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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 1  |  Issue : 1  |  Page : 20-24

Increase in screen-time for children during COVID times and its effects


Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India

Date of Submission14-Jan-2022
Date of Decision17-Jan-2022
Date of Acceptance28-Jan-2022
Date of Web Publication31-May-2022

Correspondence Address:
Sabira Aalia Dkhar
Department of Community Medicine, Government Medical College, Srinagar 190010, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JIMPH.JIMPH_1_22

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  Abstract 

INTRODUCTION: Children born today see a totally changed world. They are well experienced and exposed to technology. They have a lot of dependencies and needs on the Internet and technology in the form of educational help, recreational, or even entertainment. This kind of predisposition to digital screens has recently increased with lockdown all over the world, leading to many complications in different spheres of health like mental, physical, social, and others. MATERIALS AND METHODS: This was a cross-sectional study. The data collection was done using an online questionnaire, which was pretested in a pilot study and then later was done through Google forms. The parents of children using mobile phones and having access to the Internet were contacted and included in the study population. Statistical analysis was performed by using SPPS version 20. RESULTS: Approximately 307 parents participated in the study. Positive association was seen between increase screen time and children having personal device (P = 0.001), with increase of age (P = 0.000), where parents felt that the child was addicted (P = 0.032), with children having impact on physical heath (P = 0.000), maximum screen time allowed without causing health concern (P = 0.000), and preference of online educational app (P = 0.011). CONCLUSION: Though the digital medium can be beneficial in many ways, providing access to quality education even during these unclear times, however increased exposure to the screen can be harmful to a child’s health in many ways.

Keywords: Online, parents, screen time


How to cite this article:
Khan S M, Dkhar SA, Quansar R, Haq I. Increase in screen-time for children during COVID times and its effects. J Integr Med Public Health 2022;1:20-4

How to cite this URL:
Khan S M, Dkhar SA, Quansar R, Haq I. Increase in screen-time for children during COVID times and its effects. J Integr Med Public Health [serial online] 2022 [cited 2022 Dec 3];1:20-4. Available from: http://www.jimph.org/text.asp?2022/1/1/20/346304




  Introduction Top


Children born today see a totally changed world, where they experienced and are exposed to technology along with dependencies and needs on Internet and technology in the form of educational help, recreational, or even entertainment. There are many ways and many reasons a child is open to the digital screen.[1] This kind of predisposition to digital screen has recently increased with lockdown all over the world, leading to many complications in different spheres of health such as mental, physical, social, and others.

In recent times, the world has never experienced the degree and strength of measures that were taken to limit the COVID-19 pandemic. Many digital technologies, including the Internet of things, are currently heavily used in various areas with schools shut down, and most children holed up inside their houses all day; most are increasingly dependent on the digital medium for both education and recreation.[2] Excess screen time does not openly hamper learning capabilities, but can lead to adiposity, attention deficiency, and extreme mood alterations in children, which in turn disrupts learning capabilities.[3] There are growing apprehensions that this exposure to electronics could have negative effects on the growth and development of children.


  Materials and Methods Top


Study design

The study has a cross-sectional study design.

Research tool

Semi-structured pretested questionnaire.

Data collection tool

The study data were collected using an online questionnaire through Google Forms. The questionnaire was developed by the researcher and pretested in a pilot study on 20 parents having children who were using the electronic screen for online classes, homework, or recreational activities, and necessary changes in language, style, and responses were done following the pre-test.

Sample size

Based on the prevalence of excess screen time on adolescents of 79.5%,[4] a sample size of 251 was obtained.

Sampling technique

Convenient purposive sampling

Selection and exclusion of study subjects:

Parent having at least one child who is exposed to electronic screen for any reason be it for education, recreation, or both. The recommended time, that is, <2 h, was defined as the child not being addicted following the WHO guidelines[5] and also the American Academy of Pediatrics.[6]

Statistical analysis

The data collected were entered into MS Excel software. After cleaning, data were analyzed using SPSS software program, version 20.0. Simple descriptive tables describing sociodemographic profiles were prepared. For finding out the predictors for effects on children with increased screen time in the study, a multivariate logistic regression was applied.

Ethical clearance

The study was done after obtaining ethical clearance from the institutional ethical committee.


