Screen Time, Outdoor Play, and Sleep Routines in Early Childhood: Longitudinal Associations with Parenting Stress during Toddler to Preschool Years

Introduction: Our study examined the longitudinal relationship between parenting stress and screen time, outdoor play, and sleep routines in toddler to preschool-aged children. Method: We conducted a descriptive quantitative analysis of a prospective observational cohort study of 300 families with an 18- month-old toddler who were followed for 2 years. Parenting stress was measured using a subscale of the Parenting Stress Index-4 Short Form at child age 18 months. Screen time, outdoor play, and sleep routines were parent-reported at child age 36 months. Multi- variable regression estimated associations between parenting stress and screen time behaviors, outdoor play, and sleep routines. Results: Data from 280 children (42.1% female) showed that 39.6% did not have rules around screen time and 82% of families reported frequently having the television on without anyone watching. In adjusted models, a 1-standard deviation increase in parenting stress at 18 months was associated with increased odds of having a television on without anyone watching (OR 1.26, 95% CI: 1.01, 1.57) and decreased odds of not having rules about the amount of screen time at 36 months (OR 0.75, 95% CI: 0.58, 0.96). Discussion: Increased parenting stress in early childhood was associated with some suboptimal screen time behaviors and sleep routines when children were preschool-aged. J Pediatr Health Care. (2024) 38, 794-803