The longitudinal relationship between screen time, sleep and a diagnosis of Attention-Deficit/Hyperactivity Disorder in childhood

Birgit Levelink*, Marjolein van der Vlegel, Monique Mommers, Jessica Gubbels, Edward Dompeling, Frans J. M. Feron, Dorothea M. C. B. van Zeben-van der Aa, Petra Hurks, Carel Thijs

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: To evaluate longitudinal associations between recreational screen time and sleep in early childhood, and attention-deficit/hyperactivity disorder (ADHD) at age 8 to 10 years. Method: Questionnaires from 2,768 mother-child pairs from the Dutch KOALA Birth Cohort Study were used. General estimating equation logistic regression analyses examined associations between screen time and sleep at age 2, 4, and 6, and ADHD at age 8 to 10. Linear regression analysis examined associations between television time, sleep and CBCL/2-3 scores at age 2. Results: Longitudinally, neither screen time nor sleep were associated with ADHD. Cross-sectionally, CBCL/2-3 externalizing symptom scores increased by 0.03 with every hour television time (95% CI 0.002-0.05) and increased by 0.02 per hour of less sleep (95% CI -0.03--0.01). Conclusion: Despite an association with externalizing symptoms at age 2, screen time and sleep in early childhood were not associated with ADHD. Carefulness is warranted when extrapolating cross-sectional associations at early age to an ADHD diagnosis.

Original languageEnglish
Article number1087054720953897
Pages (from-to)2003-2013
Number of pages11
JournalJournal of Attention Disorders
Issue number14
Early online date13 Sept 2020
Publication statusPublished - Dec 2021


  • ADHD
  • child
  • television
  • digital media use
  • externalizing symptoms
  • sleep

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