Skip to content
Licensed Unlicensed Requires Authentication Published online by De Gruyter May 11, 2023

Screen time and childhood attention deficit hyperactivity disorder: a meta-analysis

  • Hezuo Liu , Xiaorong Chen , Minhui Huang , Xiaomin Yu , Ye Gan , Ji Wang , Qiujin Chen , Zhipeng Nie and Haijing Ge EMAIL logo

Abstract

Objectives

The association between screen time and attention deficit hyperactivity disorder (ADHD) has been controversial. This study sheds light on the contentious correlation between screen time and ADHD.

Content

Until August 2022, electronic searches of the PubMed, Embase, and Web of Science databases were carried out. The combined effect value odds ratios (OR) and 95 % confidence interval (95 % CI) were calculated for the meta-analysis using Stata 12.0. There were 81,234 children in the nine studies that made up this meta-analysis which included 28,997 children with ADHD and 52,237 healthy controls. When compared with the screen time <2  h/d, the OR (95 % CI) value of screen time and ADHD in the screen time ≥2 h/d group was 1.51 (1.20–1.90).

Summary and outlook

Based on the current meta-analysis results, our study found a positive correlation between screen time and the risk of ADHD. Excessive screen exposure may significantly contribute to the development of ADHD in children. Therefore, it is necessary to reduce screen time per day in children to prevent the occurrence of ADHD.


Corresponding author: Haijing Ge, Ninghai Maternal and Child Health Hospital, Ningbo, China, E-mail:

Acknowledgments

The author wish to acknowledge the staff of Child Health Department of Ninghai maternal and child health hospital and Dr. Dan Xiong for supporting this systematic review.

  1. Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  2. Conflicts of interest: No potential conflict of interest relevant to this article was reported.

  3. Financial disclosure: None.

  4. Ethical approval: An ethics statement is not applicable because this study is based exclusively on published literature.

References

1. Thapar, A, Cooper, M. Attention deficit hyperactivity disorder. Lancet 2016;387:1240–50. https://doi.org/10.1016/s0140-6736(15)00238-x.Search in Google Scholar PubMed

2. Thomas, R, Sanders, S, Doust, J, Beller, E, Glasziou, P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics 2015;135:e994–1001. https://doi.org/10.1542/peds.2014-3482.Search in Google Scholar PubMed

3. Song, P, Zha, M, Yang, Q, Zhang, Y, Li, X, Rudan, I. The prevalence of adult attention-deficit hyperactivity disorder: a global systematic review and meta-analysis. J Global Health 2021;11:04009. https://doi.org/10.7189/jogh.11.04009.Search in Google Scholar PubMed PubMed Central

4. Liu, A, Xu, Y, Yan, Q, Tong, L. The prevalence of attention deficit/hyperactivity disorder among Chinese children and adolescents. Sci Rep 2018;8:11169. https://doi.org/10.1038/s41598-018-29488-2.Search in Google Scholar PubMed PubMed Central

5. Lillard, AS, Peterson, J. The immediate impact of different types of television on young children’s executive function. Pediatrics 2011;128:644–9. https://doi.org/10.1542/peds.2010-1919.Search in Google Scholar PubMed PubMed Central

6. Lo, CK, Mertz, D, Loeb, M. Newcastle–Ottawa scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol 2014;14:45. https://doi.org/10.1186/1471-2288-14-45.Search in Google Scholar PubMed PubMed Central

7. Holton, KF, Nigg, JT. The association of lifestyle factors and ADHD in children. J Atten Disord 2020;24:1511–20. https://doi.org/10.1177/1087054716646452.Search in Google Scholar PubMed PubMed Central

8. Montagni, I, Guichard, E, Kurth, T. Association of screen time with self-perceived attention problems and hyperactivity levels in French students: a cross-sectional study. BMJ Open 2016;6:e009089. https://doi.org/10.1136/bmjopen-2015-009089.Search in Google Scholar PubMed PubMed Central

9. Xie, G, Deng, Q, Cao, J, Chang, Q. Digital screen time and its effect on preschoolers’ behavior in China: results from a cross-sectional study. Ital J Pediatr 2020;46:9. https://doi.org/10.1186/s13052-020-0776-x.Search in Google Scholar PubMed PubMed Central

