The Impact of Digital Technology Use on Child Development: A Comprehensive Literature Review

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Author(s): Maheshkumar Baladaniya*and Arpan Shaileshbhai Korat

Abstract

In recent years, the pervasive presence of digital screen media has become an integral part of children’s lives. The increasing accessibility of smartphones, tablets, and televisions has raised concerns about their potential effects on child devel- opment. This comprehensive literature review aims to explore the multifaceted relationship between digital screen media and various aspects of child development. We examine findings from several studies that shed light on cognitive development, social interactions, language acquisition, and the impact of screen time on children aged two and younger. Effects of the digital technology on the children depends on the various factors. Those factors include the socioeconomic status of the family, ecological environment, child attributes, interaction with various type of digital platform, content of the digital media and many others. It is evident that all of those factors are not associated with the experimental groups at the same time. So, there are many points which are missing in the findings from the previous studies and we cannot eliminate every gap because there would be number of permutations are present which cover various factors. There are certain things which are negatively impacting the child development and should be avoided whereas with the precaution and on the moderate level if feeded to children then the cognitive development would increase significantly in the children on the linguistic bases as well as on the cognitive bases.

Introduction

In this comprehensive review we are looking forward to analyzing the child development on the basis of the linguistic grasping and excellence of toddles, and cognitive capabilities affected by the digital media. At last, we analyzed the effects of the digital media in the brain functioning of the children. Apart from that, we also focused on the recommendations to the parents to improve their children’s childhood. Before jumping of the topic, we need to understand and define the def- inition of very fundamental concept of the child development. So, right from the beginning of the birth to the adolescence time of human being considered as a child development phase [1]. During child development phase, infants pass through various stages which contain continuous changes in the bi- ological, psychological, and emotional aspects. During this period, child is constantly gathering the information about the surrounding environment, social encounters with adults. Child spends major time with the mother and this social encounter decides how child’s development takes place. If we focus on a linguistic side of child development, there are numerous studies have been performed and analyzed tod- dlers’ capability to link very basic associations among objects and the related words, or which words is associated with which actions. Those actions cover nouns, verbs, prepositions, and an ability to generalization of words to novel exemplars. [2].

If we put focus on the cognitive development. Certain part of population thinks that children’s media, like dime novels, can make kids not think as much and not learn well. They also think to believe that it is reducing the time from activities that help them grow on the cognitive level. On the good side, some people believe these media are helpful because they let kids imagine and see things they don’t usually get to see. So, it is indirectly increasing the cognitive functionality of the children to identify and understand the new objects and to get familiarized themselves with those new objects [3]. Some studies showed that if identification process is directed by any adults or parents, then it would increase the chances of learning process.

Research Method- Literature Searching Strategy

In our literature search, a comprehensive keyword search strategy was employed to gather relevant studies from major electronic databases: Science Direct, Research gate, PubMed, ncbi and jama network. This strategy involved the use of key- words such as ‘television’ or ‘attention problem’ or ‘internet’ or ‘sleep disturbance’ or ‘development’ or ‘memory’ or ‘media exposure’ or ‘behaviour’ or ‘language’ or ‘interactive media’ or ‘screen exposure’ and various combinations thereof. The search extended up to May 2007.

Inclusion Criteria and Selection of Studies

This screening was carried out independently and in dupli-cate by the authors. Initially, the titles of the articles were screened, followed by the screening of the their abstract. Any discrepancies between the authors were resolved through consensus. As a result of this process, abstracts were identified as potentially relevant and were selected for full text review to assess their eligibility for inclusion in the final review.

