Association Between Screen Time and Children’s Performance on a Developmental Screening Test | Child Development | JAMA Pediatrics | JAMA Network
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Original Investigation
January 28, 2019

Association Between Screen Time and Children’s Performance on a Developmental Screening Test

Author Affiliations
  • 1Department of Psychology, University of Calgary, Calgary, Alberta, Canada
  • 2Department of Paediatrics, Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
  • 3Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
JAMA Pediatr. 2019;173(3):244-250. doi:10.1001/jamapediatrics.2018.5056
Key Points

Question  Is increased screen time associated with poor performance on children’s developmental screening tests?

Findings  In this cohort study of early childhood development in 2441 mothers and children, higher levels of screen time in children aged 24 and 36 months were associated with poor performance on a screening measure assessing children’s achievement of development milestones at 36 and 60 months, respectively. The obverse association (ie, poor developmental performance to increased screen time) was not observed.

Meaning  Excessive screen time can impinge on children’s ability to develop optimally; it is recommended that pediatricians and health care practitioners guide parents on appropriate amounts of screen exposure and discuss potential consequences of excessive screen use.


Importance  Excessive screen time is associated with delays in development; however, it is unclear if greater screen time predicts lower performance scores on developmental screening tests or if children with poor developmental performance receive added screen time as a way to modulate challenging behavior.

Objective  To assess the directional association between screen time and child development in a population of mothers and children.

Design, Setting, and Participants  This longitudinal cohort study used a 3-wave, cross-lagged panel model in 2441 mothers and children in Calgary, Alberta, Canada, drawn from the All Our Families study. Data were available when children were aged 24, 36, and 60 months. Data were collected between October 20, 2011, and October 6, 2016. Statistical analyses were conducted from July 31 to November 15, 2018.

Exposures  Media.

Main Outcomes and Measures  At age 24, 36, and 60 months, children’s screen-time behavior (total hours per week) and developmental outcomes (Ages and Stages Questionnaire, Third Edition) were assessed via maternal report.

Results  Of the 2441 children included in the analysis, 1227 (50.2%) were boys. A random-intercepts, cross-lagged panel model revealed that higher levels of screen time at 24 and 36 months were significantly associated with poorer performance on developmental screening tests at 36 months (β, −0.06; 95% CI, −0.10 to −0.01) and 60 months (β, −0.08; 95% CI, −0.13 to −0.02), respectively. These within-person (time-varying) associations statistically controlled for between-person (stable) differences.

Conclusions and Relevance  The results of this study support the directional association between screen time and child development. Recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use.