Association of Screen Time Exposure with Developmental Delay in Communication and Problem-Solving Skills among Children Under 5 Years of Age Presenting at Children's Hospital: An Analytical Cross-Sectional Study

Abstract

Excessive screen exposure in early childhood has been increasingly associated with adverse neurodevelopmental outcomes. Objectives: To determine the association of screen time exposure with developmental delay in communication and problem-solving skills among children under five years of age presenting at a tertiary care hospital in Pakistan. Methods: This analytical cross-sectional study was carried out at Children's Hospital Multan. A total of 236 children aged 1 to 5 years were included using consecutive sampling. Information about children's screen use was collected from parents through a structured questionnaire. Child development in communication and problem-solving was assessed using the Ages and Stages Questionnaire (ASQ-3). Associations between screen exposure and developmental delays were evaluated using chi-square analysis and multivariable logistic regression. Results: More than half of the children (58.1%) were using screens for more than 2 hours per day. Communication delay was found in 34.3% of children, while 29.7% had delay in problem-solving skills. After adjusting for potential confounders, children who used screens for more than 2 hours daily had approximately 2.4 times higher odds of communication delay (AOR=2.41; 95% CI: 1.42–4.08; p=0.001) and 2.1 times higher odds of problem-solving delay (AOR=2.08; 95% CI: 1.19–3.64; p=0.010). Conclusion: Children under five who spend more time on screens were more likely to have speech delay, understanding, and problem-solving skills. Because of these findings, children should be screened regularly for development, and parents should receive advice about healthy screen habits. Parents spending time while talking, playing, and interacting with children may help to improve child development.