Table 1

Study	Authors	Design	Participants	Results	Conclusion
Television and	Frederick J.	Telephone survey of	Random sample of	TVDVD viewing	With 90% of toddlers
DVD/Video Viewing in	Zimmerman, PhD;	1009 parents of chil-	parents of children born	among toddlers’	tuned to screens by
Children Younger Than	Dimitri A. Christakis,	dren aged 2 to 24	in the previ- ous 2 years	skyrockets from 40% at	age 2, parents need to
2 Years [1].	MD, MPH; Andrew	months.	(exclud- ing households	3 months to a whopping	be empowered media
	N. Meltzoff, PhD		where English was not	90% by age and for	mentors.
			spo- ken and children	those little viewers,
			with major disabilities).	screen time nearly
				doubles between 1 and
				2 years old, from 1 hour
				to over 1.5 hours daily.
Screen-based	Arumugam, C. T.,	Narrative review	52 studies on screen-	Screen-based media	Screen-based media
media and young	Said, M. A., & Farid,		based media and young	had positive, negative,	guidelines should
children: Review and	N. D. N.		children’s health,	and mixed effects	be                evidence-
recommendations [2].			development, and	on young children,	based, developmentally
			learning	depending on the type,	appropriate,
				content, quality, and	and culturally sensitive.
				context of media use
The impact of screen	Huber, B., Yeates, M.,	Kaufman, J.	Meta-analysis	43 studies on screen	Screen media
media on cognitive	Meyer, D., Fleckham-			media and cognitive	had a small
development	mer, L.,			development of chil-	but significant
of preschool-aged and				dren aged 2 to 12 years	positive effect on
older children [3].					cognitive development,
					especially
					for educational
					and interactive media
					& Screen media can
					enhance cognitive
					development if used
					appropriately and in
					moderation.
Infant Media Expo-	Dr.               Suzy	Longitudinal study	Infants from	Higher media	Echoes American
sure and Toddler De-	Tomopoulos, MD, Dr.		low socioeconomic	exposure  at 6	Academy of Pediatrics’
velopment [4].	Benard P. Dreyer, MD,		backgrounds	months correlated with	recommendations:
	Dr. Samantha Berkule,			lower cognitive scores	no media exposure prior
	PhD, Dr. Arthur H.			at 14 months. Reduced	to age 2 years. Further
	Fierman, MD, Dr.			language development	research needed to
	Carolyn Brockmeyer,			associated with greater	explore nuances.
	PhD, and Dr. Alan L.			media exposure at 6
	Mendelsohn, MD			months.
Screen media and lan-	Linebarger and Vaala	Comprehensive narra-	The participants in	Examined prevalence,	Screen-cognition
guage development in		tive review	the study are infants and	correlates,	relationships.
infants and toddlers: An			toddlers within the age	and patterns of screen	- Addressed
ecological per- spective			range of 0 to 3 years	viewing. Explored how	methodological
[5].				infants	challenges
				process information	and proposed
				from screens. -	future research
				Investigated	directions for a
				the impact on cognitive	more comprehensive
				domains: language,	understanding.
				executive functions,	Screen exposure effects
				imitation, parent- child	are context dependent,
				interactions, and school	with outcomes ranging
				readiness.	from positive to
				- Emphasized the role	negative. Highlighted
				of contextual factors	the              importance
				in modulating effects,	of considering
				including content	contextual elements in
				type, caregiver	understanding.
				behavior, screen
				interactivity,
				and background noise
Screen-based	Madigan, S., Browne,	Longitudinal study	2448 Canadian chil-	Higher screen time	Screen time should
media use and socio	D., Racine, N., Mori, C.,		dren aged 0 to 5 years	was associated	be limited and su-
emotional development	& Tough, S.		and their parents	with lower	pervised for young
among infants and				socio-emotional	children to support
toddlers: An ecological				development, especially	their socio-emotional
perspective [6].				for expressive	development
				communication,
				sociability, and self-
				regulation

