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

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.