Screen Time and Developmental Performance Among Children at 1-3 Years of Age in the Japan Environment and Children’s Study

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COMMENT & RESPONSEIn Reply We appreciate the thoughtful comments on our study. 1 We agree with Takahashi et al that the association between screen time and child development may be determined more accurately if genetic information is considered. Developmental delays may include neurodevelopmental disorders (autism spectrum disorder or attention-deficit/hyperactivity disorder) and other genetic characteristics. Recent studies have shown that diverse psychiatric disorders and behavioral traits, including neurodevelopmental disorders, share common genetic factors. [2][3][4][5] Adjustments for genetic factors will be particularly important in identifying high-risk children who are vulnerable to screen time and in clarifying why screen time is associated with specific developmental domains.However, we disagree that it is difficult to narrow the bidirectional association between screen time and child development to a unidirectional association without adjusting for genetic risk. In the random-intercept cross-lagged panel model, lagged associations pertain exclusively to withinperson fluctuations, and stable traitlike between-person differences are separated as random intercepts. 6 That is, the model partially adjusts for genetic factors by separating developmental traits due to the individual's own genetic factors and tendencies of screen time due to the parenting environment, affected by the parents and the individual's own genetic factors as latent variables. However, one limitation of this analysis is that it cannot separately identify the effects of genetic and environmental factors on an individual or family, nor can it determine the extent to which children are genetically vulnerable to screen time.In addition, our analysis did not focus on developmental delays. It is important to note that a directional association was demonstrated between increased screen time and lower developmental scores in children, excluding those diagnosed with autism spectrum disorder. However, there may be a genetically at-risk population among children identified as having undiagnosed neurodevelopmental or psychiatric disorders before age 3 years. In some cases, environmental factors may protect against genetic risks. In such cases, the direction of the association between screen time and development cannot be properly assessed without considering the genetic factors. An analysis that considers the genetic risk of developmental delay would provide important information for both public health and medicine.Of note, our article 1 was corrected to fix an error in the Meaning section of the key points. The text inadvertently read, "In this study, increased screen time in early childhood was negatively associated with poor performance on developmental screeners." This association was not negative.

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Role of Genetic Risk in the Association Between Screen Time and Child Development—Reply

Yamamoto,

Mezawa,

Sakurai

2024

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“…These studies on genetic risk suggest the possibility that long screen time is a characteristic of children with developmental delays . Under such circumstances, Yamamoto et al published a study that examined the associations between screen time and children’s development, focusing on the direction of the association by the random-intercept cross-lag panel model. This research is important because it replicates and updates the results of the study by Madigan et al In particular, we are interested in the finding of Yamamoto et al that bidirectional associations were found only in the communication domain of the 5 developmental domains investigated.…”

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confidence: 99%

“…Under such circumstances, Yamamoto et al published a study that examined the associations between screen time and children’s development, focusing on the direction of the association by the random-intercept cross-lag panel model. This research is important because it replicates and updates the results of the study by Madigan et al In particular, we are interested in the finding of Yamamoto et al that bidirectional associations were found only in the communication domain of the 5 developmental domains investigated. These results support our previous findings, which highlighted that the associations between screen time and child development should be examined by developmental domain …”

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confidence: 99%

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Role of Genetic Risk in the Association Between Screen Time and Child Development

Takahashi,

Obara,

Kuriyama

2024

To the Editor We recently published a study on data from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study that showed screen time for children aged 1 year was associated with developmental delays in communication and problem-solving skills domains at ages 2 and 4 years. 1 We focused on the association and could not address whether long screen time is associated with developmental delay directionally or is a characteristic of children with developmental delay. Thus, we were curious about the direction of the association between screen time and child development.Madigan et al 2 conducted an innovative analysis using a random-intercept cross-lag panel model that supported the directional association between screen time and development in children. Other studies focusing on children's genetic risk have reported that the genetic risk of autism spectrum disorder or attention-deficit/hyperactivity disorder is associated with long screen time. 3,4 These studies on genetic risk suggest the possibility that long screen time is a characteristic of children with developmental delays. 3,4 Under such circumstances, Yamamoto et al 5 published a study that examined the associations between screen time and children's development, focusing on the direction of the association by the random-intercept cross-lag panel model. This research is important because it replicates and updates the results of the study by Madigan et al. 2 In particular, we are interested in the finding of Yamamoto et al 5 that bidirectional associations were found only in the communication domain of the 5 developmental domains investigated. These results support our previous findings, which highlighted that the associations between screen time and child development should be examined by developmental domain. 1 To examine the association in more detail, Yamamoto et al 5 use various variables for environmental factors related to screen time and children's development, such as maternal psychological distress and the presence or absence of older sib-lings. On the other hand, the association may be captured in more detail if genetic information is considered. This is because it has been shown that children with a genetic risk for developmental delay typically have longer screen time. 3,4 Thus, genetic risk of developmental delay could be a confounding factor in examining the association between screen time and children's development. We believe it is difficult to narrow the bidirectional association between screen time and child development to unidirectional without adjusting for its genetic risk. Future studies that consider the genetic risk of developmental delay are warranted to further the discussion on screen time and children's development.

“…In the Original Investigation titled “Screen Time and Developmental Performance Among Children at 1-3 Years of Age in the Japan Environment and Children’s Study,” published in the November 2023 issue, there was an error in the Key Points. The Meaning section was updated to read, “In this study, increased screen time in early childhood was associated with poor performance on developmental screeners, suggesting the need to support parents in creating family media plans.” This article was corrected online …”

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confidence: 99%

Error in Key Points

2024

In the Original Investigation titled "Screen Time and Developmental Performance Among Children at 1-3 Years of Age in the Japan Environment and Children's Study," 1 published in the November 2023 issue, there was an error in the Key Points. The Meaning section was updated to read, "In this study, increased screen time in early childhood was associated with poor performance on developmental screeners, suggesting the need to support parents in creating family media plans." This article was corrected online. 2