Abstract

Screen media use, and particularly mobile device use, is frequent among preschool-age children. Studies support that problematic media use (PMU) symptoms are present among older children (4–11-year-olds) and toddlers, and PMU correlates with child temperament and parenting around child media use. We examined the performance of a widely used PMU measure among a sample of 85 3–5-year-old children to document whether variation in PMU exists in this age group and whether this PMU measure specifically has face validity relative to expected correlates of PMU. To address our study goals, we completed a confirmatory factor analysis of the PMU scale and compared PMU scores with child externalizing behaviors when parents set limits on the child’s media use and three measures of child self-regulation (emotional self-regulation, attentional focusing, and inhibitory control). Results supported a one-factor construct of PMU, and PMU was positively related to greater screen time among children. Results further documented strong associations between PMU and more extreme child behaviors when limits were set on media (e.g., more bothersome pestering, crying, whining, and physical gestures). Additionally, PMU related to less emotional self-regulation among children. Overall, findings support the validity of the PMU measure in preschool-age children and confirm associations around child media use behaviors and temperament. The implications related to media parenting are discussed.

Keywords: problematic media use, digital media, screen time, children, pestering

Acknowledgments: The authors thank the children and parents who participated in this research.

Funding: This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases under Grant K01DK117971 (Jennifer A. Emond). The funding agency had no involvement in the study other than financial support.

Disclosures: None of the authors have a real or potential conflict of interest related to this research.

Author Contributions: Jennifer A. Emond formalized hypotheses, designed the study, completed the data analyses, and drafted the article. Delaina Carlson and Grace Ballarino enrolled and consented participants, collected data, and provided critical intellectual and procedural feedback on the article. Sarah E. Domoff advised on the data analysis plan and provided critical intellectual feedback on the article.

Data Availability: Data are not freely shared because participants are children. The corresponding author will provide access to the data after reasonable request and upon approval of the analysis protocol by the study principal investigator (Jennifer A. Emond) and the Dartmouth College Institutional Review Board.

Open Access License: This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY- NC-ND). This license permits copying and redistributing the work in any medium or format for noncommercial use provided the original authors and source are credited and a link to the license is included in attribution. No derivative works are permitted under this license.

Correspondence concerning this article should be addressed to Jennifer A. Emond, Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, One Rope Ferry Road, Hanover, NH 03755, United States. Email: Jennifer.A.Emond@Dartmouth.edu

Preschool-age children in the United States are heavily engaged with screen media. In 2020, 2–4-year-olds in the United States averaged 2½ hours per day engaged with screen media (Rideout & Azman, 2020), inclusive of 1 hr per day on touchscreen mobile devices (tablet or smartphone; Rideout & Azman, 2020). Watching shows, movies, and/or videos; playing video games; and using apps are the most common screen media activities for this age group (Rideout & Azman, 2020). In contrast, the American Academy of Pediatrics recommends that preschool-age children spend no more than 1 hr per day using screen media, with a focus on quality media (Hill et al., 2016). Importantly, the COVID-19 pandemic greatly impacted children’s screen media use, with relaxed parenting around screen use (e.g., screens allowed in the child’s bedroom or during mealtime) more common during, versus before, the pandemic among 6–17-year-old children (Kroshus et al., 2022). It is unclear if those patterns persisted as the pandemic has eased. Screen media use at a young age is concerning for a multitude of reasons; high levels of screen use are related to vision problems, language delays, disrupted sleep, physical inactivity, obesity, and development delays, including impaired executive functioning (Dresp-Langley, 2020; Hill et al., 2016).

Importantly, screen media can be highly engaging for children, and it is possible that some children may exhibit symptoms of problematic media use (PMU) or dysregulated screen media use that has a negative impact on daily life (Domoff et al., 2019). Based on the Interactional Theory of Childhood Problematic Media Use (Domoff et al., 2020), multiple factors may contribute to greater PMU, including child, family, and social factors. Those factors may further interact with each other to maintain dysregulated media use. For example, parenting around media use may contribute to symptoms of PMU in children when parents use screen media as a way to pacify or manage challenging behavior in young children (Coyne et al., 2021; Radesky et al., 2023). Thus, children with greater problems self-regulating their emotions may be at risk of more dysregulated media use.

