Letters
RESEARCH LETTER
Assessment of Screen Exposure in Young Children,
1997 to 2014
There is widespread concern that children are exposed to too
much screen time1,2 via increasingly prevalent and accessible
mobile devices.3,4 This study assesses young children’s screen
time before and after commonly used mobile devices were
widely available.
Methods | We estimated young children’s screen time using time
diary data from the 1997 and 2014 Child Development Supple-
ment of the Panel Study of Income Dynamics, which collects
information of a population-based representative sample of
American children. There were 1327 and 443 children younger
than 6 years who completed the time dairy in 1997 and 2014,
respectively. In each survey, the cohort was divided into 2 age
groups: 0 to 2 years and 3 to 5 years. Based on the institu-
tional review board policy, this study did not require ap-
proval because the data used are publicly available from the
Panel Study of Income Dynamics and completely deidenti-
fied. For this reason, informed consent was not obtained.
In 1997, screen time was defined as time spent on any
activity while watching television programs or videotapes, plus
time spent on electronic video games and home computer–
related activities. By 2014, screen time activities included
the use of television, videotapes, digital video disc, game
devices, computer, cell phone, smartphone, tablet, elec-
tronic reader, and children’s learning devices.
We calculated children’s mean daily screen time (in hours)
during a typical week. We present the time spent on domi-
nant device type in both 1997 and 2014 and the time spent on
mobiles devices (including cell phones, smartphones, tab-
lets, electronic readers, and children’s learning devices) in 2014.
Lastly, we classified children into high-user and low-user
groups based on median screen time within age group and
examined differences in individual and family characteris-
tics. All analyses were adjusted for child-level sample weights.
The P value level of significance was .05, and all P values
were 2-sided.
Results | In 1997, daily screen time averaged 1.32 hours for
children aged 0 to 2 years and 2.47 hours for children aged 3
to 5 years (Figure). In comparison with other devices, screen
time allocated to television was highest; children aged 0 to 2
years and children aged 3 to 5 years watched television for
0.56 and 1.19 hours (43% and 48% of total screen time) per
day, respectively.
By 2014, total screen time among children aged 0 to 2
years had risen to 3.05 hours per day. Most of that time (2.62
hours) was spent on television, while 0.37 hours were spent
on mobile devices. The older cohort experienced no signifi-
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Figure. Screen Time by Age Group Among 1997 and 2014 Panel Study
of Income Dynamics Cohorts
Total screen time TV time Mobile device time
4
3
Screen Exposure per d, h
2
1
0
0-2 in 1997 3-5 in 1997 0-2 in 2014 3-5 in 2014
Age, y
The error bars indicate the 95% confidence intervals of the estimated hours per
day. Total screen time in 1997 included time spent on any activity while
watching television programs or videotapes plus time spent on electronic video
games and home-computer–related activities. Total screen time in 2014
included time spent on any activity while using television, videotapes, digital
video disc, game devices, computer, cell phone, smartphone, tablet, electronic
reader, and child’s learning devices. Television time refers to time spent on any
activity while watching television programs using a television set (rather than
using videotapes, digital video disc, or other devices). Mobile device time refers
to time spent on any activity while using cell phone, smartphone, tablet,
electronic reader, and child’s learning devices.
cant change in total screen time but an increase of about
80% in television time. On average, children aged 3 to 5
years spent 2.14 hours on television and 0.42 hours on
mobile devices. In 2014, television time accounted for 86%
and 78% of total screen time for the age groups of 0 to 2
years and 3 to 5 years, respectively.
In 1997 and 2014, the low-user group had higher family in-
come (Table). Among other family characteristics, significant
differences across user groups were found in age, race/
ethnicity, employment status of primary caregiver, and num-
ber of children in the household in 1997 and in sex, education
level of family unit head and spouse, and metropolitan area
residence in 2014.
Discussion | This study examines young children’s screen time
based on time diary data. Such data are shown to be highly as-
sociated with directly observed use of time, whereas time use
reported via parent surveys, such as those used in the Com-
mon Sense Census and other studies,3,4 is only moderately as-
sociated with direct observation.5 We found that, between 1997
and 2014, screen time doubled among children aged 0 to 2 years
and that, both before and after the advent of mobile devices,
young children’s television time increased tremendously. The
2014 high-user group was dominated by boys and children with
(Reprinted) JAMA Pediatrics Published online February 18, 2019 E1
 Letters

Table. Characteristics of High and Low Screen Users Among 1997 and 2014 PSID Cohortsa

