Understanding Problematic Media Use in Children and Youth with ADHD, Early Neurological Risk and a Community Sample: Exploring Parental Cognitions and Perspectives

While children at risk of attention difficulties, such as those with ADHD or early neurological risk, are recognized as more susceptible to problematic media use (PMU), less emphasis has been placed on understanding these vulnerable groups. Current theories of PMU draw from a psychopathology framework, aiming to distinguish normal variation from pathological behaviour. Measures like the Problematic Media Use Measure (PMUM) predict children's challenges over and above the amount of screen time. In light of the current literature, parent perspectives, grounded in a theoretical framework of developmental psychopathology, were used to explore the following interrelated research questions: (1) How do attention difficulties interface with PMU and how do these interactions manifest across various developmental stages? (2) How do parents understand PMU when asked to consider their child's perspective? Two studies were conducted. In Study 1, three samples of parents with children aged 6-18 were collected: community (N=386), ADHD (N=66) and early neurological risk (N=65) samples. The purpose of Study 1a was to evaluate PMUM factor structure across ages and compare PMU across samples. Parents also completed an adapted version of the PMUM with questions from their child’s perspective to explore discrepancies between parents’ own perspective and what they thought their child would report (Study 1b). In Study 2, interviews were conducted with a subset of parents in the ADHD sample. The ADHD sample showed higher levels of PMU and experienced more negative outcomes related to screens than the other samples. Parents fell into four groups based on 1) whether a discrepancy in perspective was reported and 2) the level of parent-reported problems (high or low PMU), with most parents reporting no discrepancy. Similar patterns were observed in the early neurological risk sample, while parents in the ADHD sample mainly fell into groups with high PMU, without or without discrepancy. In Study Two, thematic analysis revealed that children with ADHD face unique challenges with screen use and parents may not fully consider their child’s perspective with respect to PMU. Clinical implications and future research directions are discussed with respect to the utility of understanding parent cognitions about their child’s screen use.