Towards a more nuanced understanding of screen time

Background: Digital media has become an integral part of children’s life. At the same time, studies have shown that excessive screen time is associated with negative outcomes in children. Previous research has tended to emphasize on the quantity of screen time, assuming that different types of screen media, content, and social contexts of screen usage influence children equally. This study used a more nuanced approach in examining the associations between screen time and emotional and behavioral difficulties in children. Method: It was a cross-sectional survey conducted in Hong Kong. The sample consisted of parents of 1428 primary school children (Mean age = 8.51 years; SD = 1.9). The parents were asked to report their children’s screen time usage and behavioral and emotional difficulties (using the Strengths and Difficulties Questionnaire). Results: Logistic regression analyses showed that compared with children who used < 2 hours screen time/day, those who used ≥ 4 hours had increased odds for hyperactivity, emotional symptoms, conduct problems, and peer relationship problems (adjusted ORs = 1.54 to 2.06). Among different types of screen media, gaming was the only media that was associated with increased odds for hyperactivity, emotional symptoms, conduct problems, and peer relationship problems (adjusted ORs = 1.53 to 4.61). Also, higher ratio of solitary screen time vs. parental co-viewing was strongly associated with hyperactivity (aOR = 10.04). Conclusion: The findings provide important information for development of preventive measures to address excessive screen time in children. Additional research to examine children’s solitary screen media use is needed.