Comprehensive Child and Adolescent Nursing

ISSN: 2469-4193 (Print) 2469-4207 (Online) Journal homepage: https://www.tandfonline.com/loi/icpn21

The Mediating Effects of Academic Performance

between Screen Time, Executive Function
Difficulty and School Adjustment

Miyoung Choi & Sunghee Park

To cite this article: Miyoung Choi & Sunghee Park (2019): The Mediating Effects of Academic
Performance between Screen Time, Executive Function Difficulty and School Adjustment,
Comprehensive Child and Adolescent Nursing, DOI: 10.1080/24694193.2019.1675805

To link to this article: https://doi.org/10.1080/24694193.2019.1675805

Published online: 22 Oct 2019.

Submit your article to this journal

Article views: 11

View related articles

View Crossmark data

Full Terms & Conditions of access and use can be found at

https://www.tandfonline.com/action/journalInformation?journalCode=icpn21
COMPREHENSIVE CHILD AND ADOLESCENT NURSING
https://doi.org/10.1080/24694193.2019.1675805

The Mediating Effects of Academic Performance between

Screen Time, Executive Function Difficulty and School
Adjustment
Miyoung Choia and Sunghee Park b

a
Department of Nursing Science, Chungbuk National University, Cheongju, Republic of Korea;
b
Department of Nursing, Kunsan National University, Gunsan-si, Republic of Korea

ABSTRACT ARTICLE HISTORY

The purpose of this study was to verify the mediating effects of Received 18 August 2019
academic performance on the relationship between screen time, Accepted 27 September 2019
executive function difficulty, and school adjustment. This study KEYWORDS
analyzed secondary data of the 8th Panel Survey on Korean Academic performance;
Children. The 8th Panel Survey was the first measurement of adjustment; executive
children’s academic performance, executive function difficulty, function; schools; screen
and school adjustment through large sampling. Accordingly, it is time
possible to provide a large amount of data that can verify the
relationship between them. The respondents were parents and
teachers of students. The total number was 1,031. Data were
analyzed by descriptive, t-test, analysis of variance, Pearson corre-
lation, and three-steps multiple regression statistics. As a result,
screen time has a full mediating effect on school adjustment
through academic performance. The executive function difficulty
has a partial mediating effect on school adjustment through
academic performance. The results of this study will contribute to
the development of the school adjustment improvement program.

Introduction
Today, the use of screen media takes up a significant proportion of the daily
activities of children, and screen time of children has steadily increased
(Stiglic & Viner, 2019). Screen time is a low-energy activity that is spent in
front of electronics monitors such as TVs, computers, video games, electro-
nic games, gaming devices, and mobile phones (Garcia-Continente, Pérez-
Giménez, Espelt, & Adell, 2013). Increased screen time may have impacts on
children’s loss of self-control, sleep disturbances, and psychological well-
being (Arango et al., 2014; Stiglic & Viner, 2019; Twenge & Campbell,
2018; Zhao et al., 2018). In addition, increased screen time may cause
problems with peer relationships, academic performance, and psychological
or school adjustment (Domingues-Montanari, 2017; Fitzpatrick, Barnett, &
Pagani, 2012; Parkes, Sweeting, Wight, & Henderson, 2013). Academic per-
formance is the student’s academic output to achieve educational goals

CONTACT Sunghee Park shpark@kunsan.ac.kr Department of Nursing, Kunsan National University, #406,
Digital Information Center, 558, Daehak-ro, Gunsan-si, Jeonllabuk-do 54150, Republic of Korea
© 2019 Taylor & Francis
2 M. CHOI AND S. PARK

