Abstract: Objective To investigate the current status of screen exposure in children with global developmental delay, and to explore the related factors affecting screen time. Methods From November 2019 to June 2021, 217 children with global developmental delay aged 2 to 5 years in the Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center were enrolled in this study. Their parents completed the screen exposure questionnaire. Then the screen exposure status was described, and the risk factors of screen exposure of children with global developmental delay were analyzed by Logistic regression. Results Totally 80.2% of the children with global developmental delay had their onset age of screen use before 18 months old, and 51.6% of them use screen＞1 h/d. And 37.3% primary caregivers chose to accompany children more than half of the time during screen exposure. Logistic regression analysis showed that high frequency of reading between primary caregivers and children (> 3 days per week) was a protective factor of screen time＞1 h/d in children with global developmental delay (OR=0.246,95%CI:0.129 - 0.469). Not having mother as the primary caregiver(OR=2.055, 95%CI: 1.138 - 3.710) and having screen exposure while eating (OR=2.067, 95%CI: 1.161 - 3.680) were independent risk factors of screen time＞1 h/d in children with global developmental delay. Conclusions A higher percentage of children with developmental delays have more screen time than the guideline recommendations. And the screen time of children is influenced by the primary caregiver and their behaviors. Pediatricians should strengthen the propaganda of proper use of screens so as to prevent children from early and excessive exposure to screen.

Key words: global developmental delay, screen exposure, primary caregiver

摘要： 目的 调查发育迟缓儿童屏幕暴露现状,了解影响屏幕暴露时间的因素。方法 收集2019年11月—2021年6月于上海儿童医学中心发育行为儿科就诊的217例发育迟缓儿童的临床资料,年龄范围2~5岁,家长完成了屏幕暴露调查问卷。描述发育迟缓儿童屏幕暴露现状,采用Logistic回归法分析影响日均屏幕暴露时间＞1 h的因素。结果 发育迟缓儿童日均屏幕暴露时间＞1 h的比例为51.6%,首次屏幕暴露时间＜18月龄的比例为80.2%,儿童接触屏幕时照养人陪伴时间大于一半的比例为37.3%。Logistic回归分析显示,主要照养人与儿童进行阅读类活动的频率高(OR=0.246,95%CI:0.129～0.469)是发育迟缓儿童日均屏幕暴露时间＞1 h的独立保护因素,主要照养人不是母亲(OR=2.055,95%CI:1.138～3.710)、进餐时屏幕暴露(OR=2.067,95%CI:1.161～3.680)是发育迟缓儿童日均屏幕暴露时间＞1 h的独立危险因素。结论 发育迟缓儿童屏幕暴露不符合指南建议的比例较高,儿童屏幕暴露时间受主要照养人及其行为的影响。儿科医生应加强宣传儿童屏幕的正确使用方法,预防儿童过早、过多地接触屏幕。

关键词: 发育迟缓, 屏幕暴露, 主要照养人