New studies measure screen-based media use in children

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Credit: Pediatric Academic Societies

TORONTO, May 5, 2018 – A new study examines the effectiveness of the ScreenQ, a measure of screen-based media use in children. Findings from the study will be presented during the Pediatric Academic Societies (PAS) 2018 Meeting.

"In a single generation, the explosion of screen-based media has transformed the experience of childhood, from TV and videos, to an unlimited range of content available at any time via portable devices that can be challenging to monitor," said Dr. John S. Hutton, one of the authors of the study. "The emergence of these technologies has far outpaced our ability to quantify its effects on child development, human relationships, learning and health, fueling controversies among parents, educators and clinical providers. The ScreenQ is a novel measure of screen-based media use in children intended for pediatric clinical use, incorporating evidence-based factors known to influence these effects, including access to screens, frequency and context of use (e.g., meals), content (e.g., violent versus educational) and co-viewing with grownup caregivers."

This study involved 27 healthy children from employee families at an academic medical center (15 boys, 12 girls; mean 57±7 months old, mid/high-SES). A 17-item version of the ScreenQ was developed applying a conceptual model of screen-based media use involving aspects cited in American Academy of Pediatrics (AAP) guidelines: access, frequency (e.g., age of use), content and interactivity (e.g., co-viewing). Responses were categorical, except for frequency, where numerical response was converted into a categorical score. Higher scores reflect greater risk. Validated measures were administered as criterion-referenced standards, including the EVT and PPVT (language), BRIEF-P (executive function), BASC (behavior), and StimQ-P READ home reading environment survey. Modern theory Rasch methods were used to evaluate items for smoothness, modality, difficulty, polarity, density and outliers. Preliminary indices of internal consistency were estimated using Cronbach's, and of validity using a Spearman-rho correlation coefficient with criterion-referenced standards (

The study found that applying these methods, the ScreenQ was reduced to 10 items (three access, two frequency, three content, two interactivity). The reduced version demonstrated strong internal consistency (Crohnbach's =0.63), good person- and item-level reliability, and variability in Logit endorsability. While non-significant, ScreenQ scores were negatively correlated with StimQ-P (-0.17), PPVT (-0.17), EVT (-0.17), and positively with BRIEF composite (0.20) and BASC (0.22) scaled scores. Kolmogorov-Smirnov tests revealed near-normality for ScreenQ scores (p=0.14), but not for StimQ-P (p=0.03).

Preliminary evidence suggests that the ScreenQ is an efficient, valid means to assess screen-based media use in children in the context of AAP guidelines and cognitive-behavioral risks, warranting further development.

A related study by Dr. Hutton, to be presented as a platform at the PAS 2018 Meeting, is the first to use magnetic resonance imaging (MRI) to explore the influence of story format (audio, illustrated, animated) on the engagement of brain networks supporting language, visual imagery and learning in preschool-age children.

AAP recommends that parents begin reading to their children as soon as possible after birth, and provide limits on screen-based media use. In addition to TV, screen-based story platforms with animated features are increasingly marketed to children, yet the influence of animation on brain development is unknown. The purpose of this study was to determine whether there were differences in the engagement of functional brain networks supporting narrative processing for stories presented in audio, illustrated and animated format.

Key findings suggest a "Goldilocks Effect," where audio may be "too cold" at this age, requiring more cognitive strain to process the story, animation "too hot," fast-moving media rendering imagination and network integration less necessary, and illustration "just right," limited visual scaffolding assisting the child while still encouraging active imagery and reflection.

"They underscore the appeal of illustrated books at this age, raise important questions about the influence of media on early brain development, and provide novel context for AAP reading and screen time recommendations," said Dr. Hutton.

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Dr. Hutton will present findings from the "Assessment of Screen-Based Media Use in Children: Development and Psychometric Refinement of the ScreenQ" during the PAS 2018 Meeting on Sunday, May 6 at 5:45 p.m. EDT. Findings from "Goldilocks Effect? Illustrated Story Format Seems 'Just Right' and Animation 'Too Hot' for Integration of Functional Brain Networks in Preschool-Age Children" will be presented on Sunday, May 6 at 9:45 a.m. EDT. Reporters interested in an interview with Dr. Hutton should contact [email protected]

Please note: Only the abstracts are being presented at the meeting. In some cases, the researcher may have additional data to share with media.

The PAS 2018 Meeting, taking place in Toronto on May 5-8, 2018, brings together thousands of pediatric scientists and other health care providers to improve the health and well-being of children worldwide. For more information about the PAS 2018 Meeting, please visit http://www.pas-meeting.org.

About The Pediatric Academic Societies (PAS) Meeting

The Pediatric Academic Societies (PAS) Meeting brings together thousands of pediatricians and other health care providers united by a common mission: improve the health and well-being of children worldwide. This international gathering includes researchers, academics, as well as clinical care providers and community practitioners. Presentations cover issues of interest to generalists as well as topics critical to a wide array of specialty and sub-specialty areas. The PAS Meeting is produced through a partnership of four pediatric organizations that are leaders in the advancement of pediatric research and child advocacy: American Pediatric Society, Society for Pediatric Research, Academic Pediatric Association and American Academy of Pediatrics. For more information, please visit http://www.pas-meeting.org. Follow us on Twitter @PASMeeting and #PAS2018, or like us on Facebook.

