Longitudinal Associations Between Screen Use and Reading in Preschool-Aged Children
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Longitudinal Associations Between
Screen Use and Reading in
Preschool-Aged Children
Brae Anne McArthur, PhD,a,b Dillon Browne, PhD,c Sheila McDonald, PhD,a,d Suzanne Tough, PhD,a,b,* Sheri Madigan, PhDa,b,*
BACKGROUND AND OBJECTIVES: The
home literacy environment has been identified as a key predictor abstract
of children’s language, school readiness, academic achievement, and behavioral outcomes.
With the increased accessibility and consumption of digital media, it is important to
understand whether screen use impacts off-line enrichment activities such as reading or
whether reading activities offset screen use. Using a prospective birth cohort, we examined
reading and screen use at 24, 36, and 60 months to elucidate the directional association
between screen use and reading over time.
METHODS: Thisstudy included data from 2440 mothers and children in Calgary, Alberta, drawn
from the All Our Families cohort. Children’s screen use and reading activities were assessed
via maternal report at age 24, 36, and 60 months. Sociodemographic covariates were also
collected.
RESULTS: Using a random-intercepts cross-lagged panel model, which statistically controls for
individual-level confounds, this study revealed that greater screen use at 24 months was
associated with lower reading at 36 months (b = 2.08; 95% confidence interval: 20.13 to
20.02). In turn, lower reading at 36 months was associated with greater screen use at
60 months (b = 2.11; 95% confidence interval: 20.19 to 20.02). Covariates did not modify
the associations.
CONCLUSIONS: A reciprocal relationship between screen use and reading was identified. Early
screen use was associated with lower reading activities, resulting in greater screen use at later
ages. Findings emphasize the need for practitioners and educators to discuss screen use
guidelines and encourage families to engage in device-free activities to foster early literacy
exposure.
a
University of Calgary, Calgary Alberta, Canada; bAlberta Children’s Hospital Research Institute, Calgary, Alberta, WHAT’S KNOWN ON THIS SUBJECT: Book reading is a critical
Canada; cUniversity of Waterloo, Waterloo, Ontario, Canada; and dAlberta Health Services, Calgary, element of the home environment that promotes school
Alberta, Canada readiness and academic achievement. With increasing use of
media devices, longitudinal research is needed to determine
*Contributed equally as joint senior authors if screen use is interfering with off-line activities such as
reading.
Drs McArthur and Madigan conceptualized and designed the study, conducted data analyses,
drafted the manuscript, and reviewed and revised the manuscript; Dr Browne assisted with data WHAT THIS STUDY ADDS: Findings support a dynamic
analysis and reviewed the manuscript for important intellectual content; Drs McDonald and Tough relationship whereby screen use at 24 months leads to lower
conceptualized the cohort study, designed the data collection instruments and study methodology, reading at 36 months, which in turn leads to greater screen
secured funding for data collection, and reviewed the manuscript for important intellectual content; use at 60 months. Families should be encouraged to engage
and all authors approved the final manuscript as submitted and agree to be accountable for all in device-free time.
aspects of the work.
DOI: https://doi.org/10.1542/peds.2020-011429 To cite: McArthur BA, Browne D, McDonald S, et al.
Longitudinal Associations Between Screen Use and
Accepted for publication Feb 26, 2021
Reading in Preschool-Aged Children. Pediatrics. 2021;
147(6):e2020011429
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PEDIATRICS Volume 147, number 6, June 2021:e2020011429 ARTICLEChildren enter school with varying considered to be the most robust movies, videos, or stories on
literacy skills, and these differences method for addressing directionality a videocassette recorder or digital
tend to get larger over time without in observational studies by video disk player; and using
intervention.1,2 The home statistically controlling for individual- a computer, gaming system, or other
environment, including parent-child level confounds, such as stable screen-based device) on a typical
shared print book reading and family-level stressors.13 The weekday and typical weekend day. A
language exposure, has been shown secondary aim of this study was to weighted average across week and
to have a large impact on children’s explore the extent to which the weekend days and electronic devices
later academic achievment.3 In longitudinal associations between was calculated to yield screen use in
addition, shared book reading screen use and reading varied on the hours per week. At each time point,
promotes important parent-child basis of sociodemographic covariates. outliers .4 SDs from the mean were
engagement during sensitive periods Implications of these findings could winsorized16 (n = 8 at 24 months, n =
of development.4 As a result, there inform pediatricians, health care 16 at 36 months, and n = 7 at 60
have been long-standing efforts to practitioners, child care providers, months).
