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Background <p>Daily television viewing may be associated with social-communication difficulties in early childhood, but whether this association is related to concurrent health-related behaviors remains unclear.</p> Methods <p>This population-based cross-sectional study included 12,584 children aged 36–60 months from 96 kindergartens in Shanghai, China. Daily television viewing was parent-reported and categorized as ≤ 1&#xa0;h/day or &gt; 1&#xa0;h/day. Social communication outcomes were assessed using the Social Communication Questionnaire (SCQ). Multivariable regression models estimated associations between daily television viewing and SCQ outcomes. Outdoor activity frequency, sleep duration, and BMI z-score were examined in exploratory cross-sectional indirect-association models. FDR correction was applied.</p> Results <p>Overall, 56.6% of children had daily television viewing &gt; 1&#xa0;h/day. Television viewing &gt; 1&#xa0;h/day was associated with a slightly higher SCQ total score (B = 0.185, 95% CI 0.054–0.316), social interaction domain (B = 0.107, 95% CI 0.029–0.186), and communication domain (B = 0.034, 95% CI 0.005–0.063). After additional adjustment for outdoor activity, sleep, and BMI z-score, these associations were attenuated and were no longer statistically significant. Outdoor activity frequency showed the largest exploratory indirect association, whereas indirect associations through sleep were smaller and those through BMI z-score were weak or inconsistent.</p> Conclusions <p>Daily television viewing &gt; 1&#xa0;h/day was associated with slightly higher SCQ scores in preschoolers, but not with SCQ-positive status. This pattern suggests that TV viewing-related social communication difficulties should not be directly equated with ASD, but may represent a modifiable behavioral concern, highlighting outdoor activity as a potential focus for future interventions.</p>

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Daily television viewing and social communication in preschool children: cross-sectional associations with outdoor activity

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Xirui Ma,
  • Yuanyuan Lin,
  • Xingming Jin,
  • Hong Huang,
  • Yiwen Zhang,
  • Zhijuan Jin

摘要

Background

Daily television viewing may be associated with social-communication difficulties in early childhood, but whether this association is related to concurrent health-related behaviors remains unclear.

Methods

This population-based cross-sectional study included 12,584 children aged 36–60 months from 96 kindergartens in Shanghai, China. Daily television viewing was parent-reported and categorized as ≤ 1 h/day or > 1 h/day. Social communication outcomes were assessed using the Social Communication Questionnaire (SCQ). Multivariable regression models estimated associations between daily television viewing and SCQ outcomes. Outdoor activity frequency, sleep duration, and BMI z-score were examined in exploratory cross-sectional indirect-association models. FDR correction was applied.

Results

Overall, 56.6% of children had daily television viewing > 1 h/day. Television viewing > 1 h/day was associated with a slightly higher SCQ total score (B = 0.185, 95% CI 0.054–0.316), social interaction domain (B = 0.107, 95% CI 0.029–0.186), and communication domain (B = 0.034, 95% CI 0.005–0.063). After additional adjustment for outdoor activity, sleep, and BMI z-score, these associations were attenuated and were no longer statistically significant. Outdoor activity frequency showed the largest exploratory indirect association, whereas indirect associations through sleep were smaller and those through BMI z-score were weak or inconsistent.

Conclusions

Daily television viewing > 1 h/day was associated with slightly higher SCQ scores in preschoolers, but not with SCQ-positive status. This pattern suggests that TV viewing-related social communication difficulties should not be directly equated with ASD, but may represent a modifiable behavioral concern, highlighting outdoor activity as a potential focus for future interventions.