Table2

Study	Authors	Design	Participants	Results	Conclusion
Interactive Media	Dimitri A. Christakis,			The effects of	The article
Use at Younger Than	MD, MPH			interactive media	emphasizes
the Age of 2 Years				on young children’s	the need for informed
[7].				cognition depend on	discussions
				the context of the	and consideration
				viewing, rather than	of policy implications
				the quantity	regarding interactive
					media use in children
					under 2 years old.
Children’s and Par-	Ana Z? ulec, Vanesa	Qualitative approach	The study involved	The study found	The study concludes
ents’ Perspectives on	Varga,     and		24 children and	that both children	that digital technol-
the Effects of Chil-	Luka S?tefanic´		24 parents, who	and parents perceive	ogy use has various
dren’s Digital Tech-			were recruited	different positive and	impacts on children,
nology Use [8].			through convenience	negative effects of	and that there is a
			sampling from	digital technology	need for more aware-
			different schools and	use on emotional,	ness and education
			regions in Croatia.	behavioral, physical,	on how to use dig-
			The children and	social and cognitive	ital technology in a
			parents were divided	development and	healthy and balanced
			into six groups	functioning in	way.
			each, based on the	children, and
			children’s age and	problematic digital
			gender	technology use as
				a general effect of
				excessive digital
				technology use in
				children.
The effects of	Georgene L. Troseth,	Meta-analysis	Number of participa-	Interactive	Interactive media can
interactive media	Rachel E. Flynn, and		tions is 5,147	media had a	support preschoolers’
on preschoolers’	Megan M. Saylor		between age of 2-6	positive effect	learning, but more
learning: A review of			years	on preschoolers’	re- search is needed
the evidence [9].				learning, especially	to understand the
				when the media	opti- mal conditions
				were designed to	and mechanisms of
				be developmentally	learn- ing
				appropriate,
				engaging, and
				educational
The impact of screen	Koeun Choi, Hyun-	Systematic review	Number of participa-	Screen media had	Screen media use
media on cognitive	Jin Jeon, and Soeun		tions is 23,650 be-	both positive	should be tailored
development of chil-	Kim		tween age of 0-5	and negative	to the child’s age,
dren from birth to age			years	effects on cognitive	interests, and needs,
5 [10].				development,	and parents
				depending on	and practitioners
				the type, content,	should be aware of
				context, and amount	the developmental
				of screen media	implications
				exposure	of screen media use
Digital Screen Media	Daniel R. Anderson,	Narrative review	Children using digital	For children under 2	Understanding the
DVD and Cognitive	PhD; Kaveri Subrah-		screen media	years old, television	impact of screen
Development	manyam, PhD			viewing has negative	media on cognitive
[11].				associations, particu-	development
				larly affecting lan-	is crucial as we
				guage and executive	navigate the digital
				function.	age. Future research
					will provide further
					insights.

Table3

Study	Authors	Design	Participants	Results	Conclusion
Effects of Screen Ex-	Bahia Guellai, Eszter	Literature review	Various studies in-	Screen viewing can	The context of screen
posure on Cognitive	Somogyi, Rana Es-		volving young chil-	have positive, neutral,	viewing includes
Development [12].	seily, Adrien Chopin		dren (ages 0-6) and	or negative effects	the behavior of
			screen exposure	on infants’ cognition,	adult caregivers, the
				de- pending on the	content of the screen,
				con- text.	the interactivity
					of the screen, and
					whether the screen
					is in the background
					or not. The article
					provides some
					recommendations
					for parents and
					caregivers on how
					to use screens in a
					beneficial way for
					young children.
Screen time and	Natalia Kucirkova,	Systematic review	Number of participa-	Screen time had	Screen time is
young children:	Lydia G. M. Hedges,		tion is 106,620 be-	mixed effects on	a complex
A systematic review	Annette K. Messer,		tween age of 0-8	young children’s	and multidimensional
of literature [13].	Karen Littleton, and		years	physical, social,	phenomenon
	David K. Scanlon			emotional,	that requires
				and cognitive	more nuanced
				development, and	and contextualized
				the effects varied	research and policy
				by the quality and
				quantity of screen
				time, the age and
				characteristics of the
				child, and the family
				and environmental
				factors
The Negative Effects	Mustafaog?lu, Zirek,	Literature review		The use of digital	Parents should moni-
of Digital Technology	Yasaci, Razak O¨			technology	tor and limit the
Usage on Children’s	zdinc¸ler			by children is	time, frequency, and
Development and				associated with	con- tent of their chil-
Health [14].				developmental,	dren’s technology use
				behavioral,	and ensure a balanced
				musculoskeletal,	lifestyle.
				physical, and sleep
				problems.
Internet  Use	Genevieve	Mixed methods,	91 children aged 9 to	The Internet was part	The article proposed
and Child	Marie Johnson	including surveys,	12 years old from	of the children’s	a theoretical
Development:		inter- views, and	two schools in	microsystem,	framework for
The		observations	Australia	influencing	understanding
TechnoMicrosystem				their development	how the Internet
[15].				in variousdomains.	influences
				The children used	child development,
				the Internet	based on the
				for communication,	ecological
				information,	systems theory of
				and recreation	Bronfenbrenner. The
				purposes, and had	article also suggested
				different levels of	some methods
				access, skills, and	and measures
				preferences. The	for validating
				Internet also affected	the ecological
				the children’s	technomicrosystem,
				relationships with	and reported some
				their parents, peers,	preliminary findings
				and teachers, as well	from a study of 91
				as their academic	children aged 9 to 12
				performance, self-	years old.
				esteem, and identity
				formation.

