Clinical Summary
Clinical Summary: Reducing Screen Time in Children With Borderline IQ: A Randomized Controlled Trial of a Parent-Mediated Screen Time Usage Module
Children with borderline IQ often have difficulty with self-regulation, behavior, and daily routines, making excessive screen use especially hard for families to manage. This trial tests whether a brief parent-mediated module can improve not only screen habits but also behavior, sleep, and physical activity in a group with little intervention research.
Design
A randomized controlled design was used to assess the effectiveness of a PM-STUM on selected outcomes in children with borderline IQ.
N
A total of 60 children were randomized to either arm with 30 children in each arm.
Population
children aged 4–12 years with borderline IQ
Duration
Data were collected at baseline and 6 weeks postintervention
Key Findings
- Screen time improved significantly with the parent-mediated module, with a significant interaction effect of group × time (F1,58 =51.346, P <.001), indicating a differential reduction in screen time in the intervention group compared to the control group.
- Behavioral difficulties improved markedly in the experimental group, with mean SDQ total difficulties scores decreasing from 20.00±4.48 to 11.97±2.77; RMANOVA showed a significant group×time interaction (F1,58 =21.092, P <.001).
- Sleep quality improved in the experimental group, with mean CSHQ sleep disturbance scores decreasing from 56.47 ±8.37 to 43.13±4.63; the group×time interaction was significant (F1,58 =18.270, P <.001).
- Physical activity increased in the experimental group, with mean PAQ scores rising from 2.05±0.39 to 2.49±0.28; the group ×time interaction was significant (F1,58 =27.246, P <.001).
- All participants completed the study and adhered to the assigned intervention protocol, so the intention-to-treat and per-protocol analyses were identical.
Clinical Bottom Line
A brief parent-mediated screen time module produced significant short-term improvements in screen time, behavioral difficulties, sleep quality, and physical activity in children aged 4–12 years with borderline IQ. For families struggling with screen-related routines in borderline intellectual functioning, structured parent coaching is a practical intervention to add to routine care.
Practice Implications
- In child and adolescent psychiatry practice, involve parents directly when addressing screen time in children with borderline IQ, because the intervention effect was strongest at the family-routine level rather than through child-only strategies.
- Monitor sleep even when screen habits improve: mean CSHQ scores fell from 56.47 ±8.37 to 43.13±4.63, and scores >41 were considered indicative of clinically significant sleep problems.
- Use behavior change targets that parents can implement at home, such as mealtime screen limits, replacement routines, rewards, and modeling, since parents reported these as common implementation challenges during the intervention.
- Reassess outcomes within 6 weeks after intervention, as this study detected significant changes over that interval in screen time, SDQ total difficulties, CSHQ sleep disturbance, and PAQ physical activity scores.
