No. of participants (No. of studies) | Design | Quality assessment | Absolute effect | Quality | ||||
---|---|---|---|---|---|---|---|---|
Risk of bias | Inconsistency | Indirectness | Imprecision | Other | ||||
The range of mean ages at time of exposure measurement was ~0.5 to 4.4 years; the oldest age range at follow-up was 9 to 10 years. Data were collected cross-sectionally and up to 8 years of follow-up. Cognitive development indicators were: ADHD symptoms (assessed by checklists based on the DSM-IV); attentional problems (assessed by the BPI); attention span (assessed by the CTQ); classroom engagement (assessed by a Classroom Engagement Scale and an unpublished questionnaire); cognitive ability (assessed by the Imitation Sorting Task); cognitive development (assessed by BSID-II and BSID-III); cognitive inhibitory control (assessed by the Animal Stroop Task); executive function (assessed as a composite of cognitive inhibitory control and working memory capacity; the BASC-2; four tasks: grass/snow, whisper, backward digit span, tower); language development (total), auditory comprehension, expressive communication (assessed by ASQ, PLS-4, CELF-P2, CELF-4, CDI, K-ASQ, Thai CLAMS, medical diagnosis, and developmental assessment with Denver-II test); mathematical success (assessed as relative to the class distribution); mathematics, reading recognition, reading comprehension (assessed by the PIAT); number knowledge (assessed by NKT); receptive and total vocabulary (assessed by PPVT); short-term memory (assessed by the Memory for Digit Span of the WISC); speech disorders (assessed by the Chuturik test and Child Behavior Checklist by Achenbach, conversation with parents, and clinical examination); and working memory capacity (assessed using the Animal Stroop Task and K-ABC number recall test). | ||||||||
8927 (11) | Longitudinala | Serious risk of biasb | No serious inconsistency | No serious indirectness | No serious imprecision | None | Screen-based sedentary behaviours: Electronic media exposure (duration): 1/1 studies reported unfavourable associations [112] Other sedentary behaviours: Parents reading (frequency): 1/1 studies reported favourable associations [121] TV time (duration): 5/10 studies reported unfavourable associations [90, 92, 100, 120, 121] 4/10 studies reported null associations [88, 102, 113, 122] 1/10 studies reported mixed unfavourable, null, and favourable associations [119] | Very lowc |
166 (1) | Case-controld | Serious risk of biase | No serious inconsistency | No serious indirectness | No serious imprecision | None | Screen-based sedentary behaviours: TV time: 1/1 studies reported unfavourable associations [116] | Very lowf |
9330 (16) | Cross-sectionalg | Serious risk of biash | No serious inconsistency | No serious indirectness | No serious imprecision | None | Objectively measured sedentary time: Total sedentary time (accelerometer-derived): 1/1 studies reported null associations [104] Screen-based sedentary behaviours: Computer use (yes, no): 1/1 studies reported null associations [109] Mobile phone use (yes, no): 1/1 studies reported unfavourable associations [109] TV time (duration): 3/9 studies reported unfavourable associations [94, 108, 123] 4/9 studies reported null associations [90, 100, 114, 115, 121] 1/9 studies reported mixed unfavourable and null associations [118] Total media exposure (duration): 1/1 studies reported mixed null and unfavourable associations [124] Video games (duration): 1/1 studies reported null associations [107] Other sedentary behaviours: Reading with parents (duration, frequency): 1/3 studies reported null associations [110] 1/3 studies reported favourable associations [117] 1/3 studies reported mixed null and favourable associations [124] Screen time (duration): 1/1 studies reported unfavourable associations [111] Storytelling with parents (frequency): 2/2 studies reported mixed null and favourable associations [117, 124] | Very lowi |