# Risk Factors for Excessive Screen Exposure in Children With Epilepsy: A Cross-Sectional Study in Assiut, Egypt

## TL;DR

This study found that children with epilepsy in Egypt who use screens before bed or have less educated parents are more likely to have excessive screen time, which could worsen their condition.

## Contribution

The study identifies modifiable risk factors for excessive screen exposure in children with epilepsy in a specific Egyptian population.

## Key findings

- Pre-sleep screen use and low parental education strongly predict excessive screen time in children with epilepsy.
- Male children and younger children (3-6 years) had higher screen exposure compared to their counterparts.
- Caregiver discussion of screen content significantly reduces the likelihood of excessive screen use.

## Abstract

Purpose: This study aimed to evaluate screen exposure patterns and identify modifiable risk factors in children with epilepsy to inform targeted interventions for this vulnerable population.

Methods: A cross-sectional study was conducted at two tertiary hospitals in Assiut, Egypt, between January and December 2024. A convenience sample of 200 children aged between three and 12 years with epilepsy was recruited. Caregivers completed structured questionnaires assessing screen time, device types, and parental regulation behaviors. Univariate analyses compared screen exposure durations, while multivariate logistic regression identified predictors of excessive screen use (>1 hour/day on school days or >2 hours/day on weekends).

Results: Children aged between three and six years had significantly higher screen time than those aged between six and 12 years (mean daily: 98 ± 25 minutes vs. 87 ± 21 minutes, p < 0.001). Male children exceeded screen limits more frequently than female children (p < 0.01). Our results revealed that pre-sleep screen use (adjusted odds ratio (AOR): 3.41; 95% CI: 1.89-6.16; p < 0.001) and low parental education level (AOR: 3.39; 95% CI: 1.98-5.82; p < 0.001) remained the strongest independent predictors of excessive screen use. Additionally, caregiver discussion of screen content was found to be a significant factor, with a lack of discussion increasing the likelihood of excessive screen use by over threefold (AOR: 3.11; 95% CI: 1.44-6.73; p = 0.004). Seizure duration >5 minutes also independently predicted excessive screen exposure (AOR: 3.07; 95% CI: 1.62-5.81; p = 0.001). Notably, variables such as family income, device ownership, and total seizure count did not reach statistical significance (p > 0.05).

Conclusions: The findings of this study underscore that excessive screen exposure in pediatric patients with epilepsy is independently associated with modifiable sociobehavioral and clinical factors, including pre-sleep screen use, caregiver engagement in screen content discussions, and parental educational attainment. Interventions focused on these factors may help reduce seizure triggers and enhance overall health outcomes.