  Results Top


The maximum numbers of children belonged to the age group of 6-10 years and mostly were males (56.1%). Phone (68.7%) was the most commonly used device. 54.4% children did not owe an electronic device [Table 1].
Table 1: Demographic characteristics of the study participants

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Approximately 62.9% parents consider their children addicted to the phone. 53.1% parents were in agreement that maximum screen-time without causing any health concerns should be <2 h [Table 2].
Table 2: Parents perception regarding screen-time in children

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Approximately 94.5% parents consider that increased screen-time affected the physical health of the children, 94.1% parents consider that the increased screen-time affected the mental health of children. 61.6% parents considered that the increased screen-time decreased the academic ability of children [Table 3].
Table 3: Screen-time and its effects as per parental perception

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Increased screen-time in the children was associated with perception of parents regarding child addicted to the electronic device, increased screen-time affecting the physical health and children who owes an electronic device [Table 4].
Table 4: Association between screen-time and different variables

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The mean screen-time among the children was 4.93 h with a SD of 2.69 [Figure 1].
Figure 1: The mean screen-time among children as reported by parents

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  Discussion Top


An online survey was conducted to study the screen-time in children during COVID-19. The online Google Forms were shared through various social media sites and parents were asked to fill out the forms. A total of 307 responses were received and analyzed.

The age of the children ranged from 0 to 18 years. The maximum number of children belonged to the age group of 6–10 years (37.5%), followed by age group of 10–18 years (31.6%), followed by 0–5 years (18.3%), and least in the age group of >18 years (12.6%). The use of devices/smartphones/laptops/tablets/desktops or any other electronic gadgets increased with increasing age group and thus increasing the screen-time. The increased screen-time with increased age of the child could be attributed to the fact that ability or skill to use mobile or any other device increases with age group and thus chances of more frequency and duration of device use. The parents also allow the children to use mobile phones or other devices to keep them occupied and calm when they are doing household chores or shopping.[7] With an increase in age, the increase of screen time can be due to lesser parental control over children as they grow up and children become more independent and take over major decision-making in their life. The increasing age group is associated with increased screen-time in other studies as well.[8],[9],[10]

Approximately 56.1% of the children were males and 43.9% were females. The majority of the children used phones (68.7%), followed by tablets (11.4%), laptop (9.4%), television (8.5%), desktop (1.3%), and others (0.7%).

Approximately 45% of children in the study had personal phones/devices and 54.3% of children did not possess a personal phone/device, whereas 0.7% of children may/may not have personal devices/phones. The possession of a personal phone or device has a positive association with the increased screen-time among children. This can be due to no continuous watch over these children by their parents, easy access to their phones at any part of the day and night, no one to limit or restrict them from using their own phones. The children with personal devices or phones were more skillful and had the liberty to use the phone as per their convenience or time and preference and even during the odd hours at night or before going to bed, whereas the phone use limited if one has to ask for the phone/ device from an elder one or either of the parents. Similar findings were reported in a study by Susan Paudel et al.[7]

So far, 62.9% children reported to be addicted/glued to the devices/phones, whereas 25.4% of children were reported not to be glued/addicted and 11.7% were not sure about the addiction. The more the child was glued/addicted to the devices/phones, the more the screen-time of the children. The children once addicted to the use of these devices or phones would lead to more use of these and thus the increased screen-time. Use of electronic media acts like a digital drug for our brain and this releases dopamine in our brain which have a negative effect on impulse control.

We saw 64.5% of parents reported that they do not prefer online applications for the education of the children, whereas 20.2% of parents said that they prefer online applications and 15.3% of parents were not sure about the usage of online educational applications. The COVID-19 pandemic has led to the shift of the educational system of the nations to the online mode from the conventional school mode due to the lockdown and restrictions. The restrictions and lockdown have led to the stoppage of the school services and thus the education system has taken a setback and thus changes of the policy to the online mode. The online mode of education has thus led the children to more use of smartphones and devices and thus increases in the screen-time. The more educational applications installed in smartphones automatically leads to more time spent on the smart devices and thus increased screen-time. More dependencies have shown more use and vice versa and along with a desire to explore more applications.[11]

When parents were asked regarding the maximum screen-time for children without causing any addiction, 53.1% of parents responded to have <2 h of exposure, 28.2% of parents responded with 2–3 h, 17.7% parents said 3–6 h, and only 1% parents responded >6 h. The time spent on these devices /phones is directly related to the screen-time exposure. This is due to the constant feeling parents have after watching their children always using phone/electronic devices. Most parents recommended time, that is, <2 h was defined as the child not being addicted following the WHO guidelines[5] and also the American Academy of Pediatrics.[6]

About 61.6% of parents felt that the increased screen-time among the children leads to decreased academic achievements, whereas 18.5% of parents did not felt that the screen-time is associated with academic achievements and 19.9% of parents were not sure about the same. The usage of smart devices/phones in children may lead to less concentration on other things and thus more dependencies to online gaming.

