The context of background TV exposure and children's executive functioning.

Background: This study investigated relations between background TV exposure (BTV) and executive function (EF) when children were engaged in activities during exposure and how cumulative risk moderated these relations.

Methods: A nationally-representative survey with US caregivers (N = 1180) of 2-8-years-old children participated in a telephone survey. Data included demographic information, the child's EF, and time use across a 24-h period. Total BTV exposure within various contexts was calculated from diaries.

Results: In the direct effects regressions, BTV during sleep predicted poorer EF for all children. Playing by self with BTV predicted poorer EF for preschoolers while playing with others with BTV predicted stronger EF for school-age children. When cumulative risk was included, engaging in routines and chores with BTV predicted stronger EF for preschoolers while high-risk school-age children evidenced stronger EF when exposed to BTV while socializing with family or engaging in academic enrichment. Low-risk school-age children evidenced poorer EF in both contexts.

Conclusions: Reducing exposure can mitigate negative relations. This is an important goal as children are exposed to more of all forms of screen media during the COVID-19 pandemic. Results confirm the American Academy of Pediatrics' recommendation that TV be turned off in the background when a child is in the room.

Impact: Young children are exposed to significant hours of background television per day across multiple contexts: socializing with family, playing alone or with others, engaging in routines/chores, eating/drinking, and sleeping. Most exposure (46%) occurred while sleeping. Sleep exposure predicted poorer executive functioning (EF). During background TV exposure, as preschoolers' time spent playing alone increased, EF scores worsened. School-age children's time spent playing with others during exposure predicted stronger EF. EF scores for low-risk school-age children worsened when background TV was on while socializing with family or engaging in academic activities whereas the reverse was true for high-risk school-age children.