PAS Media Contact:

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PAS Press Office (May 5-8, 2018):

832-371-6239

Abstract: Assessment of Screen-Based Media Use in Children: Development and Psychometric Refinement of the ScreenQ

Background: Screen-based media are increasingly prevalent in children's lives beginning in infancy, with different aspects linked to potential benefits and developmental/health risks. American Academy of Pediatrics (AAP) recommendations involve access to screens, age and frequency of use, co-viewing, and content, though there is presently no validated, comprehensive measure available.

Objective: The purpose of this study was to pilot test and refine a comprehensive, evidence-based measure of screen-based media use in children (ScreenQ).

Design/Methods: This study involved 27 healthy children from employee families at an academic medical center (15 boys, 12 girls; mean 57±7 months old, mid/high-SES). A 17-item version of the ScreenQ was developed applying a conceptual model of screen-based media use involving aspects cited in AAP guidelines: access, frequency (e.g. age of use), content, and interactivity (e.g. co-viewing). Responses were categorical, except for frequency, where numerical response was converted into a categorical score. Higher scores reflect greater risk. Validated measures were administered as criterion-referenced standards, including the EVT and PPVT (language), BRIEF-P (executive function), BASC (behavior), and StimQ-P READ home reading environment survey. Modern theory Rasch methods were used to evaluate items for smoothness, modality, difficulty, polarity, density, and outliers. Preliminary indices of internal consistency were estimated using Cronbach's, and of validity using a Spearman-rho correlation coefficient with criterion-referenced standards (

Results: Applying these methods, the ScreenQ was reduced to 10 items (3 access, 2 frequency, 3 content, 2 interactivity). The reduced version demonstrated strong internal consistency (Crohnbach's =0.63), good person- and item-level reliability, and variability in Logit endorsability, summarized in figure 1. While non-significant, ScreenQ scores were negatively correlated with StimQ-P (-0.17), PPVT (-0.17), EVT (-0.17), and positively with BRIEF composite (0.20) and BASC (0.22) scaled scores, shown in table 1. Kolmogorov-Smirnov tests revealed near-normality for ScreenQ scores (p=0.14), but not for StimQ-P (p=0.03), histograms shown in figure 2.

Conclusion(s): Preliminary evidence suggests that the ScreenQ is an efficient, valid means to assess screen-based media use in children in the context of AAP guidelines and cognitive-behavioral risks, warranting further development.

Authors: John Hutton, Yuanfang Xu, Thomas DeWitt, Tzipi Horowitz-Kraus, Richard Ittenbach

Abstract: Goldilocks Effect? Illustrated Story Format Seems "Just Right" and Animation "Too Hot" for Integration of Functional Brain Networks in Preschool-Age Children

Background: The American Academy of Pediatrics (AAP) recommends that parents begin reading to their children as soon as possible after birth, and provide limits on screen-based media use. In addition to TV, screen-based story platforms with animated features are increasingly marketed to children, yet the influence of animation on brain development is unknown.

Objective: To determine whether there are differences in the engagement of functional brain networks supporting narrative processing for stories presented in audio, illustrated, and animated format.

Design/Methods: This study involved functional magnetic resonance imaging (fMRI) during a single visit. Employee families from an academic medical center were enrolled, and 27/32 children completed fMRI (84%; 15 boys, 12 girls; age 43-70 mo, mean 57±7). The fMRI protocol involved 3 different, unrhymed stories by the same author lasting 5 minutes each presented in audio, illustrated, and animated format during separate runs, shown in figure 1. These were in the same sequence for all children. Analyses involved comparison of within- and between-network functional connectivity (FC) across formats involving visual perception, visual imagery, semantic language, Default Mode (DMN), and cerebellar brain networks, defined via literature review and refined via a validated parcellation method. FC was calculated as the mean of the sum of pair-wise, Fisher-transformed, bivariate correlation coefficients for all regions of interest (ROI), then compared between formats via 2-tailed, paired t-tests applying false discovery rate (FDR) correction (p

Results: FC was decreased within the language network and increased between visual, DMN, and cerebellar networks for illustration relative to audio. Between-network FC was sharply decreased for animation relative to the other formats, especially illustration. A summary is in figure 2.

Conclusion(s): Our findings suggest that illustrated format provides visual scaffolding that assists the language network and encourages active imagery and self-reflection in young children, while animation may inhibit such network integration in favor of continuous audio-visual perception. They raise important questions about optimal promotion of healthy brain development, and provide novel neurobiological context for AAP reading and screen time recommendations.

Authors: John Hutton, Jonathan Dudley,Tzipi Horowitz-Kraus, Thomas DeWitt, Scott Holland

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