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Purpose <p>Despite the growing evidence suggesting an association between screen time exposure (STE) in children and autism symptoms, a thorough understanding of this including the directionality, especially among the general child population is lacking. We aimed to determine the associations, if any, between STE and results on the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) in children from a multi-ethnic population-based sample in Singapore.</p> Methods <p>This cross-sectional study included children (1) between 17 and 24 months of age and (2) typically developing with no known developmental conditions, attending routine visits in primary care. Caregivers reported daily screen time via a questionnaire and completed the M-CHAT-R/F (standard administration protocol followed). Logistic and linear regression analyses and structured equation modelling including covariates were conducted.</p> Results <p>The sample comprised 5,336 multi-ethnic children (mean age 18.6 ± 0.9&#xa0;months, 64.2% Chinese ethnicity, 23.9% Malay, 5.8% Indian). Mean STE was 1.31 ± 1.33&#xa0;h/day. Increased STE was associated with a higher likelihood of a positive M-CHAT-R/F screen (OR = 1.24, 95% CI [1.01, 1.53], <i>p</i> &lt; 0.05). Higher STE was associated with greater odds of having a response of concern for the social-communication questions but not those on motor/sensory aversion. Both the final M-CHAT-R/F score and the screening outcome was directly explained by STE in the structural equation model (β = 0.05, 95% CI [0.03, 0.07], <i>p</i> &lt; 0.001 and OR = 1.24, 95% CI [1.01, 1.53], <i>p</i> &lt; 0.05).</p> Conclusion <p>Findings suggest a significant association between higher STE and autism symptoms, especially related to social communication. Evaluation and support of children with a positive M-CHAT-R/F screening result should include addressing STE and mitigating exposure.</p>

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Association Between Screen Time Exposure and Scores on the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F) in Children From a Multi-ethnic Population-Based Sample in Singapore

  • 期刊论文

  • 发表日期：

    2025年10月8日

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  • Erdembileg Sundarimaa,
  • Siew Pang Chan,
  • Ruth Mingli Zheng,
  • Shang Chee Chong,
  • Ramkumar Aishworiya

摘要

Purpose

Despite the growing evidence suggesting an association between screen time exposure (STE) in children and autism symptoms, a thorough understanding of this including the directionality, especially among the general child population is lacking. We aimed to determine the associations, if any, between STE and results on the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) in children from a multi-ethnic population-based sample in Singapore.

Methods

This cross-sectional study included children (1) between 17 and 24 months of age and (2) typically developing with no known developmental conditions, attending routine visits in primary care. Caregivers reported daily screen time via a questionnaire and completed the M-CHAT-R/F (standard administration protocol followed). Logistic and linear regression analyses and structured equation modelling including covariates were conducted.

Results

The sample comprised 5,336 multi-ethnic children (mean age 18.6 ± 0.9 months, 64.2% Chinese ethnicity, 23.9% Malay, 5.8% Indian). Mean STE was 1.31 ± 1.33 h/day. Increased STE was associated with a higher likelihood of a positive M-CHAT-R/F screen (OR = 1.24, 95% CI [1.01, 1.53], p < 0.05). Higher STE was associated with greater odds of having a response of concern for the social-communication questions but not those on motor/sensory aversion. Both the final M-CHAT-R/F score and the screening outcome was directly explained by STE in the structural equation model (β = 0.05, 95% CI [0.03, 0.07], p < 0.001 and OR = 1.24, 95% CI [1.01, 1.53], p < 0.05).

Conclusion

Findings suggest a significant association between higher STE and autism symptoms, especially related to social communication. Evaluation and support of children with a positive M-CHAT-R/F screening result should include addressing STE and mitigating exposure.