1997 2014
User, Mean (SE),a % User, Mean (SE),a %
Characteristic High (n = 653) Low (n = 674) P Valueb High (n = 221) Low (n = 222) P Valueb
Age, y 3.30 (0.07) 2.85 (0.09) <.001 3.85 (0.11) 3.88 (0.11) .87
Female 46.49 (2.61) 50.53 (2.42) .26 39.83 (4.42) 54.80 (4.52) .02
White 65.22 (2.50) 68.07 (2.23) .40 73.58 (4.00) 81.52 (3.73) .15
Black 16.82 (1.87) 11.27 (1.13) .01 19.64 (2.94) 15.47 (3.30) .35
Hispanic 9.89 (1.56) 12.26 (1.71) .31 NAc NAc NA
Other races/ethnicities 8.07 (1.64) 8.40 (1.51) .88 NAc NAc NA
Enrolled in daycare/school 40.78 (2.59) 43.67 (2.40) .41 52.86 (4.65) 64.46 (4.38) .07
With 2 parents 72.66 (2.36) 77.50 (2.03) .12 73.96 (3.88) 70.34 (4.25) .53
Excellent/very good health 87.23 (1.72) 83.78 (1.75) .16 91.18 (2.69) 93.07 (2.12) .58
Family unit
Household head with bachelor’s degree 25.77 (2.32) 29.98 (2.21) .19 26.39 (4.03) 56.28 (4.54) <.001
Spouse with bachelor’s degree 20.03 (2.09) 25.57 (2.11) .06 21.32 (3.67) 50.61 (4.59) <.001
Income/FPL 2.57 (0.12) 3.10 (0.15) .01 2.58 (0.18) 3.79 (0.26) <.001
PCG employed 49.63 (2.61) 57.09 (2.42) .04 57.91 (4.62) 68.82 (4.14) .08
Children in HH, No. 2.25 (0.06) 2.08 (0.05) .03 2.30 (0.11) 2.03 (0.10) .08
Metro area 70.23 (2.47) 72.16 (2.27) .57 85.45 (2.93) 75.85 (3.61) .04
b
Abbreviations: FPL, federal poverty level; HH, household; PCG, primary P values are from the adjusted Wald test for differences between high
caregiver; PSID, Panel Study of Income Dynamics. and low users.
a c
High and low users are defined, respectively, as children who had screen time Because of small sample size, the results were not reported.
greater than and less than median hours within their age group.

low parental education level and family income. Future
research should examine the association between screen time
and other Child Development Supplement measures, such
as parenting style and sibling and peer influence. Meanwhile,
as stakeholders warn against an overreliance on mobile
devices, they should be mindful that young children spend
most of their screen time watching television.
Weiwei Chen, PhD
Jessica L. Adler, PhD
Author Affiliations: Department of Health Policy and Management, Robert
Stempel College of Public Health and Social Work, Florida International
University, Miami.
Corresponding Author: Weiwei Chen, PhD, Department of Health Policy and
Management, Robert Stempel College of Public Health and Social Work, Florida
International University, 11200 SW Eighth St, Miami, FL 33199 (wechen@fiu.edu).
Accepted for Publication: October 10, 2018.
Published Online: February 18, 2019. doi:10.1001/jamapediatrics.2018.5546
Author Contributions: Dr Chen 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: Chen.
Acquisition, analysis, or interpretation of data: Both authors.
Drafting of the manuscript: Both authors.
Critical revision of the manuscript for important intellectual content:
Both authors.
Statistical analysis: Chen.
Administrative, technical, or material support: Chen.
Supervision: Chen.
Conflict of Interest Disclosures: None reported.
1. American Acemedy of Pediatrics. American Academy of Pediatrics
announces new recommendations for children’s media use. https://www.aap.
org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-
Pediatrics-Announces-New-Recommendations-for-Childrens-Media-Use.aspx.
Published October 21, 2016. Accessed August 9, 2018.
2. Ponti M, Bélanger S, Grimes R, et al; Canadian Paediatric Society, Digital
Health Task Force, Ottawa, Ontario. Screen time and young children: promoting
health and development in a digital world. Paediatr Child Health. 2017;22(8):
461-477. doi:10.1093/pch/pxx123
3. Kabali HK, Irigoyen MM, Nunez-Davis R, et al. Exposure and use of mobile
media devices by young children. Pediatrics. 2015;136(6):1044-1050. doi:10.
1542/peds.2015-2151
4. Rideout V. The Common Sense Census: Media Use by Kids Age Zero to Eight.
San Francisco, CA: Common Sense Media; 2017.
5. Vandewater EA, Lee S-J. Measuring children’s media use in the digital age:
issues and challenges. Am Behav Sci. 2009;52(8):1152-1176. doi:10.1177/
0002764209331539

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