High screen time and low child-adult talk associated with poorer language development in early childhood

Objectives To examine associations between children's and parents' screen time, children's face-to-face talk with adults, and children's language skills. Design, setting, and participants Cross-sectional study based on mother-reported survey data collected from September 2023 to December 2024 in Estonia. Participants were 458 children aged 30–48 months; analyses included 448 children (mean SD age, 39.1 5.0 months) with complete data. Measures Daily child screen time, parental screen time, and children's time spent in face-to-face talk with adults were reported for a typical weekend day. Children's language skills were assessed using the Estonian version of the MacArthur–Bates Communicative Development Inventories III (ECDI-III). Multiple linear regression examined independent and combined associations of screen time and talk with language scores, adjusting for child age and sex. Latent class analysis (LCA) was used to identify family-level patterns of screen use and conversational engagement. Results Among the 448 children 232 girls (51.8%); mean (SD) age, 39.1 (5.0) months, 39.4% had ≤ 60 min of daily screen time, 33.7% had 61-120 min, and 27.0% had 120 min. In regression analyses, higher screen time was negatively ( B = −0.081; 95% CI, −0.115 to −0.048; P 0.001) and child-adult face-to-face talk positively (B = 0.031; 95% CI, 0.015 to 0.047; P 0.001) associated with ECDI-III scores. The full model, including age and sex, explained 26.1% of the variance in language scores. LCA identified three family profiles: Screen-Saturated, Somewhat Talkative Families (43.2%), Low-Screen, Quiet Families (40.2%), and Parent-Screen, Talk-Rich Families (16.6%). Children in Parent-Screen, Talk-Rich Families showed higher language scores and greater child-adult conversational engagement than children in the other profiles (Welch's F (2, 221) = 6.23; P = 0.002). Conclusions Higher screen time and lower child-adult conversational engagement were associated with poorer language outcomes in early childhood. Family typologies suggested that low screen time alone was not associated with stronger language skills unless accompanied by rich conversational environments. These findings highlight the importance of considering both digital media use and everyday conversational experiences when examining early language development.