Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children

Abstract

(AAP) recommends limits on screen-based media use, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown. OBJECTIVE To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged children. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of healthy children aged 3 to 5 years (n = 47) was conducted from August 2017 to November 2018. Participants were recruited at a US children's hospital and community primary care clinics. EXPOSURES Children completed cognitive testing followed by diffusion tensor imaging (DTI), and their parent completed a ScreenQ survey. MAIN OUTCOMES AND MEASURES ScreenQ is a 15-item measure of screen-based media use reflecting the domains in the AAP recommendations: access to screens, frequency of use, content viewed, and coviewing. Higher scores reflect greater use. ScreenQ scores were applied as the independent variable in 3 multiple linear regression models, with scores in 3 standardized assessments as the dependent variable, controlling for child age and household income: Comprehensive Test of Phonological Processing, Second Edition (CTOPP-2; Rapid Object Naming subtest); Expressive Vocabulary Test, Second Edition (EVT-2; expressive language); and Get Ready to Read! (GRTR; emergent literacy skills). The DTI measures included fractional anisotropy (FA) and radial diffusivity (RD), which estimated microstructural organization and myelination of white matter tracts. ScreenQ was applied as a factor associated with FA and RD in whole-brain regression analyses, which were then narrowed to 3 left-sided tracts supporting language and emergent literacy abilities. RESULTS Of the 69 children recruited, 47 (among whom 27 [57%] were girls, and the mean [SD] age was 54.3 [7.5] months) completed DTI. Mean (SD; range) ScreenQ score was 8.6 (4.8; 1-19) points. Mean (SD; range) CTOPP-2 score was 9.4 (3.3; 2-15) points, EVT-2 score was 113.1 (16.6; 88-144) points, and GRTR score was 19.0 (5.9; 5-25) points. ScreenQ scores were negatively correlated with EVT-2 (F 2,43 = 5.14; R 2 = 0.19; P < .01), CTOPP-2 (F 2,35 = 6.64; R 2 = 0.28; P < .01), and GRTR (F 2,44 = 17.08; R 2 = 0.44; P < .01) scores, controlling for child age. Higher ScreenQ scores were correlated with lower FA and higher RD in tracts involved with language, executive function, and emergent literacy abilities (P < .05, familywise error-corrected), controlling for child age and household income. CONCLUSIONS AND RELEVANCE This study found an association between increased screen-based media use, compared with the AAP guidelines, and lower microstructural integrity of brain white matter tracts supporting language and emergent literacy skills in prekindergarten children. The findings suggest further study is needed, particularly during the rapid early stages of brain development.

Effect of the Use of Smart Media on the Cognitive and Language Development of the Preschooler: The Mediating Effect of Smart Media Addiction Tendency and the Moderated Mediating Effects of Maternal Guidance on Smart Media Usage

“…게다 가 강한 시청각적 자극을 장시간 접하게 되면 표현력, 사고력, 추리력, 주의력 부족 등의 문제 (Kwon, 2012;Chonchaiya & Pruksananonda, 2008;Christakis et al, 2004)와 더불어 자극 적인 것에만 반응하는 '팝콘브레인'이 될 수 있다는 우려가 있다 (Cohen, 2011). 특히나 스마트폰, 태블릿PC 등과 같은 스마트미 디어에 과도하게 노출된 유아의 경우 인지능력과 문해능력이 현 저히 떨어진다는 연구도 밝혀진바 있다 (Hutton et al, 2019). 유아의 언어, 인지 발달은 경험과 직접 관련되며 삶에 필요한 가치나 태도를 학습하도록 돕는다 (Mussen et al, 1990).…”

Smartphone and Tablet in the Everyday Life of Preschool Children. Impact and Educational Options in the Opinion of Parents and Teachers of Kindergarten.

“…A child who abuses devices is deprived of contact with other people, has no opportunity to enrich vocabulary, and does not improve natural communication skills. [Hutton et al, 2019] -deficit of creativity and imagination -the applications available on the tablet or smartphone used by the child are to help cope with boredom. However, they kill creativity and imagination in a child.…”

“…the area responsible for the development of language and cognitive functions. [Hutton, Dudley, Horowitz-Kraus 2019]…”

Association of Screentime With Cognitive Delay In Preschool Children of Kerala, India

“…Children under 5 years are a vulnerable population as this is the age where maximum brain growth occurs and increased screen time is associated with adverse neurocognitive outcomes and speech delay. Recent studies with functional cerebral MRI have shown diminished frontal and temporal white matter content in children who were exposed to excessive screen time [4].…”