Approximately 94.5% of parents were in agreement with the fact that the increased screen-time or increased use of smartphones was affecting the physical health of the children, whereas only 5.5% were not in agreement with this. The use of smart devices/phones leads to more often sedentary behavior, less exercising, less physical activity, and thus increased obesity and adiposity in the longer run.[12] Less physical fitness as more urge to spend time with their personal device disrupted sleep schedule and strain due to screen light all affect the physical health The increased screen-time leads to digital strain to the eyes, headaches, and sleep deprivation and thus affecting physical health.[13] Similar findings were reported in some studies.[3],[10],[12]

Around 94.1% of parents were in agreement with the fact that the increased screen-time or increased use of devices/phones was affecting the mental wellbeing of the children, whereas only 5.9% were not in agreement with the statement. The use of smart devices/phones leads to poor concentration and emotional and mood instability and poor self-control. The user may also be associated with anxiety and depression and poor interpersonal relationships. Similar findings were also reported in studies.[11],[14]

The increased screen-time was associated with increasing age, personal devices, and more educational applications installed in the phone. The increased screen-time among the children was affecting their physical as well as mental health.


  Conclusion Top


The study concludes that the increased screen-time has ill effects both on the physical as well as mental health of the children. The present scenario in wake of COVID-19 has brought to the forefront the need to revisit the concept of screen time from a health perspective. This is important given the exclusive reliance on time spent looking at the screen as a measure to ensure healthy use of the Internet and Internet-enabled devices.[1] There is a need to look beyond the absolute amount of time children and adolescents spend looking at the digital screens. Hence, it is important to have a well-thought approach to the role of the Internet and digital devices in teaching and learning.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Vandewater AE, Rideout JV, Wartella AE, Huang X, Lee HJ, Shim M. Digital childhood: Electronic media and technology use among infants, toddlers, and preschoolers. Pediatrics 2007;119:e1006-15.  Back to cited text no. 1
    
2.
Dutta K, Mukherjee R, Sen D, Sahu S. Effect of COVID-19 lockdown on sleep behavior and screen exposure time: An observational study among Indian school children. Biol Rhythm Res 2020;e1825284:1-12.  Back to cited text no. 2
    
3.
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:e023191.  Back to cited text no. 3
    
4.
Schaan CW, Cureau FV, Sbaraini M, Sparrenberger K, Kohl Iii HW, Schaan BD. Prevalence of excessive screen time and TV viewing among Brazilian adolescents: A systematic review and meta-analysis. J Pediatr (Rio J) 2019;95:155-65.  Back to cited text no. 4
    
5.
World Health Organization (WHO). Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children Under 5 Years of Age. Vol. 2020. Geneva: World Health Organization; 2019.  Back to cited text no. 5
    
6.
Chassiakos YR, Radesky J, Christakis D, Moreno MA, Cross C, Hill D, et al. Children and adolescents and digital media. Am Acad Pediatr 2016;138:e20162593.  Back to cited text no. 6
    
7.
Paudel S, Jancey J, Subedi N, Leavy J. Correlates of mobile screen media use among children aged 0-8: A systematic review. BMJ Open 2017;7:e014585.  Back to cited text no. 7
    
8.
Carson V, Janssen I. Associations between factors within the home setting and screen time among children aged 0-5 years: A cross-sectional study. BMC Public Health 2012;12:539.  Back to cited text no. 8
    
9.
Duch H, Fisher EM, Ensari I, Harrington A. Screen time use in children under 3 years old: A systematic review of correlates. Int J Behav Nutr Phys Act 2013;10:102.  Back to cited text no. 9
    
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Kaur N, Gupta M, Malhi P, Grover S. Screen time in under-five children. Indian Pediatr 2019;56:773-88.  Back to cited text no. 10
    
11.
Singh S, Balhara YPS. “Screen-time” for children and adolescents in COVID-19 times: Need to have the contextually informed perspective. Indian J Psychiatry 2021;63:192-5.  Back to cited text no. 11
  [Full text]  
12.
Schmidt SCE, Anedda B, Burchartz A, Eichsteller A, Kolb S, Nigg C, et al. Physical activity and screen time of children and adolescents before and during the COVID-19 lockdown in Germany: A natural experiment. Sci Rep 2020;10:21780.  Back to cited text no. 12
    
13.
Bhattacharya S, Saleem SM, Singh A. Digital eye strain in the era of COVID-19 pandemic: An emerging public health threat. Indian J Ophthalmol 2020;68:1709-10.  Back to cited text no. 13
[PUBMED]  [Full text]  
14.
Twenge JM, Campbell WK. Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Prev Med Rep 2018;12:271-83.  Back to cited text no. 14
    


    Figures

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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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