sectional and longitudinal study. Clin Pediatr (Phila). 2013; 52(9):857–865. PMID: 23820003.

9. Hancox RJ, Milne BJ, Poulton R. Association of television viewing during childhood with poor educational achievement. Arch Pediatr Adolesc Med. 2005; 159(7):614–618. PMID: 15996992.

10. Nathanson AI, Aladé F, Sharp ML, Rasmussen EE, Christy K. The relation between television exposure and executive function among preschoolers. Dev Psychol. 2014; 50(5):1497–1506. PMID: 24447117.

11. Carson V, Kuzik N, Hunter S, Wiebe SA, Spence JC, Friedman A, et al. Systematic review of sedentary behavior and cognitive development in early childhood. Prev Med. 2015; 78:115–122. PMID: 26212631.

12. Barr R, Muentener P, Garcia A, Fujimoto M, Chávez V. The effect of repetition on imitation from television during infancy. Dev Psychobiol. 2007; 49(2):196–207. PMID: 17299795.

13. Meltzoff AN. Imitation of televised models by infants. Child Dev. 1988; 59(5):1221–1229. PMID: 3168638.

14. Fisch SM, Truglio RT. G Is for Growing: Thirty Years of Research on Children and Sesame Street. New York, NY, USA: Taylor & Francis;2014.

15. Kuhl PK, Tsao FM, Liu HM. Foreign-language experience in infancy: effects of short-term exposure and social interaction on phonetic learning. Proc Natl Acad Sci U S A. 2003; 100(15):9096–9101. PMID: 12861072.

16. Mendelsohn AL, Berkule SB, Tomopoulos S, Tamis-LeMonda CS, Huberman HS, Alvir J, et al. Infant television and video exposure associated with limited parent-child verbal interactions in low socioeconomic status households. Arch Pediatr Adolesc Med. 2008; 162(5):411–417. PMID: 18458186.

17. Troseth GL, DeLoache JS. The medium can obscure the message: young children's understanding of video. Child Dev. 1998; 69(4):950–965. PMID: 9768480.

18. Tanimura M, Okuma K, Kyoshima K. Television viewing, reduced parental utterance, and delayed speech development in infants and young children. Arch Pediatr Adolesc Med. 2007; 161(6):618–619.

19. Nikkelen SW, Valkenburg PM, Huizinga M, Bushman BJ. Media use and ADHD-related behaviors in children and adolescents: A meta-analysis. Dev Psychol. 2014; 50(9):2228–2241. PMID: 24999762.

20. Lingineni RK, Biswas S, Ahmad N, Jackson BE, Bae S, Singh KP. Factors associated with attention deficit/hyperactivity disorder among US children: results from a national survey. BMC Pediatr. 2012; 12(1):50. PMID: 22583686.

21. van Egmond-Fröhlich AW, Weghuber D, de Zwaan M. Association of symptoms of attention-deficit/hyperactivity disorder with physical activity, media time, and food intake in children and adolescents. PLoS One. 2012; 7(11):e49781. PMID: 23166770.

22. Swing EL, Gentile DA, Anderson CA, Walsh DA. Television and video game exposure and the development of attention problems. Pediatrics. 2010; 126(2):214–221. PMID: 20603258.

23. Gentile DA, Swing EL, Lim CG, Khoo A. Video game playing, attention problems, and impulsiveness: evidence of bidirectional causality. Psychol Pop Media Cult. 2012; 1(1):62–70.

24. Cooper NR, Uller C, Pettifer J, Stolc FC. Conditioning attentional skills: examining the effects of the pace of television editing on children's attention. Acta Paediatr. 2009; 98(10):1651–1655. PMID: 19500080.

25. Friedrich LK, Stein AH. Aggressive and prosocial television programs and the natural behavior of preschool children. Monogr Soc Res Child Dev. 1973; 38(4):1–64.

26. Geist EA, Gibson M. The effect of network and public television programs on four and five year olds ability to attend to educational tasks. J Instr Psychol. 2000; 27:250.

27. Ferguson CJ. Do angry birds make for angry children? A meta-analysis of video game influences on children's and adolescents' aggression, mental health, prosocial behavior, and academic performance. Perspect Psychol Sci. 2015; 10(5):646–666. PMID: 26386002.

28. Hoge E, Bickham D, Cantor J. Digital media, anxiety, and depression in children. Pediatrics. 2017; 140(Suppl 2):S76–S80. PMID: 29093037.

29. Cantor J, Riddle K. Media and fear in children and adolescents. Gentile DA, editor. Media Violence and Children: A Complete Guide for Parents and Professionals. Santa Barbara, CA, USA: Praeger/ABC-CLIO;2014. p. 179–207.

