RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1 Name of the candidate and address NASIR AI DAR
1st Year M Sc. Nursing,
Sofia College of Nursing,
Bangalore — 560064
2 Name of the institution Sofia College Of Nursing
3 Course of study and subject M Sc. Nursing,
Child Health Nursing
4 Date of admission to the course 10/10/2024
5 Title of the topic “A study to assess the impact of mobile screen
time on the cognitive development of children in
selected school, Bangalore. ”
1
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
The term “screen time” is commonly used to describe time spent on screen-based
activities like watching television, using a computer, or playing video games.1 India has emerged as
the second-largest internet user base in the world, largely fueled by increasing smartphone usage.
According to a Local Circles survey, nearly 40% of Indian households report that their children
begin using smartphones by the age of eight. While this early exposure brings connectivity benefits,
it also raises growing concerns regarding its potential effects on children’s brain development.2
The growing availability and use of digital devices—such as smartphones, tablets, and
computers—have led to a notable increase in screen-based activities among children. This trend has
sparked concern about its potential influence on children’s mental well-being. Since mental health
plays a critical role in a child’s overall growth and development, it becomes essential to explore
how screen exposure may shape mental health outcomes and to design targeted strategies to address
these effects.3
Over the last twenty years, the amount of time children spend on screens—such as
watching television or playing digital games—has significantly increased. Today, screens are a
constant part of daily life, easily accessible and often used for entertainment. While screen use can
support learning through educational content, excessive use has been associated with several
developmental concerns. These include issues like obesity, behavioral challenges, difficulty
managing emotions, speech delays, poor academic performance, and reduced problem-solving
skills. Extended screen exposure can also take away from physical playtime, reduce family and peer
interaction, and negatively affect sleep habits. Some studies indicate that children from lower-
income families may be especially vulnerable to these negative effects.4
2
Leading health organizations such as the American Academy of Pediatrics (AAP),
Canadian Pediatric Society (CPS), and Australian Department of Health (ADH) recommend that
young people should limit their screen time to no more than two hours a day. However, studies
show that a large proportion of adolescents—around 70 to 80 percent—go beyond these suggested
limits. On average, they spend nearly four hours daily on recreational screen use, which is
concerning given the long-term health risks associated with a sedentary lifestyle, including both
physical and mental health issues.5
6.1 NEED FOR THE STUDY
In recent years, mobile screen exposure among children has significantly increased,
coinciding with reports of decreased attention spans, poor academic performance, and behavioral
issues. However, many studies have broadly referred to “cognitive decline” without objectively
measuring specific functions like attention or memory. This lack of structured assessment creates a
gap in understanding the exact nature of the cognitive impact of screen time. Hence, there is a need
for studies that correlate mobile use with specific cognitive functions through measurable tools.6
Although parental reports have suggested that mobile phone use can negatively affect learning and
concentration, most studies rely on subjective reporting and do not include cognitive testing like
Raven’s Progressive Matrices or Digit Span Tests to establish evidence-based correlations. This
limits the accuracy of results and highlights the need for cross-sectional studies that use
psychometric tools to evaluate the effect of screen time on working memory, reasoning ability, and
attention span.7
Research has also shown a correlation between increased screen time and physical
inactivity, reduced sleep, and behavioral disturbances. However, the specific cognitive mechanisms
affected by these physical issues remain unexplored. For example, whether reduced sleep caused by
mobile overuse affects working memory or attention span is rarely measured using structured tools
in children aged 11-15 years. This creates a gap that cross-sectional cognitive testing can address.8
3
Furthermore, very few Indian studies have used culturally neutral tools like Raven’s
Coloured Progressive Matrices or the Digit Span Test in a school setting to assess cognitive ability
in relation to mobile screen exposure. The absence of such studies in the Indian context creates a
strong need for region-specific evidence that can guide parents and school systems.9
The author emphasized that children from disadvantaged backgrounds were
disproportionately affected due to a lack of access to safe play environments. Peckham called for
mindful screen use, encouraging interactive engagement and real-world connections to counteract
the developmental risks of passive screen consumption. Hence researcher found feasable to do this
study and it enhances the knowledge of the students.
