Screen Time Exposure and Its Impact on Development, Behaviour, and Visual Health in Children Aged 1–5 Years: A Hospital-Based CrossSectional Study

Abstract

Background: Early childhood exposure to digital media has risen substantially with the widespread adoption of smartphones and other electronic devices. Evidence indicates that excessive screen use is associated with developmental delays, particularly in language acquisition and social interaction. Objectives: To determine the prevalence of screen time ≤60 minutes and >60 minutes among children aged 1–5 years, and to evaluate its impact on developmental domains including social, language, behavioural, cognitive, and emotional. The study further aimed to identify developmental and behavioural problems associated with screen exposure exceeding 60 minutes, and to formulate evidencebased recommendations for limiting screen use and promoting digital wellbeing in early childhood. Methods: A hospitalbased, crosssectional observational study was conducted at RKDF Medical College Hospital and Research Centre, Bhopal, and its peripheral units over 18 months. A total of 180 children aged 1–5 years were enrolled using convenience sampling. Screen exposure was categorized as ≤60 minutes/day (within recommended limits) or >60 minutes/day (excessive). Developmental milestones were assessed using the Trivandrum Developmental Screening Chart (TDSC). Behavioural problems, visual disturbances, sleep duration, and physical activity were recorded. Associations were evaluated using the chi square test. Results: 68.9% of children had screen time >60 minutes/day (mean 77.5±44.5 min). Mobile phones were the most common device (41.7%). Social developmental delay was significantly more frequent in the >60 min/day group (21.8% vs 5.36%; p = 0.018). Visual disturbances were significantly associated with excessive screen time (24.2% vs 0%; p < 0.001), with digital eye strain being the most common (15.3%). Behavioural problems showed a significant overall association (p = 0.045), mainly temper tantrums and inattention. Gross motor, fine motor, and sleep duration did not differ significantly. Language delays were observed only in the excessive screen time group (expressive 14.5%, receptive 10.5%).Conclusion: Excessive screen time is highly prevalent in young children in Bhopal and is significantly associated with social developmental delay, visual disturbances, and behavioural problems. Paediatricians should routinely enquire about screen habits and actively counsel families on ageappropriate screen limits during well child visits.