Abstract
Objective: This study aimed to assess the extent and patterns of mobile media exposure in children aged 1–24 months and examine the parental practices and beliefs associated with its use. Understanding these factors is crucial for developing preventive strategies and informing public health policies.
Material and Methods: A cross-sectional study was conducted at Ankara Bilkent City Hospital, including 404 parents of children aged 1–24 months. Data were collected using a 48-item self-administered questionnaire addressing demographics, mobile media usage patterns, and parental attitudes. Statistical analysis was performed using SPSS 23.0, with chi-square and non-parametric tests applied to identify significant associations.
Results: Mobile media exposure was reported in 65.8% of children, with 10.9% exposed as early as 3 months. Daily usage increased with age, with 9.8% exceeding two hours. Children with siblings had significantly higher exposure rates (p=0.020). Despite 91.4% of parents recognizing the potential harms of mobile media, 63.2% perceived its educational benefits. Notably, parental education and income levels did not show significant associations with exposure, whereas parental awareness about media risks correlated with reduced screen time usage (p = 0.010). Video calls were a frequent exception, with 86.8% of parents engaging in them, considering them less harmful.
Conclusion: Mobile media exposure in children under two years is alarmingly high, often surpassing recommended limits. These findings highlight the urgent need for comprehensive public health policies focusing on parental education and awareness programs. Pediatricians should play a proactive role in counseling families about screen time risks and appropriate digital engagement. Considering the widespread use of video calls, updated guidelines may be necessary to differentiate their impact from passive screen exposure. Future research should explore broader socioeconomic and environmental factors to refine intervention strategies.
Keywords: Early childhood, Mobile media exposure, Screen time
References
- Covolo L, Zaniboni D, Roncali J, Mapelli V, Ceretti E, Gelatti U. Parents and Mobile Devices, from Theory to Practice: Comparison between Perception and Attitudes to 0-5 Year Old Children’s Use. Int J Environ Res Public Health 2021;18(7):3440. https://doi.org/10.3390/ijerph18073440.
- Rideout, V. Measuring time spent with media: The Common Sense census of media use by US 8- to 18-year-olds. Journal of Children and Media 2016; 10(1):138-44. https://doi.org/10.1080/17482798.2016.1129808
- The common sense census: media use by tweens and teens. Acsess date: 12 March 2013. Available from: https://apo.org.au/node/58360.
- Kabali HK, Irigoyen MM, Nunez-Davis R, Budacki JG, Mohanty SH, Leister KP, et al. Exposure and Use of Mobile Media Devices by Young Children. Pediatrics. 2015 ;136(6):1044-50. https://doi.org/10.1542/peds.2015-2151.
- Muppalla SK, Vuppalapati S, Reddy Pulliahgaru A, Sreenivasulu H. Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management. Cureus. 2023;15(6):e40608. https://doi.org/10.7759/cureus.40608.
- Devi KA, Singh SK. The hazards of excessive screen time: Impacts on physical health, mental health, and overall well-being. J Educ Health Promot. 2023;12:413. https://doi.org/10.4103/jehp.jehp_447_23
- Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry. 2021;12:628252. https://doi.org/10.3389/fpsyt.2021.628252.
- Swider-Cios E, Vermeij A, Sitskoorn MM. Young children and screen-based media: The impact on cognitive and socioemotional development and the importance of parental mediation. Cogn Dev. 2023;66:101319. https://doi.org/10.1016/j.cogdev.2023.101319.
- Bozzola E, Spina G, Ruggiero M, Memo L, Agostiniani R, Bozzola M, et al. Media devices in pre-school children: the recommendations of the Italian pediatric society. Ital J Pediatr. 2018;44(1):69.https://doi.org/10.1186/s13052-018-0508-7.
- Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO. Acsess date: 2025 Mar 19. Available from: https://www.who.int/publications/i/item/9789241550536.
