Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Screen time and developmental and behavioral outcomes for preschool children

Abstract

Background

One pressing question in the field of pediatrics is whether a dose–response relation is observed between hours of screen time and child outcomes. This study examined the association between hours of screen time (≤1 vs 2 vs ≥3 h/day) and children’s developmental and behavioral outcomes.

Methods

This study included data from 1994 mothers and children in Calgary, Canada, drawn from the All Our Families cohort. At 36 months, children’s screen time (h/day), behavior problems, developmental milestones, and vocabulary acquisition were assessed via maternal report. Socio-demographic factors and baseline levels of performance at 24 months were included as covariates.

Results

Compared to ≤1 h/day (47%; n = 935), children using screens 2 h (36%; n = 725) or ≥3 h/day (17%; n = 333) had an increased likelihood of reported behavioral problems (adjusted odds ratio (AOR) 1.30–1.90), delayed achievement of developmental milestones (AOR 1.41–1.68), and poorer vocabulary acquisition (AOR 1.94).

Conclusions

At 36 months, an association was observed between screen time and children’s developmental, language, and behavioral outcomes, suggesting that duration of screen time is associated with poor child development outcomes. Findings provide support for screen time guidelines and emphasize the need for childcare professionals to discuss screen time guidelines with families.

Impact

  • International guidelines recommend that preschoolers spend no more than 1 h/day viewing screens.

  • Research is needed to determine if there is a relation between screen time levels and child developmental and behavioral outcomes.

  • Compared to ≤1 h/day, children viewing screens 2 or ≥3 h/day had an increased likelihood of behavioral problems, delayed achievement of developmental milestones, and poorer vocabulary acquisition.

  • Findings highlight the association between duration of screen time and factors of child development.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1: Effect of screen time on child at-risk status for developmental and behavioral outcomes.

References

  1. 1.

    Son, S. H. & Morrison, F. J. The nature and impact of changes in home learning environment on development of language and academic skills in preschool children. Dev. Psychol. 46, 1103–1118 (2010).

    Article  Google Scholar 

  2. 2.

    Rideout, V. The Common Sense Census: Media Use by Kids Zero to Eight (Common Sense Media, 2017).

  3. 3.

    American Academy of Pediatrics Council on Communications and Media. Media and young minds. Pediatrics 138, e20162591 (2016).

    Article  Google Scholar 

  4. 4.

    Ponti, M. et al. Screen time and young children: promoting health and development in a digital world. Paediatr. Child Health 22, 461–468 (2017).

    Article  Google Scholar 

  5. 5.

    World Health Organization. Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children Under 5 Years of Age (World Health Organization, 2019).

  6. 6.

    Chaput, J. P. et al. Proportion of preschool-aged children meeting the Canadian 24-Hour Movement Guidelines and associations with adiposity: results from the Canadian Health Measures Survey. BMC Public Health 17, 829 (2017).

    Article  Google Scholar 

  7. 7.

    Lee, E.-Y. et al. Meeting new Canadian 24-Hour Movement Guidelines for the Early Years and associations with adiposity among toddlers living in Edmonton, Canada. BMC Public Health 17, 155–165 (2017).

  8. 8.

    Madigan, S., McArthur, B., Anhorn, C., Eirich, R. & Christakis, D. A. Associations between screen use and child language skills. JAMA Pediatr. 174, 665–675 (2020).

    Article  Google Scholar 

  9. 9.

    Rasmussen, E. E. et al. Relation between active mediation, exposure toDaniel Tiger’s Neighborhood, and US preschoolers’ social and emotional development. J. Child. Media 10, 443–461 (2016).

    Article  Google Scholar 

  10. 10.

    Christakis, D. A. The effects of infant media usage: what do we know and what should we learn? Acta Paediatr. 98, 8–16 (2009).

    Article  Google Scholar 

  11. 11.

    Carson, V. et al. Associations between meeting the Canadian 24-Hour Movement Guidelines for the Early Years and behavioral and emotional problems among 3-year-olds. J. Sci. Med. Sport 22, 797–802 (2010).