(Korean Institute of Child Care and Education, 2015). School adjustment is

a state of satisfying and maintaining a harmonious relationship between the
student and the school environment (Chi & Jung, 2006).
Recent studies show that problems of academic performance, academic
achievement, and school adjustment were related to executive function diffi-
culty (Aadland et al., 2017; De Bruijn, Hartman, Kostons, Visscher, & Bosker,
2018; Sasser, Bierman, & Heinrichs, 2015; Vitiello & Greenfield, 2017).
Executive function is the self-regulation ability to control one’s own behavior
and achieve learning goals (Diamond, 2013; Min, 2018; Song, 2014). Executive
function helps children effectively learn and adapt to school through improving
the attention and self-control (Blair & Diamond, 2008; Raver, 2012). Executive
function difficulty is that children have problems organizing learning on their
own, controlling their behavior and emotions, and concentrating attention
(Diamond, 2013; Min, 2018; Morgan et al., 2019; Song, 2014).
To summarize the above, children who experience excessive screen time
and executive function difficulty are more likely to have problems with
school adjustment (Kim, 2018; Morgan et al., 2019). Children’s school
adjustment problems are likely to lead to their delinquency, dropping out
of school, and so on, all of which contribute to the deterioration in their
quality of life (Wang & Fredricks, 2014). Therefore, it is necessary to detect
and manage the problems of screen time and executive function early before
school maladjustment occurs. To prevent the school maladjustment, there is
a need for a variable that can mediate the relationship between screen time
problems, executive function difficulty, and school maladjustment.
To be identified as a mediating variable, the variable needed to be corre-
lated with both independent and dependent variables (Lee, 2016; Park, Choi,
& Lee, 2019). We reviewed prior literatures to examine the variable related to
both independent variables (screen time and executive function difficulty)
and dependent variable (school adjustment). As a result of reviewing the
preceding literatures, we proposed that academic performance is related to
both these independent and dependent variables. There were confirmed
correlations between screen time and academic performance, between execu-
tive function difficulty and academic performance, and between academic
performance and school adjustment (Aadland et al., 2017; De Bruijn et al.,
2018; Morgan et al., 2019). Based on these results, the conceptual framework
of this study was derived as shown in Figure 1.
The Panel Survey will play an important role as a big data when it is
necessary to establish the direction for future human resource development
and demand intervention and policy in the era of the Fourth Industrial
Revolution. Fourth Industrial Revolution refers to the era of revolution created
by the convergence of information and communication technology (Korean
Institute of Child Care and Education, 2018). The Panel Survey on Korean
Children is the only longitudinal study of long-term follow-up of the children
 COMPREHENSIVE CHILD AND ADOLESCENT NURSING 3

Figure 1. Conceptual framework of this study.

that began in 2008 across Korea (Korean Institute of Child Care and Education,
2018). In addition, the Panel Survey is the only study in Korea that can confirm
the change in the growth and development of children with large sampling.
Especially, the 8th Panel Survey conducted in 2015 was the first measure-
ment of children’s academic performance, executive function difficulty, and
school adjustment unlike the previous Survey. Accordingly, it is possible to
provide a large amount of data that can verify the relationship between them.
The year 2015 was the first year that children who have followed-up were
enrolled in elementary school, and for the first time surveyed the children’s
school-related data. The purpose of using the Panel Survey data is to con-
tribute to the generalization of research results through large survey.
This study attempted to suggest a direction for improving the school
adjustment of children by using the big data survey. The significance of
this study is to confirm mediating effects between screen time, executive
function difficulty, academic performance, and school adjustment for the
first time in order to suggest direction for improvement of school adjustment
of children in a large sample.

The purpose of the study

The purpose of this study was to verify the mediating effects of academic
performance on the relationship between screen time, executive function
difficulty, and school adjustment.
The specific objectives are as follows. The first objective is to examine the
mediating effect of academic performance in relation to screen time and school
adjustment. The second objective is to examine the mediating effect of academic
performance in relation to executive function difficulty and school adjustment.

Methods
Design
This study analyzes secondary data of Panel Survey on Korean Children. This
study is a descriptive, cross-sectional correlation, which attempts to determine
4 M. CHOI AND S. PARK

the mediating effects of academic performance on the relationship between

screen time, executive function difficulty, and school adjustment.