- Beyond Screen Time: A Parent’s Guide to Media Use. American Academy of Pediatrics. Acsess date: 2025 Mar 19. Available from: https://doi.org/10.1542/peo_document099
- Reid Chassiakos YL, Radesky J, Christakis D, Moreno MA, Cross C; Council On Communications And Media. Children and Adolescents and Digital Media. Pediatrics. 2016 ;138:e20162593.https://doi.org/10.1542/peds.2016-2593.
- Screen Time and Children. The American Academy of Child and Adolescent Psychiatry. Acsess date: 2025 Mar 19. Available from: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFFGuide/Children-And-Watching-TV-054.aspx.
- Screen Time for Infants. American Academy of Pediatrics. Acsess date: 2025 Mar 19. Available from: https://www.aap.org/en/patient-care/media-and-children/center-of-excellence-on-social-media-and-youth-mental-health/qa-portal/qa-portal-library/qa-portal-library-questions/screen-time-for infants/?srsltid=AfmBOoqw1_p61xVYsIYDdNklNSdBbZLZIVtl2gO_JjpPheC8vDcn3MyG.
- HIOPS for Screen Time Limits, Early Care and Education. CDC. Acsess date: 2025 Mar 19. Available from:https://www.cdc.gov/early-care-education/php/obesity-prevention-standards/screen-time-limits.html.
- Golden SL, Blake JWC, Giuliano KK. Parental decision-making: infant engagement with smartphones. Infant Behav Dev. 2020;61:101497. https://doi.org/10.1016/j.infbeh.2020.101497.
- Dinleyici M, Carman KB, Ozturk E, Sahin-Dagli F. Media Use by Children, and Parents’ Views on Children’s Media Usage. Interact J Med Res. 2016;5(2):e18. https://doi.org/10.2196/ijmr.5668.
- Waisman I, Hidalgo E, Rossi ML. Screen use among young children in a city of Argentina. Arch Argent Pediatr. 2018;116(2):e186-95. https://doi.org/10.5546/aap.2018.eng.e186.
- Assathiany R, Guery E, Caron FM, Cheymol J, Picherot G, Foucaud P, et al. Children and screens: A survey by French pediatricians. Arch Pediatr. 2018;25(2):84-8. https://doi.org/10.1016/j.arcped.2017.11.001.
- Kılıç AO, Sari E, Yucel H, Oğuz MM, Polat E, Acoglu EA, et al. Exposure to and use of mobile devices in children aged 1-60 months. Eur J Pediatr. 2019;178(2):221-7. https://doi.org/10.1007/s00431-018-3284-x.
- Survey on Information and Communication Technology Usage by Children, Turkish Statistical Institute, 2024. Acsess date: 2025 Mar 19. Available from: https://data.tuik.gov.tr/Bulten/Index?p=Survey-on-Information-and-Communication-Technology-Usage-by-Children-2024-53638&dil=2.
- Ahearne C, Dilworth S, Rollings R, Livingstone V, Murray D. Touch-screen technology usage in toddlers. Arch Dis Child. 2016 ;101(2):181-3. https://doi.org/10.1136/archdischild-2015-309278.
- Miguel-Berges ML, Santaliestra-Pasias AM, Mouratidou T, Flores-Barrantes P, Androutsos O, De Craemer M, et al. Parental perceptions, attitudes and knowledge on European preschool children’s total screen time: the ToyBox-study. Eur J Public Health. 2020;30(1):105-11. https://doi.org/10.1093/eurpub/ckz151.
- Digital in Türkiye: All the Statistics You Need in 2021, Global Digital Insights. Acsess date: 2025 Mar 19. Available from https://datareportal.com/reports/digital-2021-Türkiye.
- Duch H, Fisher EM, Ensari I, Harrington A. Screen time use in children under 3 years old: a systematic review of correlates. Int J Behav Nutr Phys Act. 2013;10:102. https://doi.org/10.1186/1479-5868-10-102.
- Levine LE, Waite BM, Bowman LL, Kachinsky K. Mobile media use by infants and toddlers. Comput Human Behav. 2019;94:92-9. https://doi.org/10.1016/j.chb.2018.12.045.
