The Correlation between Exposure to Screen Time and Severity of Autism Spectrum Disorder in Children in Bangladesh: A...

Excessive electronic media use in early childhood is a potential risk factor for autism spectrum disorder (ASD), though evidence is inconclusive. This study examines screen exposure's relationship with ASD incidence and severity in Bangladeshi children. A hospital-based case-control study at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from July 1 2022 to June 30 2023, enrolled 260 participants (130 with ASD per DSM-5 criteria and 130 age-matched controls). Data were collected via structured caregiver interviews on children's screen exposure (including any exposure in the first year, initial exposure age, daily duration, hours during the first year and maternal screen use). ASD severity was assessed using the Autism Diagnostic Observation Schedule (ADOS). Group differences were evaluated using t-tests and χ² tests and correlations between exposure variables and severity were examined using Pearson's coefficients. Eighty percent of ASD cases were exposed to screens in their first year, compared with 46.2% of controls (p<0.001). Mean daily screen time was 6.26±2.37 hours for cases and 1.72±1.29 hours for controls (p<0.001). Children with ASD began exposure earlier (13.68±8.21 vs. 18.09±5.42 months, p<0.001). Screen duration and infant hours showed significant positive correlations with ADOS severity scores (r ≈ 0.30, p<0.001), while age at first exposure correlated negatively (r = - 0.31, p<0.001). Early, prolonged screen exposure was significantly associated with ASD diagnosis and symptom severity. Though causality is not established, these findings emphasize delaying screen introduction and promoting interactive play during early development.