Setting and respondents

This study utilized the 8th Panel Survey on Korean Children conducted by
the Korean Institute of Child Care and Education (2015). Korean parents and
teachers of the first-grade elementary school students were included in the
data. In addition, only those who agreed to participate in the study were
included. Respondents included those who continued to participate from
2008 until the 8th Panel Survey. The respondents voluntarily participated
in the survey with informed consent. The total number of respondents was
1,031. The entire data of the 8th Panel Survey were utilized in this study.

Measurements
All the scales used in this study were selected through consultation meetings
and written reviews of expert group hosted by the Korean Institute of Child
Care and Education. Expert group consisted of elementary school teachers,
professors of psychology, education, child welfare, and child education
department.

Screen time
To measure screen time, it was used the questions developed by the Korean
Institute of Child Care and Education (2015). Screen time in the parents’ self-
reports was defined as their children’s time spent on media device (e.g.,
television, internet, game machine, mobile phone, and tablet PC). The
following is an example of questions. ‘Please recall your child’s daily routine
and, on average, how many hours did you let your child use mobile phone
per day?’, ‘Please recall your child’s daily routine and, on average, how many
hours did you let your child use tablet PC per day?’. In this study, the screen
time was calculated by adding the total time using the media device.

Executive function difficulty

To measure children’s executive function difficulty, it was used the scale devel-
oped by Song (2014), and information on executive function difficulty was
obtained from children’s teachers. This scale was developed to measure the
difficulty of executive functioning of children and was validated for content
validity, construct validity, criterion validity, and reliability. This scale consisted
of 4 subscales and 40 items: difficulty with planning-organizing (11 items),
difficulty in controlling behavior (11 items), difficulty in controlling emotion
(8 items), and difficulty with attention-concentration (10 items). Each item was
measured from 1 point for “not at all” to 3 points for “very often.” The higher the
 COMPREHENSIVE CHILD AND ADOLESCENT NURSING 5

score, the greater the executive function difficulty. In the study of Song (2014),
Cronbach’s alpha was .950 and .942 in this study.

Academic performance
To measure children’s academic performance, it was used the scale developed
by the Korean Institute of Child Care and Education (2015), and relevant
information was obtained from children’s teachers. The following 10 items
were measured: abilities of reading, speaking, writing, understanding words,
number counting, addition, subtraction, and comparison (e.g., length and
weight). Each item was measured as follows: 1 point for ‘within the lower
20%’, 2 points’ for lower 21–40%’, 3 points for ‘middle 50%’, 4 points for ‘top
21–40%’, and 5 points for ‘top 20%’.

School adjustment
To measure children’s school adjustment, it was used the scale developed by
Chi and Jung (2006), and the information was provided by the children’s
teachers. This scale was developed to measure the school adjustment of first
grade elementary school students and was validated for content validity,
construct validity, and reliability. This scale consisted of 4 subscales and 35
items: adaptation to school life (11 items), academic performance (11 items),
peer adaptation (8 items), and teacher adaptation (5 items). Each item was
measured from 1 point for “not at all” to 5 points for “strongly agree.” The
higher the score was, the better the school adaptation was. In the study of Chi
and Jung (2006), Cronbach’s alpha was .978 and .949 in this study.

Data collection and ethical considerations

This study was conducted after obtaining approval from the Bioethics Committee
of the Korean Institute of Child Care and Education (Approval Number:
KICCEIRB-2015-03), and the study was approved by the institutional review
board of the university with which a researcher of this study was affiliated
(Approval Number: CBNU-201901- SBETC-766-01). Respondents were informed
that the results of the study were not used for any other purpose other than the
current work that all the questionnaires would be processed anonymously and that
they could withdraw at any time if they did not want to participate in this study.
Written consent from parents and teachers and verbal consent from children was
obtained. The data were collected from June to December 2015.