- Smahel D, Machackova H, Mascheroni G, Dedkova, L, Staksrud E, Ólafsson K, Livingstone S and Hasebrink U. (2020). EU Kids Online 2020: Survey results from 19 countries. EU Kids Online. Acsess date: 2025 Mar 19. Available from: https://doi.org/10.21953/lse.47fdeqj01ofo.
- Paudel S, Jancey J, Subedi N, Leavy J. Correlates of mobile screen media use among children aged 0-8: a systematic review. BMJ Open. 2017;7(10):e014585. https://doi.org/10.1136/bmjopen-2016-014585.
- Stiglic N, Viner RM. Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ Open. 2019;9(1):e023191. https://doi.org/10.1136/bmjopen-2018-023191.
- Pagani LS, Fitzpatrick C, Barnett TA, Dubow E. Prospective associations between early childhood television exposure and academic, psychosocial, and physical well-being by middle childhood. Arch Pediatr Adolesc Med. 2010;164(5):425-31. https://doi.org/10.1001/archpediatrics.2010.50
- Kabali HK, Irigoyen MM, Nunez-Davis R, Budacki JG, Mohanty SH, Leister KP, et al. Exposure and Use of Mobile Media Devices by Young Children. Pediatrics. 2015;136(6):1044-50. https://doi.org/10.1542/peds.2015-2151
- Poitras VJ, Gray CE, Janssen X, Aubert S, Carson V, Faulkner G, et al. Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0-4 years). BMC Public Health. 2017;17(Suppl 5):868. https://doi.org/10.1186/s12889-017-4849-8.
- Cox R, Skouteris H, Rutherford L, Fuller-Tyszkiewicz M, Dell’ Aquila D, Hardy LL. Television viewing, television content, food intake, physical activity and body mass index: a cross-sectional study of preschool children aged 2-6 years. Health Promot J Austr. 2012;23(1):58-62. https://doi.org/10.1071/HE12058.
- Griffith SF. Parent beliefs and child media use: Stress and digital skills as moderators. J Appl Dev Psychol. 2023;86:101535. https://doi.org/10.1016/j.appdev.2023.101535.
- Nikken. P. Parents’ Instrumental use of Media in Childrearing: Relationships with Confidence in Parenting, and Health and Conduct Problems in Children. J Child Fam Stud. 2019; 28:531-46. https://doi.org/10.1007/s10826-018-1281-3.
- Assathiany R, Guery E, Caron FM, Cheymol J, Picherot G, Foucaud P, et al. Children and screens: A survey by French pediatricians. Arch Pediatr. 2018;25(2):84-8. https://doi.org/10.1016/j.arcped.2017.11.001.
- Miguel-Berges ML, Santaliestra-Pasias AM, Mouratidou T, Flores-Barrantes P, Androutsos O, De Craemer M, Galcheva S, Koletzko B, Kulaga Z, Manios Y, Moreno LA. Parental perceptions, attitudes and knowledge on European preschool children’s total screen time: the ToyBox-study. Eur J Public Health. 2020;30(1):105-11. https://doi.org/10.1093/eurpub/ckz151.
- Durham K, Wethmar D, Brandstetter S, Seelbach-Göbel B, Apfelbacher C, Melter M, Kabesch M, Kerzel S; KUNO Kids Study Group. Digital Media Exposure and Predictors for Screen Time in 12-Month-Old Children: A Cross-Sectional Analysis of Data From a German Birth Cohort. Front Psychiatry. 2021;12:737178. https://doi.org/10.3389/fpsyt.2021.737178.
- Kılıç AO, Sari E, Yucel H, Oğuz MM, Polat E, Acoglu EA, Senel S. Exposure to and use of mobile devices in children aged 1-60 months. Eur J Pediatr. 2019;178(2):221-7. https://doi.org/10.1007/s00431-018-3284-x.
- McClure ER, Chentsova-Dutton YE, Barr RF, Holochwost SJ, Parrott WG. “Facetime doesn’t count.” Int J Child Comput Interact. 2015;6:1-6. https://doi.org/10.1016/j.ijcci.2016.02.002
Copyright and license
Copyright © 2025 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.