Testing Directional Associations Between Children’s Digital Media Use and Attention-Deficit/Hyperactivity Disorder Symptoms

Objective The COVID-19 pandemic was associated with increases in both digital media use and ADHD symptoms. Although digital media use has been linked to ADHD symptoms, the direction of this association is unclear. We tested bidirectional links between digital media use and ADHD across three timepoints during and after the pandemic using Random-Intercept Cross-Lagged Panel Modelling (RI-CLPM). Method Participants were 1,713 mother-child dyads (52% male) from the All our Families cohort, when children were 11 (Wave 1: March–April 2021, during pandemic), 12 (Wave 2: November 2021–January 2022, during pandemic) and 13 (Wave 3: January–July 2023, post-pandemic) years old. Children reported weekday and weekend digital media use. Mothers reported child inattention and hyperactivity symptoms. Results Between person effects suggested that children who reported higher weekday and weekend digital media use also had higher inattention and hyperactivity, on average. Within person effects emerged only for weekday use: higher weekday digital media use at age 11 predicted higher inattention at age 12 across the pandemic interval, but higher hyperactivity at age 11 predicted lower weekday screen time at age 12, which in turn predicted higher hyperactivity at age 13, spanning the pandemic and post-pandemic periods. No moderation by sex, income, or ethnicity was observed. Conclusion Limiting weekday screen time may be one useful strategy for reducing inattentiveness, though hyperactive behaviors may become more noticeable. Results highlight the value of preparing caregivers for shifts in how ADHD symptoms may present when limiting media use, and of identifying adaptive alternatives. Replication outside the COVID-19 context is needed.