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PLoS One. 2019 Apr 17;14(4):e0213995. doi: 10.1371/journal.pone.0213995. eCollection 2019.

Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study.

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Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Department of Pediatrics, Child & Family Research Institute, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada.



Pre-school children spend an average of two-hours daily using screens. We examined associations between screen-time on pre-school behavior using data from the Canadian Healthy Infant Longitudinal Development (CHILD) study.


CHILD participant parents completed the Child Behavior Checklist (CBCL) at five-years of age. Parents reported their child's total screen-time including gaming and mobile devices. Screen-time was categorized using the recommended threshold of two-hours/day for five-years or one-hour/day for three-years. Multiple linear regression examined associations between screen-time and externalizing behavior (e.g. inattention and aggression). Multiple logistic regression identified characteristics of children at risk for clinically significant externalizing problems (CBCL T-score≥65).


Screen-time was available for over 95% of children (2,322/2,427) with CBCL data. Mean screen-time was 1·4 hours/day (95%CI 1·4, 1·5) at five-years and 1·5 hours/day (95%CI: 1·5, 1·6) at three-years. Compared to children with less than 30-minutes/day screen-time, those watching more than two-hours/day (13·7%) had a 2·2-point increase in externalizing T-score (95%CI: 0·9, 3·5, p≤0·001); a five-fold increased odd for reporting clinically significant externalizing problems (95%CI: 1·0, 25·0, p = 0·05); and were 5·9 times more likely to report clinically significant inattention problems (95%CI: 1·6, 21·5, p = 0·01). Children with a DSM-5 ADHD T-score above the 65 clinical cut-off were considered to have significant ADHD type symptoms (n = 24). Children with more than 2-hours of screen-time/day had a 7·7-fold increased risk of meeting criteria for ADHD (95%CI: 1·6, 38·1, p = 0·01). There was no significant association between screen-time and aggressive behaviors (p>0.05).


Increased screen-time in pre-school is associated with worse inattention problems.

Conflict of interest statement

The authors have declared that no competing interests exist.

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