identify factors that may influence the educators and policymakers seeking
home literacy environment.5–7 to guide parents on appropriate
recommendations for screen Reading Activities
With the increased use and
exposure and off-line activities such When children were aged 24, 36, and
accessibility of media devices,8 screen
as reading during the sensitive period 60 months, mothers reported the
use is becoming a consistent part of
of early childhood. range of time their child spent in
children’s day-to-day lives. According
reading activities using a 4-point
to the displacement hypothesis,9
response scale. At 24 months,
when children are watching screens, METHODS
mothers were asked, “Do you or
they are less likely to spend time
Study Design and Population another adult of the household read
practicing skills important for
to your child or show him/her picture
learning and development.10 As such, Participants were from All Our
books?” with response options
screen use may be influencing the Families, a pregnancy cohort of 3388
ranging from (1) never to (4) daily. At
home learning environment, mothers and children from Calgary,
36 months, mothers were asked,
specifically engagement in off-line Canada.14,15 Women were recruited
“How many minutes each day do you
enrichment activities such as reading between August 2008 and December
spend sharing books with your child?
print books,11 and displacement may 2010 through primary health care
” with response options ranging from
be one mechanism to explain the offices, community advertising, and
(1) 0 to 10 minutes to (4)
relation between screen time and laboratories. Inclusion criteria were
$30 minutes. At 60 months, mothers
delays in developmental skill (1) age $18 years, (2) fluent in
were asked, “How many hours per
acquisition. Although it is possible English, (3) gestational age ,25
day does your child spend doing the
that screen use interrupts enriching weeks, and (4) receiving community-
following activities outside of child
off-line activities such as print book based prenatal care. Mothers were
care, preschool, or school: Read or
reading,9,12 it is also possible that followed-up at ,25 weeks’ gestation
look at books?” on a typical weekday
early reading activities may offset and at 4, 12, 24, 36, and 60 months’
and weekend day. Response options
later screen use. However, to test postpartum. The 24-, 36-, and 60-
ranged from (1) none or 0 minutes to
this hypothesis, longitudinal data month time points were the focus of
(4) $3 hours. At 60 months,
with repeated measurement are this analysis because screen use and
a weighted average across week and
needed to examine directional reading variables were both collected.
weekend days was calculated to yield
associations between screen use A detailed description of the study
reading in hours per day, with a range
and reading. sample can be found in Table 1. All
from (1) none or 0 minutes to (4) $3
procedures were approved by the
The primary aim of this study was to hours. The reading items were
institutional ethics board.
explicitly test what comes first: designed to reflect the natural
higher screen use or lower reading progression of reading activities
Measures
activities? In a sample of 2440 across early childhood. Results from
families, using a 3-wave (24, 36, and Screen Use this study suggest consistency in this
60 months) random intercept cross- When children were aged 24, 36, and measurement method over time
lagged panel model (RI-CLPM),13 we 60 months, mothers reported the (24–36 months [b = .23; 95%
predict that higher screen use will range of time their child spent using confidence interval (CI): .18 to .29];
relate to lower reading activities at electronic devices (ie, watching 36–60 months [b = .24; 95% CI: .18
later time points. The RI-CLPM is television programs; watching to .29]).
