Predictors of Cognitive Function in School Children: Screen Time, Nutritional Status and Pneumonia

Abstract

Cognitive development and intelligence of children are shaped by multifactorial influences, including genetic predisposition, environmental conditions, nutritional status, cognitive stimulation, educational exposure, and overall health status. The average Intelligence Quotient (IQ) of the Indonesian population is 89.96, which is categorized within the average range at the global level. A cross-sectional analytical study was conducted involving 80 school-aged children selected through simple random sampling. IQ was measured using the CFIT administered by child psychologists, while nutritional status was assessed using the WHO BMI-for-age reference. Logistic regression modeling was used to identify significant determinants, followed by ROC curve analysis, Youden Index calculation, and risk score estimation, which was derived from the ratio of each significant predictor to the smallest significant coefficient. Significant associations were observed for screen time (PR = 5.23; 95% CI: 1.49–18.29), history of pneumonia (PR = 3.92; 95% CI: 1.13–13.68), and poor nutritional status (PR = 4.03; 95% CI: 1.34–12.11). The predictive model showed an area under the curve (AUC) of 0.794, with a youden index-derived cut-off of  ≥ 2 (95% CI: 0.630–0.882), indicating a threshold for increased risk of low cognitive function among children. Screen time, a history of pneumonia, and poor nutritional status were identified as key predictors of lower cognitive function, with a risk score of ≥ 2 as the threshold. Parental control over digital exposure and the reinforcement of preventive health behaviors are essential components in improving children’s cognitive outcomes.