Table4

Study	Authors	Design	Participants	Results	Conclusion
Digital Childhood:	Vandewater, Rideout,	Survey	1,065 parents of chil-	Most children aged	Media and
Electronic Media	Wartella, Huang, Lee,		dren aged 0 to 6 in	0 to 6 watch TV	technology
and Technology Use	Shim		the US	and videos/DVDs	are pervasive
Among  Infants,				on a typical day,	and influential in the
Toddlers, and				and many uses	lives of young
Preschoolers [16].				new media such as	children. More
				computer and digital	research is needed on
				toys. Many young	the developmental
				children have a TV in	impact of media and
				their bedroom. Few	technology use.
				young children meet
				the AAP media- use
				guidelines. Media
				use is related to
				demographic and
				family factors, and to
				reading and playing
				outdoors.
Associations	John S. Hutton,	cross-sectional design	47 healthy children	Screen use beyond	Screen use may
Between	MS, MD; Jonathan		aged 3 to 5 years	the AAP guidelines	have negative
Screen Based Media	Dudley, PhD; Tzipi			was associated with	effects on brain
Use and Brain White	HorowitzKraus, PhD;			lower measures of	development and
Matter Integrity in	Tom DeWitt, MD;			mi- crostructural	cognitive outcomes
Preschool-Aged	Scott K. Holland,			organi- zation and	in preschool-aged
Children [17].	PhD			myelina- tion of brain	children
				white matter tracts,
				as well as lower
				scores on cognitive
				assessments
The effects of	Hirsh-Pasek, K.,	Narrative review	31 studies on in-	Interactive media,	Interactive media
interactive media	Zosh, J. M.,		teractive media and	such as apps, games,	can be integrated
on preschoolers’	Golinkoff, R. M.,		pre-schoolers’ learn-	and e-books, can	into early childhood
learning: A synthesis	Gray, J. H., Robb, M.		ing outcomes	support preschoolers’	education as a
of the research [18].	B., & Kaufman, J.			learning if they are	tool for enhancing
				designed based on	learning and
				four principles:	motivation.
				active, engaged,
				meaningful,
				and socially
				interactive
Violent Video Game Effects on Children and Adolescents: Theory, Research, and Public Policy [19].	Craig A. Anderson, Douglas A. Gentile, Katherine E. Buckley	Experimental	Children and college students	Even children’s games with cartoonish violence increased aggression	Consideration of video game effects on youth is crucial
Commentary: Mobile	Jenny S. Radesky,	Commentary article		Mobile and	Pediatricians
and interactive	MD			interactive media	and parents
media use by young				have potential	should be aware of
chil- dren: The good,				benefits and risks	the developmental
the bad, and the				for young children’s	implications
unknown [20].				development, but	of mobile and
				more research is	interactive media
				needed to understand	use and promote
				them	positive and mindful
					use.

Discussion

Various recommendations from the various world re- knowned organizations had published related to the digital media usage for the infants and toddlers and are as follows:

World Health Organization

The “Guidelines on Physical Activity, Sedentary Behavior and Sleep for Children under Five Years of Age” by World Health Organization (WHO) state that children within the first two years of life should not have any screen- based media exposure at all. For children aged two to four, screen time should not exceed more than an hour.

American Academy of Pediatrics

Children below the age of two are not encouraged to be exposed to any screen time at all. Now in this literature review we will discuss about the various effects of various platforms covering the various factors of combinations and ties to fill the gaps as mentioned above.

How big the issue is?

In one of the paper’s research projects on 1009 families, who were participated in the survey regarding the children and their interactions with the television and DVD/Video. One notable thing which comes up was, there are argumentsor point of view that watching television, or any understand them media may induce the better relation between the parents and children. So, researchers asked the same question to the parents as a response to that 26% to 47% parents believe that it is true and due to that reason, they let their children watch television. There is very interesting finding comes up during this study is that around 32% of parents are watching media with their children all time. This means 32% of the time children is expose to a well-regulated content approved by their parents [4].

