The Role of Screentime and Family Resiliency in Overweight/Obesity in Children and Children with Developmental Disabilities Before and During COVID-19

Highlights: What are the main findings? Prevalence of all children and children with developmental disabilities identified as overweight/obese reporting ≥4 h of screentime use increased from pre-COVID-19 to during COVID-19 years. Among all children, screentime was positively associated with overweight/obesity both before and during COVID-19, and associations with family resilience varied by resilience level and pandemic timepoint. For children with developmental disabilities, screentime associations and family resiliency were generally weaker across both pre- and during COVID-19. What are the implications of the main findings? The rise in the proportion of children and children with developmental disabilities spending more than 4 h on screens during COVID-19 is an important factor to consider for childhood obesity interventions and policies. Family resiliency may play a protective role in preventing overweight/obesity and needs to be further investigated so that best practices in supporting children and families with early overweight/obesity screening can be paired with culturally sensitive programs. Background/Objectives: This study examines factors associated with child overweight/obesity (OW/OB), pre-COVID-19 and during the COVID-19 pandemic, among all U.S. children aged 10–17 years, with or without developmental disabilities (DD) and, separately, among the subgroup of children diagnosed with a DD. Methods: Using data from the National Survey of Children’s Health (NSCH, 2018–2021), we applied descriptive statistics and multivariate logistic regression analyses to estimate the odds ratios of associations between family resilience, screen time, and childhood overweight/obesity. Family resilience measures families’ communication and problem-solving behaviors. Screentime is time spent on TV, computer, cellphone or electronic devices. Results: In descriptive analyses, during COVID-19, 35.8% of all children were identified as OW/OB compared to 32.8% pre-COVID-19—a weighted increase of 3.0%. Among children with developmental disabilities, OW/OB increased from 37.4% to 39.3%. Children reporting ≥4 h of screentime use increased from pre-COVID-19 to during COVID-19 in both groups (All Children: pre-COVID: 33.5%, during COVID: 41.6%; Developmental Disabilities: pre-COVID: 39.9%, during COVID: 49.4%). Among all children, there was a positive and strong association between screentime use and OW/OB at both pre- and during COVID-19 years. Children belonging to households with low family resiliency had 1.31 times the odds of being overweight/obese (95% CI, 1.06–1.63, p < 0.05) before the pandemic. However, these results were not significant after the pandemic. Conclusions: Prevalence of overweight/obesity in all children and children with DD during the COVID-19 pandemic continued to rise. Screentime was found to be a key determinant in increased weight status. Contrary to our hypothesis, family resilience failed to emerge as a significant protective factor for OW/OB; additional research is needed to explore the protective role of family resiliency on childhood obesity. Study findings may provide insights into developing best practices and tailored interventions with early OW/OB screening and programs tailored towards the youngest group of children aged 10–12 years or below.