Association of screen time with parent-reported cognitive delay in preschool children of Kerala, India

Abstract

Background: Screen use is increasing rapidly among preschool children and excess screen use in these children has been associated with cognitive side effects and speech delay. We undertook this study to estimate the risk associated with screen time in children, parental supervision, and parent-reported cognitive development among preschool children aged 2-5 years.

Methods: A cross-sectional study was done between July 2019 and January 2020 involving parents of all students aged 2-5 years, attending 2 kindergarten schools in Thiruvalla using a self-administered questionnaire. Parents also used the Werner David Development pictorial scale (WDDPS), a screening tool to report cognitive development. The schools were sampled based on convenience.

Results: Of the 189 children included in the study, 89.4% had excess screen use (> 1 h per day) and the average use was 2.14 h. 45.0% of parents supervised screen use inconsistently (self-reported). Meal-time screen use (OR 3.8, 95% CI 1.3-10.8), receiving screen on demand (OR 3.7, 95% CI 1.2-11.3), and using devices other than computers (OR 6.5, 95% CI 1.6-26.8) were significantly associated with excess screen use in pre-school children. Similarly, those children with inconsistently supervised screen time were significantly more likely to have suspected deficits in attention (OR 3.2, 95% CI 1.3-8.2), intelligence (OR 4.1, 95% CI 1.3-13.3), and social skills (OR 15.3, 95% CI 1.9-121.2), compared to children whose screen use was consistently supervised.

Conclusion: Screen time in the majority of preschool children is above the recommended limits, and inconsistent supervision by parents was seen in almost half of the study participants. Inconsistently supervised screen time is associated with suspected cognitive delays in children.

Keywords: Cognitive delay; Parental supervision; Preschool children; Screen use.