Association Between Screen Time Exposure in Children at 1 Year of Age and Autism Spectrum Disorder at 3 Years of Age :  The Japan Environment and Children’s Study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

This cohort study examines the association between screen time in infancy and the development of autism spectrum disorder at 3 years of age.

Key Points

Question

Is screen-time duration in children at 1 year of age associated with autism spectrum disorder at 3 years of age?

Findings

A total of 84 030 mother-child dyads were analyzed using data derived from a large birth cohort study conducted in Japan. Among boys, but not girls, longer screen time at 1 year of age was significantly associated with autism spectrum disorder diagnosis at 3 years of age.

Meaning

Guidance on appropriate screen time in infancy is recommended.

Abstract

Importance

It is unclear to what extent the duration of screen time in infancy is associated with the subsequent diagnosis of autism spectrum disorder.

Objective

To examine the association between screen time in infancy and the development of autism spectrum disorder at 3 years of age.

Design, Setting, and Participants

This cohort study analyzed data from mother-child dyads in a large birth cohort in Japan. This study included children born to women recruited between January 2011 and March 2014, and data were analyzed in December 2020. The study was conducted by the Japan Environment and Children’s Study Group in collaboration with 15 regional centers across Japan.

Exposures

Screen time at 1 year of age.

Main Outcomes and Measures

The outcome variable, children diagnosed with autism spectrum disorder at 3 years of age, was assessed using a questionnaire administered to mothers of the participating children.

Results

A total of 84 030 mother-child dyads were analyzed. The prevalence of children with autism spectrum disorder at 3 years of age was 392 per 100 000 (0.4%), and boys were 3 times more likely to have been diagnosed with autism spectrum disorder than were girls. Logistic regression analysis showed that among boys, when “no screen” was the reference, the adjusted odds ratios were as follows: less than 1 hour, odds ratio, 1.38 (95 % CI, 0.71-2.69; P = .35), 1 hour to less than 2 hours, odds ratio, 2.16 (95 % CI, 1.13-4.14; P = .02), 2 hours to less than 4 hours, odds ratio, 3.48 (95% CI, 1.83-6.65; P < .001), and more than 4 hours, odds ratio, 3.02 (95% CI, 1.44-6.34; P = .04). Among girls, however, there was no association between autism spectrum disorder and screen time.

Conclusions and Relevance

Among boys, longer screen time at 1 year of age was significantly associated with autism spectrum disorder at 3 years of age. With the rapid increase in device usage, it is necessary to review the health effects of screen time on infants and to control excessive screen time.

Related collections

Most cited references 52

Record: found
Abstract: found
Article: not found

Sensitivity Analysis in Observational Research: Introducing the E-Value.

Peng Ding, Tyler J. VanderWeele (2017)

Sensitivity analysis is useful in assessing how robust an association is to potential unmeasured or uncontrolled confounding. This article introduces a new measure called the "E-value," which is related to the evidence for causality in observational studies that are potentially subject to confounding. The E-value is defined as the minimum strength of association, on the risk ratio scale, that an unmeasured confounder would need to have with both the treatment and the outcome to fully explain away a specific treatment-outcome association, conditional on the measured covariates. A large E-value implies that considerable unmeasured confounding would be needed to explain away an effect estimate. A small E-value implies little unmeasured confounding would be needed to explain away an effect estimate. The authors propose that in all observational studies intended to produce evidence for causality, the E-value be reported or some other sensitivity analysis be used. They suggest calculating the E-value for both the observed association estimate (after adjustments for measured confounders) and the limit of the confidence interval closest to the null. If this were to become standard practice, the ability of the scientific community to assess evidence from observational studies would improve considerably, and ultimately, science would be strengthened.

0 comments Cited 1418 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan.

Toshi Furukawa, Norito Kawakami, Mari Saitoh … (2008)

Two new screening scales for psychological distress, the K6 and K10, have been developed using the item response theory and shown to outperform existing screeners in English. We developed their Japanese versions using the standard back-translaton method and included them in the World Mental Health Survey Japan (WMH-J), which is a psychiatric epidemiologic study conducted in seven communities across Japan with 2436 participants. The WMH-J used the WMH Survey Initiative version of the Composite International Diagnostic Interview (CIDI) to assess the 30-day Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV). Performance of the two screening scales in detecting DSM-IV mood and anxiety disorders, as assessed by the areas under receiver operating characteristic curves (AUCs), was excellent, with values as high as 0.94 (95% confidence interval = 0.88 to 0.99) for K6 and 0.94 (0.88 to 0.995) for K10. Stratum-specific likelihood ratios (SSLRs), which express screening test characteristics and can be used to produce individual-level predicted probabilities of being a case from screening scale scores and pretest probabilities in other samples, were strikingly similar between the Japanese and the original versions. The Japanese versions of the K6 and K10 thus demonstrated screening performances essentially equivalent to those of the original English versions.

