Beyond Screen Time: A Scoping Review of Screen Exposure and Early Childhood Development

Background: Screen exposure in early childhood has evolved beyond traditional duration-focused “screen time” to encompass a multidimensional construct including content quality, context of use, co-viewing, caregiver mediation, and developmental trajectories. Understanding these dimensions is essential for comprehensive assessment, particularly in rapidly digitizing cultural contexts such as Saudi Arabia and the broader Middle East. Objectives: This scoping review aimed to systematically map and synthesize peer-reviewed evidence on multidimensional screen exposure and developmental outcomes in children aged 0–5 years, with specific focus on language, cognitive, and socio-emotional outcomes. Methods: This scoping review followed PRISMA-ScR guidelines. Systematic searches were performed in PubMed, Scopus, Web of Science, and Google Scholar (2016–2026). Inclusion criteria were primary empirical studies (randomized trials and observational designs), children aged 0–5 years (up to 72 months, provided primary exposure was assessed within the 0–5-year window), quantitative screen exposure measurement, and validated developmental outcome assessment. Data were extracted and synthesized narratively across the developmental domains. Results: Twenty-seven studies demonstrated that content quality, context of use, and caregiver behavior (including co-viewing and active guidance of screen use) consistently modified the strength of associations between screen exposure and early developmental outcomes. Language development was the most extensively studied domain; co-viewing emerged as a key protective factor, and longitudinal trajectory analyses identified heterogeneous exposure patterns with differing developmental implications across cognitive, socio-emotional, and physical domains. Conclusions: Screen exposure in early childhood is a multidimensional phenomenon requiring assessment tools that capture content, context, co-use, and caregiver mediation alongside duration. Findings highlight the need for culturally adapted measurement instruments in the Saudi Arabian context to support evidence-based early childhood practice and align with Vision 2030 objectives.