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2 MCARTHUR et alTABLE 1 Sample Demographics and Study Characteristics Covariates
Characteristic Value Child sex (1 [female]; 0 [male]),
Maternal education, n (%) household income (reported in
Less than high school 40 (1.6) increments of $10 000 Canadian
Graduated high school 104 (4.3)
dollars [CAD]: 1 [#$29 999]; 11
Some college or trade school or university 233 (9.6)
Graduated college or trade school or university 1265 (51.9) [$$150 000]), and maternal
Some graduate school 42 (1.7) education (1 [less than a high school
Completed graduate school 307 (12.6) education]; 6 [completed graduate
Missing 449 (18.3) school]) were maternal self-report. At
Household income, CAD $, n (%)
24 months, maternal screen use and
#29 999 35 (1.4)
30 000–39 999 43 (1.8) maternal reading were measured
40 000–49 999 50 (2.1) with single self-report items asking
50 000–59 999 98 (4.0) the amount of time mothers spend
60 000–69 999 76 (3.1) watching television or reading,
70 000–79 999 122 (5.0)
respectively, on a typical weekday (1
80 000–89 999 140 (5.7)
90 000–99 999 147 (6.0) [none]; 6 [$7 hours per day]).
100 000–124 999 358 (14.7) Attending the library (eg, story time,
125 000–149 999 258 (10.6) borrowing books or videos, etc) in the
$150 000 644 (26.4) past year (yes [1]; no [0]) was also
Missing 469 (19.1)
measured with a single self-report
Maternal race and/or ethnicity, n (%)
White 1993 (81.7) item. Mothers completed the Brief
Black and/or African American 29 (1.2) Infant‐Toddler Social and Emotional
Indigenous 12 (0.5) Assessment (BITSEA) to identify child
Asian 254 (10.4) behavior problems (eg, aggression,
Latin American 37 (1.5)
defiance, over‐activity, negative
Multiracial or other 100 (4.1)
Missing 15 (0.6) emotionality, anxiety, and
Child sex, n (%) withdrawal). By using the BITSEA
Female 937 (38.4) standardized scoring cutoffs, children
Male 1018 (41.7) were categorized with possible
Missing 485 (19.9)
behavioral problems if they scored in
Nonparental child care or day care before 60 mo, n (%)
Yes 1433 (58.8) the $75th percentile on the scale.17
No 533 (21.9) At 60 months, mothers responded to
Missing 474 (19.4) “has your child been in nonparental
Maternal screen use at 24 mo, n (%) child care or day care on a regular
None 111 (4.6)
basis before this year?” (0 [no]; 1
,1 h 441 (18.1)
1–,3 h 859 (35.3) [yes]).
3–,5 h 149 (6.1)
5–,7 h 24 (1.0) Statistical Analyses
$7 h 10 (0.4) The longitudinal associations
Missing 846 (34.6)
between hours of screen use and
Maternal reading at 24 mo, n (%)
None 199 (8.2) reading activities were examined by
,1 h 879 (36.1) using an RI-CLPM.13 The RI-CLPM
1–,3 h 440 (18.1) statistically distinguishes variance at
3–,5 h 57 (2.3) the temporal level (ie, within-person
5–,7 h 13 (0.5)
or time-varying) from variance at the
$7 h 6 (0.2)
Missing 846 (34.6) individual level (ie, between-person
Attended the library at 24 mo, n (%) or stable) and, therefore, constitutes
Yes 961 (39.5) a multilevel approach accounting for
No 635 (26.0) repeated measurements that are
Missing 844 (34.5)
nested within individuals. An
Problem behavior (BITSEA) at 24 mo, n (%)
At risk 236 (9.7) important advantage of the RI-CLPM
Normative 1344 (55.1) over the common cross-lagged panel
Missing 860 (35.2) model is that RI-CLPM controls for
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PEDIATRICS Volume 147, number 6, June 2021 3TABLE 1 Continued standardized root mean square
Characteristic Value residual = 0.002).
Weekly hours of screen use at 24 mo, mean (SD) 17.07 (11.82) In the time-variant component of the
Weekly hours of screen use at 36 mo, mean (SD) 24.90 (12.50) model, statistically significant
Weekly hours of screen use at 60 mo, mean (SD) 10.84 (5.29)
Reading activities at 24 mo, mean (SD) 3.92 (0.29)
autocorrelations for every estimated
Reading activities at 36 mo, mean (SD) 2.61 (0.94) lag indicate substantial within-person
Reading activities at 60 mo, mean (SD) 2.48 (0.52) stability in constructs over time. That
is, on average, children’s screen use
and reading activities were stable
across adjacent time points. As
stable individuals’ differences (ie, at the between-person level).
