A 15-year Scottish cohort suggests that how children use screens may matter more than time alone, challenging simple limits while highlighting risks at the highest levels of gaming.
Study: Screen Use and Emotional, Behavioral, and Social Development in Children. Image Credit: Max kegfire / Shutterstock
Higher screen use was not consistently associated with poorer emotional, behavioral, and social development in children and adolescents, according to a new study published in JAMA Network Open.
Background
Electronic screen devices, such as televisions, smartphones, computers, and tablets, have become an integral part of children’s lives in the past two decades. Studies investigating the association between screen exposure and children’s mental health have produced inconsistent results. While some studies have reported associations with poorer psychosocial development, some have reported no significant long-term associations.
The association between screen use and psychosocial development may vary by screen activity and duration of exposure. These two factors may affect age groups differently. Reduced parent-child interaction and play time may contribute to greater sensitivity to screen exposure in young children. In contrast, evidence in adolescents has been less consistent, partly because of the dynamic biological and social changes associated with this developmental stage.
Given the high prevalence of screen exposure among children and adolescents in the UK and the scarcity of high-quality, longitudinal evidence, researchers at the University of Edinburgh, UK, and Imperial College London, UK, investigated the patterns of screen use and their associations with psychosocial development at the ages of 5, 10, and 15 years.
Study design
The researchers analyzed data from the Growing Up in Scotland (GUS) study, a Scottish government-funded birth cohort study that recruited infants aged 10 months living in Scotland in 2005 to 2006, who were followed up at 5, 10, and 15 years of age between 2010 and 2020. An additional 502 adolescents were recruited in 2017 to improve representation of participants from more deprived areas and were included only in the cross-sectional analysis at age 15.
The primary objectives of the study were to assess the cross-sectional association between out-of-school screen use and psychosocial development at 5, 10, and 15 years of age and the longitudinal association between screen use at 5 years of age and psychosocial development at 10 and 15 years of age.
Key findings
The study found a substantial increase in screen time with age. The cross-sectional analysis showed that total daily screen use at 5 or 10 years of age was not associated with an above-average total difficulties score, which combines emotional difficulties, conduct difficulties, hyperactivity, and peer difficulties.
Electronic gaming for 5 hours or more per day at age 15 was associated with higher odds of an above-average total difficulties score. In contrast, social media or messaging app use for 1 hour or more per day was associated with lower odds of an above-average total difficulties score compared to less than 1 hour of use per day. However, after correction for multiple testing, only the association for 1 to 2 hours per day remained statistically significant.
The longitudinal analysis revealed that screen use for 5 hours or more per day at 5 years of age was associated with higher odds of an above-average total difficulties score at 10 years of age, but not at 15 years of age. This association was also not robust across sensitivity analyses.
Study significance
The study found that screen duration alone was not consistently associated with poorer psychosocial development in children and adolescents. At age 15, some levels of social media and messaging app use were associated with lower odds of an above-average total difficulties score, but the findings do not demonstrate that social media use benefits adolescents. No corresponding robust benefit was observed for prosocial functioning.
As advised by the researchers, the apparently favorable association with social media use should be interpreted cautiously, as the possibility of reverse causation cannot be ruled out in the cross-sectional analyses. There remains a possibility that adolescents with better social functioning may be more likely to use social media. The researchers also noted that adolescents with very low social media use may differ systematically from their peers, complicating comparisons.
The inclusion of socioeconomic characteristics and parent-child relationships as potential confounding factors is a key strength of this study. Failure to adequately account for these factors may partly explain apparent associations reported in some previous cross-sectional studies linking screen use to psychosocial development problems in children.
Future research is needed to explore the impact of parent-child relationship quality or parental engagement in screen use on the psychosocial development of children exposed to screen-based devices.
Overall, the study findings indicate that public health guidelines that focus solely on screen exposure duration may not accurately reflect the complex relationship between screen time and psychosocial development.
In a world where screen use has become an integral part of life, more recent, high-quality evidence is needed to develop clearer guidelines on content type, context, age, device use, and parental involvement.
The current findings suggest possible favorable associations between some forms of adolescent screen use and psychosocial outcomes; however, the researchers emphasized that established risks associated with digital environments, including sedentary behavior, online bullying, exposure to harmful content, and online child sexual exploitation, should not be ignored.
Although key confounding factors were addressed in the analysis, some unmeasured factors, such as peer networks, platform-specific behavior, and content type, may have influenced the observed associations. This influence is particularly relevant to social media use at age 15.
Screen use was reported by parents at ages 5 and 10 and by adolescents themselves at age 15, limiting direct comparisons across ages. Total screen time also could not be calculated at age 15 because television and video viewing, gaming, and social media use were measured separately. The data may also be partly outdated given the rapidly evolving digital landscape.
The majority of study participants were White. Moreover, participants unavailable for follow-up were more likely than those retained to experience greater deprivation, lone parenthood, lower income, and younger maternal age. Although statistical weighting was used to address differential attrition, these factors may restrict the generalizability of the findings to ethnically more diverse populations or socioeconomically disadvantaged populations.