24-Hour movement behaviors among visually impaired US children and adolescents

Background: 24-h movement behavior (24-HMB) guidelines suggest that children and adolescents should limit screen time (ST), get an adequate amount of sleep (SL), and engage in a sufficient amount of physical activity (PA) to ensure optimal health. However, it is not fully understood how adherence to these 24-HMB guidelines apply specifically to visually impaired children and adolescents. To address this gap in the literature, a crosssectional study was conducted to investigate potential associations between adherence to the 24-HMB guidelines and academic, social, and emotional outcomes among a national sample of visually impaired children and adolescents. Methods: Data on movement behaviors (physical activity, screen time, and sleep duration) and specific outcome variables (academic performance, social function, and emotional function) were collected through caregiverproxy reports (questionnaires completed by the caregivers of the visually impaired children and adolescents aged between 6 and 17 years). Logistic regressions were performed to examine the associations between the adherence to 24-HMB guidelines and academic, social, and emotional outcomes adjusting for covariates (e.g., age, sex, race, weight, birth status, household poverty level, and the caregiver's education level) and calculate the odds ratio with 95% confidence interval (CI). Results: Among 907 visually impaired children and adolescents, only a small proportion adhered to all three 24HMB guidelines (6.12%). The prevalence of adhering to the SL (33.16%) was higher than those participants meeting PA (3.68%) and ST guidelines (10.28%). As compared to participants who did not meet any of the three 24-HMB guidelines, adhering to: (1) PA + ST guidelines were linked to better academic performance; (2) PA + ST guidelines were linked to less social difficulties, and (3) SL + ST guidelines were linked to better emotional functioning.Conclusion: Less than one-third of the visually impaired children and adolescents did meet one or more guidelines of the 24-HMB recommendations. Adhering to the 24-HMB guidelines, both alone and in an integrated manner, was linked to better academic performance, social relationships, and emotional functioning while visually impaired children and adolescents who adhered to PA + ST guidelines benefited the most. Our results suggest that the promotion of the 24-HMB guidelines among visually impaired children and adolescents might be an effective intervention strategy to promote academic, social, and emotional development among this unique group, although further research is necessary to empirically buttress this assumption.