detailed in Fig 1 and Table 2, after
between-person and time-invariant Statistical significance was set at the
accounting for this temporal stability,
effects, such as stable family-level P , .05, 2-tailed level; 95% CIs are
there was a significant and negative
stressors) in reading activities and reported. All analyses were
cross lag linking higher levels of
screen use, allowing for greater conducted in Mplus version 8.1.21
screen use at 24 months of age with
insight into how the two central
lower levels of reading activities at
constructs in the model (ie, screen
Missing Data 36 months of age (b = 2.08; 95% CI:
use and reading activities) are linked
From the initial pregnancy cohort 2.13 to 2.02). The obverse direction
at an intraindividual (ie, within-
(N = 3388), 95% (n = 3223) agreed to of higher levels of reading activities at
person and time-varying) level. This
be contacted for follow-up research. 24 months being associated with
approach has been shown to reduce
Of those who agreed to follow-up and lower exposure to screens at
bias in directional estimates and
were eligible at the time of 36 months was not observed (b =
more closely approximate causal
questionnaire completion, 76% 2.05; 95% CI: 2.11 to .01). At
relationships.18
completed the 24-month 36 months of age, lower levels of
questionnaire (n = 1595), 69% reading activities predicted higher
First, the standard RI-CLPM was
completed the 36-month exposure to screen use at 60 months
estimated. In the RI-CLPM, between-
questionnaire (n = 1994), and 71% (b = 2.11; 95% CI: 2.19 to 2.02).
person (stable) factors were
completed the 60-month The obverse association was not
extracted from the repeated measures
questionnaire (n = 1992). Attrition observed (b = .01; 95% CI: 2.04 to
of screen use and reading, and these
rates observed in the current study .06). Also, within-time covariances
factors were permitted to covary. The
are similar to other prospective birth were significant at 24 and 36 months
within-person component comprises
cohorts.22–24 Predictors of dropout but not at 60 months, suggesting that,
3 types of estimates: (1)
are reported elsewhere (younger on average, at the 24- and 36-month
autoregressions (ie, lags) capture the
mothers and lower income).10 study waves, children’s screen use
within-person, rank-order stability in
Consistent with other pediatric RI- was significantly related to children’s
constructs over time; (2) within-time
CLPMs,10 participants were included reading activities (b = 2.10 [95% CI:
covariances capture the strength and
(n = 2440) if they completed 2.17 to 2.04] and b = 2.08 [95% CI:
direction of associations between
questionnaires for at least 1 time 2.13 to 2.03], respectively).
screen use and reading within
persons at each time point; and (3) point at either 24, 36, or 60 months. Taken together, these findings suggest
the cross lags capture the longitudinal To adjust for missing data, models that higher levels of screen use at
and directional associations between were run with full-information 24 months of age, relative to a child’s
screen use and reading within maximum likelihood estimation.25,26 average level of screen use (ie, the
persons and are comparable to the child’s stable mean), was associated
proportion of unique variance with significantly lower levels of
explained in the outcome that is not RESULTS reading activities at the next study
shared with any other predictor (ie, wave, relative to a child’s average
a squared semipartial Primary Analyses level of reading. In addition, lower
correlation19,20; Fig 1). After fitting The standard RI-CLPM (Fig 1) levels of reading activities at
the standard RI-CLPM, pairwise revealed that the model was a good fit 36 months of age, relative to a child’s
comparisons were conducted by to the observed data on the basis of average level of reading, was
using post hoc t tests to identify the fit indices (x21 = 0.09; P = .768; root associated with significantly higher
extent to which the cross-lag mean square error of approximation levels of screen use at 60 months of
estimates varied between different = 0.00; 95% CI: 0.00 to 0.04; age, relative to a child’s average level
levels of the covariates (measured comparative fit index = 1.00; of screen use.
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4 MCARTHUR et alFIGURE 1
The standard RI-CLPM revealing within-person association between screen use and reading from ages 24 to 60 months, controlling for between-person
differences. Standardized estimates (b) and 95% CIs are presented. Solid lines represent estimates in which 95% CIs do not include 0. The central, blue-
tinted part of the model is the within-person (dynamic) part, and the outer, gray-tinted part of the model is the between-person (stable) component.
a
Pathways constrained to 1.00 to extract between-person factor (n = 2440).
