European Child & Adolescent Psychiatry

, Volume 26, Issue 5, pp 541–548 | Cite as

The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China

  • Xiaoyan Wu
  • Shuman Tao
  • Erigene Rutayisire
  • Yunxiao Chen
  • Kun Huang
  • Fangbiao Tao
Original Contribution

Abstract

The purpose of this study was to evaluate the relationships between screen time (ST), nighttime sleep duration, and behavioural problems in a sample of preschool children in China. A sample of 8900 children aged 3–6 years was enrolled from 35 kindergartens, in four cities, in two provinces, in China to evaluate the relationships between ST, nighttime sleep duration, and behavioural problems. Children’s ST and nighttime sleep duration were assessed by questionnaires completed by parents or guardians. Behavioural problems were assessed using the Strengths and Difficulties Questionnaire (SDQ), and the Clancy Autism Behaviour Scale (CABS). Multivariate analysis was used to assess the associations between ST, nighttime sleep duration, and behavioural problems. The total SDQ and CABS scores were higher in children with ST ≥2 h/day and sleep duration <9.15 h/day (a P < 0.001 for all). After adjusting for potential confounders, children with ST ≥2 h/day had a significantly increased risk of having total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial problems, as well as behavioural symptoms of autism spectrum disorder. Similar results were found in children with sleep duration <9.15 h/day. No significantly increased risk of emotional symptoms was observed for short sleep duration. Preschool children with more ST and short nighttime sleep duration were significantly more likely to have behavioural problems. These results may contribute to a better understanding of prevention and intervention for psychosocial problems in children.

Keywords

Screen time Sleep duration Strengths and Difficulties Questionnaire (SDQ) Autism spectrum disorder (ASD) Behavioural problem Preschool children 

Notes

Acknowledgements

The authors are grateful to parents and children who participated in the present study. The authors also thank their partners from maternal and child health care center from 4 research sites. This work was supported by National Natural Science Foundation of China (81573168, 81373012).

Compliance with ethical standards

Ethical standards

Approval for the study was obtained from the Ethics Committee of Anhui Medical University. Written informed consents were obtained from all of the participants.

Conflict of interest

The authors declare that there are no conflicts of interest.