Data analysis
The collected data were analyzed using Statistical Package for the Social Sciences
24.0 program. The 8th Panel Survey was constructed by stratified multilevel
sampling. In order to analyze the sample data obtained from such a complex
6 M. CHOI AND S. PARK

sample design, it is necessary to apply the theoretical calculated weights. In the

8th Panel Survey, weighting was applied through non-response correction and
post stratification correction process based on design weights according to
extraction probability. The level of significance was .05 in two tails. The char-
acteristics of the respondents were analyzed by frequency, percentage, mean, and
standard deviation. The differences in school adjustment according to the
characteristics of the respondents were analyzed by t-test and analysis of var-
iance with Scheffe test, and the correlation between variables was analyzed by
Pearson correlation coefficients. The mediating effects of academic performance
were performed by using 3-steps multiple regression statistics, and the statistical
significance of the mediating effects was analyzed by the Sobel test.

Results
Characteristics of the respondents
The characteristics of the respondents in this study are shown in Table 1. Of the
respondents, 50.8% were male and 49.2% were female. Among parental respon-
dents, 98.4% were mothers, and 96.3% were married. The most common age
group for the parents was between 35 and 39 (52.0%), and the most common
educational level of the parents was college graduate (38.95%). Most of the
teachers in this study were female (95.1%), and the teachers’ mean age was
42.13 ± 9.34 years. The most common teacher educational level was college
graduate (61.1%), and their average teaching experience was 17.76 ± 9.84 years.

The differences in school adjustment according to the characteristics of the

respondents
Table 2 shows the differences in school adjustment according to the characteristics
of the respondents. Children’s school adjustment varied according to a children’s
gender, number of friends, school adaptational level, and his or her parents’
educational level. The school adjustment score of female children was higher
than that of male (t = −7.86, p < .001), and children who had 11 or more friends
showed higher school adjustment scores (F = 3.79, p < .01) than those who had
fewer than three. The school adjustment score was higher in the order of excellent,
good, and moderate school adaptational level (F = 29.15, p < .001). The school
adjustment score was higher for children whose parents graduated college than for
those whose parents graduated only high school (F = 6.76, p < .001).

Correlations between the variables

There was a correlation between screen time, executive function difficulty,
academic performance, and school adjustment (Table 3). There were significant
 COMPREHENSIVE CHILD AND ADOLESCENT NURSING 7

Table 1. Characteristics of the respondents (N = 1,031).

Characteristics Categories n (%) M± SD
Child’s gender Male 524 (50.8)
Female 507 (49.2)
Number of a child’s friends 0–3 221 (21.4) 7.60 ± 6.07
4–5 314 (30.5)
6–10 344 (33.4)
≥11 152 (14.7)
Child’s school absences Yes 235 (22.8)
No 796 (77.2)
School adaptational level Moderate 56 (5.4)
Good 444 (43.1)
Excellent 531 (51.5)
Relationship with child Mother 1014 (98.4)
Father 17 (1.6)
Marital status Married 993 (96.3)
Other 38 (3.7)
Parent’s age (year) 25–29 11 (1.1) 37.91 ± 3.72
30–34 164 (15.9)
35–39 536 (52.0)
40–44 277 (26.8)
≥45 43 (4.2)
Parent’s educational level High school 318 (30.8)
College 312 (30.3)
University 401 (38.9)
Teacher’s gender Male 51 (4.9)
Female 980 (95.1)
Teacher’s age (year) 21–30 124 (12.0) 42.13 ± 9.34
31–40 344 (33.4)
41–50 355 (32.5)
≥51 228 (22.1)
Teacher’s educational level College 52 (5.0)
University 630 (61.1)
Masters 335 (32.5)
Doctor 14 (1.4)
Teacher’s career (year) ≤5 116 (11.3) 17.76 ± 9.84
6–10 170 (16.5)
11–20 367 (35.6)
21–30 241 (23.4)
≥31 137 (13.3)

correlations between screen time and academic performance (r = −.15, p < .001),
and between screen time and school adjustment (r = −.13, p < .001). There were
correlations between executive function difficulty and academic performance
(r = –.61, p < .001), and between execution function difficulty and school
adjustment (r = −.67, p < .001), and between academic performance and school
adjustment (r = .54, p < .001).

