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Comment & Response
July 29, 2019

Challenging the Association Between Screen Time and Cognitive Development

Author Affiliations
  • 1Paediatric Department, Nepean Hospital, Sydney, Australia
  • 2Sydney Medical School Nepean, The University of Sydney, Sydney, Australia
JAMA Pediatr. 2019;173(9):890-891. doi:10.1001/jamapediatrics.2019.2249

To the Editor We read with interest the article by Madigan et al,1 which demonstrated an association between more screen time and subsequent lower performance on developmental screening tests. We noted a substantial drop in screen time between ages 36 months and 60 months (from 24.9 to 10.8 hours) and speculated whether it was perhaps as a result of increase in social play, including play with siblings. Children lacking older siblings would miss out on this social learning opportunity and might also have more screen time. We would be most interested to know whether association between higher screen time at 36 months and lower Ages and Stages Questionnaire at 60 months was more marked in children without siblings. Could the authors therefore please investigate the possible confounding association of birth order with screen time and development?