Impact of the covid-19 pandemic on screen time of children and adolescents
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v31.i3.27823Keywords:
adolescents, children, COVID- 19 pandemic, screen timeAbstract
The use of screens by children and adolescents has been increasing in the last two decades, including mobile devices and interactive and social platforms. At present media exposure affects even young children and is part of their daily routine.
Although there are benefits of media use for children, including educational potential, there are concerns about their overuse, especially in early childhood, during the crucial period of brain development.
Data from national and international studies, reveal that COVID-19 pandemic- related restrictions, lockdowns and stay-at- home orders contributed to a remarkable increase in screen time (ST) in pediatric ages.
The authors present a literature review on the repercussions of COVID-19 pandemics on the use of digital media, the associated risks and its impact on different health domains.
Scientific evidence associates excessive use of digital media with physical, neurodevelopmental and mental adverse consequences. Excessive ST has been associated with obesity, sleep disturbance, language delay, impaired executive functions, general cognition and mental health, namely anxiety and depression.
There are evidence-based recommendations to promote healthy screen habits for children and their families in order to mitigate the adverse effects of screen use.
Increased ST in children and youth during the COVID-19 pandemic is a public health concern demanding policy-level interventions to promote accessible outdoor facilities for recreational and physical activities offering active and social alternatives to screens, to improve the mental and physical well-being of children and adolescents.
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References
Kabali H, Irigoyen M, Nunez-Davis R, Budacki JG, Mohanty SH, Leister KP, et al. Exposure to and use of mobile devices by young children. Pediatrics 2015;136(6):1044–50. https://doi.org/10.1542/peds.2015-2151.
Wartella E, Rideout V, Lauricella AR, et al. Parenting in the age of digital technology. Chicago: Northwestern University Press; 2014.
Chen W, Adler JL. Assessment of Screen Exposure in Young Children, 1997 to 2014. JAMA Pediatr. 2019;173(4):391-393. https://doi.org/10.1001/jamapediatrics.2018.5546.
Rideout V, Robb MB. The Common Sense Census 2019: media use by tweens and teens. https://www.commonsensemedia.org/sites/default/files/uploads/research/2019-census-8-to-18-full-report-updated.pdf.
Ponte C, Batista S. EU Kids Online Portugal - Usos, Competências, Riscos e Mediações da Internet reportados por crianças e jovens (9-17 anos). Lisboa: Universidade Nova;2019. https://fabricadesites.fcsh.unl.pt/eukidsonline/wp-content/uploads/sites/36/2019/03/RELATO%CC%81RIO-FINAL-EU-KIDS-ONLINE.docx.pdf.
Radesky JS, Christakis DA. Increased Screen Time: Implications for early childhood development and behavior. Pediatr Clin North Am. 2016;63(5):827-839. https://doi.org/10.1016/j.pcl.2016.06.006.
Palha C, Tavares B, Morgado DL, Fonseca D, Castro J, Castro PS. Influência das características familiares no tempo de ecrã em crianças até aos 18 meses de idade. Rev. Port. Clínica Geral. 2019;35(6):438–448. https://doi.org/10.32385/rpmgf.v35i6.12541.
Canadian Paediatric Society, Digital Health Task Force, Ottawa, Ontario. Digital media: Promoting healthy screen use in school-aged children and adolescents. Paediatric Child Health. 2019;24(6):402-408. https://doi.org/10.1093/pch/pxz095.
World Health Organization (WHO), Guidelines on physical activity, sedentary behaviour and sleep. 2019.
Tremblay MS, Carson V, Chaput JP, Connor Gorber S, Dinh T, Duggan M, et al. Canadian 24-hour movement guidelines for children and youth: An integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab. 2016;41(6 (Suppl. 3)):S311-S327. https://doi.org/10.1139/apnm-2016-0151.
Media and Young Minds. Council on Communication and media. Policy Statement. Pediatrics.2016;138 (5). https://doi.org/10.1542/peds.2016-2591.
UNICEF. Rethinking screen-time in the time of COVID 19. https://www.unicef.org/globalinsight/stories/rethinkingscreen-time-time-covid-19.