Mediating effects of academic performance

The mediating effects of academic performance on the relationship between screen
time, executive function difficulty, and school adjustment are shown in Table 4. To
examine multicollinearity between independent variables, we evaluated the
8 M. CHOI AND S. PARK

Table 2. Differences in school adjustment according to the character-

istics of the respondents (N = 1,031).
Characteristics Categories M± SD F or t (p)
Child’s gender Male 3.60 ± 0.64 −7.86 (<.001)
Female 3.90 ± 0.59
Number of a child’s friends 0–3a 3.64 ± 0.66 3.79 (.010)
4–5b 3.74 ± 0.63 a<d
6–10c 3.77 ± 0.59
≥11d 3.86 ± 0.67
Child’s school absences Yes 3.72 ± 0.64 −0.58 (.562)
No 3.75 ± 0.63
School adaptational level Moderatea 3.27 ± 0.73 29.15 (<.001)
Goodb 3.67 ± 0.61 a<b<c
Excellentc 3.86 ± 0.61
Relationship with child Mother 3.75 ± 0.63 0.48 (.631)
Father 3.67 ± 0.61
Marital status Married 3.75 ± 0.63 1.32 (.187)
Other 3.61 ± 0.64
Parent’s age (year) 25–29 3.32 ± 0.54 1.41 (.228)
30–34 3.77 ± 0.62
35–39 3.74 ± 0.65
40–44 3.74 ± 0.61
≥45 3.81 ± 0.57
Parent’s educational level High schoola 3.64 ± 0.64 6.76 (.001)
Collegeb 3.76 ± 0.63 a < b,c
Universityc 3.81 ± 0.62
Teacher’s gender Male 3.84 ± 0.56 −1.16 (.247)
Female 3.74 ± 0.64
Teacher’s age (year) 21–30 3.78 ± 0.61 0.67 (.571)
31–40 3.76 ± 0.60
41–50 3.74 ± 0.60
≥51 3.70 ± 0.74
Teacher’s educational level College 3.59 ± 0.82 1.36 (.253)
University 3.75 ± 0.60
Masters 3.74 ± 0.66
Doctor 3.92 ± 0.54
Teacher’s career (year) ≤5 3.76 ± 0.59 0.72 (.579)
6–10 3.76 ± 0.61
11–20 3.78 ± 0.62
21–30 3.69 ± 0.65
≥31 3.72 ± 0.73

Table 3. Correlations between the variables (N = 1,031).

Executive function Academic School
Screen time difficulty performance adjustment
r (p) r (p) r (p) r (p)
Screen time 1
Executive function .09 (.006) 1
difficulty
Academic performance −.15 (<.001) −.61 (<.001) 1
School adjustment −.13 (<.001) −.67 (<.001) .54 (<.001) 1
Table 4. Mediating effect of school adjustment (N = 1,031).
Step 1. Academic performance Step 2. School adjustment Step 3. School adjustment
Variables B SE β t p B SE β t p B SE β t p
Constant 6.109 0.091 67.17 <.001 5.205 0.060 86.13 <.001 4.416 0.138 31.97 <.001
Screen time −0.022 0.010 −.055 −2.16 .031 −0.014 0.007 −.048 −2.00 .046 −0.011 0.007 −.038 −1.61 .108
Executive function −1.301 0.059 −.582 −21.96 <.001 −1.018 0.039 −.645 −25.86 <.001 −0.085 0.047 −.539 −18.13 <.001
difficulty
Academic 0.129 0.020 .183 6.32 <.001
performance
R2 = .397, Adj. R2 = .391, R2 = .465, Adj. R2 = .460, R2 = .486, Adj. R2 = .480,
F(p) = 67.11 (<.001) F(p) = 88.80 (<.001) F(p) = 87.43 (<.001)
COMPREHENSIVE CHILD AND ADOLESCENT NURSING
9
10 M. CHOI AND S. PARK