According to the study and the response gathered from the parents, it is evident that among all the children 40% of them started watching television at the age of 3 months. By the time of 24 months among all of them 90% of them are watching the television. Median age of children who watch the television is the 9 months. So, it is evident that the standards or recommendation from the AAP is clearly not followed in actual world. Another interesting thing which comes out is that families with more than one child is very less likely to state that their children are spending their time in front of television. This is due to the fact that they have sibling to play with. Television is basically working as an electronic babysitter for the parents. Parents are desperately looking for the educational content on the TV. In the study it is observable that 1 in 5 parents need to their work done at home therefore it is very great and obvious way to distract their children by engaging them in the television

Till now we saw various studies which are not mentioning the frequency whether they are exposed on daily bases or once a week or when. Now, let’s talk about the frequency during how many times children are exposed to the digital medium and how that will affect them. A recent large study conducted with a French population shows that 84% of 2-year- old toddlers watch television at least once a week, and 68% every day. The average time of exposure to television for 2- to-24-month-old infants is 40 min per day and only half of the programs are educational programs, according to the parents [5].

Cognitive Development and Effects

There is one study conducted to directly conduct the neu- roendocrine responses from the infants with the age of 15 to 18 months. That study tried to collect the data of the serial salivary cortisol levels while playing the block game and while watching the DVD. Tasks were assigned randomly to infants. Noticeable thing was there is no perfect standard set at the infant age of the cortisol levels and performance level. Due to some previous examinations and tryouts researchers know that block play has a great result in the language development. If anything comes near to such levels, then it is considered to be a healthy and agreeable. Infants who played block play has measurably higher level of cortisol, on the counterpart infants with the DVD videos had comparatively lower levels of cortisol. The main reason behind such result is that block play gave the sense of achievement to the infants whereas such factor is not present in the DVD videos. Due to this sense of achievements children are become addicted to the video games, because after finishing every level of the game they fill that they achieve something and eager to play more increases automatically. Cognitive development can be seen different for the different age group children. For instance, infants and toddlers who watch television, or another kind of interactive media can make a significant impact on the quality and quantity interaction with the parent and child. Meanwhile on the positive side children watching television specifically intended to child-directed purpose may tend to have a richer vocabulary, while watching the show or imme- diately after the show. Another thing which is also impact the child development is the interaction of the parents with the digital technology. As the interaction of parents go higher with such interactive medium then they are compromising the time with their children. During the infancy and toddler age background television plays significant role as well because of the background audio interference with the playing time with the toys. Now as per the educational point of view, it is perceived that increasing the vocabulary and learning words are correlated with the education video or TV, but studies found that 12-to-18- month infants are not learning any words by watching the educational videos. To test the infants, researchers asked infants to direct to the things meanwhile they were exposed to the names of those same things. In this case-control study, the authors also evidenced that children at age 2 who had language delay usually started watching television earlier than a control group, and also spent more time watching television than other children (around 3 h per day vs. less than 2 h per day). Children who started watching television during their first year and who watched television more than 2 h/day were approximately six times more likely to have language delays than the ones who did not. On the negative side, interaction of children with the other human being per say with the parents reduce due to the watching television, whereas conversation and interactions are essential driver of the language development. So, talk about the language development there are two factors which we look towards. One is quantity and other is quality, so there is no correlation between the quantity and language development, but bad quality may cause the less vocabulary. Bad quality refers to the fact the shows are not intended for children, solitary viewing, background television. Children pay less attention to the television programs unless those shows are intended for them, because children less than 24 months of age barely understand the words. So, for younger than 24 months children all the adult shows play a role of background television. Background television also plays significant role in the child development. According to one of the studies performed on the background television indicates that parents are more likely to talk less with the child and engage passively with the infants with the age of 12 to 24 months. Whereas in the other study, performed on the 13 months of infants while turning on the television in the background, shows that mother use minimal vocabulary while playing with infants. Basically, background television increases the chances of less interaction between parents and child. Apart from that it also distractschild from their ongoing activity. Reason behind the change in attention is changes in the audio and visuals. Screen viewing is associated with lower cognitive development when viewing is unsupervised, when content is not appropriate for the age, or when in the background. Studies have been performed on many children, but according to this study it becomes evident that toddlers with the age of less than 2 years with the low socioecomical family background are more likely to exposed to severe effects of the digital platforms. This led to the adverse effect in development at the earlier stage of the reading capabilities and academic prowess [6].

