ArticleJournal of autism and developmental disorders2025
Association Between Screen Time Exposure and Scores on the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F) in Children From a Multi-ethnic Population-Based Sample in Singapore.
Article in Journal of autism and developmental disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeDespite the growing evidence suggesting an association between screen time exposure (STE) in children and autism symptoms, a thorough understanding of this including the directionality, especially among the general child population is lacking. We aimed to determine the associations, if any, between STE and results on the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) in children from a multi-ethnic population-based sample in Singapore.
methodsThis cross-sectional study included children (1) between 17 and 24 months of age and (2) typically developing with no known developmental conditions, attending routine visits in primary care. Caregivers reported daily screen time via a questionnaire and completed the M-CHAT-R/F (standard administration protocol followed). Logistic and linear regression analyses and structured equation modelling including covariates were conducted.
resultsThe sample comprised 5,336 multi-ethnic children (mean age 18.6 ± 0.9 months, 64.2% Chinese ethnicity, 23.9% Malay, 5.8% Indian). Mean STE was 1.31 ± 1.33 h/day. Increased STE was associated with a higher likelihood of a positive M-CHAT-R/F screen (OR = 1.24, 95% CI [1.01, 1.53], p < 0.05). Higher STE was associated with greater odds of having a response of concern for the social-communication questions but not those on motor/sensory aversion. Both the final M-CHAT-R/F score and the screening outcome was directly explained by STE in the structural equation model (β = 0.05, 95% CI [0.03, 0.07], p < 0.001 and OR = 1.24, 95% CI [1.01, 1.53], p < 0.05).
conclusionFindings suggest a significant association between higher STE and autism symptoms, especially related to social communication. Evaluation and support of children with a positive M-CHAT-R/F screening result should include addressing STE and mitigating exposure.
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