Impact Of Screen Time Exposure and Social Communication Deficits in Children With Autism Spectrum Disorder
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Background: Screen exposure is increasingly common among children, including those with autism spectrum disorder, and may reduce opportunities for reciprocal caregiver-child interaction when used passively or without supervision. Children with autism spectrum disorder already experience difficulties in eye contact, response to name, gesture use, joint attention, peer interaction, and social reciprocity, making screen-use patterns clinically relevant. Objective: To determine the association between daily screen time exposure and severity of social communication deficits among children with autism spectrum disorder in Punjab, Pakistan. Methods: This cross-sectional observational study included 180 children aged 3–12 years with clinically diagnosed autism spectrum disorder from selected developmental clinics, therapy centers, and special education settings in Punjab. Parent-reported data were collected on demographic characteristics, daily screen duration, device type, age at first regular exposure, supervision, contextual screen use, and social communication deficits. Screen time was categorized as <1 hour, 1–2 hours, 2–4 hours, and >4 hours per day. Descriptive statistics, group comparisons, and correlation analysis were used. Results: The mean age was 6.8 ± 2.4 years, and 131 children (72.8%) were male. Mobile phones were the most commonly used device, reported in 104 children (57.8%). Mean social communication deficit scores increased across screen-time categories from 24.6 ± 7.8 in children with <1 hour/day exposure to 48.9 ± 10.4 in those with >4 hours/day exposure. The association was statistically significant (p < 0.001), and daily screen hours showed a moderate positive correlation with social communication deficit score (r = 0.58, p < 0.001). Conclusion: Higher parent-reported screen time was significantly associated with greater parent-reported social communication deficits among children with autism spectrum disorder. Screen-use assessment and practical counselling to reduce prolonged passive and unsupervised exposure should be incorporated into autism spectrum disorder management
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