Early Childhood Screen Use Contexts and Cognitive and Psychosocial Outcomes
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Published:2024-08-05
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ISSN:2168-6203
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Container-title:JAMA Pediatrics
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language:en
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Short-container-title:JAMA Pediatr
Author:
Mallawaarachchi Sumudu12, Burley Jade12, Mavilidi Myrto12, Howard Steven J.12, Straker Leon23, Kervin Lisa12, Staton Sally24, Hayes Nicole25, Machell Amanda26, Torjinski Marina27, Brady Brodie12, Thomas George28, Horwood Sharon27, White Sonia L. J.25, Zabatiero Juliana23, Rivera Clara12, Cliff Dylan12
Affiliation:
1. School of Education, University of Wollongong, Wollongong, New South Wales, Australia 2. Australian Research Council Centre of Excellence for the Digital Child, Brisbane, Queensland, Australia 3. School of Allied Health, Curtin University, Perth, Western Australia, Australia 4. Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia 5. School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, Queensland, Australia 6. College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia 7. School of Psychology, Deakin University, Geelong, Victoria, Australia 8. Health and Wellbeing Centre for Research Innovation, The University of Queensland, Brisbane, Queensland, Australia
Abstract
ImportanceThe multifaceted nature of screen use has been largely overlooked in favor of a simplistic unidimensional measure of overall screen time when evaluating the benefits and risks of screen use to early childhood development.ObjectiveTo conduct a systematic review and meta-analysis to examine associations of screen use contexts in early childhood with cognitive and psychosocial outcomes.Data SourcesPsycINFO, Embase, MEDLINE Ovid, ProQuest, CINAHL, Web of Science, and Scopus were searched from inception to December 31, 2023.Study SelectionA total of 7441 studies were initially identified. Studies were included if they examined associations between a contextual factor of screen use among children aged 0 to 5.99 years and cognitive or psychosocial development. Observational, experimental, and randomized clinical trial study designs were included.Data Extraction and SynthesisAll studies were independently screened in duplicate following PRISMA guidelines. Effect sizes of associations (r) from observational studies were pooled using random-effects 3-level meta-analyses. The remaining study designs were narratively synthesized.Main Outcomes and MeasuresScreen use contexts included content (child directed and age inappropriate), type (program viewing and game or app use), co-use (or solo use), background television, caregiver screen use during child routines, and purpose. Outcomes were cognitive (executive functioning, language, and academic skills) or psychosocial (internalizing and externalizing behavior problems and socioemotional competence).ResultsOverall, 100 studies (176 742 participants) were included, and of these, 64 observational studies (pooled sample sizes ranging from 711 to 69 232) were included in meta-analyses. Program viewing (n = 14; k = 48; r, −0.16; 95% CI, −0.24 to −0.08) and background television (n = 8; k = 18; r, −0.10; 95% CI, −0.18 to −0.02) were negatively associated with cognitive outcomes, while program viewing (n = 6; k = 31; r, −0.04; 95% CI, −0.07 to −0.01), age-inappropriate content (n = 9; k = 36; r, −0.11; 95% CI, −0.17 to −0.04), and caregiver screen use during routines (n = 6; k = 14; r, −0.11; 95% CI, −0.20 to −0.03) were negatively associated with psychosocial outcomes. Co-use was positively associated with cognitive outcomes (n = 8; k = 28; r, 0.14; 95% CI, 0.03 to 0.25).Conclusions and RelevanceFindings show small to moderate effect sizes that highlight the need to consider screen use contexts when making recommendations for families, clinicians, and educators beyond screen time limits; including encouraging intentional and productive screen use, age-appropriate content, and co-use with caregivers.
Publisher
American Medical Association (AMA)
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