0 comments Cited 337 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Rationale and study design of the Japan environment and children’s study (JECS)

Toshihiro Kawamoto, Hiroshi Nitta, Katsuyuki Murata … (2014)

Background There is global concern over significant threats from a wide variety of environmental hazards to which children face. Large-scale and long-term birth cohort studies are needed for better environmental management based on sound science. The primary objective of the Japan Environment and Children’s Study (JECS), a nation-wide birth cohort study that started its recruitment in January 2011, is to elucidate environmental factors that affect children’s health and development. Methods/Design Approximately 100,000 expecting mothers who live in designated study areas will be recruited over a 3-year period from January 2011. Participating children will be followed until they reach 13 years of age. Exposure to environmental factors will be assessed by chemical analyses of bio-specimens (blood, cord blood, urine, breast milk, and hair), household environment measurements, and computational simulations using monitoring data (e.g. ambient air quality monitoring) as well as questionnaires. JECS’ priority outcomes include reproduction/pregnancy complications, congenital anomalies, neuropsychiatric disorders, immune system disorders, and metabolic/endocrine system disorders. Genetic factors, socioeconomic status, and lifestyle factors will also be examined as covariates and potential confounders. To maximize representativeness, we adopted provider-mediated community-based recruitment. Discussion Through JECS, chemical substances to which children are exposed during the fetal stage or early childhood will be identified. The JECS results will be translated to better risk assessment and management to provide healthy environment for next generations.

0 comments Cited 329 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): JAMA Pediatr

Journal ID (iso-abbrev): JAMA Pediatr

Title: JAMA Pediatrics

Publisher: American Medical Association

ISSN (Print): 2168-6203

ISSN (Electronic): 2168-6211

Publication date (Electronic): 31 January 2022

Publication date (Print): April 2022

Publication date PMC-release: 31 January 2022

Volume: 176

Issue: 4

Pages: 384-391

Affiliations

[1 ]Center for Birth Cohort Studies, University of Yamanashi, Chuo, Yamanashi, Japan

[2 ]Department of Health Sciences, University of Yamanashi, Chuo, Yamanashi, Japan

Author notes

Article Information

Group Information: The members of the Japan Environment and Children’s Study Group appear in Supplement 2.

Accepted for Publication: October 27, 2021.

Published Online: January 31, 2022. doi:10.1001/jamapediatrics.2021.5778

Corresponding Author : Megumi Kushima, MA, Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3821, Japan ( kumegumi@ 123456yamanashi.ac.jp ).

Author Contributions : Ms Kushima had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Kushima, Yamagata.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Kushima.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Kushima, Shinohara.

Obtained funding: Yamagata.

Administrative, technical, or material support: Kushima, Shinohara, Horiuchi, Otawa, Ooka, Yokomichi, Yamagata.

Supervision: Yamagata.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was funded by the Ministry of Environment, Japan.

Role of the Funder/Sponsor : The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Group Information: Members of the Japan Environment and Children's Study Group are listed in Supplement 2.

Disclaimer: The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of the above government body.

Additional Contributions: We thank all the participants and cooperating institutions for their contribution to the Japan Environment and Children’s Study Group.

Article

Publisher ID: poi210088

DOI: 10.1001/jamapediatrics.2021.5778

PMC ID: 8804971

PubMed ID: 35099540

SO-VID: e5a46693-0546-4ff4-9fb0-00d7cb8cfa1f

License:

This is an open access article distributed under the terms of the CC-BY License.

History

Date received : 27 June 2021

Date accepted : 27 October 2021

Funding

Funded by: Ministry of Environment, Japan

Comments

Comment on this article

scite_

Cited by 23

See all cited by

Association Between Screen Time Exposure in Children at 1 Year of Age and Autism Spectrum Disorder at 3 Years of Age : The Japan Environment and Children’s Study

Read this article at

Abstract

Key Points

Question

Findings

Meaning

Abstract

Importance

Objective

Design, Setting, and Participants

Exposures

Main Outcomes and Measures

Results

Conclusions and Relevance

Related collections

50 years of ROAPE

Most cited references 52

Sensitivity Analysis in Observational Research: Introducing the E-Value.

The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan.

Rationale and study design of the Japan environment and children’s study (JECS)

Author and article information

Journal

Affiliations

Author notes

Article

History

Funding

Categories

Comments

Comment on this article

Cited by 23