Montag C, Elhai J. Discussing digital technology overuse in children and adolescents during the COVID-19 pandemic and beyond: On the importance of considering Affective Neuroscience Theory. Addictive Behavior Reports 12. 2020; 100313. https://doi.org/10.1016/j.abrep.2020.100313.
WHO. (2020). WHO EMRO | Excessive screen use and gaming considerations during #COVID19 | News | Mental health. http://www.emro.who.int/mnh/news/considerations-for-young-people-on-excessive-screen-use-during-covid19.html.
Wiederhold BK. Children’s Screen Time During the COVID-19 Pandemic: Boundaries and Etiquette. Cyberpsychology, Behavior, and Social Networking. 2020; 23:(6): 359-360. https://doi.org/10.1089/cyber.2020.29185.bkw.
Loades ME, Chatburn E, Higson-Sweeney N, Reynolds S, Shafran R, Brigden A, et al. (2020 Jun 3). Rapid systematic review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. Journal of the American Academy of Child & Adolescent Psychiatry. 2020;59(11): 1218-1239.e3. https://doi.org/10.1016/j.jaac.2020.05.009.
Rundle AG, Park Y, Herbstman JB, Kinsey EW, & Wang YC. COVID-19-Related school closings and risk of weight gain among children. Obesity (Silver Spring).2020;28(6):1008–1009. https://doi.org/10.1002/oby.22813.
Eidi A, & Delam, H. internet addiction is likely to increase in home quarantine caused by coronavirus disease 2019 (COVID 19). Journal of Health Sciences & Surveillance System. 2020:8(3):137–138. https://doi.org/10.30476/jhsss.2020.87015.1104.
Kir´aly O, Potenza MN, Stein DJ, King DL, Hodgins DC, Saunders, JB, et al. Preventing problematic internet use during the COVID-19 pandemic: Consensus guidance. Comprehensive Psychiatry. 2020;100:152180. https://doi.org/10.1016/j.comppsych.2020.152180.
Kovacs VA, Starc G, Brandes M, Kaj M, Blagus R, Leskošek B, et al. Physical activity, screen time and the COVID-19 school closures in Europe – An observational study in 10 countries, European Journal of Sport Science. 2021;22(7):1094-1103. https://doi.org/10.1080/17461391.2021.1897166.
Moore SA, Faulkner G, Rhodes RE, Brussoni M, Chulak-Bozzer T, Ferguson LJ, et al. Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. International Journal of Behavioral Nutrition and Physical Activity. 2020;17:85. https://doi.org/10.1186/s12966-020-00987-8.
Xiang M, Zhang Z, Kuwahara K. Impact of COVID-19 pandemic on children and adolescents’ lifestyle behavior larger than expected. Progress in Cardiovascular Diseases. 2020; 63(20):531–537. https://doi.org/10.1016/j.pcad.2020.04.013.
Pombo A, Luz C, Rodrigues LP, Cordovil R. COVID-19 confinement in Portugal: Effects on the household routines of children under 13. Res Sq. Published online April 11, 2022. https://doi.org/10.1007/s10826-021-01961-z.
Bergmann C, Dimitrova N, Alaslani K, et al. Young children’s screen time during the first COVID-19 lockdown in 12 countries. Sci Rep. 2022;12(1):2015. https://doi.org/10.1038/s41598-022-05840-5.
Alguilar-Farias N, Toledo-Vargas M, Miranda-Marquez S, Cortinez-O’Ryan A, Cristi-Montero C, Rodriguez-Rodriguez F, et al. Sociodemographic Predictors of Changes in Physical Activity, Screen Time, and Sleep among Toddlers and preschoolers in Chile during COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(1):176. https://doi.org/10.3390/ijerph18010176.
Cardoso JS, Correia C, Gomes R, Fraga C, Cascais I, Monteiro S, B. COVID-19 Pandemic Influence on Toddlers and Preschoolers’ Screen Time. International Scholarly and Scientific Research & Innovation. 2021:15(12):315-319.
