Mediating effect of family nurturing environment on the association between early screen exposure and autism spectrum disorder-like behavior in high-risk children

HU Zhouming; LI Peipei; HUANG Xiaoman; JIN Lan; GAO Mingjuan; GE Jie; XU Yuxiang; SUN Yu

doi:10.11852/zgetbjzz2025-1106

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (3) : 284-289. DOI: 10.11852/zgetbjzz2025-1106

olumn on Autism Spectrum Disorder in Children

Mediating effect of family nurturing environment on the association between early screen exposure and autism spectrum disorder-like behavior in high-risk children

HU Zhouming¹, LI Peipei², HUANG Xiaoman², JIN Lan², GAO Mingjuan², GE Jie², XU Yuxiang³, SUN Yu^1,2

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Abstract

Objective To explore the association between early screen exposure and autism spectrum disorder (ASD)-like behavior in high-risk toddlers, and to examine the mediating role of the family nurturing environment, so as to provide evidence for early intervention of ASD-like behavior. Methods A total of 377 high-risk toddlers aged 18 to 35 months, who underwent re-screening at the Hefei Women and Children′s Health Center from January to December 2024, were enrolled.Data on basic information and screen exposure were collected via questionnaires.ASD-like behavior was assessed using the Autism Behavior Checklist (ABC), and the family nurturing environment was evaluated using the 1-3 Year Old Children′s Family Nurturing Environment Questionnaire (Urban Version).Logistic regression was used to analyze the association between screen exposure and ASD-like behavior.The mediating effect of the family nurturing environment was tested using Structural Equation Modeling (SEM). Results Among the 377 high-risk toddlers, 96 (25.5%) exhibited ASD-like behavior, and 182 (48.3%) had high screen exposure.The average total score of the Family Nurturing Environment Scale is (131±19.63).Compared with children without ASD-like behavior, those with ASD-like behavior had a significantly higher rate of high screen exposure and lower scores in the social adaptation/self-care dimension of the family nurturing environment (both P<0.05).Logistic regression analysis showed that high screen exposure was a risk factor for ASD-like behavior (OR=1.710, 95%CI: 1.055 - 2.771, P=0.029).Mediation analysis revealed that the social adaptation/self-care dimension of the family nurturing environment played a full mediating role between screen exposure and ASD-like behavior (significant indirect effect, 95%CI: 0.001 - 0.042). Conclusions The social adaptation/self-care dimension of the family nurturing environment fully mediates the relationship between early screen exposure and ASD-like behavior in high-risk toddlers.Optimizing the family nurturing environment, particularly enhancing the quality of parenting in the social adaptation/self-care dimension, may help alleviate the adverse effects of screen exposure on ASD-like behavior in young children.

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screen exposure / family nurturing environment / autism spectrum disorder like behavior / mediation effect / infant

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HU Zhouming, LI Peipei, HUANG Xiaoman, JIN Lan, GAO Mingjuan, GE Jie, XU Yuxiang, SUN Yu. Mediating effect of family nurturing environment on the association between early screen exposure and autism spectrum disorder-like behavior in high-risk children[J]. Chinese Journal of Child Health Care. 2026, 34(3): 284-289 https://doi.org/10.11852/zgetbjzz2025-1106

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