The Impact of Adverse Childhood Experiences on Severity of Digital Media Use Among U.S. Children in Immigrant Households

Background and Purpose: The overuse of digital media among youth is a growing concern. While digital media offers positive benefits, excessive use can increase the risk of mental health challenges. Youth with Adverse Childhood Experiences (ACEs) are particularly vulnerable to this overuse. In addition, youth from immigrant households are less likely to have parental guidance when using digital media. Therefore, this study determined the prevalence of ACEs and examined the relationship between exposure to ACEs and the use of digital media among U. S. children.

Methods: The data for this study came from the 2023 National Survey of Children’s Health (n = 7746; children aged 6 to 17). The independent variable, which is adverse childhood experiences (ACEs), was assessed by combining nine domains (i.e., economic hardships, parental divorce, parental incarceration, parental death, household mental illness, household substance use, discrimination, witnessing domestic violence, and being a victim of violence, as reported by their parents. These were categorized into several ACE scores: 0 ACEs, 1 ACE, and 2 or more ACEs. The dependent variable was the severity of digital media use, which was assessed by asking whether a child used TV, cell phone, or computer during weekdays. This was recoded dichotomously as “lower “(if used for less than 2 hours) and “moderate-to-severe” (if used for 3-12 hours or more). Covariates included the child's sex, age, race, parental marital status, parental education, parental employment status, language spoken in the household, household poverty level, and residency status. Cross-tabulations (chi-square tests) were used to estimate weighted rates of ACEs and digital media use. Unadjusted and adjusted logistic regressions were performed to assess the association between ACEs and digital media use in children. Data analysis was conducted using SPSS vs. 29 (p< .05).

Results: Out of 7,746 children, 66.1% (n=5,084) were reported by their parents to have moderate-to-severe digital media use. Particularly, children with two or more ACEs (82.0%) and at least one ACE (76.0%) had higher prevalence of moderate-to-severe digital media use compared to those without ACEs (62.6%). In an unadjusted logistic regression model, children with at least one ACE (aOR=1.89, 95% CI=1.65–2.17, p<.001) and two or more ACEs (aOR=1.57, 95% CI = 1. 15–2. 16, p =. 005) were significantly associated with increased odds of moderate-to-severe digital media use compared to those without ACEs. Similarly, after adjusting for other factors in the model, children with at least one ACE (aOR =1.46, 95% CI=1.18–1.80, p<.001) and two or more ACEs (aOR=1.57, 95% CI=1.15–2.16, p< 0.001) were more likely to be reported as having moderate- to- severe digital media use compared to those without ACEs.

Conclusion: This study underscores the need for interventions to mitigate severe digital media use. Interventions should focus on early screening for ACEs and culturally sensitive support services to reduce children's reliance on digital media as a coping mechanism. Collaborating with schools, healthcare providers, and community organizations can help deliver these interventions effectively, aimed at preventing both ACEs and digital media overuse in children.