10. Tong, L, Xiong, X, Tan, H. Attention-deficit/hyperactivity disorder and lifestyle-related behaviors in children. PLoS One 2016;11:e0163434. https://doi.org/10.1371/journal.pone.0163434.Search in Google Scholar PubMed PubMed Central

11. Soares, PSM, de Oliveira, PD, Wehrmeister, FC, Menezes, AMB, Gonçalves, H. Is screen time throughout adolescence related to ADHD? Findings from 1993 pelotas (Brazil) birth cohort study. J Atten Disord 2022;26:331–9. https://doi.org/10.1177/1087054721997555.Search in Google Scholar PubMed

12. Tandon, PS, Sasser, T, Gonzalez, ES, Whitlock, KB, Christakis, DA, Stein, MA. Physical activity, screen time, and sleep in children with ADHD. J Phys Activ Health 2019;16:416–22. https://doi.org/10.1123/jpah.2018-0215.Search in Google Scholar PubMed

13. Moulin, F, El-Aarbaoui, T, Bustamante, JJH, Héron, M, Mary-Krause, M, Rouquette, A, et al.. Risk and protective factors related to children’s symptoms of emotional difficulties and hyperactivity/inattention during the COVID-19-related lockdown in France: results from a community sample. Eur Child Adolesc Psychiatr 2022;31:1–12. https://doi.org/10.1007/s00787-021-01752-3.Search in Google Scholar PubMed PubMed Central

14. Palladino, VS, McNeill, R, Reif, A, Kittel-Schneider, S. Genetic risk factors and gene-environment interactions in adult and childhood attention-deficit/hyperactivity disorder. Psychiatr Genet 2019;29:63–78. https://doi.org/10.1097/ypg.0000000000000220.Search in Google Scholar

15. Owen, N, Healy, GN, Matthews, CE, Dunstan, DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev 2010;38:105–13. https://doi.org/10.1097/jes.0b013e3181e373a2.Search in Google Scholar

16. Suchert, V, Hanewinkel, R, Isensee, B. Sedentary behavior and indicators of mental health in school-aged children and adolescents: a systematic review. Prev Med 2015;76:48–57. https://doi.org/10.1016/j.ypmed.2015.03.026.Search in Google Scholar PubMed

17. Ceranoglu, TA. Inattention to problematic media use habits: interaction between digital media use and attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2018;27:183–91. https://doi.org/10.1016/j.chc.2017.11.009.Search in Google Scholar PubMed

18. Lingineni, RK, Biswas, S, Ahmad, N, Jackson, BE, Bae, S, Singh, KP. Factors associated with attention deficit/hyperactivity disorder among US children: results from a national survey. BMC Pediatr 2012;12:50. https://doi.org/10.1186/1471-2431-12-50.Search in Google Scholar PubMed PubMed Central

19. Levelink, B, van der Vlegel, M, Mommers, M, Gubbels, J, Dompeling, E, Feron, FJM, et al.. The longitudinal relationship between screen time, sleep and a diagnosis of attention-deficit/hyperactivity disorder in childhood. J Atten Disord 2021;25:2003–13. https://doi.org/10.1177/1087054720953897.Search in Google Scholar PubMed PubMed Central

20. Stevens, T, Mulsow, M. There is no meaningful relationship between television exposure and symptoms of attention-deficit/hyperactivity disorder. Pediatrics 2006;117:665–72. https://doi.org/10.1542/peds.2005-0863.Search in Google Scholar PubMed

21. Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;339:b2535. https://doi.org/10.1136/bmj.b2535.Search in Google Scholar PubMed PubMed Central

22. Tamana, SK, Ezeugwu, V, Chikuma, J, Lefebvre, DL, Azad, MB, Moraes, TJ, et al.. Screen-time is associated with inattention problems in preschoolers: results from the CHILD birth cohort study. PLoS One 2019;14:e0213995. https://doi.org/10.1371/journal.pone.0213995.Search in Google Scholar PubMed PubMed Central

