Screen-Time Exposure and Behavioral Problems in Early Childhood: A Cross-Sectional Survey of School Children
DOI:
https://doi.org/10.61919/m3vs9491Keywords:
Behavioral Problems; Child Development; Cross-Sectional Studies; Early Childhood; Pakistan; Screen Time; Social Behavior; Television; Video Display Terminals.Abstract
Background: Children’s screen exposure has increased substantially and may affect behavioral regulation during early school years, yet context-specific evidence in low- and middle-income settings remains limited. Objective: To evaluate the association between total daily screen time and behavioral difficulties among children aged 4–10 years in Lahore, Pakistan. Methods: A cross-sectional observational survey was conducted from January to August 2025 among 420 school-going children selected via multistage probability sampling. Parents reported average daily screen exposure and completed a standardized behavioral difficulties instrument generating total and domain scores. Group comparisons across <2, 2–4, and >4 hours/day were assessed using one-way ANOVA with post hoc testing, and associations were examined using correlation and adjusted regression controlling for prespecified sociodemographic covariates. Results: Mean age was 7.1 ± 1.8 years and mean screen time 3.2 ± 1.5 hours/day. Mean total behavioral difficulties increased across exposure categories: 10.2 ± 3.1 (<2 hours/day), 14.6 ± 4.5 (2–4 hours/day), and 18.7 ± 5.2 (>4 hours/day) (p<0.001). Screen time correlated positively with total difficulties (r=0.62, p<0.001) and remained independently associated after adjustment (β=0.42, p<0.001). Conclusion: Higher daily screen exposure was associated with substantially greater behavioral difficulties and less favorable domain profiles, supporting early family-centered guidance emphasizing moderated and purposeful screen use.
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Copyright (c) 2025 Maryam Imad, Naveed Anjum, Iqbal Ahmad Azhar, Muhammad Israr, Saher Ahmed, Muhammad Saleem Malik, Mehnaz Begum (Author)
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