Association of Screen Content With Early Development Among Preschoolers in Shanghai: 7-Day Monitoring Study With Auto Intelligent Technology.

Background: It is unclear how exposure to different types of screen content is associated with early development among preschool children.

Objective: This study aims to precisely evaluate the screen exposure time across different content types and to explore the associations with the Ages and Stages Questionnaire, Third Edition (ASQ-3) score and 5 capacity domains in children aged 34.5-66 months.

Methods: This monitoring study used intelligent technology to collect data on the 7-day screen time and the time spent viewing each content type. The participants were 2 groups of Shanghai kindergarten kids. The data were collected between March 2023 and July 2023. Screen exposure data (total daily time and time for each type of content) were collected from children aged between 34.5 and 66 months. A self-designed questionnaire and the Healthy Screen Viewing for Children intelligent technology app were used to assess screen exposure to all media and tablets. The ASQ-3 was used to assess early development in children aged 34.5-66 months.

Results: In the 535-child sample, the results of linear regression analysis indicated that both screen time of more than 60 minutes and exposure to smartphones and tablets were negatively associated with ASQ-3 score. Among 365 participants with data collected by the Healthy Screen Viewing for Children app, median regression showed that the median total ASQ-3 score was negatively associated with screen time for noneducational content (β=-.055; 95% CI -0.148 to -0.006; P=.03), screen time for both educational and noneducational content (β=-.042; 95% CI -0.081 to -0.007; P=.001), and fast-paced content (β=-.034; 95% CI -0.062 to -0.011; P=.049). The median gross motor score was negatively associated with screen time for parental guidance-13-rated content (β=-.015; 95% CI -0.022 to 0.009; P=.03), educational and noneducational content (β=-.018, 95% CI -0.038 to -0.001; P=.02), static content (β=-.022; 95% CI -0.050 to 0.007; P=.02). This study also revealed that the median fine motor score was negatively associated with screen time for guidance-rated content (β=-.032, 95% CI -0.057 to -0.003; P=.006), parental guidance (PG) rated content (β=-.020; 95% CI -0.036 to -0.007; P=.004), noneducational content (β=-.026; 95% CI -0.067 to -0.003; P=.01), both educational and noneducational content (β=-.020; 95% CI -0.034 to -0.001; P<.001), fast-paced content (β=-.022; 95% CI -0.033 to -0.014; P<.001), static content (β=-.034; 95% CI -0.050 to 0.018; P<.001), animated content (β=-.038; 95% CI -0.069 to -0.001; P=.004), and screen use during the daytime (β=-.026; 95% CI -0.043 to 0.005; P=.005).

Conclusions: The results indicated that the time spent viewing noneducational, static, fast-paced, and animated content was negatively associated with early development among preschool children. Limiting screen time in relevant aspects is recommended.