6.2 REVIEW OF LITERATURE
“A literature review is an evaluative report of information found in the literature related
to selected area of study. The review describes, summarizes, evaluates and clarifies this literature. It
gives a theoretical base for the research and helps to determine the nature of research.”10
A cross-sectional study was conducted in 2024 to evaluate the effects of screen time on
children's mental health. The most common complications were emotional symptoms associated
with prolonged screen exposure. The study sample consisted of 670 children aged 6 to 14 who were
selected using stratified random sampling in Saudi Arabia and Bahrain. Screen time habits and
emotional symptoms were assessed through self-reported questionnaires and parental surveys. The
results indicated that children spent an average of 7.25 hours on screens during weekdays and 8.4
hours on weekends, with smartphone use averaging 2.75 hours daily. A positive correlation was
observed between screen time and emotional symptoms (weekday r = 0.43, weekend r = 0.47). The
study concluded that excessive screen time negatively impacts children's mental health and
emphasized the need for public health measures and parental guidance to regulate digital habits.11
4
A cross-sectional study conducted in 2021 in Xiangcheng, China, explored the link
between screen time and gross motor development in 817 left-behind children aged 3 to 6 years.
Using randomized whole-group sampling from 15 kindergartens, the researchers assessed motor
skills with the Test of Gross Motor Development–Third Edition (TGMD-3) and collected screen
time data through a structured questionnaire. The results showed children averaged 1.9 hours of
screen use on weekdays and 2.1 hours on weekends, with 22.43% to 33.73% exceeding the
recommended daily limit of 2 hours. A low to moderate negative correlation was found between
screen time and gross motor scores (weekday r = -0.354; weekend r = -0.133), and regression
analysis indicated screen time explained 21.4% of the variance in motor development. The study
concluded that higher screen use was associated with poorer gross motor skills and called for
increased physical activity and reduced screen time among left-behind children.12
A descriptive review highlighted that, in recent years, children have been spending
significantly more time on screens than earlier generations, primarily due to the rapid growth of
digital media and technology. This shift has raised concerns among parents and health professionals
about the potential consequences on children’s overall development. Multiple studies have
established a strong association between excessive screen time and various negative outcomes, such
as emotional dysregulation, increased signs of attention-related difficulties, and weakened parent-
child bonding, which are essential for a child’s emotional and social growth. Moreover, it was
observed that even background screen noise, like that from a television, could interfere with critical
caregiver-child interactions. Such interruptions often reduce opportunities for play, a fundamental
aspect of healthy childhood development. Nevertheless, the study emphasized that strategic and
mindful screen use—such as implementing a family media plan—can help mitigate risks and
promote positive developmental outcomes.13
A 2023 integrative review examined the impact of excessive screen time on children’s
development, analyzing studies from 2010 to 2022 across countries like the U.S., Canada, Spain,
and Hispanic populations. The review included long-term follow-ups and cross-sectional studies
involving children from infancy to 16 years. It found that high screen time, especially with multiple
devices, was linked to poorer cognitive abilities and academic performance. A Quebec study
5
showed that an extra hour of TV at age two led to a 7% drop in classroom participation and a 6%
decrease in math scores. Over 2-3 hours of screen time per day was associated with smaller
vocabularies. Emotional issues, such as anxiety and depression, were also linked to excessive screen
use. The study concluded that excessive screen time affects cognitive, language, and emotional
development, recommending age-based screen time limits and more research.14
A cross-sectional study conducted in 2016–2017 in Barcelona, Spain, explored how
mobile phone screen exposure affects cognitive health in adolescents. The study involved 632
participants with an average age of 13.89 years. Self-reported questionnaires and computer-based
neuropsychological tests were used to evaluate cognitive functions. The results showed that
adolescents using their phones for 9–20 minutes per day had a 14.9-millisecond increase in hit
reaction time standard error (HRT-SE), indicating reduced attention. Those in the highest usage
group (more than 20 minutes per day) had an 11.1-millisecond rise in HRT-SE compared to the