Secondary Analyses use is a common household activity activities at 36 months is associated
To determine the extent to which the for young children.8 With this change with greater screen use at 60 months.
longitudinal associations between comes growing concern about the The obverse associations (ie, greater
screen use and reading varied on the role of screen use on the home reading at 24 months leading to
basis of covariates, the differences in learning environment, specifically lower screen time at 36 months and,
the cross-lagged associations engagement in off-line enrichment in turn, greater reading at 60 months)
between levels of each study activities such as print book reading. were not observed.
covariate were examined (Table 3). This longitudinal, 3-wave study uses
repeated measures and a rigorous A robust body of literature
Cross-lagged parameters did not
statistical model that more closely underscores the importance of the
significantly differ on the basis of
approximate causality to clarify early home learning environment to
different levels of the study
whether screen use interferes with encourage the development of school
covariates.
later print book reading or if early readiness and literacy skills.5,23
reading activities may offset later Consistent with the displacement
screen use. Results suggest that hypothesis,9 this study provides
DISCUSSION higher screen use at 24 months is support for the notion that screen use
With expanding media options and related to lower reading activities at may be interfering with reading
a dynamic digital landscape, screen 36 months, and in turn, lower reading activities. Indeed, at 24 months, it
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PEDIATRICS Volume 147, number 6, June 2021 5TABLE 2 Standardized and Unstandardized Autoregressive and Cross-Lagged Coefficients From the no more than 1 hour of screen time
Standard RI-CLPM daily.31 Family media plans32 can be
Paths b (95% CI)a B (95% CI)b devised to help families develop
Autoregressive parameters healthy media habits. Early
Screen time, mo discussions with family may be
24 → 36 .48 (.42 to .53)c .51 (.43 to .59)c critical because research reveals that
36 → 60 .42 (.33 to .51)c .12 (.07 to .17)c once problematic screen use habits
Reading, mo
are developed, they tend to persist
24 → 36 .23 (.18 to .29)c .79 (.61 to .97)c
36 → 60 .24 (.18 to .29)c .13 (.09 to .16)c over the early childhood period.33 On
Cross-lagged parameters the basis of the within-person
Screen time → reading, mo stability of shared reading and screen
24 → 36 2.08 (2.13 to 2.02)c 2.01 (2.01 to 2.002)c media habits starting at 24 months of
36 → 60 .01 (2.04 to .06) .00 (2.002 to .003)
age, this study also emphasizes the
Reading → screen time, mo
24 → 36 2.05 (2.11 to .01) 22.24 (24.80 to .32) importance of establishing early
36 → 60 2.11 (2.19 to 2.02)c 2.39 (2.67 to 2.11)c reading routines known to be
B, unstandardized b coefficient; b, standardized b coefficient; →, predicting. foundational for child development
a Standardized b coefficients represent the SD change in an outcome variable (eg, reading at 36 mo) associated with a 1
and learning and reaffirms the need
SD change in the predictor (eg, screen time at 24 mo).
b Unstandardized B coefficients represent the unit change in an outcome variable (eg, 1 level of reading at 36 mo)
for early discussion of reading in
associated with a unit change in the predictor (eg,1 hour of screen time at 24 mo). pediatric offices. These discussions
c Estimates in which 95% CIs do not include 0.
can focus on the 5 R’s34 of early
learning: reading together every day;
was observed that greater screen use activities that involve print books for rhyme and play; developing
per week relates to a lower level of young children may be advised. consistent sleep, eating, reading and
reading activities at 36 months. In play routines; reward with praise;
Although past research supports that
addition, through interpretation of and nurture relationships rich in
many factors in the home
the unstandardized coefficients, a 10- serve and return interactions. At
environment influence screen use29
minute decrease in reading per day at a policy level, increased access to
and reading activities,4,5 results from
36 months of age relates to a ∼25- books, programs designed to help
the post hoc analysis of covariates
minute increase in screen use per connect at risk-families with literary
reveal that the sociodemographic
week at 60 months of age. These resources (eg, reach out and read35),
variables included in this study did
findings highlight a reciprocal process broader dissemination of screen use
not significantly modify the
between screen use and reading that guidelines for children aged ,5 years,
magnitude of the associations
unfolds over time, in which screen and a combination of early
between screen use and reading over
use negatively influences reading interventions targeted at both
time. This finding suggests that
activities and then lowered reading reading and screen use habits are
sociodemographic factors may be
activities lead to greater screen use. needed.
