High screen time and internalizing and externalizing behaviours among children aged 3 to 14 years during the COVID-19 Pandemic in France

Objective: Children's screen time increased as a result of the COVID-19 pandemic. In summer 2021 we explored the association between high screen time over a period of one year since May 2020 and behavioural problems among children and adolescents. Methods: The data was derived from the French EpiCov cohort study, collected in spring 2020, autumn 2020, and spring 2021. Participants (N=1,089) responded to online or telephone interviews about one of their children aged 3 to 14 years. Screen time was categorized as high if the daily mean screen time exceeded recommendations at each collection time. The Strengths and Difficulties Questionnaire (SDQ) was completed by parents to identify internalizing (emotional or peer problems) and externalizing (conduct problems or hyperactivity/inattention) behaviours in their children. Results: Internalizing behaviours: No interaction was highlighted between children's age and high screen time. High screen time was not associated with internalizing behaviours (OR [95% CI]: 1.20 [0.90-1.59]) while it was associated with peer problems (1.42 [1.04-1.95]). Externalizing behaviours: there was an interaction of children's age in the relationship between high screen time and externalizing behaviours. High screen time was associated with externalizing problems (1.63 [1.01-2.63]) and conduct problems (1.91 [1.15-3.22]) only among older children aged 11 to 14 years. Conclusion: This study found that persistent high screen time over one year after the onset of the pandemic was associated with peer problems among children aged 3-14 years and externalizing and conduct problems among 11-14-year-olds. Despite this very specific context, exposure to screens is not negligible.