lowest usage group (less than 9 minutes per day). No clear association was found between screen
time and working memory or fluid intelligence scores. The study concluded that even short mobile
phone use could negatively affect attention in adolescents, recommending a reassessment of screen
time guidelines and public health initiatives.15
A cross-sectional observational study in 2023–2024 at a pediatric outpatient clinic in
Mahbubabad examined the impact of screen time on cognitive development in 100 children aged 6
months to 5 years. Using parent-reported data and the Ages and Stages Questionnaire, Third Edition
(ASQ-3), the study assessed five developmental domains. Findings showed 20% had no screen
exposure, 35% had ≤1 hour/day, 25% had 1–2 hours, and 20% had >2 hours/day. About 80% of
screen time was passive; 20% was interactive. Children with >2 hours/day of screen exposure had a
45% prevalence of developmental delays, especially in problem-solving (60%) and communication
(50%), and were 2.8 times more likely to experience delays. Passive screen users scored lower in
communication than interactive users. The study concluded that excessive, passive screen time
negatively affects cognitive development, while interactive use with caregiver involvement
mitigates this impact. It recommended limiting screen time to <1 hour/day.16
6
A cross-sectional study conducted in 2024 analyzed national data collected across the
United States from 2018 to 2021 to explore how screen time patterns were related to the
psychological well-being of school-aged children, particularly during the COVID-19 pandemic. The
study used data from the National Survey of Children’s Health (NSCH), which included 88,823
children aged 6 to 17 years, following a repeated cross-sectional design with yearly samples. Screen
time data were reported by parents, focusing on recreational use, while mental health was assessed
through various well-being indicators. The study found that children spending four or more hours
per day on screens were significantly more likely to experience emotional and behavioral
difficulties, especially during the peak pandemic years of 2020 and 2021. The study concluded by
emphasizing the urgent need for practical screen time guidelines and encouraged families,
educators, and policymakers to implement strategies to promote healthier digital habits for
children.17
A review article published in 2023 in the International Journal of Contemporary
Pediatrics by Goswami and Parekh explored how prolonged screen use influences various aspects
of child and adolescent development. The review examined 27 studies published over the last
decade, focusing on developmental outcomes related to cognition, social-emotional skills, and
physical health, using data from PubMed and Scopus. It found that excessive screen time caused
issues like poor concentration, delayed memory and language skills, anxiety, aggression, sleep
problems, and increased obesity risk. Although some educational content showed benefits, the
review emphasized that unregulated screen use often did more harm than good. The study
concluded that parents, teachers, and healthcare providers must take a more active role in managing
screen time to support healthy development.18
A report updated in 2023 by the Canadian Pediatric Society, led by Michelle Ponti,
reviewed how screen time affects children under 5, based on studies and expert opinions from
Canada, the U.S., and Europe. The report, which incorporated research from 2021, did not specify a
sample size but included various groups, such as Canadian children aged 3-4 and U.S. children
under 3. It found that nearly every Canadian child uses screens by age 2, but only 15% of 3- to 4-
year-olds adhere to the recommended limit of less than 1 hour of screen time daily, with an average
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of 1.9 hours pre-pandemic. In the U.S., 90% of children under 1 use screens, 60% of children under
3 use touchscreens daily, and 39% of parents leave the TV on most of the time. The study concluded
that excessive screen time harms development, leading to issues like language delays, behavior
problems, and sleep disturbances. However, watching quality content with parents improved
literacy. It recommended limiting screen time to 1 hour per day for children aged 2 to 5,
encouraging co-viewing, creating family media plans, and modeling healthy screen habits.19
A review carried out from January 2017 to July 2023 by Nikos Priftis and
Demosthenes Panagiotakos explored how excessive screen time affects the health of children and
adolescents across Greece, Canada, Sweden, Brazil, and Taiwan. The review analyzed 43 original
studies, including 29 cross-sectional, 10 longitudinal (one blending both methods), 3 case-control,
and 2 randomized crossover clinical trials, along with 10 meta-analyses, 10 reviews, one position
