Parental Education for Limiting Screen Time in Early Childhood: A Randomized Controlled Trial

To assess the impact of focused parental education on limiting screen time in early childhood.

An open label randomized controlled trial was conducted in a tertiary care hospital in Delhi wherein 120 healthy children aged 9-10 months of age, born at term gestation and appropriate for gestational age (birth weight ≥ 2500 g), attending the immunization clinic reporting for measles-rubella (MR) vaccination were enrolled. Primary caregivers were randomized to either receive 30 minutes of in-person active counselling with pre-designed content including a printed pamphlet targeted at reduction of screen time (Educational group, n = 61) or to receive routine in-person counseling on general health measures (Control group, n = 61). All caregivers were followed up. Primary caregivers in both groups were reinforced telephonically every month for 6 months. At the end of six months, we assessed the proportion of children with screen-time > 1 hour/day and the median duration of screen-time (minutes /day). We also compared both groups in terms of changes in pre-post intervention developmental and behavioral scores (measured with Ages and Stages questionnaires).

After 6 months of follow-up, 3% (2/61) children in the Educational group had screen time > 1 hour/day as compared to 53% (32/61) (P < 0.001) in the Control group. Median (IQR) for total screen duration in the Educational group was 35 (30,49) minutes/day compared to 75 (50,90) minutes/day in the Control group (P < 0.001). Children in the Educational group were also observed to have a significant change in behavioral score and fine motor and adaptive skills as compared to controls.

Parental education starting in infancy is a promising intervention to reduce screen exposure in children; it may also have a positive impact on their developmental and behavioral skills.