"nem sempre funciona, mas ajuda": percepções parentais sobre a exposição do bebê às telas / "it doesn't always work, but it helps": parental perceptions of baby's screen exposure

RESUMO. Frente ao número crescente de crianças menores de dois anos expostas às telas, preocupações com o desenvolvimento dos bebês têm emergido e sido foco de discussões acadêmicas e clínicas. Para buscar compreender as razões que levam os pais a disponibilizarem as mídias digitais aos bebês, entrevistas foram conduzidas com mães e pais de crianças com idades entre dez e 17 meses, domiciliados na região metropolitana de Porto Alegre, Brasil. Apesar das orientações das sociedades de pediatria, verifica-se discrepância entre a divulgação deste conteúdo e o acesso a ele. Os pais, por desconhecimento e também por necessidade, disponibilizam diferentes mídias ao bebê, que é percebida em diversas situações como positiva e facilitadora nos cuidados com a criança; os pais alegam que o acesso precoce pelo bebê é importante para aprimorar a destreza cognitiva e capaz de gerar interação familiar. Por outro lado, apresentam preocupações diante do uso de telas em detrimento de outras formas de brincar. Evidencia-se que os pais precisam de orientações e suporte, assim como os profissionais devem considerar as necessidades das famílias ao elaborar diretrizes a fim de orientá-los.

RESUMEN Frente al creciente número de niños menores de dos años expuestos a las pantallas, preocupaciones sobre el desarrollo de los bebés han sido el foco de discusiones académicas y clínicas. Para comprender porque madres y padres exponen a sus hijos a tecnologías digitales se han realizado entrevistas en profundidad con madres y padres de bebés con edades entre 10 y 17 meses, domiciliadas en la región metropolitana de Porto Alegre, Brasil. A pesar de las pautas recomendadas por las sociedades pediátricas sobre al acceso a las pantallas, los padres muestran discrepancia acerca de las mismas. Los progenitores, debido tanto a la falta de conciencia, como a la necesidad comparten sus dispositivos con los bebés. Los padres afirman estar preocupados por el futuro de los niños y perciben el acceso temprano a la tecnología como una herramienta importante para mejorar las habilidades cognitivas y fortalecer los lazos familiares. También señalaron que las potencialidades en el uso para generar interacciones familiares, destacando la supervisión de los padres. Por otro lado, los padres manifiestan preocupación ante el uso de la tecnología a expensas de otras formas de juego. Los progenitores necesitan orientación y apoyo, al igual que los profesionales deben considerar las necesidades de las familias al formular recomendaciones.

ABSTRACT. Considering the large number of children under the age of two that are constantly exposed to digital screens, concerns about child development have been emerging and becoming the focus of academic and clinical discussions. In order to understand the reasons why parents expose their infants to digital technologies, we conducted in-depth interviews with mothers and fathers of infants aged between 10 and 17 months living in the metropolitan region of Porto Alegre, Brazil. Despite the guidelines of local pediatric societies, our data points to divergences between what is recommended by the board of pediatrics and the patterns of screen exposure documented in our study. Parents, out of unawareness and/or urgent need, introduce their babies to digital technologies. Parents claimed to be concerned with the future of children and perceived early access to digital technology as an important tool to improve cognitive skills and to strength family bonds. Conversely, parents had concerns in face of technology at the expense of other forms of play. Our findings highlight that parents need additional guidance and support, while professionals should weight needs and daily challenges experienced by families when formulating guidelines.

Effects of screen exposure on morbidity risk in children with autism spectrum disorder and language retardation / 中华行为医学与脑科学杂志

Objective:To explore the effects of screen exposure on morbidity risk in children with autism spectrum disorder (ASD) or language retardation.Methods:In a case-control study, 64 children with autism spectrum disorder were selected as the ASD group, 64 children with language retardation as the language retardation group, and 52 normal children as the control group. Descriptive analysis, t-test, Chi-square test, Logistic regression analysis and other statistical methods of SPSS 17.0 software were used to analyze the data.The differences of screen exposure between the case groups and control group were compared to analyze the effects of screen exposure on the diseases. Results:There were statistically significant differences in daily cumulative screen time ( F=27.758), duration of screen exposure ( F=12.516), first-time exposure to screen(χ 2 = 13.749) and parents' explanation during screen contact(χ 2 = 16.368) among the three group (all P<0.05). The proportion of first-time exposure to screen before 1 year old was 65.62% (42/64) in ASD group, 40.63% (26/64) in language retardation group and 33.33%(17/51) in control group. Compared with the control group ((1.42±1.44)h), the ASD group ((4.04±2.00)h) and the language delay group ((3.53±2.07)h) had longer daily cumulative screen time, and the differences were statistically significant (both P<0.05). Compared with the control group ((6.14±4.59) months), children in the ASD group ((11.97±7.32) months) or the language retardation group ((9.96±5.15) months) had the longer duration of screen exposure, and the differences were statistically significant (both P<0.05). Compared with the control group, parents in ASD group and language retardation group elaborated less while the children were exposed to screen, the differences were statistically significant (both P<0.05). Logistic regression analysis showed that cumulative daily exposure time less than 2 hours ( β=-5.338, OR=0.005, 95% CI=0.001-0.120), democratically parenting style ( β=-3.279, OR=0.038, 95% CI=0.003-0.554), paternal age less than 35 years old ( β=-5.432, OR=0.004, 95% CI=0.001-0.691) were protective factors for autism spectrum disorder, while paternal education level below junior college was a risk factor ( β=3.125, OR=22.755, 95% CI=1.866-277.463). Cumulative exposure time less than 2 hours per day ( β=-3.357, OR=0.035, 95% CI=0.002-0.526) was a protective factor for language retardation, and paternal education less than college degree ( β=2.740, OR=15.482, 95% CI=1.350-177.573) was a risk factor for language retardation. Conclusion:Excessive screen exposure has certain effects on morbidity risk of autism spectrum disorder and language retardation, which should be paid more attention to.

Screen Time in Under-five Children

Context:Screen-viewing in childhood is primarily a mean of entertainment, during the unstructured time. We aimed to review the burdenof the problem, delineate the associated factors and correlates, evaluate the impact of screen-time on the overall health of under-fivechildren, and the interventions to reduce screen-time. Evidence acquisition:Published articles from January 2009 to June 2018 weresearched through PubMed, Clinical Key, Scopus, Embase, and Google Scholar using key Medical Subject Heading words. Results: Theburden of screen-time varied from 21% to 98% in the middle-income, and 10% to 93.7% in the high-income countries. The socialecological model was used to illustrate associated factors and correlates including child, caregiver, micro and macro digital-mediaenvironment related factors. The interventions included increase in the physical activity, reduction in the body mass index, improvingsleep and dietary behaviors etc. The effectiveness of these interventions ranged from 0.3 minutes (standard error 13.3) to -47.16minutes (standard error 2.01). Conclusion: Clinicians should obtain history of screen-time in children, and advise limiting the screenexposure according to the child’s age. There is a need to generate evidence on burden and effectiveness of interventions amongchildren in the Indian settings, owing to the limited data.