The media content and design itself can further maintain dysregulated media use among children. Children’s TV shows are largely colorful, fantastical, and fun, and children can form positive parasocial relationships with media characters (Brunick et al., 2016). Contemporary media, such as online videos and apps, may be especially rewarding for young children because they are persuasively designed to prolong engagement (Vox, 2022). Touchscreen mobile devices likely increase the rewarding effects of screen media because young children can easily navigate within and across media on these devices and gain autonomy in their own media use. It is possible that such characteristics of media activate reward systems of the brain, stimulating the release of dopamine and elevating mood (Brand et al., 2016; Dresp-Langley, 2020). Additionally, the rapid pace and fantastical content of children’s media (Jiang et al., 2019; Li et al., 2020; Lillard et al., 2015; Lillard & Peterson, 2011; Rhodes et al., 2020) and the multitude of media options that children can navigate on a touchscreen device can deplete children’s “top–down” executive functioning, leaving children in a depleted state when they transition away from screen media (Rhodes et al., 2020) that can make children vulnerable to emotional outbursts when media is removed or limited. It is thus not surprising that limiting children’s screen time can be quite difficult for parents; it limits anger in children and creates conflict in the home (Evans et al., 2011; Hiniker et al., 2016; Jago et al., 2016).

Identifying PMU among young children is important to intervene and reduce the potential negative effects of such screen use. Several studies (Harris et al., 2020; Marengo et al., 2021; Rozgonjuk et al., 2021; Sahu et al., 2019; Sohn et al., 2019) document that addiction-like or dysregulated media use is evident among school-age children and adolescents. Measures of PMU vary across specific measurement scales; however, symptoms are largely reflective of use disorders and addiction (Brand et al., 2016) and include preoccupation with media use, use of media to regulate mood, interference with family relationships, and irritability when media is not available (Domoff et al., 2019). In 2019, Domoff and colleagues developed and validated the PMU measure, a parent-reported scale to measure PMU among 4–11-year-olds (Domoff et al., 2019). However, research on PMU among younger children is only recently emerging. In a study among 269 2–3-year-old children (Coyne et al., 2021), children with a temperament marked by more negative affect (e.g., getting easily irritated) had higher scores on the PMU measure, and parents’ use of media to manage children’s negative emotions partially mediated that effect. Additional studies on the same cohort of toddlers demonstrated that parents with greater efficacy around managing their child’s media use (Coyne et al., 2023) related to less PMU, and greater viewing of educational TV programming among children related to less PMU 1 year later (Coyne et al., 2022). However, a comprehensive assessment of the proposed factor structure and validity of the PMU measure among that sample of toddlers was not provided.

The goals of this study are to confirm the validity of the PMU measure among a sample of preschool-age children and to understand the correlates of PMU among this sample, including children’s screen media use and externalizing behaviors reflective of behavioral problems when parents set limits on screen media use. We predicted that PMU would be related to measures of children’s trait-level emotional and behavioral (i.e., attention and inhibition) self-regulation. That later hypothesis is grounded in our framework (as summarized above) that children with self-regulatory problems may use, or be provided with, media for mood regulation and that the use of persuasive screen media may impact children’s self-regulation directly by depleting children’s executive functioning.

Method

Study Sample

This study is a cross-sectional, secondary analysis of data collected from the baseline visit of a study examining screen media use and obesity risk among preschool-age children. Parents of preschool-age children, aged 3–5-years-old, were recruited from the community during July 2019 and October 2022; all parents resided in two states in Northern New England (93.8% and 92.6% White, non-Hispanic; 41.7% and 39.0% of adults with a bachelor’s degree or higher per 2022 U.S. Census estimates) and had to live with the child at least half of the week. Children were ineligible if they had any significant developmental or language delays, sleep disorders, food allergies or dietary restrictions, appetite- or attention-altering disorders or medications, or if they were not fluent in English. Participants were excluded if they had an immediate family member who had previously participated in the study or if the family was planning to relocate within 6 months. Parents provided written informed consent, and children provided verbal assent. Up to $60 compensation was provided for the baseline visit. Dartmouth College’s Committee for the Protection of Human Subjects approved all study protocols (CPHS No. 31097).

Measures

PMU

Parents completed the nine-item Problematic Media Use Measure, short form (Domoff et al., 2019) for their child. This scale was developed to measure PMU among children 4–11 years old and was based on the nine Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria for internet gaming disorder. Scale items address preoccupation with and unsuccessful control of media use, loss of interest in other activities, psychosocial and family-related problems because of media use, use of media to relieve mood, withdrawal, tolerance, and deception related to use. Parents rated how much each item reflects their child; all items are scored on a 5-point Likert scale (1 = never, 2 = rarely, 3 = sometimes, 4 = often, and 5 = always). Final scores are the mean across all nine items, with higher scores reflecting more severe PMU. There is no established threshold for this scale to create a binary classification of PMU, although a mean score ≥3 has been used as a way to denote higher PMU (Magis-Weinberg et al., 2021) Thus, we also categorized PMU as ≥3 versus <3, and we also examined the number of items that were scored as a 3 or greater (i.e., a response answer of sometimes, often, or always) per child. Internal consistency of the PMU measure in our sample was excellent, with a Cronbach’s α = .86.

