Most Preschool-Age Children Get Double the Daily Recommended Screen Time

Study finds children in home-based child care get the most screen-time

Sixty-six percent of preschool-age children exceed the recommended daily amount of screen time. This is according to a new study led by Pooja Tandon, MD, MPH of Seattle Children’s Research Institute and researchers at the University of Washington. The study, “Preschoolers’ Total Daily Screen Time at Home and by Type of Child Care”, will publish online October 28 in The Journal of Pediatrics.

According to Tandon, “A majority of children under the age of five years in the United States spend almost 40 hours a week with caregivers other than their parents, and it’s important to understand what kind of screen time exposure children are getting with these other caregivers.”

The American Academy of Pediatrics (AAP) recommends that parents limit combined screen time from television, DVDs, computers, and video games to 2 hours per day for preschool-age children. Television viewing in young children has been associated with speech delays, aggressive behavior, decreased academic performance, and obesity.

Tandon and co-investigators studied nearly 9,000 preschool-age children who took part in the Early Childhood Longitudinal Study – Birth Cohort, a longitudinal, observational study of over 10,000 children born in 2001 with diverse socioeconomic and ethnic backgrounds. The researchers used data from interviews with parents and child care providers to calculate each child’s total daily screen time.

On average, children were exposed to 4 hours of screen time each weekday, with 3.6 hours of exposure coming from home. Children in home-based child care spent an average of 5.6 hours watching television or videos, with 87% exceeding the 2 hour recommendation. Center-based child care scored slightly better, with children watching approximately 3.2 hours each weekday. Children who did not go to child care also tended to exceed the recommendations, however, with the average child watching 4.4 hours a day.

Children enrolled in Head Start, a program for more socioeconomically vulnerable children, watched an average of 4.2 hours a day. However, very little of this time was accrued at the child care center. “Only 2% of the 4.2 hours occurred while the children were attending Head Start,” Dr. Tandon explains, “with the rest of the exposure happening at home.”

Few states have regulations about screen time in licensed child care settings. Tandon believes that such regulations may be helpful in curbing screen time, at least in the licensed settings. “Parents also play an important role,” she suggests, “by making sure all of their child’s caregivers are aware of the AAP’s advice regarding screen time.”

Co-authors were Chuan Zhou, PhD, Paula Lozano, MD, MPH, and Dimitri Christakis, MD, MPH.

Tips and resources for parents and caregivers include the following recommendations:

For babies:

  • Avoid TV for babies under age two. Choose activities that promote language development and brain growth such as talking, playing, reading, singing and enjoying music.

For children over age two:

  • If you allow TV time, choose age-appropriate programs. Involve older children in setting guidelines for what to watch. Use guides and ratings to help, but beware of unproven claims that programs or DVDs are educational. Even cartoons produced for children can be violent or over stimulating.
  • Limit TV time to no more than two hours per day. Less is better.
  • Keep TV off during meals.
  • Set “media-free” days, and plan other fun things to do.
  • Avoid using TV as a reward.
  • Turn off TV when a chosen program is over. When no one is actively watching, turn TV off.
  • Watch TV with your child. Talk about what you see and engage with your child about the content.
  • Keep TVs out of bedrooms.

Helpful websites include:;;;; and

About Seattle Children’s

Seattle Children’s Hospital, Foundation and Research Institute together deliver superior patient care, advance new discoveries and treatments through pediatric research, and raise funds to create better futures for patients. Consistently ranked as one of the top 10 children’s hospitals in the country by U.S. News & World Report, Seattle Children’s Hospital specializes in meeting the unique physical, emotional and developmental needs of children from infancy through young adulthood. Through the collaboration of physicians in nearly 60 pediatric subspecialties, Seattle Children’s Hospital provides inpatient, outpatient, diagnostic, surgical, rehabilitative, behavioral, and emergency and outreach services to families from around the world.

Located in downtown Seattle’s biotech corridor, Seattle Children’s Research Institute is pushing the boundaries of medical research to find cures for pediatric diseases and improve outcomes for children all over the world. Internationally recognized investigators and staff at the research institute are advancing new discoveries in cancer, genetics, immunology, pathology, infectious disease, injury prevention, bioethics and much more.

Seattle Children’s Hospital and Research Foundation and Seattle Children’s Hospital Guild Association work together to gather community support and raise funds for uncompensated care, clinical care and research. The foundation receives nearly 80,000 gifts each year, from lemonade stand proceeds to corporate sponsorships. Seattle Children’s Hospital Guild Association is the largest all-volunteer fundraising network for any hospital in the country, serving as the umbrella organization for 450 groups of people who turn an activity they love into a fundraiser. Support from the foundation and guild association makes it possible for Seattle Children’s care and research teams to improve the health and well-being of all kids.

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