variance inflation factor (VIF), which ranged from 1.081 to 1.354, indicating no
multicollinearity issues among the independent variables. Therefore, the current
data set was suitable for a multiple regression analysis.
A children’s gender, number of friends, school adaptational level, and
parents’ educational level were all introduced into the multiple regression
analysis. To test the mediating effects of academic performance on the rela-
tionship between screen time, executive function difficulty, and school adjust-
ment, we followed the 3-steps multiple regression analysis. In the first step, the
independent variables of screen time and executive function difficulty had
a significant relationship to the mediating variables of academic performance.
In the second step, the independent variables of screen time and executive
function difficulty had a significant association with dependent variable of
school adjustment. In the third step, the mediating effect was tested. The
screen time did not have a significant effect on school adjustment (p = .108)
and its unstandardized coefficient (B) decreased from −0.014 to −0.011,
suggesting a full mediating effect. On the other hand, the executive function
difficulty was significantly related to school adjustment (p < .001), and its
unstandardized coefficient (B) decreased from −1.018 to −0.850, suggesting
a partial mediating effect. Sobel test results showed that academic performance
was statistically significant as a full mediating variable in the relationship
between screen time and school adjustment (Z = −2.082, p < .05). In addition,
academic performance was found to be a significant partial mediating variable
in the relationship between difficulty in executive function and school adjust-
ment (Z = −6.191, p < .001).

Discussion
The results of this study show that academic performance had a full mediat-
ing effect between screen time and school adjustment, and a partial mediat-
ing effect between executive function difficulty and school adjustment.
In their studies that examined the relationship between screen time and
academic performance, Peiró-Velert et al. (2014) and Morita et al. (2016)
reported a correlation relationship between these two variables. The screen
time and academic performance were found to be associated factors of school
adjustment in Kim’ study (2018). In order to improve the school adaptation of
children with screen time problems, not only efforts to reduce the screen time
continuously but also improve academic performance together. This requires
the formation of close mutual partnerships between teachers, school nurses,
and parents. Because academic performance is managed by teachers and the
screen time is controlled by parents and school nurses, all of them need to must
make efforts to improve the school adjustment of children and prevent addic-
tion of smart devices. School nurses should have an early detection system that
regularly checks children’s screen time problems, and work with teachers and
 COMPREHENSIVE CHILD AND ADOLESCENT NURSING 11

parents to plan and implement diversion activities to reduce screen time. In

addition, efforts should be made to improve the academic performance of
children through the provision of supplementary learning opportunities.
The academic performance has a partial mediating effect between execu-
tive function difficulty and school adjustment, which implies children’s
executive function difficulty directly affects school adjustment and indirectly
influences school adjustment through academic performance. The results
also show that significant correlations exist between executive function
difficulty and academic performance, and between academic performance
and school adjustment (Aadland et al., 2017; De Bruijn et al., 2018; Morgan
et al., 2019). In order to prevent school maladjustment due to executive
function difficulty, only executive function difficulty can be mediated and
mediated with academic performance because of partial mediating effect.
Executive function difficulty is the ability of children to control and learn
for themselves. Eventually, executive function difficulties will cause problems
with academic performance and negatively affect school adjustment
(Aadland et al., 2017; De Bruijn et al., 2018; Knouse, Feldman, & Blevins,
2014). Therefore, a system should be established to detect executive function
difficulties early on from elementary school entrance. Executive function
difficulties should be checked together by teachers, school nurses, and par-
ents. In this study, the executive function difficulty was measured by the
teachers, but when examining the sub-items of the scale such as emotional
control and attention difficulties, it is often necessary for the parents and
school nurses to measure together. Therefore, it may be necessary to establish
a system of mutual relations between teachers, parents and school nurses to
assess and continuously manage children’s executive function difficulty.
Children with executive function difficulty at the time of elementary school
entry should be more intensively managed, which is a collaborative effort
between parents and teachers under the guidance of school nurses. While
maintaining a mutual relationship, the executive function difficulty should be
reduced, and academic performance should be improved. This ultimately
contributes to improving the school adjustment of children and preventing
problem behavior.