Child Bothersome Pestering Behaviors to Use Screen Media

Parents were asked, Does your child ever ask you to use media devices, even after you’ve said no (yes vs. no)? Parents who answered yes were then asked, How bothersome is it when your child asks you to use media devices, even after you’ve said no? Response options were not at all bothersome, a little bothersome, bothersome, or very bothersome. We also categorized these responses to reflect more bothersome pestering (bothersome or very bothersome) versus less bothersome pestering (not at all bothersome, a little bothersome), consistent with the methods of a previous study of 2–5-year-old children that used this measure (Domoff et al., 2021). Parents then reported on four behaviors their child might display when asking to use screen media after the parent denied the child’s request: whining, crying, making physical gestures like stomping his/her feet or making fists, and physically taking a device on his/her own. Responses to each item were never, rarely, sometimes, or a lot. Notably, only one item of the PMU measure overlaps with these child pestering behaviors: My child becomes frustrated when he/she cannot use screen media.

Children’s Screen Media Use

Parents reported how often their child did each of the following screen activities for a typical weekday and weekend day, separately: (a) watch shows, videos, or movies on a TV set (inclusive of streaming services); (b) use a computer, laptop, or desktop; (c) use a smartphone; (d) use a touchscreen tablet; or (e) use a videogame console or handheld videogame device. Weekday responses were multiplied by 5, and weekend day responses were multiplied by 2, then summed to compute total screen media time per week. Total screen media time was further stratified by screen time on touchscreen mobile devices (smartphones and/or touchscreen tablets) and other devices to approximate the use of more versus less persuasive media.

Children’s Self-Regulation

Parents completed separate scales to measure three aspects of children’s self-regulation: emotional self-regulation, attentional focusing, and inhibitory control. Emotional self-regulation was assessed with the emotional dysregulation subscale of the Child Social Behavior Questionnaire, a scale initially developed for children with autism or pervasive developmental disorder (Agalioti-Sgompou et al., 2017; Hartman et al., 2006; Luteijn et al., 1998) and adopted to measure emotional self-regulation in a nonclinical sample of preschool-age children (S. E. Anderson et al., 2017). Five items are included that refer to the child’s ability to regulate their mood and temper (e.g., My child shows wide mood swings). For our study, each item was scored on a 7-point Likert scale anchored at 1 = extremely untrue to 7 = extremely true, and the final score was the mean across all items. The Cronbach’s α of this scale in the current sample was 0.72. Final scores were reversed in this analysis, such that higher scores indicate better emotional self-regulation.

Child attentional focusing and inhibitory control were assessed using subscales from the Children’s Behavior Questionnaire (Putnam & Rothbart, 2006), a validated assessment of temperament in children aged 3–8 years based on parent report. The attentional focusing subscale consists of 15 items that reflect a greater ability to stay focused on a task and avoid distraction (e.g., When drawing or coloring in a book, he/she shows strong concentration). All items are scored on a 7-point Likert scale anchored at extremely untrue to extremely true; a final score is the mean across all items, and higher scores indicate better attentional focusing. The inhibitory control subscale consists of 13 items reflecting the child’s ability to regulate behavioral reactions (e.g., My child can wait before entering into new activities if he/she is asked to). All items are scored on a 7-point Likert scale anchored at extremely untrue to extremely true; a final score is the mean across all items, and higher scores indicate better inhibitory control. The Cronbach’s α of the attentional focusing and inhibitory control subscales for the current sample were 0.75 and 0.82, respectively.

Covariates

Parents completed an online survey at baseline to capture sociodemographic characteristics and parenting style. For parenting style, parents completed the 15-item authoritative and the five-item permissive subscales of the Parenting Styles and Dimensions Questionnaire, a questionnaire that characterizes parents based on their responsiveness and demandingness scored on a 5-point Likert scale (Robinson et al., 1995). An average score was calculated for each parenting style. The Cronbach’s α of the Parenting Styles and Dimensions Questionnaire subscales of authoritative and permissive parenting styles for the current sample were 0.84 and 0.67, respectively. A higher score on authoritative parenting style indicates more nurturing and responsive parenting with consistent and fair discipline; a higher score on permissive parenting style indicates less disciplined and structured parenting with overindulgence to avoid conflict.