statement, and a meta-synthesis. The study found that excessive screen time increased obesity risk
by 13% per additional hour, along with a higher chance of heart-related issues, depression in girls,
mental health problems like Attention-Deficit/Hyperactivity Disorder (ADHD), poor eating habits,
developmental delays, disrupted sleep, reduced physical activity, and eye and musculoskeletal
problems. The study concluded that too much screen time harms young people’s health but
emphasized the need for further research. It recommended that doctors guide parents on screen time
risks and encourage adherence to WHO guidelines.20
In an opinion piece published in The Guardian in 2025, early childhood expert
Kathryn Peckham discussed the negative impact of excessive screen exposure on young children’s
readiness for school. Drawing from her professional experience and research, Peckham highlighted
that many children now enter school lacking basic physical and social skills, such as sitting
properly, holding a pencil, and forming peer relationships. While the pandemic worsened these
developmental delays, she noted that the reliance on smartphones and reduced outdoor play had
already contributed to these issues. Peckham pointed to studies showing weakened muscle
development , delayed language, and diminished social bonds due to limited physical activity and
decreased adult-child interaction.21
8
A study conducted in the Global Health Research and Policy journal. analyzed screen
time among children aged 6 to 14 years. The review included 53 studies conducted between 2016
and 2021, with a total sample size exceeding 470,000 children from various global regions. The
study conducted a systematic search through databases, focusing on both the types and duration of
screen use. The results indicated that the average screen time was over 2.77 hours per day, with
nearly half of the children exceeding the recommended 2-hour limit. The study found that screen
time usage, particularly surpassing the 2-hour threshold, increased post-COVID-19, rising from
41.3% to 59.4%. Children primarily used devices such as phones, tablets, and computers for
recreational purposes, including TV and online interactions. The study concluded that excessive
screen time was becoming more prevalent and should be addressed through tailored policies that
consider how children engage with screens.22
6.3 STATEMENT OF THE PROBLEM
“A CROSS-SECTIONAL CORRELATIONAL STUDY TO ASSESS THE IMPACT OF MOBILE
SCREEN TIME ON COGNITIVE DEVELOPMENT OF CHILDREN IN SELECTED SCHOOLS
IN BANGALORE.”
6.4 OBJECTIVES
1. To assess the relationship between the type of mobile screen content and cognitive abilities.
2. To evaluate the impact of different types of mobile screen content.
3. To compare the cognitive performance of children with varying amounts of mobile screen
exposure.
6.5 OPERATIONAL DEFINITIONS
Cross-Sectional Correlational Study: A cross-sectional correlational study gathers data at one
point in time to examine the relationship between variables.
Assess: Assess means to carefully observe, measure, and understand how mobile screen time is
linked to children’s mental and physical growth using specific tools and a structured approach.
9
Impact: Impact refers to the kind of effect—positive, negative, or neutral—that mobile screen time
may have on children’s ability to think, remember, pay attention, and develop physically.
Mobile Screen Time: Mobile screen time refers to the total time children spend using mobile
phones.
Cognitive Development: Cognitive development includes how a child thinks, solves problems,
pays attention, and remembers things. In this study, it specifically refers to areas such as attention
span, memory, and reasoning ability.
Children: Children in this study are students studying in grades 5 to 7, generally aged between 11
and 15 years.
School: A structured educational institution where children receive formal instruction and cognitive
stimulation appropriate to their age and developmental level.
6.6 HYPOTHESIS
H1: There is a significant relationship between the duration and type of mobile screen time and the
cognitive and physical development of school-aged children.
H2: There will be significant relationship between duration and type of mobile screen time and
cognitive development with selected social demographic variables.
6.7 ASSUMPTION
1. There is an underlying relationship between the duration of mobile screen exposure and the
level of cognitive functioning in children.
2. Different types of mobile screen content have distinct associations with children’s cognitive
abilities.
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6.8 DELIMITATION
1. The research focuses solely on mobile screen time; other types of screen exposure such as
television, laptops, or gaming consoles are not considered.
