Sleep and Technology in Early Childhood.

Research suggests that technology use is associated with poorer sleep outcomes among children less than 6 years of age. These associations are evident regardless of the type of technology studied, although evening exposure may have the greatest impact compared with technology use during other parts of the day. More work is needed, particularly given that technology use is relatively high among young children. Clinicians should assess patients' technology exposure, including before bedtime, to assess whether sleep issues stem from children's technology use. Moreover, clinicians should educate caregivers about the association between technology use and sleep problems among young children.

Sleep and Technology in Early Childhood.

Research suggests that technology use is associated with poorer sleep outcomes among children less than 6 years of age. These associations are evident regardless of the type of technology studied, although evening exposure may have the greatest impact compared with technology use during other parts of the day. More work is needed, particularly given that technology use is relatively high among young children. Clinicians should assess patients' technology exposure, including before bedtime, to assess whether sleep issues stem from children's technology use. Moreover, clinicians should educate caregivers about the association between technology use and sleep problems among young children.

Electronic Media Use and Sleep Among Preschoolers: Evidence for Time-Shifted and Less Consolidated Sleep.

This study examined the association between electronic media use and sleep among preschoolers, using a national sample of 402 mothers of 3- to 5-year-olds. Participants completed an online survey assessing preschoolers' electronic media use, bedtime and wake time, sleep time, napping behaviors, and sleep consolidation. Results showed that heavier television use and tablet use, both overall and in the evening, were associated with later bedtimes and later wake times, but not with fewer hours of sleep, providing evidence for a time-shifting process. In addition, heavier daily television use and evening smartphone use were associated with increased daytime napping. Moreover, heavier daily television use, daily and evening smartphone use, and evening tablet use were associated with poorer sleep consolidation, suggesting less mature sleep patterns. These findings indicate that media effects on the timing of sleep and the proportion of sleep that occurs at night are important to consider when assessing the health risks of electronic media on children.

The Relation Between Use of Mobile Electronic Devices and Bedtime Resistance, Sleep Duration, and Daytime Sleepiness Among Preschoolers.

This study investigated the relation between preschoolers' mobile electronic device (MED) use and sleep disturbances. A national sample of 402 predominantly college-educated and Caucasian mothers of 3-5-year-olds completed a survey assessing their preschoolers' MED use, bedtime resistance, sleep duration, and daytime sleepiness. Heavier evening and daily tablet use (and to some extent, smartphone use) were related to sleep disturbances. Other forms of MED use were not consistently related to sleep disturbances. In addition, playing games on MEDs at bedtime was related to compromised sleep duration, although other forms of MED use at bedtime were not related to sleep outcomes. Although the relations between MED use and sleep disturbances were small in size, they were larger than the relations between sleep and other predictors in the models. Continued work should investigate how MED exposure is related to children's cognitive, psychological, emotional, and physiological development, particularly given the popularity and widespread use of these devices.

The role of sleep in the relation between young children's mobile media use and effortful control.

We explored the relations among young children's mobile media use, sleep, and a form of self-regulation, temperamental effortful control (EC), among a national sample of 402 mothers who completed an online survey. We found that the relation between mobile media use and EC was moderated by children's sleep time. Tablet use was negatively related to EC only among children who slept less at night (40% of our sample). However, hand-held game player use was positively related to EC among children who slept longer at night (60% of our sample). In addition, sleep quality was a mediator in the relation between evening tablet use and EC. Evening use related to later bedtimes, more bedtime resistance, and worse sleep duration, and these indicators of poor sleep quality, in turn, predicted weaker EC. Statement of contribution What is already known on this subject? Young children are spending increasing amounts of time with mobile media, such as tablets and hand-held game players. Media exposure is related to children's self-regulation. Media exposure is related to children's sleep quality. What does this study adds? Number of sleep hours moderates the relation between mobile media use and EC among young children. Tablet time is negatively related to EC among young children who get fewer sleep hours. Hand-held game playing is positively related to EC among young children who get greater sleep hours. Sleep quality mediates the relation between evening tablet time and EC among young children.

Parenting and Digital Media.

Understanding the family dynamic surrounding media use is crucial to our understanding of media effects, policy development, and the targeting of individuals and families for interventions to benefit child health and development. The Families, Parenting, and Media Workgroup reviewed the relevant research from the past few decades. We find that child characteristics, the parent-child relationship, parental mediation practices, and parents' own use of media all can influence children's media use, their attitudes regarding media, and the effects of media on children. However, gaps remain. First, more research is needed on best practices of parental mediation for both traditional and new media. Ideally, this research will involve large-scale, longitudinal studies that manage children from infancy to adulthood. Second, we need to better understand the relationship between parent media use and child media use and specifically how media may interfere with or strengthen parent-child relationships. Finally, longitudinal research on how developmental processes and individual child characteristics influence the intersection between media and family life is needed. The majority of children's media use takes place within a wider family dynamic. An understanding of this dynamic is crucial to understanding child media use as a whole.

Protective effects of parental monitoring of children's media use: a prospective study.

IMPORTANCE: Children spend more time with electronic media than they do in any other activity, aside from sleep. Many of the negative effects that stem from media exposure may be reduced by parental monitoring of children's media use; however, there lacks a clear understanding of the mechanisms and extent of these protective effects. OBJECTIVE: To determine the prospective effects of parental monitoring of children's media on physical, social, and academic outcomes. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort design. Data were collected by in-home and in-school surveys in 2 communities in Iowa and Minnesota, where 1323 third- (n = 430), fourth- (n = 446), and fifth- (n = 423) grade students participated. A primary caregiver and teachers also provided data about the student. INTERVENTIONS: Participants in the current study were recruited to participate in a social ecological model-based obesity prevention program. MAIN OUTCOMES AND MEASURES: Body mass index, average weekly sleep, school performance, prosocial behavior, and aggressive behavior. RESULTS Structural equation modeling revealed that parental monitoring of children's media influences children's sleep, school performance, and prosocial and aggressive behaviors and that these effects are mediated through total screen time and exposure to media violence. CONCLUSIONS AND RELEVANCE: Parental monitoring of media has protective effects on a wide variety of academic, social, and physical child outcomes. Pediatricians and physicians are uniquely positioned to provide scientifically based recommendations to families; encouraging parents to monitor children's media carefully can have a wide range of health benefits for children.

The relation between television exposure and executive function among preschoolers.

This study investigated the relations between television exposure during the preschool years and the development of executive function (EF). Data were gathered from 107 parents of preschoolers who provided information on children's television viewing, background television exposure, exposure to specific televised content, and the age at which children began watching television. Preschoolers' EF was assessed via one-on-one interviews. We found that several indicators of television exposure were significantly related to EF. These findings suggest that EF may be an important construct for continued research on the effects of media on young children.