Dunton GF, Do B, Wang SD. Early effects of the COVID-19 pandemic on physical activity and sedentary behavior in children living in the U.S. BMC Public Health. 2020;20(1):1351. https://doi.org/10.1186/s12889-020-09429-3.
Wai Wong C, Tsai A, Jonas JB, Ohno-Matsui K, Chen J,Ang M, et al. Digital Screen Time During COVID-19 Pandemic: Risk for a Further Myopia Boom?, American Journal of Ophthalmology. 2020;223: March 2021: 333-337. https://doi.org/10.1016/j.ajo.2020.07.034.
Toombs E, Mushquash CJ, Mah L, et al. Increased screen time for children and youth during the COVID-19 pandemic. Science Briefs of the Ontario COVID-19 Science Advisory Table. 2022;3(59). https://doi.org/10.47326/ocsat.2022.03.59.1.0.
Hartshorne JK, Huang YT, Lucio Paredes PM, Oppenheimer K, Robbins PT, Velasco MD. Screen time as an index of family distress. Curr Res Behav Sci. 2021;2: 100023. https://doi.org/10.1016/j.crbeha.2021.100023.
Seguin D, Kuenzel E, Morton JB, Duerden EG. School’s out: Parenting stress and screen time use in school-age children during the COVID-19 pandemic. J Affect Disord Rep. 2021;6:100217. https://doi.org/10.1016/j.jadr.2021.100217.
American Academy of Pediatrics. The Importance of Family Routines. 2007. Available at: https://www.healthychildren.org/English/family-life/family-dynamics/Pages/The-Importance-of-Family-Routines.aspx.
Brazendale K, Beets MW, Weaver RG, Pate RR, Turner- McGrievy, GM, Kaczynski AT, et al. Understanding differences between summer vs. School obesogenic behaviors of children: The structured days hypothesis. International Journal of Behavioral Nutrition and Physical Activity. 2017;14(1):100. https://doi.org/10.1186/s12966-017-0555-2.
Kim S, Favotto L, Halladay J, Wang L, Boyle MH, Georgiades K. Differential associations between passive and active forms of screen time and adolescent mood and anxiety disorders. Soc Psychiatry Psychiatr Epidemiol. 2020;55(11):1469- 1478. https://doi.org/10.1007/s00127-020-01833-9.
Hill D, Ameenuddin N, Chassiakos YR, et al. Media Use in School-aged children and adolescents. Pediatrics. 2016;138(5). https://doi.org/10.1542/peds.2016-2592.
Chassiakos YR, Radesky J, MD; Christakis D, et al. Children and Adolescents and Digital media. Pediatrics. 2016;138(5). https://doi.org/10.1542/peds.2016-2593.
Korhonen L. The good, the bad and the ugly of children´s screen time during the COVID-19 pandemic. Acta Paediatr. 2021;110:2671–2672. https://doi.org/10.1111/apa.16012.
Nagata, JM, Magid, HAS, Gabirel, KP. Screen time for children and Adolescents During the Coronavirus Disease 2019 Pandemic. Obesity. 2020 28(9). https://doi.org/10.1002/oby.22917.
Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study. Environmental Research. 2018;164:149–157. https://doi.org/10.1016/j.envres.2018.01.015.
Lin LY, Cherng RJ, Chen YJ, Chen YJ, Yang HM. Effects of television exposure on developmental skills among young children. Infant Behavior and Development. 2015;38:20-26. https://doi.org/10.1016/j.infbeh.2014.12.005.
Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL, Wartella E. Screen Media Exposure and Obesity in Children and Adolescents. Pediatrics. 2017;140(Suppl 2):S97-S101. https://doi.org/10.1542/peds.2016-1758K.
Yang GY, Huang LH, Schmid KL, et al. Associations between screen exposure in early life and myopia amongst Chinese preschoolers. Int J Environ Res Public Health. 2020;17(3):1056. 19. https://doi.org/10.3390/ijerph17031056.
Carter B, Rees P, Hale L, Bhattacharjee D, Paradkar MS. Association between portable screen-based media device access or use and sleep outcomes: a systematic review and meta-analysis. JAMA Pediatr. 2016;170(12):1202-1208. https://doi.org/10.1001/jamapediatrics.2016.2341.
