Evidence map›Paper›PMID 40828191›Full record

ArticleEuropean child & adolescent psychiatry2026

Longitudinal associations of screen time and outdoor physical activity trajectories with executive function and behavioral problems in children aged 4 years in china: a prospective cohort study.

Luanluan Li, Jingjing Pei, Yan Zhang, Han Qiu, Shouxun Hu, Jun Zhang, Ying Tian, Xiaodan Yu

Abstract read
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In one paragraph

Article in European child & adolescent psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Luanluan Li *Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jingjing Pei *Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Women's Hospital of Jiangnan University, Wuxi, China.
Yan ZhangDepartment of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Han QiuDepartment of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shouxun HuDepartment of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jun ZhangMOE‑Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ying TianDepartment of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xiaodan YuDepartment of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. xd_yu2003@126.com.

Funding

the Clinical Research Center for Pediatric Neurodevelopmental Disease of Fujian Province 2022Y2016the Clinical Research Center of ADHD affiliated with Pediatrics College, Shanghai Jiao Tong University School of Medicine ELYZX202207the High-level Medical Introduction Teams in Fujian Province RT2022-022the National Key Research and Development Program of China 2022YFC2705200the Shanghai Municipal Education Commission-Gaofeng Clinical Medical Grant Support 20152234the Shanghai Municipal Health Commission 2020CXJQ01
6 · The paper itself

Abstract

This study investigated longitudinal trajectories of screen time and outdoor physical activity from ages 6 to 48 months, and their independent and interactive associations with children's executive function (EF) and behavioral problems. This study included 1414 children from a prospective cohort study, the Shanghai Birth Cohort, enrolled between 2013 and 2016. Parents reported their children's screen time and outdoor physical activity at ages 6, 12, 24 and 48 months. Children's EF and behavioral problems were assessed at age 48 months using the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) and the Strengths and Difficulties Questionnaire (SDQ), respectively. We identified 3 trajectories of screen time: low stable, medium increasing, and high increasing; and 2 trajectories of outdoor physical activity: low activity and high activity. After adjusting for confounders, we found a significant trend across screen time trajectories, with higher screen time trajectory linked to greater EF difficulties and behavioral problems. Furthermore, children in the low outdoor physical activity trajectory exhibited more EF difficulties and behavioral problems than those in the high activity trajectory. While no significant interaction effects between screen time and outdoor physical activity trajectories were observed, the negative impact of high screen exposure appeared more pronounced in children with low activity trajectory. Higher screen time and lower outdoor physical activity during early years were associated with worse EF and behavioral problems, and sufficient outdoor physical activity may partly mitigate the negative effects of increased screen exposure.

Indexed as

Child BehaviorChild Behavior DisordersExecutive FunctionExerciseProblem BehaviorScreen TimeChild, PreschoolChinaFemaleHumansInfantLongitudinal StudiesMaleProspective StudiesBehavioral problemsExecutive functionOutdoor physical activityScreen timeTrajectory analysis

Identifiers

PMID40828191

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.