116 - Early Screen Exposure and Psychopathology in Children Born During the COVID-19 Pandemic

Publication Number: 1106.116

Sophia Duby, Columbia University Vagelos College of Physicians and Surgeons, Morristown, NJ, United States; Paul Curtin, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Jennifer Warmingham, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Karen Heffler, Drexel University College of Medicine, Philadelphia, PA, United States; Dave Bennett, Drexel University College of Medicine, Philadelphia, PA, United States; Dani Dumitriu, Columbia University, New York, NY, United States

Background: Elevated screen use among young children has been associated with increased externalizing and internalizing behaviors. These behaviors may persist throughout childhood and adversely affect later academic and social outcomes. Although screen use increased across all age groups during the COVID-19 pandemic, the impact of this increased screen exposure on early childhood psychopathology-particularly in children born during the height of the pandemic-remains largely unexplored.

Objective: Evaluate the associations between child daily screen exposure at 24 months and total, externalizing, and internalizing problems at both 24 and 36 months in a cohort of children born during the COVID-19 pandemic.

Design/Methods: This study used data from the COVID-19 Mother Baby Outcomes (COMBO) initiative at Columbia University. Daily screen exposure at 24 months was measured using the Screen Exposure Inventory (SEI). Psychopathology was assessed via parent report using the Child Behavior Checklist, Pre-school Edition (CBCL) at 24 (n=583) and 36 months (n=417). Negative binomial regression models were used to estimate associations between daily screen exposure and CBCL total, externalizing, and internalizing t-scores at both time points. Covariates included child's age at assessment, maternal education (as a proxy for SES), child sex assigned at birth, and race/ethnicity. Statistical significance was set at p< 0.05.

Results: At 24 months of age, we found that for each hour increase in daily screen exposure, there was a 2.9% (IRR: 1.029, 95% CI [1.012, 1.035], p< 0.001) increase in total problems, a 2.1% (IRR: 1.021, 95% CI [1.0, 1.033], p< 0.001) increase in externalizing problems, and a 2.2% (IRR: 1.022, 95% CI [1.011, 1.033], p< 0.001) increase in internalizing problems. At 36 months, each hour of additional screen exposure at 24 months predicted a 1.5% (IRR: 1.015, 95% CI [1.002, 1.028], p=0.02) increase in total problems, as well as a 1.4% increase (IRR: 1.014, 95% CI [1.001, 1.027], p=0.03) in externalizing problems. 24-month screen exposure had no significant effect on internalizing problems at 36 months (IRR: 1.008, 95% CI [-1.005, 1.022], p=0.21).

Conclusion(s): These results suggest that increased screen exposure during early childhood is associated with elevated psychopathology in young children, and that these effects can persist. As screen use increased during the COVID-19 pandemic, continued research is needed to understand how early digital experiences shape children's emotional and social growth.

Table 1: Study Cohort Characteristics
Table 1 shows the demographics of this study cohort.

Table 2: Model Results
Table 2 shows the results of the models associating child screen exposure at 24 months with total, externalizing, and internalizing problems at 24 and 36 months. The leftmost column shows the model outcomes. The incidence rate ratio (IRR) for each model is included alongside the 95% confidence interval (CI) for each model. P-values less than 0.05 were considered significant.