2. The study uses a cross-sectional correlational design, so it does not track developmental
changes over time or establish direct causation.
3. Data regarding screen time and development are collected through standardized tools and
structured questionnaires, which rely on self-reporting by children.
4. This study is limited to school children studying in 6th, 7th and 8th standard.
6.9 PROJECTED OUTCOME
The study is expected to identify a correlation between mobile screen time and specific cognitive
functions such as attention, memory, and reasoning abilities in children. It may reveal that increased
screen time negatively affects cognitive development. The findings can help in designing guidelines
for safe screen use among children and assist parents, teachers, and healthcare professionals in
promoting healthier digital habits. The study could also contribute to the body of research on
pediatric cognitive health in the Indian context, encouraging further exploration and interventions in
this area.
7.0 METHODS AND MATERIALS
7.1 Sources of Data
The data for this study were collected from school-aged children studying in selected English-
medium schools in Bangalore. Responses were gathered using structured tools from children,
depending on the component being assessed.
Research Approach
A evaluative approach was used to measure and analyze the relationship between mobile screen
time and children’s cognitive and physical development.
Research Design
A cross-sectional correlational design was adopted to assess the association between screen time
variables (duration and content type) and developmental outcomes at a single point in time.
11
Setting of the Study
The Study Was Conducted in Selected Schools Located Within the Urban Limits of Bangalore,
Karnataka, Based on Administrative Approval and Accessibility.
Sample Size
The Sample Consisted of 60 Children, With 20 Participants Each From 5th, 6th, and 7th Grades. A
Stratified Sampling Method Was Used To Ensure Age-Wise Representation, Facilitating
Comparison Across Developmental Stages.
Sample Method
Stratified Random Sampling Method.
7.2 METHODS OF DATA COLLECTION
Data will be collected using standardized tools and structured questionnaires. The collection process
will take place within the school setting through direct administration of tests to children and
distribution of questionnaires to children's. Prior informed consent and necessary permissions will
be obtained.
Tools for Data Collection
Structured Questionnaire
Raven’s Progressive Matrices (SPM)
Digit Span Test (Forward and Backward – WISC Subtest)
7.2a SELECTED VARIABLES
Independent Variables
Duration of Mobile Screen Time
Type of Screen Content
Context of Screen Use
Dependent Variables
Cognitive Development
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Attention Span
Standardized Tools
Demographic Variables
Age, Gender, Grade
Parental Education and Occupation
Previous Knowledge About the Topic
7.2b SAMPLING CRITERIA
Inclusion Criteria
Children studying in 5th, 6th, or 7th standard.
Children who are willing to participate.
Children who are available during the study.
Exclusion Criteria
Children not available during the study.
Teachers and office staff.
Children not willing to participate.
7.2c METHODS OF DATA ANALYSIS
The collected data will be organized, coded, and analyzed using descriptive and inferential
statistical techniques:
Descriptive statistics such as frequency, percentage, mean, and standard deviation will be used to
summarize demographic variables and overall scores on cognitive and physical development.
Inferential statistics such as Pearson’s correlation coefficient and chi square will be applied to
determine the relationship between screen time and cognitive and physical development outcomes.
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7.2d DURATION OF THE STUDY
The data collection for this study will be conducted over a period of six weeks, which includes
obtaining permissions, participant briefing, administration of tools, and gathering responses from
parents, teachers, and students.
7.3 DOES THIS STUDY REQUIRE ANY INVESTIGATION OR INTERVENTIONS
TO BE CONDUCTED ON PARENT OR OTHER HUMANS OR ANIMALS
No investigation or intervention will be conducted on samples. Parents may be involved only for
obtaining consent and providing background information but will not be direct subjects of the study.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED?
Yes, ethical clearance has been obtained from the Institutional Ethics Committee (IEC). The study
will be conducted in accordance with ethical standards for research involving human subjects,
including informed consent and confidentiality.
