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

Abstract Background: Screen use is increasing rapidly among preschool children and excess screen use in these children has been associated with neurocognitive side effects and speech delay.Objectives: To look at patterns of screen use, determinants of excess screen use, and its association with socio-cognitive development among preschool children attending two kindergarten schools in urban Kerala.Methodology: A questionnaire-based survey was conducted among parents of children attending 2 urban kindergarten schools. Cognitive development was reported by the parents as per Werner David Development pictorial scale (WDDPS).Results: Of the 189 children included in the study, 89.4% had excess screen use (>1 hour per day) and the average use was 2.14 hours. Earlier age at introduction to screen (2.5 vs. 2.09 hours, p=0.01), meal-time screen use (OR 3.4, 95% CI 1.3-8.9), lack of parental co-viewing (2.19 vs. 1.96 hours, p=0.03), and receiving screen on demand (OR 3.7, 95% CI 1.3-10.8) were all significantly associated with excess screen use in pre-school children. Children with inconsistently supervised screen time had significantly more deficits as per WDDPS in attention (OR 3.2, 95% CI 1.3-8.2), intelligence (OR 4.1, 95% CI 1.3-13.3) and social skills (OR 15.3, 95% CI 1.9-121.2), compared to children whose screen use was consistently supervised.Conclusion: Screen time in the majority of preschool children is above the recommended limits, and consistent supervision by parents is seen in only half the preschool population. Inconsistently supervised screen time is associated with an increase in the time spent on screens, and significant cognitive delays in children.