References

  1. 1.
    LeBlanc AG, Spence JC, Carson V, Connor Gorber S, Dillman C, Janssen I, Kho ME, Stearns JA, Timmons BW, Tremblay MS (2012) Systematic review of sedentary behaviour and health indicators in the early years (aged 0–4 years). Appl Physiol Nutr Metab 37(4):753–772. doi:10.1139/h2012-063 CrossRefPubMedGoogle Scholar
  2. 2.
    Carson V, Tremblay MS, Spence JC, Timmons BW, Janssen I (2013) The Canadian Sedentary Behaviour Guidelines for the Early Years (zero to four years of age) and screen time among children from Kingston, Ontario. Paediatr Child Health 18(1):25–28CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Hinkley T, Teychenne M, Downing KL, Ball K, Salmon J, Hesketh KD (2014) Early childhood physical activity, sedentary behaviors and psychosocial well-being: a systematic review. Prev Med 62:182–192. doi:10.1016/j.ypmed.2014.02.007 CrossRefPubMedGoogle Scholar
  4. 4.
    Strasburger VC, Jordan AB, Donnerstein E (2012) Children, adolescents, and the media: health effects. Pediatr Clin N Am 59(3):533–587vii. doi:10.1016/j.pcl.2012.03.025 CrossRefGoogle Scholar
  5. 5.
    Strasburger VC, Jordan AB, Donnerstein E (2010) Health effects of media on children and adolescents. Pediatrics 125(4):756–767. doi:10.1542/peds.2009-2563 CrossRefPubMedGoogle Scholar
  6. 6.
    Hancox RJ, Milne BJ, Poulton R (2004) Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. Lancet 364(9430):257–262. doi:10.1016/S0140-6736(04)16675-0 CrossRefPubMedGoogle Scholar
  7. 7.
    Matricciani LA, Olds TS, Blunden S, Rigney G, Williams MT (2012) Never enough sleep: a brief history of sleep recommendations for children. Pediatrics 129(3):548–556. doi:10.1542/peds.2011-2039 CrossRefPubMedGoogle Scholar
  8. 8.
    de Jong E, Visscher TL, HiraSing RA, Heymans MW, Seidell JC, Renders CM (2013) Association between TV viewing, computer use and overweight, determinants and competing activities of screen time in 4- to 13-year-old children. Int J Obes (Lond) 37(1):47–53. doi:10.1038/ijo.2011.244 CrossRefGoogle Scholar
  9. 9.
    Garrison MM (2015) The feedback whirlpool of early childhood sleep and behavior problems. JAMA Pediatr 169(6):525–526. doi:10.1001/jamapediatrics.2015.0356 CrossRefPubMedGoogle Scholar
  10. 10.
    Jansen PW, Saridjan NS, Hofman A, Jaddoe VW, Verhulst FC, Tiemeier H (2011) Does disturbed sleeping precede symptoms of anxiety or depression in toddlers? The generation R study. Psychosom Med 73(3):242–249. doi:10.1097/PSY.0b013e31820a4abb CrossRefPubMedGoogle Scholar
  11. 11.
    Comer JS, Chow C, Chan PT, Cooper-Vince C, Wilson LA (2013) Psychosocial treatment efficacy for disruptive behavior problems in very young children: a meta-analytic examination. J Am Acad Child Adolesc Psychiatry 52(1):26–36. doi:10.1016/j.jaac.2012.10.001 CrossRefPubMedGoogle Scholar
  12. 12.
    Stone LL, Janssens JM, Vermulst AA, Van Der Maten M, Engels RC, Otten R (2015) The Strengths and Difficulties Questionnaire: psychometric properties of the parent and teacher version in children aged 4–7. BMC Psychol 3(1):4. doi:10.1186/s40359-015-0061-8 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Hinkley T, Verbestel V, Ahrens W, Lissner L, Molnar D, Moreno LA, Pigeot I, Pohlabeln H, Reisch LA, Russo P, Veidebaum T, Tornaritis M, Williams G, De Henauw S, De Bourdeaudhuij I (2014) Early childhood electronic media use as a predictor of poorer well-being: a prospective cohort study. JAMA Pediatr 168(5):485–492. doi:10.1001/jamapediatrics.2014.94 CrossRefPubMedGoogle Scholar
  14. 14.
    Scharf RJ, Demmer RT, Silver EJ, Stein RE (2013) Nighttime sleep duration and externalizing behaviors of preschool children. J Dev Behav Pediatr 34(6):384–391. doi:10.1097/DBP.0b013e31829a7a0d CrossRefPubMedGoogle Scholar
  15. 15.
    Sikora DM, Johnson K, Clemons T, Katz T (2012) The relationship between sleep problems and daytime behavior in children of different ages with autism spectrum disorders. Pediatrics 130(Suppl 2):S83–S90. doi:10.1542/peds.2012-0900F CrossRefPubMedGoogle Scholar
  16. 16.
    Theunissen MH, Vogels AG, de Wolff MS, Reijneveld SA (2013) Characteristics of the strengths and difficulties questionnaire in preschool children. Pediatrics 131(2):e446–e454. doi:10.1542/peds.2012-0089 CrossRefPubMedGoogle Scholar
  17. 17.
    Montes G (2016) Children with autism spectrum disorder and screen time: Results from a large nationally representative US Study. Acad Pediatr 16(2):122–128. doi:10.1016/j.acap.2015.08.007 CrossRefPubMedGoogle Scholar
  18. 18.
