SCREEN TIME AND BEHAVIORAL PROBLEMS IN PRESCHOOL CHILDREN: A CROSS-SECTIONAL STUDY

Abstract

Background: Excessive screen exposure among preschool children has emerged as a critical public health concern, with growing evidence linking it to adverse behavioral outcomes. As digital media becomes increasingly integrated into early childhood routines, its influence on emotional regulation, attention span, and sleep patterns warrants further exploration, particularly in low- and middle-income regions.

Objective: To evaluate the association between daily screen time duration and behavioral issues—specifically irritability, attention problems, and sleep disturbances—in children aged 2 to 5 years.

Methods: A cross-sectional study was conducted over eight months across pediatric outpatient and early childhood centers in urban Pakistan. A total of 310 children aged 24 to 60 months were included through convenience sampling. Data on screen exposure were collected via caregiver-reported questionnaires. Behavioral assessments included the Affective Reactivity Index (ARI), Strengths and Difficulties Questionnaire (SDQ) for attention, and Children’s Sleep Habits Questionnaire (CSHQ). Data were analyzed using ANOVA, Pearson correlation, and multivariate regression, with significance set at p<0.05.

Results: Screen time exceeding two hours daily was significantly associated with higher behavioral symptom scores. Mean ARI, SDQ, and CSHQ scores increased with longer screen exposure. Pearson’s correlation showed positive relationships between screen time and irritability (r=0.62), inattention (r=0.58), and sleep disturbances (r=0.64). Regression analyses confirmed screen time as an independent predictor of all three behavioral outcomes (p<0.001).

Conclusion: Excessive screen time is significantly linked with increased irritability, attention problems, and sleep disturbances in preschool-aged children. These findings underscore the importance of limiting screen exposure during early development and informing caregivers about screen-related behavioral risks.