According to Dr. Pooja Tandon, "A majority of children under the age of 5 years in the United States spend almost 40 hours a week with caregivers other than their parents, and it's important to understand what kind of screen time exposure children are getting with these other caregivers." Dr. Tandon and fellow researchers from the Seattle Children's Research Institute and the University of Washington studied nearly 9000 preschool-age children who took part in the Early Childhood Longitudinal Study -- Birth Cohort (ECLS-b), a longitudinal, observational study of over 10,000 children born in 2001 with diverse socioeconomic and ethnic backgrounds. The ECLS-b used interviews with parents and child care providers to collect data about each child's daily screen time.

On average, children were exposed to 4 hours of screen time each weekday, with 3.6 hours of exposure coming from home. Children in home-based child care spent a combined average of 5.6 hours watching television or videos at home and while at child care, with 87% exceeding the 2 hour recommendation. Center-based child care scored slightly better, with children watching an approximate total of 3.2 hours each weekday at home and while at child care. Children who did not go to child care also tended to exceed the recommendations, however, with the average child watching 4.4 hours a day.

Children enrolled in Head Start, a program for economically disadvantaged children, watched an average of 4.2 hours a day. However, very little of this time was accrued at the child care center. "Only 2% of the 4.2 hours occurred while the children were attending Head Start," Dr. Tandon explains, "with the rest of the exposure happening at home."

Television viewing in young children has been associated with speech delays, aggressive behavior, and obesity, but few states have regulations about screen time in licensed child care settings. Dr. Tandon believes that such regulations may be helpful in curbing screen time. "Parents can also play an important role," she suggests, "by making sure all of their child's caregivers are aware of the AAP's advice regarding screen time."

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