Impact of Screen Time and Occurrence of Autism Spectrum Disorder among Toddlers in Field Practice Area at Tertiary Care Medical College of Southern India: A Cross-sectional Study

Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with multiple causative factors and various symptoms, including impaired social communication, repetitive behaviour and restricted interests. It has a significant impact on early childhood, manifesting as poor schooling and social interaction, which later continues to hamper adult productivity. Increased screen time is one of the important predisposing factors for ASD in toddlers and there is a lack of studies regarding the screening of ASDs in Southern India, especially in rural areas. Aim: To evaluate the impact of screen time exposure on the occurrence of ASD in toddlers. Materials and Methods: This cross-sectional study was conducted from July 2022 to January 2024 in the Department of Paediatrics at Sri Siddhartha Medical College and Research Hospital, Tumkur, Karnataka, Southern India. A total of 600 toddlers aged between 16 and 30 months, visiting the Outpatient Department (OPD), camps, Anganwadi centres and Montessoris from urban and rural areas of Tumkur, were included, provided that informed consent was obtained from their parents. All were assessed using pretested questionnaires regarding screen media use and the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) questionnaire. The Chi-square test, Spearman’s rank correlation coefficient and Analysis of Variance (ANOVA) test were used for statistical analysis. Results: In total, 600 children from both urban and rural communities were assessed using the M-CHAT-R screening tool. Of these, six screened positive. Toddlers with positive screens (M-CHAT-R Score >2) had a significantly higher mean age (29.17±1.33 months) compared to those with negative screens (M-CHAT-R Score ≤2) (22.17±4.07 months), p-value <0.001. The gender distribution in the present study revealed a maleto-female ratio of 1.1:1. However, a significant gender disparity was observed among participants screening positive for ASD, with a male predominance (n=5, 0.83%) and a male-to-female ratio of 5:1 (p-value=0.07). A significant correlation between screen time and ASD was observed (r=0.124, p-value <0.001). Conclusion: Early intervention and education for parents/ caregivers should be provided to prevent harmful effects, as screen time is a predisposing factor in toddlers.