    Article  Google Scholar 

  12. 12.

    Madigan, S., Browne, D., Racine, N., Mori, C. & Tough, S. Association between screen time and children’s performance on a developmental screening test. JAMA Pediatr. 173, 244–250 (2019).

    Article  Google Scholar 

  13. 13.

    Straker, L., Zabatiero, J., Danby, S., Thorpe, K. & Edwards, S. Conflicting guidelines on young children’s screen time and use of digital technology create policy and practice dilemmas. J. Pediatr. 202, 300–303 (2018).

    Article  Google Scholar 

  14. 14.

    Trinh, M.-H. et al. Association of trajectory and covariates of children’s screen media time. JAMA Pediatr. 174, 71–78 (2020).

    Article  Google Scholar 

  15. 15.

    McArthur, B., Browne, D., Tough, S. & Madigan, S. Trajectories of screen use during early childhood: predictors and associated behavior and learning outcomes. Comput. Hum. Behav. 113, 106501 (2020).

    Article  Google Scholar 

  16. 16.

    Zimmerman, F. J., Christakis, D. A. & Meltzoff, A. N. Associations between media viewing and language development in children under age 2 years. J. Pediatr. 151, 364–368 (2017).

    Article  Google Scholar 

  17. 17.

    Tough, S. C. Cohort Profile: the All Our Babies pregnancy cohort (AOB). Int. J. Epidemiol. 46, 1389–1390k (2017).

    Article  Google Scholar 

  18. 18.

    Randall Simpson, J. A., Keller, H. H., Rysdale, L. A. & Beyers, J. E. Nutrition Screening Tool for Every Preschooler (NutriSTEP™): validation and test–retest reliability of a parent-administered questionnaire assessing nutrition risk of preschoolers. Eur. J. Clin. Nutr. 62, 770–780 (2008).

    CAS  Article  Google Scholar 

  19. 19.

    Statistics Canada, Human Resources Canada. National Longitudinal Survey of Children NLSCY. Overview of Survey Instruments for 1994–1995 (Statistics Canada, 1995).

  20. 20.

    Achenbach, T. M. & Ruffle, T. M. The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies. Pediatr. Rev. 21, 265–271 (2000).

    CAS  Article  Google Scholar 

  21. 21.

    Briggs-Gowan, M. J. The brief infant-toddler social and emotional assessment: screening for social-emotional problems and delays in competence. J. Pediatr. Psychol. 29, 143–155 (2004).

    Article  Google Scholar 

  22. 22.

    Squires, J., Bricker, D. Ages & Stages Questionnaires®, Third Edition (ASQ- 3™). A Parent-Completed Child-Monitoring System (Paul H. Brookes Publishing Co., 2009).

  23. 23.

    Alvik, A. & Grøholt, B. Examination of the cut-off scores determined by the Ages and Stages Questionnaire in a population-based sample of 6 month-old Norwegian infants. BMC Pediatr. 11, 117 (2011).

    Article  Google Scholar 

  24. 24.

    Fenson, L. et al. The MacArthur-Bates Communicative Development Inventories: User’s Guide and Technical Manual, 2nd edn (Brookes, 2006).

  25. 25.

    Heilmann, J., Ellis Weismer, S., Evans, J. & Hollar, C. Utility of the MacArthur-Bates communicative development inventory in identifying language abilities of late-talking and typically developing toddlers. Am. J. Speech Lang. Pathol. 14, 40–51 (2005).

    Article  Google Scholar 

  26. 26.

    Cohen, S., Kamarck, T. & Mermelstein, R. A global measure of perceived stress. J. Health Soc. Behav. 24, 385–396 (1983).

    CAS  Article  Google Scholar 

  27. 27.

    Muthén, L. & Muthén, B. Mplus Statistical Modeling Software: Release 8.0 (Muthén & Muthén, 2017).

  28. 28.

    Sontag-Padilla, L. et al. The Urban Child Institue CANDLE Study (Rand Corporation, 2015).

  29. 29.