    Hanratty J, Livingstone N, Robalino S, Terwee CB, Glod M, Oono IP, Rodgers J, Macdonald G, McConachie H (2015) Systematic Review of the Measurement Properties of Tools Used to Measure Behaviour Problems in Young Children with Autism. PLoS One 10(12):e0144649. doi:10.1371/journal.pone.0144649 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Clancy H, Dugdale A, Rendle-Short J (1969) The diagnosis of infantile autism. Dev Med Child Neurol 11(4):432–442CrossRefPubMedGoogle Scholar
  20. 20.
    Sun X, Allison C, Auyeung B, Matthews FE, Zhang Z, Baron-Cohen S, Brayne C (2014) Comparison between a Mandarin Chinese version of the Childhood Autism Spectrum Test and the Clancy Autism Behaviour Scale in mainland China. Res Dev Disabil 35(7):1599–1608. doi:10.1016/j.ridd.2014.02.005 CrossRefPubMedGoogle Scholar
  21. 21.
    World Health Organization (2006) WHO Child Growth Standards: methods and development. http://www.who.int/childgrowth/standards/Technical_report.pdf?ua=1. Accessed 2006
  22. 22.
    Tandon PS, Zhou C, Lozano P, Christakis DA (2011) Preschoolers’ total daily screen time at home and by type of child care. J Pediatr 158(2):297–300. doi:10.1016/j.jpeds.2010.08.005 CrossRefPubMedGoogle Scholar
  23. 23.
    Vanderloo LM (2014) Screen-viewing among preschoolers in childcare: a systematic review. BMC Pediatr 14:205. doi:10.1186/1471-2431-14-205 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Griffiths LJ, Dowda M, Dezateux C, Pate R (2010) Associations between sport and screen-entertainment with mental health problems in 5-year-old children. Int J Behav Nutr Phys Act 7:30. doi:10.1186/1479-5868-7-30 CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Manganello JA, Taylor CA (2009) Television exposure as a risk factor for aggressive behavior among 3-year-old children. Arch Pediatr Adolesc Med 163(11):1037–1045. doi:10.1001/archpediatrics.2009.193 CrossRefPubMedGoogle Scholar
  26. 26.
    Mistry KB, Minkovitz CS, Strobino DM, Borzekowski DL (2007) Children’s television exposure and behavioral and social outcomes at 5.5 years: does timing of exposure matter? Pediatrics 120(4):762–769. doi:10.1542/peds.2006-3573 CrossRefPubMedGoogle Scholar
  27. 27.
    Cheng S, Maeda T, Yoichi S, Yamagata Z, Tomiwa K (2010) Early television exposure and children’s behavioral and social outcomes at age 30 months. J Epidemiol 20(Suppl 2):S482–S489CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Swing EL, Gentile DA, Anderson CA, Walsh DA (2010) Television and video game exposure and the development of attention problems. Pediatrics 126(2):214–221. doi:10.1542/peds.2009-1508 CrossRefPubMedGoogle Scholar
  29. 29.
    Strasburger VC (2011) Children, adolescents, obesity, and the media. Pediatrics 128(1):201–208. doi:10.1542/peds.2011-1066 CrossRefPubMedGoogle Scholar
  30. 30.
    Sivertsen B, Harvey AG, Reichborn-Kjennerud T, Torgersen L, Ystrom E, Hysing M (2015) Later emotional and behavioral problems associated with sleep problems in toddlers: a longitudinal study. JAMA Pediatr 169(6):575–582. doi:10.1001/jamapediatrics.2015.0187 CrossRefPubMedGoogle Scholar
  31. 31.
    Engelhardt CR, Mazurek MO, Sohl K (2013) Media use and sleep among boys with autism spectrum disorder, ADHD, or typical development. Pediatrics 132(6):1081–1089. doi:10.1542/peds.2013-2066 CrossRefPubMedGoogle Scholar
  32. 32.
    Varni JW, Magnus B, Stucky BD, Liu Y, Quinn H, Thissen D, Gross HE, Huang IC, DeWalt DA (2014) Psychometric properties of the PROMIS (R) pediatric scales: precision, stability, and comparison of different scoring and administration options. Qual Life Res 23(4):1233–1243. doi:10.1007/s11136-013-0544-0 CrossRefPubMedGoogle Scholar
  33. 33.
    Werner H, Molinari L, Guyer C, Jenni OG (2008) Agreement rates between actigraphy, diary, and questionnaire for children’s sleep patterns. Arch Pediatr Adolesc Med 162(4):350–358. doi:10.1001/archpedi.162.4.350 CrossRefPubMedGoogle Scholar
  34. 34.
    Scrimgeour MB, Davis EL, Buss KA (2016) You get what you get and you don’t throw a fit!: Emotion socialization and child physiology jointly predict early prosocial development. Dev Psychol 52(1):102–116. doi:10.1037/dev0000071 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Xiaoyan Wu
    • 1
    • 2
  • Shuman Tao
    • 1
  • Erigene Rutayisire
    • 1
  • Yunxiao Chen
    • 1
  • Kun Huang
    • 1
    • 2
  • Fangbiao Tao
    • 1
    • 2
  1. 1.Department of Maternal, Child and Adolescent Health, School of Public HealthAnhui Medical UniversityHefeiChina
  2. 2.Anhui Provincial Key Laboratory of Population Health and AristogenicsHefeiChina

Personalised recommendations