Association between early digital exposure and cognitive function in children under six: A meta-analysis

Early exposure to screen-based devices has become increasingly prevalent among young children, raising concerns about its potential impact on cognitive development. This systematic review and meta-analysis aimed to synthesize the available evidence regarding the effects of screen time on cognitive outcomes in children aged 0 to 6 years. A comprehensive search of the PubMed and Cochrane Library databases, complemented by additional sources, identified 190 studies, of which 5 met the eligibility criteria. These included 2,195 children and employed standardized cognitive instruments such as WPPSI, BSID, and SDQ. The meta-analysis, conducted using a random-effects model due to high heterogeneity (I² = 75.63%), revealed a moderate negative association between screen exposure and cognitive performance (SMD = -0.49; 95% CI: -0.64 to -0.33; p < 0.0001). Subgroup analyses demonstrated stronger effects for passive content, early exposure (<2 years), and daily usage exceeding two hours. Sensitivity analyses confirmed the robustness of these findings. These results highlight the relevance of content type, screen time duration, and age of exposure in shaping cognitive trajectories. Public health strategies and parental guidance should consider these aspects to mitigate developmental risks associated with screen media exposure.