23. Wu, X, Tao, S, Rutayisire, E, Chen, Y, Huang, K, Tao, F. The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China. Eur Child Adolesc Psychiatr 2017;26:541–8. https://doi.org/10.1007/s00787-016-0912-8.Search in Google Scholar PubMed

24. Vohr, BR, McGowan, EC, Bann, C, Das, A, Higgins, R, Hintz, S, et al.. Eunice Kennedy Shriver national institute of child health and human development neonatal research network. Association of high screen-time use with school-age cognitive, executive function, and behavior outcomes in extremely preterm children. JAMA Pediatr 2021;175:1025–34. https://doi.org/10.1001/jamapediatrics.2021.2041.Search in Google Scholar PubMed PubMed Central

25. Beyens, I, Valkenburg, PM, Piotrowski, JT. Screen media use and ADHD-related behaviors: four decades of research. Proc Natl Acad Sci U S A 2018;115:9875–81. https://doi.org/10.1073/pnas.1611611114.Search in Google Scholar PubMed PubMed Central

26. Nikkelen, SW, Valkenburg, PM, Huizinga, M, Bushman, BJ. Media use and ADHD-related behaviors in children and adolescents: a meta-analysis. Dev Psychol 2014;50:2228–41. https://doi.org/10.1037/a0037318.Search in Google Scholar PubMed

27. Christakis, DA, Zimmerman, FJ, DiGiuseppe, DL, McCarty, CA. Early television exposure and subsequent attentional problems in children. Pediatrics 2004;113:708–13. https://doi.org/10.1542/peds.113.4.708.Search in Google Scholar PubMed

28. Harley, KG, Gunier, RB, Kogut, K, Johnson, C, Bradman, A, Calafat, AM, et al.. Prenatal and early childhood bisphenol a concentrations and behavior in school-aged children. Environ Res 2013;126:43–50. https://doi.org/10.1016/j.envres.2013.06.004.Search in Google Scholar PubMed PubMed Central

29. Sisson, SB, Church, TS, Martin, CK, Tudor-Locke, C, Smith, SR, Bouchard, C, et al.. Profiles of sedentary behavior in children and adolescents: the US national health and nutrition examination survey, 2001–2006. Int J Pediatr Obes 2009;4:353–9. https://doi.org/10.3109/17477160902934777.Search in Google Scholar PubMed PubMed Central

30. Zhao, J, Yu, Z, Sun, X, Wu, S, Zhang, J, Zhang, D, et al.. Association between screen time trajectory and early childhood development in children in China. JAMA Pediatr 2022;176:768–75. https://doi.org/10.1001/jamapediatrics.2022.1630.Search in Google Scholar PubMed PubMed Central

31. Madigan, S, Browne, D, Racine, N, Mori, C, Tough, S. Association between screen time and children’s performance on a developmental screening test. JAMA Pediatr 2019;173:244–50. https://doi.org/10.1001/jamapediatrics.2018.5056.Search in Google Scholar PubMed PubMed Central

32. Silva, D, Colvin, L, Hagemann, E, Bower, C. Environmental risk factors by gender associated with attention-deficit/hyperactivity disorder. Pediatrics 2014;133:e14–22. https://doi.org/10.1542/peds.2013-1434.Search in Google Scholar PubMed

33. Zhang, T, Sidorchuk, A, Sevilla-Cermeño, L, Vilaplana-Pérez, A, Chang, Z, Larsson, H, et al.. Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: a systematic review and meta-analysis. JAMA Netw Open 2019;2:e1910236. https://doi.org/10.1001/jamanetworkopen.2019.10236.Search in Google Scholar PubMed PubMed Central

34. Skogheim, TS, Weyde, KVF, Engel, SM, Aase, H, Surén, P, Øie, MG, et al.. Metal and essential element concentrations during pregnancy and associations with autism spectrum disorder and attention-deficit/hyperactivity disorder in children. Environ Int 2021;152:106468. https://doi.org/10.1016/j.envint.2021.106468.Search in Google Scholar PubMed

Received: 2022-12-27
Accepted: 2023-04-24
Published Online: 2023-05-11

© 2023 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 26.2.2024 from https://www.degruyter.com/document/doi/10.1515/reveh-2022-0262/html
Scroll to top button