Screen Time and Meeting Daily Health Recommendations in Children With and Without Autism

Objective To describe daily recreational screen time of 6-17-year-old children with and without autism and association of >2 hours screen time per day with the likelihood of meeting Centers for Disease Control and Prevention (CDC) recommendations of 1 hour/day physical activity, sleep 9-12 hours/night for ages 6-12 years, 8-10 hours/night for ages 13-17 years, and body mass index (BMI) <85%ile. Methods Secondary analysis of 2020 National Survey of Children's Health. Children were divided into 2 groups: autism and neurotypical. Parents reported 6-17-year-old children's weekday recreational screen time, physical activity, sleep duration, weight, and height. Variables were dichotomized: screen time ≤2 hours / screen time >2 hours and met / did not meet each CDC recommendation. Descriptive statistics, χ 2 , and logistic regression were used. Data were weighted and adjusted for complex sampling. Results Among 1030 children with autism and 24 205 neurotypical children aged ≥6 years, 68.6% vs 56.5% respectively had >2 hours of daily screen time ( P = .001). More 6-12-year-olds with autism viewed >2 hours screen time daily (62.9% vs 48.0%, P < .001), but adolescents in the 2 groups did not differ. Those with autism and >2 hours screen time/weekday less often met CDC daily physical activity recommendation (16.2% vs 29.8%, P = .004), but this relationship held only among adolescents (11.0% vs 27.8%, P = .009). Among those 6–12 years old, with autism, screen time >2 hours/day was associated with a lower percentage with BMI ≥85%ile (22.2% vs 43.9%, P = .035). The autism group had no significant differences in sleep duration. In contrast, screen time >2 hours/day is associated with not meeting any of the guidelines among neurotypical children. Conclusion These findings may have implications for counseling on realistic screen time habits.