Abstract
Navigating the safe use of screen time among developing children is an emerging topic. Screen use by young children has increased over the last 3 decades, yet there is little research on its long-term effects. The AAP recommends that children aged 18-24 months only watch high-quality programs with an adult present, and children aged 24-36 months watch only 1 hour of non-educational screen time per day. This study assessed whether children enrolled in HealthySteps, an evidence-based program that provides resources, support, and developmental screening for children aged 0-36 months, are meeting AAP screen time guidelines and whether screen time has an effect on subsequent language and social development.
Patients aged 18-36 months were recruited at two pediatric clinics in a metropolitan area. Exclusion criteria included premature birth (<37 weeks’ gestation) and preexisting developmental delays. Parents were asked to complete a questionnaire to gauge screen use followed by the ASQ-3 to assess communication and personal-social development.
Forty-eight children (52% female, Mage = 25 months, SD = 5.89, Min = 18, Max = 36; 79% White, 8% Black, 6% Asian, 90% Latine) enrolled in the study. Almost half of families reported receiving government assistance (40%; e.g., WIC, Medicaid). On average, caregivers reported their children currently use screens for almost an hour and a half per day (M = 87 minutes, SD = 51.56, Min = 0, Max = 180) and started using screens at 13 months old (SD = 6.74, Min = 0, Max = 24), which is 5 months earlier than the AAP recommendation of when to start screen time. A third of caregivers of children aged 18-24 months reported their children watch screens alone, which contradicts the AAP recommendation that children in this age range only watch screens with an adult present. Caregivers' own screen time was significantly associated with their child's screen time (r = .48, p = .002). Interestingly, child screen time was not significantly associated with caregiver-reported communication skills (r = -.09, p = .59) or social skills (r = -.16, p = .33), which is possibly due to ceiling effects. Only 2 caregivers reported significant delays in communication skills, and only 5 caregivers reported significant delays in social skills. However, a significant association did emerge between social skills and the number of days caregivers' reported reading to their child; stronger social skills were associated with more days of joint reading per week (r = .40, p = .01).
On average, children in our sample started using screens 5 months prior to the AAP recommended age, and their current screen time surpasses AAP guidelines. While screen time did not emerge as a significant predictor of language and social development, frequency of joint reading emerged as a protective factor and should be explored further as a buffer against the potential negative effects of screen time.