Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In a prospective cohort study, researchers used apps to accurately track the mobile device use of children 3 to 5 years old and compared data to parental estimates of children’s device use.

2. The majority of parents either underestimated or overestimated their child’s duration of device use. Children spent the most time on video and streaming services, and duration of use varied widely.

Evidence Rating Level: 2 (Good)

Study Rundown:

Mobile device use has been rising among young children as devices become more prevalent. Research into the harms and benefits of device use at a young age have been limited by the lack of precise measurement tools, and previous studies have largely relied on parent or guardian report of children’s habits. In this prospective cohort study, researchers sampled the mobile device use of children aged 3 to 5 years from 2018 to 2019 using apps and compared data with parent reports of children’s device use on surveys. The apps recorded that mobile device use among children with their own devices averaged about 2 hours daily, and varied widely. Children spent most of the time on devices using YouTube, video streaming services, and web browsers. About a third of parents underestimated their child’s mobile device use, and about a third of parents overestimated.

This study was limited by its online-only data collection and suffered from a high attrition rate. Generalizability may be limited by the exclusion of non-English speaking parents and families that owned devices that did not run iOS or Android. Furthermore, parents’ awareness of their child’s device usage being tracked may have influenced behavior. Nonetheless, this study is strengthened by its prospective use of software that should reliably capture all device use. For physicians, these findings highlight the importance of counseling parents on the challenge of accurately understanding their child’s device use.

In-Depth [prospective cohort study]:

Researchers used online survey, e-mail, and mobile device sampling to compare duration of mobile device usage among children aged 3 to 5 years and parent or guardian estimates of children’s mobile device usage from 2018 to 2019. Participants were recruited via flyers posted in community centers, preschools, child care centers, and pediatric clinics in Michigan, and online via social media. Included parents spoke English and owned at least one Android or iOS tablet or smartphone; other devices were excluded. Mobile device usage was sampled using study apps and device battery recordings.

Among the 121 children with their own tablet or smartphone, the average daily usage was 115.3 minutes (standard deviation [SD] 11.5.1; range 0.20-632.5). The most commonly used apps by children were YouTube, YouTube Kids, web browsers, camera and photos, and streaming services. The majority of parents either underestimated (35.7%) or overestimated (34.8%) their child’s device use.

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