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Preschoolers' Tablet Time Linked to Increase in Anger Outbursts

— Proneness to anger, frustration then linked to more tablet use, prospective study suggested

MedpageToday
A photo of a little girl using a tablet.

Tablet use was associated with more expressions of anger and frustration among preschool-age kids, and proneness to these emotions was associated with more tablet use, a prospective study of a community-based convenience sample indicated.

According to an analysis of 315 preschool-age kids, every 69 minutes of daily tablet use at 3.5 years was associated with an increase in expressions of anger and frustration on the Children's Behavior Questionnaire a year later (standardized coefficient 0.22, 95% CI 0.01-0.44), reported Caroline Fitzpatrick, PhD, of the Université de Sherbrooke in Québec City, Canada, and colleagues.

Conversely, each standard deviation increase in anger and frustration at 4.5 years was associated with an increase of about 17 minutes in tablet use at 5.5 years (standardized coefficient 0.22, 95% CI 0.01-0.43), they noted .

"Despite widespread use, there is still limited research examining how tablet use contributes to child development in general, and social and personal development in particular," Fitzpatrick told ľֱ. "We expected child proneness to anger and frustration at age 3.5 to be associated with more tablet use at age 4.5. However, this was only observed later on, between the ages of 4.5 and 5.5."

"I think our work suggests that parents should exercise caution when introducing tablets into children's routines and closely monitor usage, especially in younger preschool-age children," she added. "Parents of children who are more prone to outbursts of anger and frustration should also favor activities that have been found to help build self-regulation skills like playing make-believe, book reading, and physical activity. Parents should also avoid handing children mobile devices as a strategy for calming them, or as digital pacifiers."

According to a , most 4-year-olds have their own mobile device, and the amount of time spent by young children on mobile devices from 5 minutes per day in 2020 to 55 minutes per day in 2022, Fitzpatrick and team noted.

Children in this study spent an average of 6.5 hours per week (55 minutes per day) using tablets at 3.5 years, 6.7 hours per week (57 minutes per day) at 4.5 years, and 7 hours per week (1 hour per day) at 5.5 years.

"The preschool-age years represent a sensitive period for the development of emotional regulation skills," the authors wrote. "Children who spend more hours using screens may forfeit opportunities to engage in activities, such as interactions with caregivers or free play with other children that are essential for rehearsing and eventually mastering self-regulation. Children who fail to develop the ability to effectively manage outbursts of anger and frustration in particular are then likely to face poor health, academic, and psychosocial outcomes."

Fitzpatrick and team reported that there were significant positive bivariate correlations between tablet use between 3.5 and 4.5 years (r=0.55, P<0.001) and 4.5 and 5.5 years (r=0.49, P<0.001). "Similarly, bivariate correlations revealed a significant and slightly stronger pattern of associations for anger" between 3.5 and 4.5 years (r=0.63, P<0.001) and 4.5 and 5.5 years (r=0.59, P<0.001), they wrote.

In addition, tablet use and anger symptoms were cross-sectionally correlated at each age (3.5 years: r=0.18, P=0.001; 4.5 years: r=0.23, P<0.001; 5.5 years: r=0.18, P=0.01).

The children (54% boys) were studied longitudinally from 2020 to 2022 in Nova Scotia. Participating parents, most of whom reported being born in Canada (91%) and being married (82%), were recruited via newspaper and radio advertisements, as well as posters and flyers distributed to preschools and pre-kindergarten classes, sign-up sheets and presentations given at school registration nights, and a Facebook page.

Mothers were the respondent in 93.4% of cases, and parents reported tablet time through a media assessment questionnaire. Specifically, they were asked to report the average amount of time their child spent using an iPad, tablet, LeapPad, iTouch, or similar mobile device (excluding smartphones) on weekdays and weekends. Response options included: never; less than 30 minutes; 30 minutes to 1 hour; 1 to 2 hours; 2 to 3 hours; 4 to 5 hours; or more than 5 hours. Categorical responses were then converted into continuous variables reflecting hours of tablet use.

The dimension of anger/frustration was based on a mean of seven items ranging from 0 to 7 on the Children's Behavior Questionnaire. Higher scores indicated greater intensity and duration of the child's angry or frustrated response to environmental stimuli.

Limitations included that the study was based on a convenience sample, and that children in the sample were observed during the COVID-19 pandemic, "a unique socio-historical period," Fitzpatrick and colleagues noted.

Additionally, the measure of tablet use was parent-reported, and it was not possible to account for the quality of content kids viewed and the context in which they engaged in tablet use, they added. It was also not possible to account for certain covariates, such as those involving fluctuations in parent mental health and observed associations.

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    Jennifer Henderson joined ľֱ as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.

Disclosures

The study was supported by grants from the Canadian Institutes of Health Research, the Social Sciences and Humanities Research Council, and Research Nova Scotia.

Fitzpatrick reported no conflicts of interest. A co-author reported receiving personal fees from Abbott and Libbs.

Primary Source

JAMA Pediatrics

Fitzpatrick C, et al "Early-childhood tablet use and outbursts of anger" JAMA Pediatr 2024; DOI: 10.1001/jamapediatrics.2024.2511.