more influential at a between-person
level (eg, when predicting overall
With the increased use and Using a large cohort and a longitudinal
screen use or reading activities for
accessibility of media devices, research design, as well as a robust
different children) but may be less
families may turn to electronics to statistical method, this study sheds
impactful at a within-person level (eg,
promote reading. Although reading light on the direction of the association
impacting the associations between
electronic books was not examined between screen use and reading
reading and screen use over time for
herein, researchers have recently activities across early childhood.
a specific child).
found that, for preschool-aged However, the findings must be
children, parents and children tend to A number of practice and policy interpreted with the following
collaborate and verbalize less when implications arise from this study. limitations in mind. First, this
reading electronic books in Most importantly, this study study included a predominantly
comparison with reading print highlights the need for practitioners, high-income, highly educated sample
books.27,28 Overall, there appears to health care workers, parents, of participants, which may limit
be less reciprocity and conversational policymakers, and educators to generalizability to other populations.
turns (specific elements of the early promote adherence to screen use Second, the method of measurement
reading environment known to guidelines. This is especially used for screen use did not capture
promote language learning and important because up to 95% of the content (eg, educational
literacy skills) when using electronic preschoolers are exceeding the programing) or context (eg, solitary
books,4 and thus encouraging reading current screen use guidelines30 of versus coviewing) of screen use.
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6 MCARTHUR et alTABLE 3 Differences in the Cross-Lagged Associations Linking Screen Use and Reading, by measurement of the home reading
Covariates environment, including parent literacy
Paths Difference (95% CI)a skills and objective measures of
Income b
Educationc parent-child shared reading
experiences (eg, conversational turns,
Screen time → reading, mo
24 → 36 0.00 (20.01 to 0.01) 0.01 (20.004 to 0.02) parent engagement, etc).
36 → 60 0.00 (20.01 to 0.01) 0.00 (20.004 to 0.01)
Reading → screen time, mo
24 → 36 20.55 (27.39 to 6.28) 2.33 (23.32 to 7.97)
CONCLUSIONS
36 → 60 20.66 (21.64 to 0.32) 20.11 (20.83 to 0.62) With the increased exposure to digital
Maternal readingd Maternal screen usee media, screen use is now a regular
Screen time → reading, mo
part of children’s day-to-day lives. In
24 → 36 0.00 (20.01 to 0.01) 0.00 (20.01 to 0.01)
36 → 60 20.01 (20.01 to 0.00) 0.01 (20.001 to 0.01) response to this increase in exposure,
Reading → screen time, mo there is a critical need to understand
24 → 36 23.93 (29.50 to 1.65) 4.44 (21.39 to 10.27) how screen use may be influencing
36 → 60 0.14 (20.55 to 0.83) 20.20 (21.46 to 1.05) the home learning environment,
Problem behaviorf Child sexg
specifically engagement in off-line
Screen time → reading, mo
24 → 36 0.01 (20.01 to 0.02) 20.01 (20.02 to 0.004) enrichment activities such as
36 → 60 0.00 (20.01 to 0.01) 0.00 (20.001 to 0.005) reading. This study provides
Reading → screen time, mo support for a reciprocal relationship
24 → 36 1.41 (25.28 to 8.10) 0.89 (24.78 to 6.53) between screen use and reading
36 → 60 20.31 (21.21 to 0.59) 20.33 (20.88 to 0.22)
activities. Higher screen use at
Child careh Access to libraryi
Screen time → reading, mo 24 months of age related to lower
24 → 36 0.00 (20.01 to 0.01) 0.01 (20.003 to 0.02) reading activities at 36 months of
36 → 60 0.01 (20.001 to 0.01) 0.01 (20.001 to 0.01) age, and in turn, lower levels of
Reading → screen time, mo reading at 36 months of age related
24 → 36 1.13 (24.58 to 6.84) 0.17 (25.00 to 5.33)
to higher levels of screen use at
36 → 60 20.26 (20.94 to 0.42) 20.17 (20.87 to 0.52)
the next time point. The findings
→, predicting.
