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Heavy TV viewing in early childhood has been linked with language, cognitive, and social-emotional delays. However, studies on use of newer forms of screen media (e.g., mobile devices) in early childhood are limited and are mostly cross-sectional, so they cannot test whether more media use causes developmental problems or, vice versa, whether children with developmental delays use more media (e.g., as a behavior modulation strategy).
Using sophisticated longitudinal modeling, investigators assessed the effect of amount of screen media use (parent-reported TV, video, computer, or other screen-based device use) on developmental progress (via the Ages and Stages Questionnaire, Third Edition [ASQ-3]) at ages 24, 36, and 60 months in over 2400 children in a Canadian cohort study.
Children viewed about 2.4 hours/day of media at 24 months, 3.6 hours/day at 36 months, and 1.6 hours/day at 60 months. Overall amount of screen media use was negatively correlated with time reading books and children's sleep duration. After accounting for household income, maternal education, maternal depression, and parenting style, there were significant associations between more media use at 24 months and lower ASQ scores at 36 months and between more media use at 36 months and lower ASQ scores at 60 months. Lower ASQ scores, on the other hand, did not predict later use of more media.
Madigan S et al. Association between screen time and children's performance on a developmental screening test. JAMA Pediatr 2019 Jan 28. (https://jamanetwork.com/journals/jamapediatrics/fullarticle/2722666) [e-pub]
Comment
This study provides some of the strongest evidence of a directional link between media use and developmental difficulties, a topic of frequent public debate. Although the sizes of associations were small, they were similar to the effect of maternal depression, a well-known risk factor for developmental delay. And even small effects are worth addressing for modifiable, common behaviors like media use. These findings support the American Academy of Pediatrics guidelines (disclaimer: I helped write these) recommending that families make a media use plan, create unplugged spaces, keep limits on media time, and find alternate activities that let the child's mind guide the play.