Journal Article Reviews.

Academic Performance, Screen Media Use Adelantado-Renau M, Molinder-Urdiales D, CaveroRedondo I, et al. Association between screen media use and academic performance among children and adolescents. JAMA Pediatr. 2019;173:1058–1067. The literature has shown mixed results in the evaluation of the association between screen media use and academic performance. This study seeks to examine the association between time spent on screen-based activities and specific academic performance areas. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane handbook. The search strategy was performed through multiple databases from their inception through September 2018. Inclusion criteria were studies with the following characteristics: (1) participants who were 4 to 18 years of age or primary, elementary, and secondary school students; (2) exposure was usage time or frequency of screen-based activities; (3) outcomes analyzed as academic performance recorded as school grades, standardized test, or other measurements, including school performance or academic failure; (4) study design was cross sectional; and (5) language of articles in English or Spanish. Articles excluded were those not reporting findings concerning the association between time or frequency of screen media use and academic performance, and studies that included toddlers or participants with disorders that could limit generalization of data. Of 5599 records identified, 58 cross-sectional studies met the inclusion criteria, and 30 (52%) were included in the meta-analysis. There were a total of 106,653 total participants (ranging from 70 to 42,041 people per study). The pooled effect size estimate did not find an association between overall screen media time/frequency and composite scores on academic performance {pooled estimated effect size [ES]20.29 (95% confidence interval [CI],20.65 to 0.08)}. Television viewing and academic performance areas were inversely associated (pooled ES 20.19 (95% CI,20.29 to 20.09) for composite academic performance scores, 20.18 [95% CI, 20.36 to 20.01] for language scores, and 20.25 [95% CI, 20.33 to 20.16] for math). This was also true for association between the duration of video game time and composite scores (pooled ES 20.15 (95% CI, 20.22 to 20.08). Subgroup analyses conducted in children (between 4 and 11.9 years) and adolescents demonstrated that in children, television watching duration was inversely associated with language (ES 20.20; 95% CI, 20.26 to 20.15) and math (ES 20.36; 95% CI, 20.66 to 20.07) while in adolescents, the duration of television watching was inversely associated with composite scores (ES 20.19; 95% CI, 20.30 to 20.07) and math (ES 20.21; 95% CI, 20.26 to 20.15). Video game playing duration was also inversely associated with composite scores of adolescents only (ES 20.16; 95% CI, 20.24 to 20.09). Although there was a lack of association between the amount of time on overall screen media use and academic performance, specific screen-based activities such as television viewing and video game playing were found to have inverse associations with academic performance. J.K.P.