“Watching TV for three hours a day will not harm your children”, The Independent reports. However, The Daily Express contradicts this, saying “Too much television turns children into monsters”. In this case, The Independent is closer to the truth.

It has long been said that too much TV or video games could be bad for children. The study reported in the news set out to discover whether there is any truth in this belief.

It was a large UK study, tracking children aged from five to seven years of age, to see what – if any – effect TV viewing and video game playing had on their behaviour, attention span, emotions and peer relationships.

Researchers found that regularly watching three hours a day was linked to a tiny increase in ‘conduct problems’ (essentially ‘being naughty’) after adjusting for many factors. This was just one of many outcomes the researchers examined. There was no evidence that TV viewing affected other issues, including hyperactivity, emotions and peer relationships.

Interestingly, there was also no association between time spent playing video games and any emotional or behavioural problems.

Unfortunately, this research can’t conclusively tell us if there’s a link between watching TV and psychological and behavioural problems. From these limited results, it seems that any such link is likely to be small. Other influences are very likely to play a more significant role in children’s developing emotions and behaviour.

Where did the story come from?

The study was carried out by researchers from the Medical Research Council/SCO Social and Public Health Sciences Unit at the University of Glasgow. It was funded by the UK Medical Research Council.

The study was published in the peer-reviewed journal Archives of Disease in Childhood. This article was open-access, meaning that it is available free online.

The media reported this story from two opposing angles, with headlines either suggesting that watching TV does not harm children (The Independent, and BBC News), or concentrating on the small increase in conduct problems and suggesting that TV watching is linked to behavioural problems or that children are naughtier (The Daily Telegraph and the Daily Mail).

While a case could be made that the Telegraph and Mail’s headlines are accurate at face value – there was a very small increase in naughty behaviour – the tone of their headlines are not really a fair reflection of the findings of the study. However, the Daily Express claim that TV turns ‘kids into monsters’ is totally inaccurate.



What kind of research was this?

This was a cohort study. It aimed to determine whether there was a link between the amount of time spent watching TV and playing computer games at five years of age, and changes in psychosocial adjustment at seven years of age.

Cohort studies are the ideal study design for this type of research, although they cannot show causation. For example, in this study we cannot be sure that TV watching causes the increase in conduct problem score, as it could be that other factors, called confounders, are responsible for the link.

What did the research involve?

Mothers of 11,014 children in the UK Millennium Cohort study (a study of a sample of children born between September 2000 and January 2002) were asked questions about their children’s behaviour.

They were asked the typical time during term-time spent watching television and playing electronic games when children were five years of age. This was categorised into:

none

less than one hour per day

between one and less than three hours

three hours to less than five hours

between five hours and less than seven hours

seven hours or more per day

Using the ‘Strengths and Difficulties Questionnaire’, when children were five and seven years of age, researchers assessed:

conduct problems

emotional symptoms

peer relationship problems

hyperactivity/inattention

prosocial behaviour (helpful behaviour)

The researchers collected information on maternal characteristics, family characteristics and family functioning (potential confounding factors), including:

mother’s ethnicity, education, employment, and physical and mental health

family’s household income

family composition

warmth and conflict in the mother-child relationship at three years of age – as assessed by interview

frequency of parent-child joint activities at five years of age

“household chaos” – a psychological term used to describe how chaotic or not daily life in the house tends to be in terms of issues such as sticking to set routines, household noise and how crowded the house is

The researchers also collected information on the child’s characteristics at five years of age, including:

cognitive development (assessed by the researchers)

whether they had a long-term illness or disability (reported by the mother)

sleeping difficulties

the amount of physical activity they performed

negative attitudes at school

The researchers then looked to see if there was an association between time spent watching television and playing electronic games and psychosocial problems, after adjusting for maternal characteristics, family characteristics and functioning, and child characteristics.

What were the basic results?

Almost two-thirds of children in this study watched between one hour and three hours of TV per day aged five years old, with 15% watching more than three hours of TV and very few children (<2%) watching no TV.

The majority of children played computer games for less than one hour per day, with 23% of children playing for one hour or more.

Initially, the researchers found that exposure to either TV or games for three hours or more was associated with an increase in all problems, and three hours or more of TV with reduced prosocial behaviour. However, after maternal and family characteristics, child characteristics and family functioning were adjusted for, the researchers found that:

Watching TV for three hours or more per day at five years of age, compared to watching television for under an hour, predicted a 0.13 point increase (95% confidence interval (CI) 0.03 to 0.24) in conduct problems at seven years of age (after adjusting for the amount of time spent playing computer games).

No association between time spent watching TV and emotional symptoms, peer relationship problems, hyperactivity/inattention and prosocial behaviour was found.

The amount of time spent playing electronic games was not associated with any emotional or behaviour problems.

When television watching and time spent playing electronic games were considered together, it was again found that three hours or more per day of screen time was associated with a 0.14 point increase (95% CI 0.05 to 0.24) in conduct problems compared to scores for those who watched less than an hour, but that screen time was not associated with emotional symptoms, peer relationship problems, hyperactivity/inattention or prosocial behaviour.

There was no evidence that screen time had different effects on boys and girls.

The researchers report that the relationships remaining the same when current (at age seven years) screen time was adjusted for.

How did the researchers interpret the results?

The researchers concluded that “TV but not electronic games predicted a small increase in conduct problems. Screen time did not predict other aspects of psychosocial adjustment.” The researchers go on to add that further work is required to establish the cause of these relationships.

Conclusion

This large UK cohort study has found that watching TV for three hours or more daily at five years predicted a small increase in conduct problems between the ages of five and seven years compared to watching TV for under an hour (0.13 point increase, on average). However, the time spent watching TV was not linked to hyperactivity/inattention, emotional symptoms, peer relationship problems, or prosocial behaviour.

The time spent playing electronic games was not associated with any emotional or behavioural problems.

Strengths of this study include the fact that it was large and well designed. It also accounted for many of the potential “confounding” factors (although there may still be others that weren’t accounted for), and examined TV/video/DVD watching (considered passive activities) and playing computer games (active activities) separately, which many previous studies have failed to do.

However, this study does have a significant limitation in that it relied on the mother’s reporting of both watching TV or playing computer games, and the child’s emotional and behavioural problems.

Although increased television watching was associated with an increase conduct problem score, it is not known whether the minimal point increases in average score for this sample between the ages of five and seven would actually make any noticeable difference to an individual child’s overall functioning and behaviour.

The study also suggests that family characteristics and functioning, and child characteristics also play an important role in the development of emotional and behavioural problems and that it may not be down to TV viewing alone.

Adjusting for confounders such as family composition, mother-child relationship and child’s activity levels had a significant effect on the initial results. This arguably suggests that these types of factors may have a considerable influence on how a child develops, rather than TV watching.

Given the lack of significant associations found between TV viewing and game playing and child psychosocial problems, no conclusive answers can be drawn from this study alone.

Further work is required to examine the child and family characteristics which could be targeted to improve outcomes.

Analysis by Bazian

Edited by NHS Website