Abstract
BACKGROUND: The rapid proliferation of smartphones and digital devices among children has raised concerns about potential neurobehavioral consequences. This study aimed to assess screen time usage patterns and their association with neurobehavioral problems among school-going children in West Bengal, India. MATERIAL AND METHODS: A cross-sectional observational study was conducted among 777 school-going children (270 preadolescents aged 6-9 years; 507 adolescents aged 10-18 years) from a cantonment town in West Bengal. Data were collected using structured questionnaires covering sociodemographic characteristics, screen time, and neurobehavioral assessment using the Child Behavior Checklist. Statistical analysis included Mann-Whitney U-test, Chi-square test, and Kruskal-Wallis test, with P < 0.05 considered significant. RESULTS: The median cumulative screen time was 7.0 h daily across both age groups, substantially exceeding recommended guidelines. Preadolescents showed significantly higher cumulative screen time (6.83 ± 2.11 vs. 6.44 ± 2.21 h, P = 0.016) and greater engagement in gaming activities (3.08 ± 1.32 vs. 2.50 ± 1.12 h, P < 0.001) compared to adolescents. Overall, 31.5% of children exhibited borderline-to-clinical range neurobehavioral problems, with attention problems being most prevalent (18.3%). Preadolescents demonstrated higher rates of total problems (37.8% vs. 28.2%, P = 0.003) and externalizing behaviors, while adolescents showed more social difficulties. Strong dose-response relationships were observed between recreational screen time and neurobehavioral problems across both age groups, with children having clinical range problems showing significantly higher gaming exposure. CONCLUSION: Excessive screen time is significantly associated with neurobehavioral problems in Indian children, with age-specific vulnerability patterns. These findings highlight an urgent need for evidence-based digital wellness guidelines and interventions to protect child mental health in the digital era.