JMIR Publications

ABSTRACT

Background:

The content and context of screen exposure are important potential determinants of early childhood development (ECD) that have been overlooked in past research in LMICs. Given the prevalence of digital devices and diverse digital content today, determining the optimal duration and modality of screen use is crucial for educating caregivers on minimizing the negative impacts of screen exposure on children’s development.

Objective:

This study aims to explore the status quo of screen exposure among children under three years old in rural China and the relationship between the quantity, content, and context of screen exposure and ECD outcomes.

Methods:

The sample includes all children aged 6 to 26 months and their primary caregivers residing in the study area. A survey of screen exposure and household characteristics was conducted for 1052 eligible households, and ECD outcomes were assessed using the Bayley-III assessment scale and BITSEA. Ordinary least squares regression analysis, logistic regression analysis, and chi-square test analysis were performed.

Results:

28.23% (297/1052) of the sample children were first exposed to screens before 12 months of age. Child exposed to screens had an average daily screen time of 27.57 (SD 38.90) minutes. Children exposed to screens before 12 months old and those with longer screen time during 12 to 18 months old were more likely to be at risk of motor developmental delays. Children exposed to educational content for more than 15 minutes daily had fewer social-emotional/behavioral problems than those with no screen exposure and a lower risk of delay in motor skills development than those exposed to educational content for less than 15 minutes daily. Caregiver interaction during screen exposure was associated with lower risk of cognitive and language delays and better socio-emotional skills.

Conclusions:

The type of content viewed and how caregivers engaged in children’s screen time were more strongly associated with ECD outcomes than the amount of screen time itself. The findings complement conclusions regarding the impact of screen exposure on early childhood development in rural areas of low- and middle-income countries.