30. Stevens T, Barnard-Brak L, To Y. Television viewing and symptoms of inattention and hyperactivity across time: the importance of research questions. J Early Interv. 2009; 31(3):215–226.

31. Parkes A, Sweeting H, Wight D, Henderson M. Do television and electronic games predict children's psychosocial adjustment? Longitudinal research using the UK Millennium Cohort Study. Arch Dis Child. 2013; 98(5):341–348. PMID: 23529828.

32. Sameroff A. A unified theory of development: a dialectic integration of nature and nurture. Child Dev. 2010; 81(1):6–22. PMID: 20331651.

33. Achenbach TM, Rescorla LA. Manual for the ASEBA School-Age Forms & Profiles: an Integrated System of Multi-Informant Assessment. Burlington, VT, USA: University of Vermont, Research Center for Children, Youth, & Families;2001. p. 1617.

34. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D.C., USA: American Psychiatric Association;2013.

35. Magyar CI, Pandolfi V. Utility of the CBCL DSM-oriented scales in assessing emotional disorders in youth with autism. Res Autism Spectr Disord. 2017; 37:11–20. PMID: 28970862.

36. Ebesutani C, Bernstein A, Nakamura BJ, Chorpita BF, Higa-McMillan CK, Weisz JR, et al. Concurrent validity of the child behavior checklist DSM-oriented scales: correspondence with DSM diagnoses and comparison to syndrome scales. J Psychopathol Behav Assess. 2010; 32(3):373–384. PMID: 20700377.

37. Buss AH, Plomin R. Temperament: Early Developing Personality Traits. London, England: Psychology Press;2014.

38. Connelly R, Platt L. Cohort profile: UK millennium cohort study (MCS). Int J Epidemiol. 2014; 43(6):1719–1725. PMID: 24550246.

39. Trinh MH, Sundaram R, Robinson SL, Lin TC, Bell EM, Ghassabian A, et al. Association of trajectory and covariates of children's screen media time. JAMA Pediatr. 2020; 174(1):71–78. PMID: 31764966.

40. Rideout V. Measuring time spent with media: the common sense census of media use by US 8-to 18-year-olds. J Child Media. 2016; 10(1):138–144.

41. Coyne SM, Shawcroft J, Gale M, Gentile DA, Etherington JT, Holmgren H, et al. Tantrums, toddlers and technology: Temperament, media emotion regulation, and problematic media use in early childhood. Comput Human Behav. 2021; 120:106762. PMID: 33927469.

42. Thompson AL, Adair LS, Bentley ME. Maternal characteristics and perception of temperament associated with infant TV exposure. Pediatrics. 2013; 131(2):e390–e397. PMID: 23296440.

43. Tamana SK, Ezeugwu V, Chikuma J, Lefebvre DL, Azad MB, Moraes TJ, et al. Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study. PLoS One. 2019; 14(4):e0213995. PMID: 30995220.

44. Verlinden M, Tiemeier H, Hudziak JJ, Jaddoe VW, Raat H, Guxens M, et al. Television viewing and externalizing problems in preschool children: the generation R study. Arch Pediatr Adolesc Med. 2012; 166(10):919–925. PMID: 22869354.

45. Allen MS, Walter EE, Swann C. Sedentary behaviour and risk of anxiety: a systematic review and meta-analysis. J Affect Disord. 2019; 242:5–13. PMID: 30170238.

46. Khouja JN, Munafò MR, Tilling K, Wiles NJ, Joinson C, Etchells PJ, et al. Is screen time associated with anxiety or depression in young people? Results from a UK birth cohort. BMC Public Health. 2019; 19(1):82. PMID: 30654771.

47. Stanczykiewicz B, Banik A, Knoll N, Keller J, Hohl DH, Rosińczuk J, et al. Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis. BMC Public Health. 2019; 19(1):459. PMID: 31039760.

48. Cantwell DP, Lewinsohn PM, Rohde P, Seeley JR. Correspondence between adolescent report and parent report of psychiatric diagnostic data. J Am Acad Child Adolesc Psychiatry. 1997; 36(5):610–619. PMID: 9136495.

49. Weissman MM, Wickramaratne P, Warner V, John K, Prusoff BA, Merikangas KR, et al. Assessing psychiatric disorders in children. Discrepancies between mothers' and children's reports. Arch Gen Psychiatry. 1987; 44(8):747–753. PMID: 3632247.

50. Council on Communications and Media. Brown A. Media use by children younger than 2 years. Pediatrics. 2011; 128(5):1040–1045. PMID: 22007002.