Statistical Analyses

PMU scores were summarized, and the internal consistency across the nine items was computed using Cronbach’s α (as reported above). A confirmatory factor analysis was completed to assess the fit of a one factor solution in our data (Rosseel, 2012). The model fit was assessed with the chi-square test of fit (the null hypothesis is that the specific model adequately fits the data), the comparative fit index (values >0.9 indicate a good fit), the Tucker–Lewis index (values >0.9 indicate a good fit), and the root-mean-square error of approximation (values <0.10 indicate a good fit, values ≤0.05 indicate an excellent fit) (Kline, 2016). A series of linear regression models were next fit to test the associations between PMU and children’s bothersome pestering to use screen media and, separately, children’s total screen media use. All linear regression models included standardized measures (each centered at the mean) and were adjusted for child age, sex, and household income; age was selected a priori, and sex and income were the only sociodemographic characteristics associated with PMU at the p < .10 level in unadjusted bivariate analyses. Another series of adjusted linear regression models regressed PMU on each measure of children’s self-regulation. The distribution of PMU scores had a slight right skew, and therefore, all linear regression models were completed using PMU scores untransformed and then repeated using natural log transformed PMU scores (Supplemental Table S1 lists the goodness of fit measure for all of these models). In all but one case, models using the untransformed PMU scores had a better fit as measured with the adjusted coefficient of determination, and thus, we present models using the untransformed PMU scores. In one case, the model with log-transformed PMU had a better fit (R² = .3006 log-transformed vs. .2700 untransformed), and we note that finding below and present both models in the Supplemental Material.

Finally, because study enrollment began before the start of the COVID-19 pandemic, all analyses were repeated, controlling for whether the visit was before or after March 11, 2020, the date declared as the start of the pandemic by the World Health Organization (Hirose et al., 2020). Fifty-four (63.5%) of the 85 visits were after this date, and all study findings were the same when adjusting for this start date in the models (Supplemental Tables S4–S6). All analyses were performed with the R statistical language (Version 4.2.0).

Results

Sample Characteristics

The final sample included 85 child–parent dyads with baseline data. Children’s age was equally distributed across 3, 4, and 5 years of age; 57.6% of the sample were male, and a majority of children were non-Hispanic, White (Table 1). The sample was from a higher socioeconomic status, with 20.0% of households earning $145,000 or more per year and 48.2% of parents having a graduate degree. Children averaged 11.5 hr of total screen time per week, 2.9 hr of which was on touchscreen mobile devices. The sample’s mean PMU score was 2.06 (SD = 0.63), and mean scores were greater for males, 2.19 vs.1.88; t(df = 82.6) p = .01, and were highest for children in families with incomes $65,000–$144,999, F(df = 3.81) p = .08. No other measures in Table 1 were related to PMU at the p < .10 level in bivariate analyses.

Characteristics of the PMU Measure

Results from the confirmatory factor analysis supported that a one-factor solution was a good fit to the current sample data, with one item less correlated with the PMU factor than others. Specifically, while the chi-square test of fit (df = 27) p value was .024, indicating an insufficient fit, the comparative fit index (0.944) and Tucker–Lewis index values were high (0.926), and the root-mean-square error of approximation was low (0.08; 90% CI [0.031, 0.129]), both indicating a good fit to the data. Additionally, all but one of the nine items loaded onto the PMU factor with medium-to-high standardized loadings (range = 0.55–0.82), with one item (When my child has had a bad day, screen media seems to be the only thing that helps him/her feel better) having a standardized loading of 0.28. Only seven (8.2%) children had a PMU score ≥3. About half (n = 43; 50.6%) of children scored a three or more on at least three of the nine PMU items; 19 (22.4%) children scored a three or more on at least five of the nine PMU measure items (Supplemental Figure S1).

Associations Between PMU and Child Bothersome Pestering Behaviors to Use Screen Media

PMU was significantly greater among children who asked to use screen media, even after the parent had said no, 2.2 versus 1.6; t(df = 37.8) p < .001. PMU was also positively associated with more bothersome pestering behaviors among children when they asked to use screen media based on parent report (Figure 1). For example, the adjusted mean PMU was 1.9 among children whose pestering was rated as “not at all bothersome” versus 2.8 whose pestering was rated as “very bothersome.” PMU scores were also positively associated with the frequency of each of the four pestering behaviors (Figure 2). For one model (parent rating of child behaviors when limits are placed on media use: frequency of whining, Figure 2 Panel 2), including PMU log-transformed produced a slightly better model fit, although the findings were similar across the two models (Supplemental Tables S2 and S3).

