Associations between Symptom Severity of Autism Spectrum Disorder and Screen Time among Toddlers Aged 16 to 36 Months

Abstract

There is growing evidence that prevalence rates of autism spectrum disorder (ASD) are increasing. A number of factors appear to contribute to this increase, including excessive screen time. Screen time seems to be linked to the severity of the symptoms of ASD. Given this, the aim of the present cross-sectional study was to investigate the association between early screen time and ASD symptoms severity in the first 36 months of life. To this end, sixty-eight Iranian toddlers (mean age: 27.09 months; 22.1% females) with ASD were recruited. Parents completed the modified checklist for autism in toddlers (M-CHAT), the Repetitive Behavior Scale-Revised (RBS-R), and a lifestyle checklist. Next, parents rated children’s daily exposure to content specifically designed (foreground media) and not specifically designed (background media) for children, along with their daily exposure to social interaction. Per day, toddlers spent 5.12 h (±3.77) with foreground media, 3.72 h (±3.57) with background media, and 2.89 h (±2.74) in interaction with other people (parents). To test the hypotheses, we performed a series of Pearson’s correlations and multiple regression analyses. Toddlers’ higher severity scores for ASD symptoms were associated with longer foreground (r = 0.234, p = 0.001) and longer background (r = 0.180, p = 0.012) media duration, and with shorter duration of interaction with others (r = 0.192, p = 0.009). Toddlers spending 1 h more in foreground screen time and background screen time have 0.38 and 0.29 more units in the ASD symptom severity scale, respectively, while toddlers spending 1 h more in social interactions have 0.42 fewer units in the ASD symptom severity scale. The screen time and interaction duration are related to ASD symptoms severity of toddlers. The cross-sectional study design precludes causal associations, although bi-directional relationships appear plausible.

Screen Time and Autism Spectrum Disorder

“…The initial systematic literature search yielded 4682 records (Figure 1). The first filtering step resulted in 145 studies, and the second filtering step resulted in a final collection of 46 studies that examined the association between screen time and ASD (Figure 1 and Table 1).…”

“…Thirteen studies reported on data collected since the COVID-19 pandemic (Table 1). Notably, the research design of all 46 studies was observational: 41 were cross-sectional and 5 were longitudinal . Accordingly, the overall research quality of these studies was determined to be relatively low (according to the GRADE approach) …”

“…The initial systematic literature search yielded 4682 records ( Figure 1 ). The first filtering step resulted in 145 studies, and the second filtering step resulted in a final collection of 46 studies 9 , 10 , 11 , 12 , 13 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 that examined the association between screen time and ASD ( Figure 1 and Table 1 ).…”

“…Thirteen studies reported on data collected since the COVID-19 pandemic ( Table 1 ). 13 , 26 , 27 , 28 , 33 , 34 , 36 , 39 , 49 , 59 , 60 , 65 , 66 Notably, the research design of all 46 studies was observational: 41 were cross-sectional 9 , 13 , 26 , 27 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 and 5 were longitudinal. 10 , 11 , 12 , 31 ,…”

Effects of Screen Time and Phonemic Segmentation in School Going Children

“…Building on these findings, it is recommended that future studies adopt longitudinal designs to more accurately ascertain the longterm impacts of screen time on language development. Moreover, there is a need to explore the qualitative aspects of screen time, such as content type and interactivity level, to determine more precisely how different screen activities contribute to phonological awareness and overall language development (20).…”