Frequently Asked Questions

The parent-mediated screen time usage module significantly reduced screen time compared with routine care in children aged 40 years with borderline IQ. The between-group change over time was significant on repeated-measures analysis, with a groupd7time interaction of F1,58 = 51.346, P < .001, indicating a greater reduction in the intervention group than in the control group.

Yes. In the intervention group, behavioral difficulties improved significantly, with the Strengths and Difficulties Questionnaire total difficulties score decreasing from 20.00b14.48 to 11.97b12.77. This moved the group average from the abnormal range into the normal range, and the groupd7time interaction was significant (F1,58 = 21.092, P < .001).

Sleep quality improved significantly in the intervention group. Mean Child Sleep Habit Questionnaire sleep disturbance scores decreased from 56.47b18.37 at baseline to 43.13b14.63 postintervention, with a significant groupd7time interaction of F1,58 = 18.270, P < .001. Because the study used a cutoff of >41 for clinically significant sleep problems, the average postintervention score remained near the clinical threshold.

Yes. Physical activity increased significantly in the intervention group even though the module did not include a dedicated exercise component. Mean Physical Activity Questionnaire scores rose from 2.05b10.39 to 2.49b10.28, and the groupd7time interaction was significant (F1,58 = 27.246, P < .001), suggesting greater improvement than with routine care.

The intervention was a structured educational module delivered by a trained mental health professional to parents in group sessions. It comprised 4 sessions, was delivered in groups of 10 parents, and included booster sessions 3 weeks after the initial intervention to address implementation difficulties and provide tailored solutions. Outcomes were assessed at baseline and again 6 weeks after the intervention.

The trial enrolled 60 children aged 42 years with borderline intellectual functioning, with 30 randomized to the intervention group and 30 to routine care. Participants were recruited from a child and adolescent psychiatry outpatient department at a tertiary care hospital in North India. Children with autism spectrum disorder, attention-deficit/hyperactivity disorder, or chronic medical illness were excluded.

This was a randomized controlled trial with 1:1 allocation, block randomization, allocation concealment using sequentially numbered opaque sealed envelopes, and blinded outcome assessment. Participant and facilitator blinding was not feasible because of the nature of the intervention. All 60 participants completed the study and adhered to the assigned protocol, so the intention-to-treat and per-protocol analyses were identical.

Parents most commonly reported difficulty with children refusing to eat without screens, engaging children in household chores, limited parental familiarity with technology, and high parental mobile use related to work. The intervention addressed these problems with behavioral strategies such as replacing mealtime screens with a promised reward afterward, encouraging patience and consistency in building routines, and using positive reinforcement and parental role modeling. The authors reported that most parents considered the strategies feasible, although consistent use required persistence and support.

The main limitations were that the intervention was delivered online, so exact adherence to the prescribed guidelines could not be objectively monitored, and outcomes were measured only 6 weeks after the intervention. The short follow-up limited assessment of long-term behavioral change and also limited evaluation of physical activity effects on weight and body mass index. In addition, the module focused mainly on screen use and sleep-related behaviors and did not include explicit physical activity strategies, so improvements in activity may have been indirect.

Children with borderline intellectual functioning may be especially vulnerable to excessive screen exposure because they commonly have deficits in attention, self-regulation, behavior, and language, and they perform poorly on theory of mind assessments. The study was designed on the premise that parental involvement is critical in this group, because children with borderline IQ often struggle with consistency and self-regulation in daily routines.