Examining the Impact of Screen Time on Clinical Presentation and Symptom Severity in Children Diagnosed with Attention Deficit Hyperactivity Disorder: A Cross-sectional Study

Background: Long-term screen exposure negatively impacts children’s physical, psychosocial, and cognitive development. Studies reveal an association between prolonged media exposure, attention deficit hyperactivity disorder-related behaviors, and a heightened risk for the diagnosis. This study investigated the psychosocial and symptomatic impacts of screen time in children with attention deficit hyperactivity disorder. Methods: Children aged 6-18 years with attention deficit hyperactivity disorder recruited to the child and adolescent psychiatry outpatient clinic were included ( n = 215). A sociodemographic form including information on media usage and the Conners’ Parent Rating Scale were applied. Independent groups were compared using t -tests and analysis of variance, Mann–Whitney U -test, and Kruskal–Wallis H -test. Chi-squared analysis was used for categorical variables, and Spearman correlation was used for quantitative variables. Results: Average media exposure was 6.27 ± 2.89 h/day. No significant differences were observed based on gender or attention deficit hyperactivity disorder subtype. Lower maternal education was associated with decreased internet and computer use, whereas television viewing and smartphone use were similar across groups. Daily smartphone use was significantly associated with low paternal education and low academic achievement. A significant relationship was found between oppositional, inattention, and Clinical Global Impression scores and daily smartphone usage. Hyperactivity scores were significantly higher in patients who watched TV for more than 2 h/day. A weak but significant positive correlation was detected between hyperactivity and TV exposure as measured by the Conners’ Parent Rating Scale ( r = 0.165). A weak but significant positive correlation was also found between internet/computer use and both restless-impulsive ( r = 0.188) and emotional lability scores ( r = 0.219). Additionally, total media exposure showed a weak significant correlation with oppositional scores on the Conners’ Parent Rating Scale ( r = 0.189). Furthermore, attention deficit hyperactivity disorder-Combined type was significantly associated with longer media exposure. Conclusions: Increased media exposure may contribute to attention deficit hyperactivity disorder-related behaviors. Assessing media exposure across diverse sociocultural backgrounds is essential to promote healthier habits and enhancing well-being in children with ADHD.