Use of high-dose electronic media in connection with psychosocial symptoms in 5 year olds

Study data published in BMJ Open describe the negative psychosocial effects of the use of high-dose electronic media (e-media) in children. In a large-scale cohort study, almost all of the children surveyed exceeded the recommended daily exposure to e-media. Significant use of e-media has been associated with a myriad of psychosocial symptoms, including difficulty concentrating and paying attention, emotional problems, and problems with peers.

This longitudinal cohort study included parents and their children from the Pirkanmaa Hospital District area in southern Finland. The baseline surveys were completed prenatally after 32 weeks. Follow-up surveys were conducted when children were 3, 8, 18, 24, and 60 months (5 years) old. The current analysis used data from the base, 18-month and 5-year time points.

The surveys included the Strengths and Difficulties Questionnaire (SDQ) and the Five to Fifteen Questionnaire (FTF), which recorded behavior and mental symptoms in children. Clinically increased psychosocial symptoms were assumed in children who reached the 75th percentile or more on the SDQ and FTF subscales.

Parents were also asked to report socio-demographics and estimate their child’s average daily e-media usage.

Logistic regression models were used to examine the relationship between e-media use and certain psychosocial outcomes. Regression models compared the results between children in the 75th percentile for e-media use and children in the lowest quartile.

The study cohort included 699 children for whom SDQ or FTF survey data were available. The mean age at follow-up was 5.68 (± 0.54) years; 52.4% were boys; and 67.7% were in a full-time daycare. The majority of parents (63.4%) had a university degree.

At the age of 18 months, children spent an average of 32.4 (± 31.0) minutes per day with e-media devices. At the age of 5 this number increased to 114.1 (± 50.6) minutes per day. By the age of 5, almost all children (94.6%) consumed more than 60 minutes of screen media per day.

In unmatched regression models, longer screen time at age 5 was associated with multiple psychosocial issues as measured by FTF subscales, including difficulty concentrating and attention (odds ratio) [OR]1.88; P <0.01), hyperactivity and impulsiveness (OR 1.57; P = 0.03), internalization symptoms (OR 1.75; P = 0.01) and externalization symptoms (OR 1.69; P = 0.01) . In addition, the screening time at age 5 was also associated with hyperactivity (OR, 2.18; P <0.01) and behavioral problems (OR, 1.53; P = 0.03) according to SDQ.

The screening time at the age of 18 months had a less negative impact and was only associated with an increased risk of peer problems in the longitudinal direction at the age of 5 years (OR, 1.64; P = 0.03). In models that were adapted to age, gender, parental upbringing and care in day-care centers, only the relationship between the screening time at the age of 5 and the symptoms of internalization remained significant (OR, 2.01; P = 0.01).

The results of this study underline the negative effects of the use of high-dose e-media on the psychosocial well-being of children. While the use of e-media at the age of 18 months did not significantly predict the psychological problems at the follow-up examination, significant cross-sectional associations between the screening time and the psychosocial symptoms were observed at the age of 5 years.

The primary limitation of the study was the use of self-reported questionnaires to measure e-media usage instead of logs or some other objective observational measure.

“Health professionals and paediatricians play an important role as communicators of current research on the safe life of e-media for families … and in enhancing parents’ skills as regulators for the safe use of e-media by children,” wrote the Researcher. “More research is needed into the family conditions of high-dose e-media users.”


Niiranen J, Kiviruusu O, Vornanen R, Saarenpää-Heikkilä O, Paavonen EJ. Use of high-dose electronic media in five-year-olds and its association with their psychosocial symptoms: a cohort study. BMJ Open. 2021; 11 (3): e040848. doi: 10.1136 / bmjopen-2020-040848

This article originally appeared on Psychiatry Advisor

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