Too much screen time in early childhood may delay development

Children who spend greater screen time at age 1 are more likely to have developmental delays in communication and problem-solving at ages 2 and 4 years, according to a study.

“The association observed between screen time and developmental delay among young children was domain specific. For example, the associations between screen time of children aged 1 year and the communication and problem-solving domains were consistent across ages, although no association was observed in the gross motor domain at ages 2 and 4 years,” the investigators said.

The analysis included 7,097 children in Japan. Developmental delays across five domains were assessed at age 2 and 4 years using the Japanese version of the Ages & Stages Questionnaires, Third Edition. Each domain ranged from 0 to 60 points, with developmental delay defined if the total score for each domain was less than 2 standard deviations (SDs) from its mean score.

Results showed a dose-response association between longer screen time and developmental delays. When compared with less than 1 hour, at least 4 hours of screen time per day at age 1 was significantly associated developmental delays at age 2 in the following domains: communication (vs <1 hour per day: odds ratio [OR], 4.78, 95 percent confidence interval [CI], 3.24–7.06), fine motor (OR, 1.74, 95 percent CI, 1.09–2.79), problem-solving (OR, 2.67, 95 percent CI, 1.72–4.14), and personal and social skills (OR, 2.10, 95 percent CI, 1.39–3.18). [JAMA Pediatr  2023;doi:10.1001/jamapediatrics.2023.3057]

Likewise, at least 4 hours of screen time per day at age 1 was associated with greater odds of developmental delay at age 4 years in the domains of communication (OR, 2.68, 95 percent CI, 1.68–4.27) and problem-solving (OR, 1.91, 95 percent CI, 1.17–3.14) when compared with less than 1 hour of screen time per day.

“The differing levels of developmental delays in the domains, and the absence of any detected delay in some of them at each stage of life examined, suggest that the domains should be considered separately in future discussions of the association between screen time and child development,” said one of the study authors Prof Taku Obar of Tohoku University in Sendai, Japan.

“The rapid proliferation of digital devices, alongside the impact of the COVID pandemic, has markedly increased screen time for children and adolescents, but this study does not simply suggest a recommendation for restricting screen time,” Obara said, acknowledging that screen time may have an educational aspect.

Indeed, a meta-analysis has shown that while greater screen use was associated with decreased language skills, screen time spent on educational programs was associated with increased language skills. Furthermore, the American Academy of Pediatrics recommends that high-quality (eg, educational) programs should be selected when introducing digital media to children aged 18 to 24 months. [JAMA Pediatr  2020;174:665-675; Pediatrics 2016;138:e20162591]

“Because it is difficult to limit screen time in general in today’s world of electronic devices, it may be beneficial to identify and limit the screen time aspects that are associated with developmental delays while taking advantage of the educational aspects,” Obara said.