a Difference in the cross-lagged associations by covariate group. from this study support the need
b Defined as low income (CAD$ ,60 000; 1) and high income (CAD$ $60 000; 0). for practitioners, child care
c Defined as lower education (some high school, graduated high school, and some postsecondary; 1) and higher
professionals, and educators to
education (graduated postsecondary, some graduate school, and completed graduate school; 0).
d Defined as low maternal reading (below median; 1) and high maternal reading (at or above median; 0). encourage families to engage in
e Defined as low maternal screen use (below median; 1) and high maternal screen use (at or above median; 0). healthy use of screen devices (ie,
f Defined as at risk (at or above the cutoff score on the BITSEA problem behavior scale; 1) and normative (below the cutoff
limited duration) and to encourage
score on the BITSEA problem behavior scale; 0).
g Defined as male (1) and female (0). device-free time to establish early
h Defined as nonparental child care or day care (1) and other (0). reading habits.
i Defined as attending the library (1) and not attending the library (0).
ACKNOWLEDGMENTS
Presumably, families vary on the informants of child activities between
We acknowledge the contributions of
content and context in which screens 24 and 60 months, single-informant
the All Our Families research team
are used, and these elements of screen measurement introduces the potential
and thank the participants who took
use may have a different association for bias. With regards to reading,
part in the study.
with language and literacy.36 Third, a single item was used to capture the
although this study reveals an frequency of reading activities at each
association between screen use and time point. Although the reading items
reading, further research is needed to were designed to reflect the natural ABBREVIATIONS
determine the specific threshold at progression of reading activities BITSEA: Brief Infant‐Toddler So-
which screen use influences reading. across early childhood, single-item cial and Emotional
Fourth, because of the rapid measurement at each time point Assessment
progression of technology, exposure provides fewer points of CAD: Canadian dollar
and accessibility to screens may have discrimination and potentially limits CI: confidence interval
changed over the course of this the sensitivity, or variation, in the RI-CLPM: random intercept cross-
multiwave study.8 Additionally, measure. This study would be lagged panel model
although parents are arguably the best strengthened by more detailed
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PEDIATRICS Volume 147, number 6, June 2021 7Address correspondence to Sheri Madigan, PhD, Department of Psychology, University of Calgary, 2500 University Ave, Calgary, AB, Canada T2N 1N4.
E-mail: sheri.madigan@ucalgary.ca
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2021 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: Supported by Alberta Innovates Health Solutions Interdisciplinary Team grant 200700595, the Alberta Children’s Hospital Foundation, and the Max Bell
Foundation. The principal investigator of the All Our Families Study is Dr Tough. Research support was provided to Dr Madigan and Dr. Browne by the Canada
Research Chairs program. Dr McArthur was supported by a fellowship from the Alberta Children’s Hospital Research Institute.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
COMPANION PAPER: A companion to this article can be found online at www.pediatrics.org/cgi/doi/10.1542/peds.2020-047472.
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PEDIATRICS Volume 147, number 6, June 2021 9Longitudinal Associations Between Screen Use and Reading in Preschool-Aged
Children
Brae Anne McArthur, Dillon Browne, Sheila McDonald, Suzanne Tough and Sheri
Madigan
Pediatrics 2021;147;
DOI: 10.1542/peds.2020-011429 originally published online May 24, 2021;
Updated Information & including high resolution figures, can be found at:
Services http://pediatrics.aappublications.org/content/147/6/e2020011429
References This article cites 28 articles, 3 of which you can access for free at:
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Downloaded from www.aappublications.org/news by guest on October 13, 2021Longitudinal Associations Between Screen Use and Reading in Preschool-Aged
Children
Brae Anne McArthur, Dillon Browne, Sheila McDonald, Suzanne Tough and Sheri
Madigan
Pediatrics 2021;147;
DOI: 10.1542/peds.2020-011429 originally published online May 24, 2021;
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/147/6/e2020011429
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