Associations Between PMU and Children’s Screen Media Use

PMU was positively associated with more screen media use per week among children (Table 2). For each 1 SD increase in hours per week of screen media use, mean PMU increased by 0.27 standard deviations (95% CI [0.06, 0.48]; p = .012). Effects were similar when considering touchscreen mobile device use or other screen media use separately (Table 2).

Associations Between PMU and Child Self-Regulation

PMU was positively and statistically associated with worse emotional self-regulation among children (adjusted standardized β = −.24; p = .03) and positively associated with worse inhibitory control (r = −.20; p = .08), with a trend toward statistical significance. PMU was not associated with child attentional focusing (r = −.07; p = .49; Figure 3).

Discussion

This study examined the performance of the PMU measure in a sample of 3–5-year-olds and is, to our knowledge, the first study to formally assess the validity of this scale in this age group. A one-factor solution of PMU was supported by the data, and the scale had a high internal consistency. PMU scores were positively associated with more bothersome pestering to use screen media and with a greater frequency of each externalizing behavior related to pestering among children when limits were set on children’s media use, each as reported by the parent. PMU was also positively associated with a greater quantity of screen media use per week among children per parent report. The standardized association was 0.27 that translates into an increase of 0.63 points in mean PMU score for each 7.3 hr more total screen use per week. Overall, findings combine to support the face validity of the PMU measure among preschool-age children.

The overall mean PMU score was 2.06 in this sample of preschool-age children, which is comparable though slightly less than the mean of 2.16 in the original PMU measurement study among 4–11-year-olds and higher than the mean 1.72 among 2–3-year-olds (Coyne et al., 2021). Notably, mean PMU increased to 1.9 1 year later in that sample (Coyne et al., 2022). Few children (8.2%) had a final score ≥3 in our sample, although 22.4% of children scored a response of ≥3 on 5 or more of the nine items (i.e., at least 50% of all items). Thus, the PMU measure appears sensitive to detecting the emergence of dysregulated screen use at this age.

In our sample, PMU scores were positively associated with more frequent externalizing behaviors exhibited by children when limits were set on their media use. These behaviors were whining, crying, making physical gestures, and taking devices—behaviors that can impact the parent–child relationship and the parent’s management of screen media for the child. Indeed, parents may be reluctant to set limits on children’s media use if it will upset the child (Evans et al., 2011; Hiniker et al., 2016; Jago et al., 2016). PMU was positively related to parent-reported conflicts with their children when asked to turn off screen devices in the original PMU validation study among 4–11-year-olds (Domoff et al., 2019). Screen media, particularly contemporary digital, including media targeting kids, is designed to be engaging and rewarding (Franqueira et al., 2022; Goldsmith, 2022; Koetsier, 2020; Vox, 2022). Screen media use likely increases the release of dopamine and elevates a child’s mood acutely, which likely contributes to later craving for screen media (Brand et al., 2016). Thus, it is not surprising that children have strong reactions when limits are set on screen media use. In contrast, PMU was not related to young children’s (aged 2–3 years old) emotional reactions when a TV program ended unexpectedly as part of a controlled experiment in the abovementioned study of 269 toddlers (Coyne et al., 2021). That study used the same TV program as the exposure for all children, and it is possible that an exposure more specific to each child’s own media viewing may be needed. However, it is also possible that parent report of child externalizing behaviors when limits are placed on media could be biased and does not reflect child behaviors when observed by an independent researcher. Future research to clarify these questions is needed.

It is likely that such externalizing behaviors exhibited when limits are set on screen media use coevolve with PMU, and child- and parent-level factors may modify that evolution. For example, greater parental use of media to help regulate their children’s emotions was strongly related to children’s PMU in a prior study of toddlers mentioned previously (Coyne et al., 2021) and more restrictive rules on media use (Coyne et al., 2023; Shawcroft et al., 2023), and greater parental efficacy (Coyne et al., 2023) in setting those rules for children at a younger age (∼30 months) predicted less PMU by age 4 in that same sample. Across two different sampled populations of 3-year-olds in the United States and New Zealand (Swit et al., 2023), researchers found that low levels of closeness between the child and parent and, separately, harsh criticism from the parent were related to greater PMU scores among children. We did not find an association between the general permissive and authoritative parenting style and PMU in our sample. A more authoritative parenting style is marked by warmth and fair and consistent rule setting, and it was surprising that this parenting style was not related to less PMU. It is possible that a harsher parenting style such as authoritarian may relate to PMU; however, we did not measure authoritarian parenting style in our sample.

