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pie chart: CSHCN with more than one hour of screen time per weekday pie chart: Non-CSHCN with more than one hour of screen time per weekday pie chart: CSHCN with television in the bedroom pie chart: Non-CSHCN with television in the bedroom Bar graph: children who have a Television in their bedroom and watch two or more hours per week by poverty and CSHCN status

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Television and Media

The Bright Futures guidelines for infants, children, and adolescents recommend that parents limit children's screen time to 1-2 hours per day for children aged 1-5 years.1 Excessive screen time is linked to a variety of adverse health outcomes, including violent behavior, poor school performance, sleep pattern disturbances, overweight, and substance abuse later in life.2, 3, 4, 5

Parents of children aged 1-5 years were asked how many hours children spent watching TV or videos on weekdays. For children aged 6-17, the survey also asked if the child had a television in his or her bedroom. Children with special health care needs were slightly more likely than other children to watch more than one hour of television or videos per weekday, to have a television in their bedrooms, or both. This difference remained significant even after statistical adjustment for other differences between CSHCN and non-CSHCN.

Among children with and without special health care needs, children with the lowest household incomes are the most likely to have higher levels of screen time. Among CSHCN with household incomes below the Federal poverty level (FPL), 78.4 percent had a TV in their bedrooms or watched more than two hours of TV per weekday, or both; among CSHCN with household incomes of 400 percent or more of FPL, fewer than half (47.2 percent) did.

Children in certain racial and ethnic groups have greater exposure to television and videos as well. Among CSHCN, 81.4 percent of Black children and 74.1 percent of Hispanic children in English-speaking households had a TV in their bedrooms or watched more than two hours of TV per weekday or both, compared to 55.5 percent of White children (data not shown).

1 Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. Third edition. Elk Grove Village, IL: American Academy of Pediatrics. 2008.

2 Thompson, D. A., Christakis, D. The association between television viewing and irregular sleep schedules among children less than 3 years of age. Pediatrics. 2005;116(10):851-856.

3 Landhuis, E. C., Poulton, R., Welch, D., & Hancox R. J. Programming obesity and poor fitness: The long-term impact of childhood television. Obesity. 2008;16(6):1457-1459.

4 Johnson, J., Brook, J., Cohen, P., Kasen, S. Extensive television viewing and the development of attention and learning difficulties during adolescence. Arch Pediatr Adolesc Med. 2007;161(5):480-486.

5 Manganello, J.A., Taylor, C.A.Television exposure as a risk factor for aggressive behavior among 3 year-old children. Archives of Pediatrics & Adolescent Medicine. 2009;163(11):1037-1045.