Linguistic Development and Effects

According to several, research indicates that toddlers with the age of less than 24 months are unable to comprehend the child directed television program and have negative affect on the language and executive function level. Meaning they are getting negative impact on a cognitive level. Whereas children with the age more than 2 years start to understand the child-directed television shows. Majority of the research indicates that educational television has a positive impact on cognitive development. Parent-child interaction is the main driving factor of the cognitive, language, and executive function in child. There are few evidence suggests that, during preschool aged children are developing the ability to read and increasing the vocabulary of the language, but increasing or interaction with the television reading ability of the children may be compromised, because children pay less attention to the reading. On the positive side, numerous evaluations of preschool educational television programs such as “Sesame Street” have found a positive impact on vocabulary, literacy, social behavior, and academic knowledge. This can be un- derstood, toddlers with 2 years of age with “Sesame Street” exposure has the wider letter, number, shape, color knowledge on the readiness level whereas comparing with the 3 – 4 years who are exposed to the adult directed television program have general measure of school readiness [7].

Positive Effects of the Digital Media

Till now we talked enough about the adverse effects of the digital platforms on the development on the infants and toddlers, now we will see the flip side the coin and focuses on the brighter side of those platforms. It turns out, if babies watch shows with any adult that would make a significant impact on the language development on the positive end. According to Bronfenbrenner, ecological atmosphere imposes a signif- icant impact on the learning capabilities for the toddlers. Bronfenbrenner further included that controlled environment negates the interdependent complexities and variation of the surrounding space and social interactions. Sometimes this will lead to a misleading and not conclusive results. Language development depends on the biologically (age of the child) as well as the surrounding environment. Studies can be divided into various categories. Most importantly in order to develop the lingual skill it is very important that whatever the digital media children are exposed but those media contain certain characteristics. As infants has very less background knowledge about the language or any signs presented in frontof them, so it become more important that digital media create the content use the simple sentences, have a really slow and understandable speech, very clear and precise paraphrased content repetitions, significant time between two sentences and phrases in order to understand clearly [8].

Negative Effects of the Screen Media

The rapid rise of screen-based media usage among children, starting in infancy and continuing throughout childhood, has raised concerns about its impact on child development and health. The American Academy of Pediatrics (AAP) has recommended limits on screen time due to these concerns. To better understand the effects of screen time on early brain development, this study used diffusion tensor imaging (DTI) to investigate the relationship between screen-based media use and white matter integrity in preschool-aged children, focusing on brain tracts related to language, executive function, and literacy. The study found that greater screen use was associated with reduced integrity of these critical brain tracts and poorer cognitive outcomes. The research involved 69 parent-child pairs, with behavioral analyses conducted using SAS software. The ScreenQ survey assessed screen use adherence to AAP guidelines, while standardized assessments measured language and literacy skills. The study revealed that children with higher screen time had lower white matter tract integrity, particularly in areas crucial for language and literacy development. Cor- relations between screen time and cognitive test scores were also observed. Excessive use of mobile devices, tablets, and increased screen time in children can have both short- term and long-term effects on the brain, including changes in white matter and gray matter [9].

Altered Connectivity in White Matter

• Prolonged screen time may lead to changes in the connectivity of white matter tracts in the brain.
• White matter is crucial for transmitting signals be- tween different brain regions.
• Excessive screen time could potentially disrupt the normal development of these neural connections.

Attention and Impulsivity Issues

• Increased screen time, especially in younger children, might be associated with attentional problems and impulsivity.
• Behavioral issues observed could be linked to alter- ations in white matter connectivity.

Structural Changes in Gray Matter

• Studies indicate that excessive screen time can result in structural changes in the gray matter of the brain.
• Particularly affects areas responsible for information processing and decision-making.
• These changes may have implications for cognitive and behavioral functions.

Reduction in Gray Matter Volume

• High screen time has been correlated with a decrease in gray matter volume.
• Impacts areas involved in language, memory, and spatial skills.
• Reductions in gray matter volume may influence cognitive development.

Sleep Disturbances

• Excessive screen time, especially before bedtime, can interfere with sleep patterns.
• Poor sleep quality may further impact overall brain function and development.

Impact on Cognitive Development

• Excessive screen time may limit the time children spend in active, exploratory play.
• Active play is crucial for cognitive development in children.