Interventions that help parents set clear media use limits for their children and avoid using media to regulate their children’s moods are important to shape healthy media use behaviors and avoid PMU at a young age. Additionally, the impact of media on PMU likely differs by media content. In the previously mentioned cohort of 2–3-year-olds (examined in different studies; Coyne et al., 2021, 2022, 2023), viewing educational TV was inversely related to PMU scores (Coyne et al., 2022). High-quality educational media can also have beneficial effects on cognitive development among young children (D. R. Anderson & Subrahmanyam, 2017). Thus, media use limits for young children must consider content. Importantly, technology companies must be held accountable and design age-appropriate media that support children’s growth and development, not media designed to simply increase engagement (Franqueira et al., 2022; US Congress, 2021/2022).

We further found an association between greater PMU and poorer emotional self-regulation among this sample of preschool-age children. PMU was associated with poorer emotional regulation in the original validation study among 4–11-year-olds (Domoff et al., 2019) and with negative affect among 2–3-year-olds (Coyne et al., 2021). These findings are consistent with the model that children with poorer emotional self-regulation may be more responsive to the rewarding effects of screen media and thus more likely to exhibit symptoms of PMU. Furthermore, parents may use media to pacify children with poor emotional self-regulation (Coyne et al., 2021; Domoff et al., 2020; Halpin et al., 2021). It is thus important to understand that some children may be more at-risk of developing PMU than others, and parenting practices around children’s media use should consider those differences. In our study, there was also a trend between PMU relating to worse inhibitory control, which may support that children with less behavioral control may be more responsive to the stimulating effects of media. We did not find an association between PMU and attentional focusing, which may suggest that children with higher PMU scores are not using media to calm attentional deficits at this age.

Limitations

Participants largely reflect a convenience sample from the local communities. The study sample was primarily White, non-Hispanic of higher socioeconomic status from a largely rural area of New England. Additional studies among diverse samples are needed to understand if findings are generalizable. Additionally, children’s weekly screen time was lower than national averages for this age (Rideout & Azman, 2020). Household income was inversely associated with children’s TV and tablet time in a cohort of 2–3-year-olds (Shawcroft et al., 2023). Thus, while our results support that PMU and externalizing behaviors are correlated in this population with low levels of media use among children, it is unclear if similar effects exist or are perceived by parents when children’s screen media use is higher, acknowledging that those effects may be further impacted by household income. All study measures were also all parent-reported, which introduces the possibility of common method bias. Additionally, parent report of PMU may be shaped by parents’ own attitudes about and use of digital media, and future studies are needed to understand how such factors may influence parental attitudes about problematic versus normal media use among their children. Parenting around media may also impact the development of PMU, as shown in previous studies (Coyne et al., 2021). While our study reports on the validity of the PMU measure among preschool-age children, our study was not designed to assess risk factors of PMU. This study is cross-sectional and does not address the temporal associations between screen media use and self-regulation.

Implications

As stated by the Interactional Theory of Childhood Problematic Media Use (Domoff et al., 2020), the development of more severe PMU is influenced by multiple factors, including the use of persuasive media by children, parenting around children’s media behaviors and habits, and children’s own self-regulatory capacity. This cross-sectional study supports that the PMU measure, a measure first validated for 4–11-year-olds, is valid among 3–5-year-olds. Our findings also complement previous studies among 2–3-year-olds supporting the validity of the PMU measure. Longitudinal studies with multiple repeated assessments are needed to properly assess factors that contribute to the development of more severe PMU across childhood, including the reciprocal associations between child media use, media parenting, child PMU, and self-regulation

The PMU measure is thus a valid and important tool for such studies. Our findings also demonstrate that media use among contemporary preschool-age children can create conflict in the parent–child relationship, and those conflicts should be considered when assessing children’s screen time, above and beyond assessing if children exceed recommended limits of screen time.

Supplemental Materials

https://doi.org/10.1037/tmb0000135.supp

Copyright © The Author(s) 2024

Received September 26, 2023
Revision received May 6, 2024
Accepted May 21, 2024