Chen B, van Dam RM, Tan CS, et al. Screen viewing behavior and sleep duration among children aged 2 and below. BMC Public Health. 2019;19(1):59. https://doi.org/10.1186/s12889-018-6385-6.
Anderson DR, Subrahmanyam K; Cognitive Impacts of Digital MediaWorkgroup. Digital screen media and cognitive development. Pediatrics. 2017; 140(suppl 2):S57-S61. https://doi.org/10.1542/peds.2016-1758C.
Ma J, Birken C. Handheld screen time linked with speech delays in young children. Paper presented at: Pediatric Academic Societies Meeting; May 6, 2017; San Francisco, CA. https://www.pas-meeting.org/wp-content/uploads/PAS-2698024-Birken-Ma-Screens-Speech-Delays-PAS-17-FINAL.
Hutton JS. Associations Between Screen Use and White Matter Integrity in Preschoolers JAMA Pediatr.2020;174(1):e193869. https://di.org/10.1001/jamapediatrics.2019.3869.
Madigan S, Browne D, Racine N, Morim C, Tough S. Association between screen time and children’s performance on a developmental screening test. JAMA Pediatr.2019;173(3):244–250. https://doi.org/10.1001/jamapediatrics.2018.5056.
Lillard AS, Li H, Boguszewski K. Television and children’s executive function. Adv Child Dev Behav. 2015;48:219-248.https://doi.org/10.1016/bs.acdb.2014.11.006.
Walsh JJ, Barnes JD, Tremblay MS, Chaput JP. Associations between duration and type of electronic screen use and cognition in US children. Comput Hum Behav. 2020;108:106312. https://doi.org/10.1016/j.chb.2020.106312.
Tomopoulos S, Dreyer BP, Berkule S, Fierman AH, Brockmeyer C, Mendelsohn AL. Infant media exposure and toddler development. Arch Pediatr Adolesc Med. 2010;164(12):1105-1111. https://doi.org/10.1001/archpediatrics.2010.235.
Mendelsohn AL, Berkule SB, Tomopoulos S, 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. https://doi.org/10.1001/archpedi.162.5.411.
International Classification of Diseases 11th Revision- ICD-11. Icd.who.int. 2019. Available from: https://icd.who.int/en.
The Implications of COVID‑19 for Mental Health and Substance Use. KFF; 2020. https://www.kff.org.
Liang L, Ren H, Cao R, Hu Y, Qin Z, Li C, et al. The Effect of COVID‑19 on Youth Mental Health. Psychiatr Q 2020;17:15-54. https://doi.org/10.1007/s11126-020-09744-3.
Gao J, Zheng P, Jia Y, et al. Mental health problems and social media exposure during COVID-19 outbreak. PLoS One. 2020;15(4):e0231924. Published 2020 Apr 16. https://doi.org/10.1371/journal.pone.0231924.
Li X, Vanderloo LM, Keown-Stoneman CDG, et al. Screen use and mental health symptoms in canadian children and youth during the COVID-19 pandemic. JAMA Netw Open. 2021;4(12).https://doi.org/10.1001/jamanetworkopen.2021.40875.
Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health. 2020;14:20. https://doi.org/10.1186/s13034-020-00329-3.
Vanderloo LM, Carsley S, Aglipay M, Cost KT, Maguire J, Birken CS. Applying harm reduction principles to address screen time in young children amidst the COVID-19 pandemic. J Dev Behav Pediatr. 2020;41(5):335-336. https://doi.org/10.1097/DBP.0000000000000825.
Yilmaz G, Demirli Caylan N, Karacan CD. An intervention to preschool children for reducing screen time: a randomized controlled trial. Child Care Health Dev. 2015;41(3):443-449. https://doi.org/10.1111/cch.12133org/10.1097/DBP.0000000000000825.