Study limitations and recommendations for future research

This study was based on survey information from parents and teachers in
elementary schools in Korea, so caution is needed when applying the findings
of this study to children in other countries or to other research subjects. In
addition, the scales used in this study were developed and their validity and
reliability assessed in Korea. Therefore, the scales may have limitations related
to their validity and reliability when used in other countries. The screen time is
a value measured depending on the recall of the respondents. Therefore, there is
12 M. CHOI AND S. PARK

a limit that cannot measure accurate value. Caution is required to interpret and
apply the values calculated by recall of respondents such as screen time.
In the future, it is suggested to develop a school adjustment improvement
program including parents, students, school nurses, and teachers, and to try
a research that verifies its effectiveness.

Conclusions
Screen time of children affects school adjustment through the academic
performance, and executive function difficulty also directly affects school
adjustment and indirectly influences school adjustment through academic
performance. Therefore, screen time and executive function difficulty should
be reduced, and academic performance should be improved to promote
school adjustment for elementary school students.

Acknowledgments
The authors would like to thank the Korean Institute of Child Care and Education for their
resources.

Declaration of interest statement

The authors declare that they have no conflict of interests.

ORCID
Sunghee Park http://orcid.org/0000-0003-3920-6025

References
Aadland, K. N., Moe, V. F., Aadland, E., Anderssen, S. A., Resaland, G. K., & Ommundsen, Y.
(2017). Relationships between physical activity, sedentary time, aerobic fitness, motor skills
and executive function and academic performance in children. Mental Health and Physical
Activity, 12, 10–18. doi:10.1016/j.mhpa.2017.01.001
Arango, C. M., Parra, D. C., Gómez, L. F., Lema, L., Lobelo, F., & Ekelund, U. (2014). Screen
time, cardiorespiratory fitness and adiposity among school-age children from monteria,
colombia. Journal of Science and Medicine in Sport, 17(5), 491–495. doi:10.1016/j.
mhpa.2017.01.001
Blair, C., & Diamond, A. (2008). Biological processes in prevention and intervention: The
promotion of self-regulation as a means of preventing school failure. Development and
Psychopathology, 20(3), 899–911. doi:10.1017/S0954579408000436
Chi, S. A., & Jung, D. H. (2006). Validation of school adjustment inventory for first grade
elementary school students. Korean Journal of Child Studies, 27(1), 1–15.
 COMPREHENSIVE CHILD AND ADOLESCENT NURSING 13