8. REFERENCES
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Medicine; 2023 [cited 2025 Apr 7]. Available from: [Link]
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Pune (IN): Dr. D. Y. Patil Vidyapeeth; [date unknown] [cited 2025 Apr 7]. Available from: https://
[Link]/blogs/smartphone-effects-child-development-india
3. Mulla W, Ahmed W, Radhi M, et al. Exploring screen time and its effects on children’s mental
health: a cross-sectional study. Cureus [Internet]. 2024 Oct 10 [cited 2025 Apr 9];16(10):e71215.
Available from: [Link]
14
4. Kerai S, Almas A, et al. Screen time and developmental health: results from an early childhood
study in Canada. BMC Public Health [Internet]. 2022 [cited 2025 Apr 9];22:310. Available from:
[Link]
5. Poujol MC, Pinar-Martí A, et al. Impact of mobile phone screen exposure on adolescents’
cognitive health. Int J Environ Res Public Health [Internet]. 2022 [cited 2025 Apr 9];19(19):12070.
Available from: [Link]
6. Poujol MC, Pinar-Martí A, et al. Impact of mobile phone screen exposure on adolescents’
cognitive health. Int J Environ Res Public Health [Internet]. 2022 [cited 2025 Apr 9];19(19):12070.
Available from: [Link]
7. Kerai S, Almas A, et al. Screen time and developmental health: results from an early childhood
study in Canada. BMC Public Health [Internet]. 2022 [cited 2025 Apr 9];22:310. Available from:
[Link]
8. Mulla W, Ahmed W, Radhi M, et al. Exploring screen time and its effects on children’s mental
health: a cross-sectional study. Cureus [Internet]. 2024 Oct 10 [cited 2025 Apr 9];16(10):e71215.
Available from: [Link]
9. Wu HT, Li J, Tsurumi A. Change in screen time and overuse, and their association with
psychological well-being among US-wide school-age children during the COVID-19 pandemic:
analysis of the National Survey of Children’s Health (NSCH) years 2018–21. Child Adolesc
Psychiatry Ment Health. 2024;18:9. Available from: [Link]
10. Sharma SK. Nursing Research and Statistics. 3rd ed. New Delhi: Elsevier; 201
11. Mulla W, Ahmed W, Radhi M, et al. Exploring screen time and its effects on children’s mental
health: a cross-sectional study. Cureus [Internet]. 2024 Oct 10 [cited 2025 Apr 9];16(10):e71215.
Available from: [Link]
15
12. Yuan R, Zhang J, et al. The relationship between screen time and gross motor movement: A
cross-sectional study of pre-school aged left-behind children in China. PLoS One [Internet]. 2024
Apr 5 [cited 2025 Apr 9];19(4):e0296862. Available from: [Link]
articles/PMC10997071
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updated review and strategies for management. Cureus. 2023 Jun 18;15(6):e40608. Available from:
[Link]
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Cognitive Health. Int J Environ Res Public Health. 2022;19(19):12070. Available from: https://
[Link]/10.3390/ijerph191912070
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under five years: a critical analysis. Int J Acad Med Pharm. 2024;6(6):635–640. Available from:
[Link]
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psychological well-being among US-wide school-age children during the COVID-19 pandemic:
analysis of the National Survey of Children’s Health (NSCH) years 2018–21. Child Adolesc
Psychiatry Ment Health. 2024;18:9. Available from: [Link]
16
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[Link]/ijcp/article/view/5550
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21. Peckham K. Children are starting school unable to sit up or hold a pencil – and I know the
culprit. The Guardian [Internet]. 2025 Feb 18 [cited 2025 Apr 21]; Available from: https://
[Link]/commentisfree/2025/feb/18/children-school-screen-time-early-years-
specialist-smartphones-physical-activity
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Glob Health Res Policy. 2023;8:12. Available from: [Link]
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9 SIGNATURE OF THE CANDIDATE
This study is feasible and is according to
10 REMARKS OF THE GUIDE
genuine interest of the students.
11 NAME AND DESIGNATION
11.1 GUIDE
11.2 SIGNATURE
11.3 HEAD OF THE DEPARTMENT
11.4 SIGNATURE
12 REMARKS OF THE PRINCIPAL
12.1 SIGNATURE
18
