Effect of parental education on screen exposure, development and socio-emotional outcomes in early childhood: a prospective comparative interventional study
Abstract
Background: Early childhood screen exposure may displace developmentally important activities and caregiver–child interaction. This study evaluated the effect of structured parental education on screen exposure and developmental and socio-emotional outcomes among children aged 9-18 months. Methods: This prospective comparative interventional study included 176 children enrolled at 9 months of age and followed prospectively until 18 months. Caregivers in intervention group received structured education regarding appropriate screen use, parental media practices, responsive parenting, and alternative age-appropriate activities, with periodic reinforcement. The comparison group received routine care. Screen exposure, anthropometric parameters, developmental outcomes using ages and stages questionnaire, third edition (ASQ-3), and socio-emotional outcomes using ages and stages questionnaire: social-emotional, second edition (ASQ:SE-2) were assessed at baseline at 9 months of age and reassessed at 18 months following intervention. Results: Total screen exposure decreased by 5.85 minutes/day in intervention group and increased by 24.15 minutes/day in comparison group (between-group difference: -30.00 min/day; 95% CI: -34.37 to -25.63; p<0.001). Mobile screen exposure was reduced by 23.52 min/day more in intervention group (95% CI: -26.45 to -20.59; p<0.001). Intervention group demonstrated significantly greater improvements in all ASQ-3 domains (all p<0.05). ASQ:SE-2 scores also showed greater reduction in intervention group (between-group difference: -5.23; 95% CI: -6.25 to -4.21; p<0.001). No significant between-group differences were observed in anthropometric outcomes. Conclusions: Structured parental education with periodic reinforcement was associated with reduced screen exposure and more favourable developmental and socio-emotional outcomes. Caregiver-focused screen-time counselling may be beneficial in routine pediatric services.