Screen Time and Social Emotional Development

Introduction Increased screen-based media accessibility has stirred public health concern on possible effects of their usage among young children in the vital phase of development. World Health Organization (WHO) and American Academy of Pediatrics (AAP) call for limitation of screen time to an hour per day for children aged two to five, whereas children below the age of two are not encouraged of any screen-based media exposure. This study is aimed to determine the impact of excessive screen time on early childhood social emotional development.

Methodology Study design: Cross-sectional. Sample size: 600 respondents (Malaysian parents of children aged 18 and 36 months old). Study sites: Government Health Clinics in Gombak, Selangor. Data collection: Self-administered questionnaire. Main independant variable: Average child screen time/day calculated using Global Time Estimate method based on media usage (television, computer, laptop, smartphone, tablet/iPad and game console) on a typical day. Excessive screen time classification is based on WHO and AAP recommendations. Main dependant variable: Social emotional development measured using ‘Ages and Stages Questionnaire: Social Emotional-2’ (Validated into Malay language). Social emotional development scoring is classified dichotomously into normal and poor mastery. Data analysis: Multivariate Logistic Regression using SPSS software.

Results Mean screen time recorded is 141.7 minutes (SD 131.6). 82.2% toddlers did not adhere to screen time recommendations. Screen time is found to be a significant independent predictor of poor mastery of social emotional development among toddlers; adjusted for birth weight, prematurity, maternal education, non parental care and six months of exclusive breastfeeding; (Adjusted odds ratio 2.50, 95% CI: 1.11 – 5.62, p-value 0.027).

Conclusion Displacement of parent-child interaction and active play through which toddlers learn, imitate and attain competencies occurs due to excessive screen time. Outcome of this study is hoped to pave the way for development of a national policy on mindful usage of screen-based media aimed at creating an enabling environment for young children to thrive in.