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Too much electronic media exposure harms kids

Two new studies, both published online in the journal JAMA Pediatrics on March 17, stress the need for parental supervision of their kids’ media exposure
Two new studies, both published online in the journal JAMA Pediatrics on March 17, stress the need for parental supervision of their kids’ media exposure
Robin Wulffson, MD

Before television sets began to appear in US homes in the 1950s, the only form of electronic media available was an AM radio. Today’s children have access to a wide range of electronic devices. Two new studies, both published online in the journal JAMA Pediatrics on March 17, stress the need for parental supervision of their kids’ media exposure. Lack of such supervision can result in a myriad of problems including poorer well-being and obesity.

In the first study, European researchers evaluated the relationship between the time young children spent using electronic media use and their later well-being. They accessed data from the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants), which was prospective study (forward-looking) with an intervention component. Data were collected September 1, 2007 (baseline) through June 30, 2008 in 8 European countries participating in the IDEFICS study. Follow-up was conducted from September 1, 2009 through May 31, 2010. The researchers reviewed data from 3,604 children aged 2 to 6 years who participated in the longitudinal (over time) component of the IDEFICS study only and not in the intervention.

The researchers used the following six indicators of well-being from two authenticated tools as outcomes at follow-up: Peer problems and Emotional problems subscales from the Strengths and Difficulties Questionnaire and Emotional well-being; and Self-esteem, Family functioning, and Social networks subscales from the KINDLR (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents–Revised Version). Each scale was tailored to identify those children at risk for poorer outcomes. Indicators of electronic media use (weekday and weekend television and electronic game/computer use) from baseline were used as predictors.

The investigators found that associations varied between boys and girls; however, associations suggested that increased levels of electronic media use by both genders predicted poorer well-being outcomes. Television viewing on weekdays or weekends was more consistently related to poorer outcomes than electronic game/computer use. The likelihood of adverse outcomes in children ranged from a 1.2- to 2.0-fold increase for emotional problems and poorer family functioning for each additional hour of television viewing or electronic game/computer use depending on the outcome examined.

The study authors concluded that higher levels of early childhood electronic media use are associated with children being at risk for poorer outcomes as measured by some indicators of well-being. They recommended that further research should be conducted to identify the underlying mechanisms.

The second study was conducted by researchers at Oregon State University (Corvallis, Oregon) and Karolinska Institute (Stockholm, Sweden). The objectives of the study was to evaluated the influences of parental monitoring of child media exposure and children’s general activities on body mass index (BMI) in middle childhood. The researchers conducted a longitudinal (over time) study; they evaluated as subsample of the Three Generational Study, which was comprised mainly of Caucasian individuals who resided in a Pacific Northwest community. The overall participation rate was 89.6%. The evaluations were conducted from June 1998 through September 2012. The evaluations comprised 112 mothers, 103 fathers, and their 213 children (55.4% girls) at age 5, 7, and/or 9 years. Among the three assessments, the participation rates ranged from 66.7% to 72.0% of all eligible Three Generational Study children.

The parents reported on their general monitoring of their children (whereabouts and activities), specific monitoring of child media exposure, children’s participation in sports and recreational activities, children’s media time (hours per week), annual income, and educational level. In addition, parental BMI was recorded.

The main outcome measurements were predictors to level and amount of change in the children’s BMI Z scores. A Z score is a statistical measurement of a score's relationship to the average in a group of scores. A Z score of 0 means the score is the same as the average. A Z-score can also be positive or negative, indicating whether it is above or below the average and to what degree. A statistical analysis revealed that more maternal, but not paternal, monitoring of child media exposure predicted lower BMI Z scores at age 7 years and less sharply increasing BMI Z scores from 5 to 9 years. These effects persisted when more general parental monitoring, as well as parent BMI, annual income, and educational level were controlled for. The significant negative effect of maternal media monitoring on children’s BMI Z scores at age 7 years was partially accounted for by the effect of child media time. The maternal media monitoring effect on children’s BMI Z score changes remained significant after adjustment for children’s media time and sports and recreational activity.

The authors concluded that their findings suggest that parental behaviors related to children’s media intake may have long-term effects on children’s BMI in middle childhood. They stressed the importance of targeting parental media monitoring in efforts to prevent childhood obesity.

Take home message:

These studies stress the need for parental monitoring of the media children are Parents should be involved with monitoring the type of media that their children are watching or interacting with; in addition, the amount of time spent using electronic media should be controlled. The American Academy of Pediatrics (AAP) recommends that children limit screen time (i.e., the time spent in front of a TV, computer, or other screen for entertainment) to no more than two hours per day. Furthermore, the AAP does not recommend TV watching for children under age 2.

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