More than one third of US children used media addictively in fall 2020, a finding tied to family stressors but not a decrease in the number of screen-time rules implemented, finds a survey of US parents published today in Pediatrics.
Investigators from Seattle Children’s Research Institute surveyed 1,000 US parents who had at least one child aged 6 to 17 years to evaluate how COVID-19 pandemic-related family stressors and the number of screen-time rules affected their children’s media use in October and November 2020. The sample included 500 parents each with children in the 6- to 10-year-old group and in the 11- to 17-year-old group.
Parents completed the Patient Health Questionnaire-4 (PHQ-4) and the Problematic Media Use Scale and were asked about parental employment status, demographic characteristics, and whether their child attended school in person or remotely.
Boys had more problematic media use
Parents worked full time in 36% of families, and 22% of children attended school in person. The average parent PHQ-4 score was 3.15, indicating mild depression and anxiety. A total of 32.6% of children 6 to 10 years old and 38.8% of those 11 to 17 had Problematic Media Use Measure scores of 27 and up, indicating excessive screen time.
Addictive child media use was most common in households in which parents worked full time, were home (eg, worked from home), had low levels of formal education, and were psychologically stressed, and in which the children had a hybrid school model (part in person and part remote).
Among 6- to 10-year-olds, parents enforced slightly fewer media limits on weekdays or weekends and during meals than before the pandemic (2.55 vs 2.82). This was mainly due to changes in implementation of four of the seven media-use rules: mobile devices charged outside the child’s bedroom (45% vs 49% prepandemic), no screen use during meals (43% vs 46%), weekday media-use limits (21% vs 29%), and weekend limits (17% vs 21%).
In the 11- to 17-year-old age-group, the number of rules put in place amid the pandemic fell slightly (average, 1.74) from before the pandemic (2.00). The decrease was driven by changes in implementation of five of the seven screen-time–limiting rules, including no media use during meals (41% vs 43% prepandemic), no screen time at least 1 hour before bed (28% vs 36%), limits on types of content accessed (41% vs 43%), and screen-time limits on weekdays (11% vs 17%) and weekends (7% vs 10%).
The absolute number of rules implemented, however, was not significantly associated with addictive media use in either age-group. But in the younger age-group, a greater drop in screen-time rules was significantly associated with excessive media use (rate ratio [RR], 0.99).
For each 1-point increase in parental PHQ-4 score, excessive media use scores increased by 0.46 points in the younger age-group and 1.27 points in the older children. Child gender was significantly associated with problematic media use in the younger age-group—girls scored 1.71 fewer points, on average, than boys on the excessive screen-time scale.
Adjusting family screen time
The study period was marked by the closure of many schools, childcare centers, workplaces, and entertainment venues, and physical distancing precluded the usual social interactions. Family stressors, the researchers said, may have included parental psychological distress due to structural racism, health inequities, financial insecurity stemming from job loss or reduced hours, less workplace flexibility, and less ability to supervise children at home.
“Consequently, screen-based media became increasingly central for child learning and enrichment, supervision, recreation, and socialization,” the researchers wrote. “Such changes may have strengthened peer norms related to media use and changed the family media landscape such that devices were used across more times and places in the home (eg, as more school, employment, and socialization occurred remotely).”
Excessive screen time has been linked to adverse health consequences in children, the authors said. “A growing body of research suggests that when screen use interferes with other developmentally important activities (sleep, physical activity, or in-person social interaction), physical and psychosocial health can suffer,” they wrote.
As a result, the American Academy of Pediatrics recommends that parents restrict screen time and media content, promote good sleep habits, and set aside screen-free times such as during family meals, the authors noted.
They acknowledged, however, that allowing children some screen time can have some benefits, including giving parents time to do household tasks such as meal preparation, making bedtime smoother, occupying and calming children, rewarding good behavior, providing enrichment, and supporting the parent-child bond.
“As we emerge from the pandemic, it will be important to help parents adjust their family’s media practices cognizant of the fact that additional children may have developed problematic screen use behaviors,” the researchers wrote. “Such efforts should center the role of structural and social determinants of health inequities on the stressors that families experience and that impact media use.”