A Systematic Review and Meta-Analysis on the Impact of Screen-Time on the Social-Emotional Development of Children Under Five Years

Given the rising consumption of electronic media by children under five years of age, it is crucial to study the impact of screen time (ST) on the social-emotional development (SED) of children. Heterogenous past studies have reported emotional and behavioural problems, delayed language and motor milestones, and increased peer victimisation due to increasing ST. This review consolidates existing literature on the link between ST and children's SED, providing a comprehensive analysis of its impact. A detailed literature search across PubMed, Scopus, CINAHL, Cochrane Database of Systematic Review, and manual citation searching was conducted. Inclusion criteria were studies from 2012 up till July 2023, participants under age 5 years, and studies reporting the impact of ST on SED of children. This systematic review was performed using the PRISMA guidelines. Meta-analysis was conducted on articles that reported OR and used the strengths and difficulties questionnaire (SDQ) as the assessment tool. This review included 12 studies from 7 countries. The methodological quality of studies was good (n = 2), fair (n = 9), and poor (n = 1). Descriptive analysis revealed that ST was generally associated with poorer SED. The meta-analysis revealed that ST was significantly related to SED in children with an overall OR (using a randomeffects model) of 1.24 (95% CI: 1.16-1.33). ST had a significant positive impact on hyperactivity and emotional problems with an OR of 1.39 (95% CI: 1.15-1.67) and 1.21 (95% CI: 1.15-1.27), respectively. These findings support the recommendations outlined by the AAP to limit ST for children. Caregivers and policymakers need to be recruited to prevent harmful impacts on SED outcomes of children.