    Graham, J. W. Missing data analysis: making it work in the real world. Annu. Rev. Psychol. 60, 549–576 (2009).

    Article  Google Scholar 

  30. 30.

    McDaniel, B. T. & Radesky, J. S. Technoference: parent distraction with technology and associations with child behavior problems. Child Dev. 89, 100–109 (2018).

    Article  Google Scholar 

  31. 31.

    Radesky, J. S., Peacock-Chambers, E., Zuckerman, B. & Silverstein, M. Use of mobile technology to calm upset children. JAMA Pediatr. 170, 397 (2016).

    Article  Google Scholar 

  32. 32.

    Suchert, V., Hanewinkel, R. & Isensee, B. Sedentary behavior and indicators of mental health in school-aged children and adolescents: a systematic review. Prev. Med. 76, 48–57 (2015).

    Article  Google Scholar 

  33. 33.

    Browne, D., Thompson, D. & Madigan, S. Digital media use in children: clinical versus scientific responsibilities. JAMA Pediatr. 174, 111 (2020).

    Article  Google Scholar 

  34. 34.

    Barr, R. Growing up in the digital age: early learning and family media ecology. Curr. Direct. Psychol. Sci. 28, 341–346 (2019).

    Article  Google Scholar 

  35. 35.

    Stanovich, K. E. Matthew effects in reading: some consequences of individual differences in the acquisition of literacy. Read. Res. Q. 21, 360–407 (1986).

    Article  Google Scholar 

  36. 36.

    American Academy of Pediatrics. Family Media Plan (American Academy of Pediatrics, 2019)

  37. 37.

    Bento, G. & Dias, G. The importance of outdoor play for young children’s healthy development. Porto Biomed. J. 2, 157–160 (2017).

    Article  Google Scholar 

  38. 38.

    Mendelsohn, A. L. et al. Reading aloud, play, and social-emotional development. Pediatrics 141, e20173393 (2018).

    Article  Google Scholar 

  39. 39.

    Yuan, N. et al. How much do parents actually use their smartphones? Pilot study comparing self-report to passive sensing. Pediatr. Res. 86, 416–418 (2019).

    Article  Google Scholar 

  40. 40.

    Parkes, A., Sweeting, H., Wight, D. & Henderson, M. Do television and electronic games predict children’s psychosocial adjustment? Longitudinal research using the UK Millennium Cohort Study. Arch. Dis. Child. 98, 341–348 (2013).

    Article  Google Scholar 

  41. 41.

    Allen, M. S. & Vella, S. A. Screen-based sedentary behaviour and psychosocial well-being in childhood: cross-sectional and longitudinal associations. Ment. Health Phys. Act. 9, 41–47 (2015).

    Article  Google Scholar 

  42. 42.

    Swing, E. L., Gentile, D. A., Anderson, C. A. & Walsh, D. A. Television and video game exposure and the development of attention problems. Pediatrics 126, 214–221 (2010).

    Article  Google Scholar 

Download references

Acknowledgements

We acknowledge the contributions of the All Our Families research team and thank the participants who took part in the study. The All Our Families study was supported by Alberta Innovates Health Solutions Interdisciplinary (Team grant 200700595), the Alberta Children’s Hospital Foundation, and the Max Bell Foundation to S.T. Research support was provided by the Canada Research Chairs program to S.M. Postdoctoral Fellowship support was provided by the Alberta Children’s Hospital Research Institute to B.M.

Author information

Affiliations

Authors

Contributions

B.M. and S.M. conceptualized and designed the study, conducted data analyses, drafted the manuscript, and reviewed and revised the manuscript. S.T. conceptualized the cohort study, designed the data collection instruments and study methodology, secured funding for data collection, and reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Sheri Madigan.

Ethics declarations

Competing interests

The authors declare no competing interests.

Consent statement

All participants provided written informed consent to participate.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

McArthur, B.A., Tough, S. & Madigan, S. Screen time and developmental and behavioral outcomes for preschool children. Pediatr Res (2021). https://doi.org/10.1038/s41390-021-01572-w

Download citation

Search

Quick links