De Bruijn, A., Hartman, E., Kostons, D., Visscher, C., & Bosker, R. (2018). Exploring the
relations among physical fitness, executive functioning, and low academic achievement.
Journal of Experimental Child Psychology, 167, 204–221. doi:10.1016/j.jecp.2017.10.010
Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135–168.
doi:10.1146/annurev-psych-113011-143750
Domingues-Montanari, S. (2017). Clinical and psychological effects of excessive screen time
on children. Journal of Paediatrics and Child Health, 53(4), 333–338. doi:10.1111/
jpc.13462
Fitzpatrick, C., Barnett, T., & Pagani, L. S. (2012). Early exposure to media violence and later
child adjustment. Journal of Developmental & Behavioral Pediatrics, 33(4), 291–297.
doi:10.1097/DBP.ob013e31824eaab3
Garcia-Continente, X., Pérez-Giménez, A., Espelt, A., & Adell, M. N. (2013). Factors asso-
ciated with media use among adolescents: A multilevel approach. The European Journal of
Public Health, 24(1), 5–10. doi:10.1093/eurpub/ckt013
Kim, E. S. (2018). Exploring effective variables for school adjustment in the first grade. The
Korean Journal of Applied Developmental Psychology, 7(1), 19–34.
Knouse, L. E., Feldman, G., & Blevins, E. J. (2014). Executive functioning difficulties as
predictors of academic performance: Examining the role of grade goals. Learning and
Individual Differences, 36, 19–26. doi:10.1016/j.lindif.2014.07.001
Korean Institute of Child Care and Education. (2015). The Korean child panel 2015. Retrieved
from http://www.kicce.re.kr/kor/publication/02_03.jsp?mode=view&idx=
19180&startPage=0&listNo=0&code=&search_item=&search_order=2015&order_list=
10&listScale=5&view_level=0
Korean Institute of Child Care and Education. (2018). The Korean child panel 2018. Retrieved
from http://www.kicce.re.kr/kor/publication/02_03.jsp?mode=view&idx=
24706&startPage=0&listNo=0&code=&search_item=&search_order
Lee, I. (2016). Easy flow regression analysis (pp. 73–78). Seoul, Korea: Hannarae Publishing
Co.
Min, M. H. (2018). The effects of mother’s warmth parenting, control parenting and child
executive function difficulty on the school adjustment in the first grade. Journal of Early
Childhood Education & Educare Welfare, 22(3), 91–121.
Morgan, P. L., Farkas, G., Wang, Y., Hillemeier, M. M., Oh, Y., & Maczuga, S. (2019).
Executive function deficits in kindergarten predict repeated academic difficulties across
elementary school. Early Childhood Research Quarterly, 46, 20–32. doi:10.1016/j.
ecresq.2018.06.009
Morita, N., Nakajima, T., Okita, K., Ishihara, T., Sagawa, M., & Yamatsu, K. (2016).
Relationships among fitness, obesity, screen time and academic achievement in japanese
adolescents. Physiology & Behavior, 163, 161–166. doi:10.1016/j.physbeh.2016.04.055
Park, S., Choi, M., & Lee, S. (2019). The mediating effects on the relationship between
campus life adaptation and clinical competence. Nurse Education Today, 72, 67–72.
doi:10.1016/j.nedt.2018.11.009
Parkes, A., Sweeting, H., Wight, D., & Henderson, M. (2013). Do television and electronic
games predict children’s psychosocial adjustment? longitudinal research using the UK
millennium cohort study. Archives of Disease in Childhood, 98(5), 341–348. doi:10.1136/
archdischild-2011-301508
Peiró-Velert, C., Valencia-Peris, A., González, L. M., García-Massó, X., Serra-Añó, P., &
Devís-Devís, J. (2014). Screen media usage, sleep time and academic performance in
adolescents: Clustering a self-organizing maps analysis. PloS One, 9(6), e99478.
doi:10.1371/journal.pone.0099478
14 M. CHOI AND S. PARK

Raver, C. C. (2012). Low-income children’s self-regulation in the classroom: Scientific inquiry

for social change. American Psychologist, 67(8), 681–689. doi:10.1037/a0030085
Sasser, T. R., Bierman, K. L., & Heinrichs, B. (2015). Executive functioning and school
adjustment: The mediational role of pre-kindergarten learning-related behaviors. Early
Childhood Research Quarterly, 30, 70–79. doi:10.1016/j.ecresq.2014.09.001
Song, H. (2014). Validity of child-adolescent self-reported executive function difficulty
screening questionnaire. The Korean Journal of Clinical Psychology, 33(1), 121–137.
doi:10.15842/kjcp
Stiglic, N., & Viner, R. M. (2019). Effects of screen time on the health and well-being of
children and adolescents: A systematic review of reviews. BMJ Open, 9(1), e023191.
doi:10.1136/bmjopen-2018-023191
Twenge, J. M., & Campbell, W. K. (2018). Associations between screen time and lower
psychological well-being among children and adolescents: Evidence from a
population-based study. Preventive Medicine Reports, 12, 271–283. doi:10.1016/j.
pmedr.2018.10.003
Vitiello, V. E., & Greenfield, D. (2017). Executive functions and approaches to learning in
predicting school readiness. Journal of Applied Developmental Psychology, 53, 1–9.
doi:10.1016/j.appdev.2017.08.004
Wang, M., & Fredricks, J. A. (2014). The reciprocal links between school engagement, youth
problem behaviors, and school dropout during adolescence. Child Development, 85(2),
722–737. doi:10.1111/cdev.12138
Zhao, J., Zhang, Y., Jiang, F., Ip, P., Ho, F. K. W., Zhang, Y., & Huang, H. (2018). Excessive
screen time and psychosocial well-being: The mediating role of body mass index, sleep
duration, and parent-child interaction. The Journal of Pediatrics, 202, 157–162.
doi:10.1016/j.jpeds.2018.06.029