Mylona I, Deres ES, Dere GDS, Tsinopoulos I, Glynatsis M. The impact of internet and videogaming addiction on adolescent vision: A review of the literature. Front Public Health. 2020;8. https://doi.org/10.3389/fpubh.2020.00063.
LeBlanc AG, Spence JC, Carson V, et al. Systematic review of sedentary behaviour and health indicators in the early years (aged 0–4 years). Appl Physiol Nutr Metab. 2012;37(4):753-772. https://doi.org/10.1139/h2012-063.
Downing KL, Hinkley T, Salmon J, Hnatiuk JA, Hesketh KD. Do the correlates of screen time and sedentary time differ in preschool children? BMC Public Health. 2017;17(1):285. https://doi.org/10.1186/s12889-017-4195-x.
Stiglic N, Viner RM. Effects of screentime on the health and well-being of children and adolescents: A systematic review of reviews. BMJ Open. 2019;9(1). https://doi.org/10.1136/bmjopen-2018-023191.
Biddle SJH, García Bengoechea E, Wiesner G. Sedentary behaviour and adiposity in youth: A systematic review of reviews and analysis of causality. Int J Behav Nutr Phys Act. 2017;14(1):43. https://doi.org/10.1186/s12966-017-0497-8.
Sanders T, Parker PD, del Pozo-Cruz B, Noetel M, Lonsdale C. Type of screen time moderates effects on outcomes in 4013 children: Evidence from the longitudinal study of Australian children. Int J Behav Nutr Phys Act. 2019;16(1):117. https://doi.org/10.1186/s12966-019-0881-7.
Chetty-Mhlanga S, Fuhrimann S, Eeftens M, et al. Different aspects of electronic media use, symptoms and neurocognitive outcomes of children and adolescents in the rural Western Cape region of South Africa. Environ Res. 2020. https://doi.org/10.1016/j.envres.2020.109315.
Çaksen H. Electronic screen exposure and headache in children. Ann Indian Acad Neurol. 2021;24(1):8. https://doi.org/10.4103/aian.AIAN_972_20.
Staples AD, Hoyniak C, McQuillan ME, Molfese V, Bates JE. Screen use before bedtime: Consequences for nighttime sleep in young children. Infant Behav Dev. 2021;62:101522. 24. https://doi.org/10.1016/j.infbeh.2020.101522.
Beyens I, Nathanson AI. Electronic media use and sleep among preschoolers: Evidence for time-shifted and less consolidated sleep. Health Commun. 2019;34(5):537-544. 25. https://doi.org/10.1080/10410236.2017.1422102.
Zhang J, Liu MW, Yu HJ, et al. Associations of health-risk behaviors with mental health among Chinese children. Psychol Health Med. 2022;27(3):528-536. https://doi.org/10.1080/13548506.2020.1859559.
Lin HP, Chen KL, Chou W, et al. Prolonged touch screen device usage is associated, with emotional and behavioral problems, but not language delay, in toddlers. Infant Behav Dev. 2020;58:101424. https://doi.org/10.1016/j.infbeh.2020.101424.
van den Heuvel M, Ma J, Borkhoff CM, et al. Mobile media device use is associated with expressive language delay in 18-month-old children. J Dev Behav Pediatr. 2019;40(2):99-104. https://doi.org/10.1097/DBP.0000000000000630.
Madigan S, McArthur BA, Anhorn C, Eirich R, Christakis DA. Associations between screen use and child language skills: A systematic review and meta-analysis. JAMA Pediatr. 2020;174(7):665-675. https://doi.org/10.1001/jamapediatrics.2020.0327.
Hill MM, Gangi D, Miller M, Rafi SM, Ozonoff S. Screen time in 36-month-olds at increased likelihood for ASD and ADHD. Infant Behav Dev. 2020;61:101484. https://doi.org/10.1016/j.infbeh.2020.101484.
Zulkarnain BS, Budiatin AS, Aryani T, Loebis R. The effect of 20-20-20 rule dissemination and artificial tears administration in high school students diagnosed with computer vision syndrome. J Pengabdi Kpd Masy Indones J Community Engagem. 2021;7(1):24-29. https://doi.org/10.22146/jpkm.54121.
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