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Category: Project

Description: Electronic screens are everywhere and are easily accessible to children. Parents report fears that screens cause socio-emotional problems. But, most research has been cross-sectional, making it difficult to establish causality. We reviewed the longitudinal evidence to answer two fundamental questions: does screen use lead to socio-emotional problems and do socio-emotional problems lead children to use screens more often? A total of 132 longitudinal studies met the inclusion criteria and were included in the systematic review. From these, 117 studies (292,739 children; 2,284 effects) were meta-analysed. Small significant associations were found in both directions: screen use led to socio-emotional problems (b = 0.06, 95% confidence interval (CI) = 0.02 to 0.11, p ≤ 0.05, n = 200,018, K = 117), and socio-emotional problems led to greater screen use (b = 0.06, 95% CI = 0.01 to 0.12, p = 0.01, n = 200,018, K = 117). Moderation analyses showed stronger effects in both directions when screens were used for gaming than for other purposes: socio-emotional problems led to more gaming behaviour (b = 0.44, 95% CI = 0.29 to 0.60, n = 80,809, K = 31), and playing games led to later socio-emotional problems (b = 0.32, 95% CI = 0.23 to 0.42, n = 80,809, K = 31). The reciprocal relationship between socio-emotional problems and screen use was moderated by children’s age, total screen time at baseline, and type of socio-emotional problem (i.e., externalising and internalising behaviour). Compared with prior cross-sectional studies, our temporal evidence reinforces the benefits of screen time guidelines, but suggests a change in focus. Instead of merely emphasising the reduction of screen time, guidelines should prioritise improving the quality of screen content and enhancing social interactions during screen use. Additionally, screen time guidelines should discorage high levels of the most high-risk behaviours like gaming.