不同发育阶段儿童视屏时间与执行功能的关联

Association between screen time in different developmental stages and children's executive function

目的探讨不同发育阶段儿童视屏时间与执行功能(executive function,EF)的相关性,为促进儿童身心健康提供参考。方法方便整群抽取安徽省蚌埠市2所小学一~二年级儿童,共收集完整父母问卷1 269份,调查儿童幼儿期(0~3岁)、学龄前期(3~6岁)及学龄期学习日与周末视屏时间;采用《学龄儿童执行功能行为评定量表—父母版》(BRIEF-P)评价儿童执行功能指标:行为管理指数(BRI)、元认知功能指数(MI)和总执行功能复合分(GEC),同时开展体格发育检查,计算体质量指数(body mass index,BMI)。采用多因素Logistic回归分析不同发育阶段视屏时间与EF各指标的关联。结果父母报告幼儿期与学龄前期平均视屏时间1~<2 h/d的比例分别为13.1%和24.5%,≥2 h/d的比例分别为4.3%和8.4%。学龄期学习日与周末视屏时间≥2 h/d的报告率分别为15.6%和74.2%。多元Logistic回归分析显示,在幼儿期,相对于无视屏暴露组,视屏时间为<0.5,0.5~<1,1~<2,≥2 h/d组儿童BRI T得分增高(OR值分别为1.880,1.894,2.125,3.110,P值均<0.05);视屏时间为0.5~<1和≥2 h/d组儿童GEC T得分升高(OR值分别为1.776,2.344,P值均<0.05)。在学龄前期,相对于视屏时间<0.5 h/d组,视屏时间0.5~<1,1~<2,≥2 h/d组儿童BRI T得分升高(OR值分别为1.828,2.304,2.293,P值均<0.05);视屏时间1~<2 h/d组儿童MI T得分增加(OR=2.036,P<0.05);视屏时间0.5~<1,1~<2,≥2 h/d组儿童GEC T得分升高(OR值分别为1.640,2.304和2.109,P值均<0.05)。学龄期视屏时间对EF各指标影响均无统计学意义。结论学龄期儿童周末视屏时间≥2 h/d普遍存在,幼儿期和学龄前期视屏时间超过0.5 h/d与行为管理、元认知和总执行功能降低密切相关。

Objective To explore the association between screen time in different developmental stages and executive function （EF）, and to provide reference for promoting children＇s mental and physical health. Methods With informed consent, children in grade 1 and 2 from 2 primary schools in Bengbu city and their parents were invited to participate, and a total of 1 269 complete parents＇ questionnaires were collected. The average daily screen time in early childhood（ 0-3 years old）, pre-sehool（ 3-6 years old） and current weekdays and weekends （ school age） were collected from parents＇ questionnaire survey. Executive function was assessed by Behavior Rating Inventory of Executive Function-Preschool （ BRIEF-P）. Score of behavioral regulation index（ BRI）, meta- cognition index（MI） and global executive composite（GEC） were evaluated. Body mass index （BMI） was calculated based on physical examination. Multivariate Logistic regression analysis was recruited to examine the association between screen time at different developmental stages and the indexes of EF. Results About 13.1% and 24.5% of children had 1-2 h/d screen time during early childhood and pre-school period, and 4.3% and 8.4% had ≥2 h/d, respectively. The students who had screen time 1〉2 h/d during weekdays and weekends accounted for 15.6% and 74.2% of all children. Multivariate Logistic regression analysis showed that compared with the no screen time group in early childhood, those who had screen time 〈0.5 h/d, （0.5-1） h/d, （1-2） h/d and ≥2 h/ d had significantly higher BRI T（ OR= 1.880, 1.894, 2.125, 3.110, P〈0.05）. In the group who had screen time （0.5-1） h/d and ≥2 h/d had significantly higher GEC T（ OR = 1.776, 2.344, P〈0.05）. Compared with the group who had screen time 〈0.5 h/d in pre-school, those who had screen time （0.5-1） h/d, （1-2） h/d and ≥2 h/d had significantly higher BRI T（ OR = 1.828, 2.304, 2.293, P〈0.05）. In the group who had screen time 1-2 h/d had significantly higher MIT（ OR = 2.036, P〈0.05）. And who had screen time （0.5-1.0） h/d, （1-2） h/d and ≥2 h/d had significantly higher GEC T（ OR = 1.640, 2.304, 2.109, P〈0.05）. The influence of the screen time on the indexes of EF was of no statistical significance. Conclusion A large proportion of school-aged children had screen time more than 2 h/d, especially during weekends. Screen time more than 0.5 h/el during early childhood and pre-sehool pe- riod closely correlates with sub-optimal performance in behavioral regulation, metacognition and global executive function.