Screen time and language/cognitive development in preschoolers aged 3–5 years

BACKGROUND: Digital media use in early childhood has increased rapidly in recent years. However, findings on its developmental correlates remain inconsistent, particularly across different domains of early learning. Guided by ecological and cognitive stimulation frameworks, this study examined associations between weekday time spent on electronic devices and multiple indicators of language and cognitive development in preschool children aged 3-5 years. Because the National Survey of Children's Health captures time-based exposure only, the present analyses address overall device-use duration rather than content, context, or co-use. METHODS: Cross-sectional analyses used data from the 2016 National Survey of Children's Health. Of 15,402 preschool-aged children in the survey, 6905 with non-missing data on exposure, outcomes, and co-variates were included in the complete-case analytic sample. Caregivers reported children's weekday electronic-device use, excluding schoolwork, and early learning outcomes including beginning sounds, letter recognition, rhyming, verbal expression, name writing, counting, and shape recognition. For consistency with the reported odds ratios, outcomes were analyzed as dichotomized indicators in multi-variable logistic regression models adjusted for child age, sex, race/ethnicity, household poverty ratio, parental education level, household size, sleep duration, prematurity, and working-poor household status. RESULTS: Weekday electronic-device use was not significantly associated with most language outcomes. Greater amount of device use was associated with lower odds of name writing and higher odds of counting. Sociodemographic and household characteristics were also associated with several outcomes. Sleep-duration estimates were large and imprecise in several models and are therefore interpreted cautiously. CONCLUSIONS: In this cross-sectional sample, associations between weekday electronic-device use and development were domain-specific rather than uniform across outcomes. These findings support cautious interpretation of time-based screen measures and highlight the importance of considering family context, sleep, and the qualitative features of media use that were not measured in the present dataset.