Screen Use and Emotional, Behavioral, and Social Development in Children

Importance: The association between electronic screen use and psychosocial development in children remains unclear. Few studies account for longitudinal associations or fully adjust for key covariates such as family functioning. Objective: To evaluate the cross-sectional association between screen use and psychosocial development at 5, 10, and 15 years of age and the longitudinal association between screen use at 5 years of age and psychosocial development at 10 and 15 years of age. Design, Setting, and Participants: This secondary analysis of a cohort study used data from a large Scottish birth cohort, with follow-up at 5, 10, and 15 years of age between January 1, 2010, and December 31, 2020. Data were obtained and analyzed between April 2025 and March 2026. Exposure: Screen use during nonschool hours was reported by parents or participants for children at 5, 10, and 15 years of age. Main Outcomes and Measures: Psychosocial development was measured using a parent-completed Strengths and Difficulties Questionnaire (SDQ) at each time point. SDQ scores were analyzed continuously and dichotomized at established cutoffs for above-average total difficulties scores (TDSs; score ≥14) and below-average prosocial scores (<8). Multivariable linear and logistic regression models assessed cross-sectional associations at each age and longitudinal associations between screen use at 5 years of age and SDQ scores at 10 and 15 years of age. Results: A total of 3786 children were included at 5 years of age (median [IQR] age, 58 [58-58] months; 1929 [51.0%] male and 1857 [49.0%] female), 3126 at 10 years of age (median [IQR] age, 122 [120-125] months; 1578 [50.5%] male and 1548 [49.5%] female), and 2598 at 15 years of age (median [IQR] age, 175 [172-179] months; 1289 [49.6%] male and 1308 [50.3%] female). Daily screen use increased with age, with patterns varying by screen type. Cross-sectional analyses showed no significant associations between screen use and TDS at 5 or 10 years of age. At 15 years of age, more than 5 h/d of gaming was significantly associated with higher odds of above-average TDS than less than 1 h/d (odds ratio [OR], 2.61; 95% CI, 1.49-4.57). Conversely, more than 1 h/d of social media and messaging was associated with lower odds of above-average TDS than less than 1 h/d (ranging from OR, 0.57 [95% CI, 0.39-0.84] to 0.61 [95% CI, 0.38-1.00] for 1-2 h/d of screen use). Longitudinally, more than 5 h/d of screen use at 5 years of age was associated with increased odds of above-average TDSs at 10 years of age (OR, 2.68, 95% CI, 1.25-5.76), but this association was lost at 15 years of age and in sensitivity analyses. No associations were seen for the prosocial score. Conclusion and Relevance: In this cohort study, screen use was not consistently associated with poorer outcomes for children. These findings suggest that guidelines focusing solely on screen time may have limited impact on psychosocial outcomes.