Association of Screen Time with Obesity, Behavioural Health Problems, and Academic Performance among Children Aged 8 to 18 Years: An Observational Study

Abstract

Background: Excessive screen exposure among children and adolescents has become increasingly common and may be associated with adverse physical, behavioural, and developmental outcomes. However, the relationship between screen time, obesity, behavioural health, and academic performance remains complex. This study evaluated these associations among children aged 8–18 years. Methods: A cross-sectional observational study was conducted among 1,000 children aged 8–18 years. Participants were categorized according to average daily screen time as ?2 hours/day or >2 hours/day. Sociodemographic information was collected, and anthropometric measurements were obtained to classify body mass index (BMI). Behavioural and emotional health was assessed using the Strengths and Difficulties Questionnaire (SDQ). Academic performance was categorized based on previous academic-year examination grades. Associations between screen-time category and BMI, behavioural health, and academic performance were assessed using the chi-square test. A p-value <0.05 was considered statistically significant. Results: Of the 1,000 children, 565 (56.5%) reported ?2 hours/day of screen time and 435 (43.5%) reported >2 hours/day. Screen-time category was not significantly associated with age, gender, socioeconomic status, parental working status, or family type. A highly significant association was observed between screen time and BMI category (?²=120.99, p<0.00001). The prevalence of obesity was substantially higher among children with >2 hours/day of screen exposure compared with those with ?2 hours/day (26.2% vs. 11.2%). Screen time was also significantly associated with behavioural health status (?²=94.39, p<0.00001). Substantial behavioural health risk was present in 37.9% of children with >2 hours/day compared with 18.6% of those with ?2 hours/day. In contrast, no significant association was observed between screen time and academic performance (?²=0.16, p=0.922). Poor academic performance was reported in 14.5% of children with >2 hours/day and 15.4% of those with ?2 hours/day. Conclusion: Screen exposure exceeding 2 hours/day was significantly associated with obesity and behavioural health problems among children aged 8–18 years. However, no significant association was observed with academic performance. These findings support the importance of monitoring excessive recreational screen exposure as part of strategies promoting healthy physical and behavioural development in children and adolescents. Longitudinal studies incorporating physical activity, dietary habits, sleep, and type of screen use are warranted to further clarify these relationships. Keywords: Screen time; children; adolescents; obesity; behavioural health; Strengths and Difficulties Questionnaire; academic performance; sedentary behaviour.