Physical Health Consequences

• Increased screen time is associated with a sedentary lifestyle.
• Sedentary behavior can lead to physical health prob- lems such as obesity, potentially affecting brain function.

Social and Emotional Development

• Excessive screen time may reduce face-to-face social interactions among children.
• Impacts emotional development, potentially hinder- ing social Skills.

In a prospective cohort study of more than 16,000 children between ages of two and nine years, every additional hour of screen time showed an increase of 1.2- to 2-fold in the proba- bility of emotional problems and poorer family functioning. In a systematic review of sedentary behavior and health indicators among school children and youths, 68% of longitudinal studies showed that greater amounts of television viewing at baseline were associated with steeper increases in body mass index (BMI), body weight and fat mass over time. The Malaysian National Health and Morbidity Survey 2016 reported that 52.2% of children nationwide experience excessive screen time exposure, defined as any electronic media usage among children below the age of two and screen time of more than two hours among children aged 24 to 59 months [10].

Results

Survey in UK suggests that around 21% of the toddles around the age of three to four years have their own tablet. In 2017 one publication found that 274 out of 489 children age ranging from two to six years had their own media device. In a prospective cohort study that assessed the media usage of children at six months old and then reassessed at 14 months old, lower cognitive and language development were displayed among children with early exposure to electronic media, even after adjusting for co-founders. Toddlers with 60 minutes of screen-based media exposure had lower developmental scores in both domains compared to their peers who had no exposure. There was significant study conducted on the toddlers with the age of 6 months and results were assessed based on the exposure time and the content of the digital platform at theend results were assessed when children were 14 months old. Results were shocking and totally opposite of the guidance issued by the AAP. It turned out that average exposure for the children to the media was 152.7 minutes, which is more than 2.5 hours. Not only that but children also watched adult oriented shows averaging 91.5 minutes. In the study it was cleared that children with absolute zero exposure to digital platform has the cognitive development (Bayley-III) score of 102.1 but with the one-hour exposure it directly dropped by the 7 points and became 95.9 worst of all with higher than one hour exposure infants got 93.2 score. For the language development point of view, they conducted PLS-4 test. Toddlers with none of the exposure from media got 103.0 score, with one hour exposure it became 98.2 and more than that even dropped to 96.0 [11].

Recommendations

There are plenty of studies have been conducted and many publications have look into the most probable health impacts of early exposure and excessive usage of screen-based media among children, there are very clear and evident links are interconnected between screen time and behavioral difficulties in the social activities, moreover delays can be seen in the development in the child, and risk of obesity is increasing day by day in the young children, there are many more issues are connected with this screen-based media.

A. Merge with The Above Child-Parent Interaction and Para- Phrase

Excessive screen time among young children is associated with high chances of displacing parent– child interaction, which is fundamental to a thriving child’s process of learning and development. Childhood is filled with the continuous learning with the adaptation of changes which are going around. Everything can be measured by the small and simple milestones, which can be tracked by the parents. Inadequate or inappropriate social and emotional experiences in a child’s early life can compromise higher–level brain functioning that provides the processing information necessary to socially bond and respond. Various changes in childhood and parenting may affect the child’s mind for a long period. In other words, environment in the childhood more of less develops the psychological mental state of the children. Specifically, poor relations between mother and child place child in an insecure mental state which have the long-lasting affect. Looking at the different side, if parents read together with their children, then their vocalization ability naturally increases as well as the attention to the minor details as well. It’s important to note that while these potential effects have been observed in some studies, the research on this topic is ongoing, and more studies are needed to fully understand the long-term consequences of screen time on the developing brain. Additionally, not all screen time is equal; the content and quality of the screen- based activities matter. Parents and caregivers should consider setting appropriate limits on screen time, ensuring that screen- based activities are educational and age-appropriate, and en-couraging a balanced lifestyle that includes physical activity, social interactions, and other forms of learning and play. It’s also advisable to consult with healthcare professionals for guidance on managing screen time for children. In conclusion, increased screen-based media use among preschool-aged chil- dren, even within AAP-recommended limits, was linked to compromised white matter integrity in brain tracts essential for language, executive function, and literacy. These structural changes were associated with lower cognitive test scores, underscoring the need for further research to fully understand the implications of screen-based media exposure during early childhood brain development. Given the widespread use of screens in various settings, additional studies are essential to uncover the effects on developing brains during the early stages of childhood growth [12-23].

References

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