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Media Exposure in Low-Income Preschool-Aged Children Is Associated with Multiple Measures of Self-Regulatory Behavior

Munzer, Tiffany G., MD*; Miller, Alison L., PhD†,‡; Peterson, Karen E., DSc†,§; Brophy-Herb, Holly E., PhD; Horodynski, Mildred A., RN, PhD; Contreras, Dawn, PhD‖,**; Sturza, Julie, MPH; Lumeng, Julie C., MD*,†,§; Radesky, Jenny, MD*

Journal of Developmental & Behavioral Pediatrics: May 2018 - Volume 39 - Issue 4 - p 303–309
doi: 10.1097/DBP.0000000000000560
Original Articles

Objective: Excessive screen media exposure in childhood is associated with parent-reported self-regulation difficulties. No studies have used laboratory-based or teacher-reported measures of child self-regulatory behaviors. This study examines cross-sectional associations between preschooler screen media exposure and multiple measures of self-regulatory behaviors.

Methods: Preintervention data were used from 541 preschoolers in the Growing Healthy study, an obesity prevention trial (2011–2015). Screen media exposure was measured by daily screen media exposure (hr/d), television (TV) in the bedroom, frequency of background TV, and TV with meals (1 = rarely/never, 4 = frequently). Child self-regulatory behaviors were measured by the following: child ability to delay gratification, a standardized waiting paradigm; teacher-reported Social Competence and Behavior Evaluation; and parent-reported difficult temperament on the Child Behavior Questionnaire (CBQ). Multivariate regression analyses modeled screen media exposure predicting each self-regulatory measure, adjusting for child age, sex, parent age, education, marital status, income-to-needs ratio, number of adults in household, parent depressive symptoms, and sensitivity.

Results: Children were aged 4.1 years (SD = 0.5), parents were aged 29.6 years (SD = 6.8), 48% had high school education or less, and 67% were married. Daily screen media exposure and background TV were associated with weaker observed self-regulation (β: −10.30 seconds for each hr/d media, −12.63 seconds for 1-point increase, respectively). Background TV and TV with meals were associated with greater parent-reported difficult temperament (β: 0.04 and 0.05 CBQ, respectively, for 1-point increase).

Conclusion: Greater screen media exposure had small but significant associations with weaker observed and parent-reported, but not teacher-reported, self-regulatory behaviors. Longitudinal studies are needed to determine the directionality of associations.

*Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI;

Center for Human Growth and Development, University of Michigan, Ann Arbor, MI;

Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI;

§Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI;

Department of Human Development and Family Studies, Michigan State University, Lansing, MI;

College of Nursing, Michigan State University, Lansing, MI;

**Health and Nutrition Institute; Michigan State University Extension, Lansing, MI.

Address for reprints: Tiffany G. Munzer, MD, Center for Human Growth and Development, 300 North Ingalls St, 10th Floor, University of Michigan, Ann Arbor, MI 48109-5406; e-mail:

Disclosure: The authors declare no conflict of interest. This work was funded by the United States Department of Agriculture (USDA)/National Institute of Food and Agriculture/Agriculture and Food Research Initiative (NIFA/AFRI) [Grant No. 2011-68001-30089], which made it possible to collect, analyze, and interpret the data for the primary Growing Healthy study. This work was also funded by the National Institute of Child Health and Development (NICHD) [Grant No. 5T32HD079350-02], which made it possible to conceptualize and write this article. The principal investigator for both grants is J. C. Lumeng.

Received July , 2017

Accepted January , 2018

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