Keywords: Screen overexposure, kid, prevention

Background:

Excessive screen time is associated with developmental, behavioral, and health risks in children. Despite growing concern, no validated tool currently exists in any language to identify screen overexposure in routine clinical practice.

Research questions:

To validate e-KID, a novel screening tool for detecting screen overexposure among children and adolescents aged 0 to 18 during primary care consultations.

Method:

This was a prospective, multicenter, cross-sectional validation study conducted between December 2023 and March 2024. A total of 439 children aged 0 to 18 years were recruited by 74 primary care physicians and 3 child health institutions in France. The tool was originally developed during a previous thesis through a systematic literature review and Delphi consensus process.

Results:

A threshold score of 6 out of 21 was identified as the optimal cutoff for screen overexposure, yielding a sensitivity of 96% and specificity of 74.1%. The tool’s total score correlated strongly with clinician assessment (AUC = 0.925; 95% CI, 0.899–0.951; p < .001). Age-specific thresholds were established, and weighted scoring was proposed for each age group. Professional participants rated the tool as easy to use, well integrated into clinical practice, and effective in initiating discussions with families. Known risk and protective factors (e.g., maternal education, screen rules, outdoor space) were confirmed.

Conclusions:

This study validates the first screening tool for screen overexposure in children, designed for use in everyday primary care settings. The tool meets a widely recognized clinical need and provides a practical method to support prevention, early detection, and family education in pediatric consultations. An online score is developed for practitioners

Points for discussion:

Develop this tool for follow up

Discussion on threshold

Discussion on age variations