Screen Use and Child and Adolescent Development and Mental Health Outcomes

This is the authors' abstract. We don't add key points for this paper.

Importance: Given the ubiquity of screens in children's lives and public concerns about potential effects on development and mental health, a consolidated, up-to-date synthesis of empirical evidence linking screen exposure with development and mental health outcomes is needed to inform stakeholders and policymakers. Objective: To synthesize and quantify meta-analytic associations between screen-based media exposure and developmental outcomes among individuals aged 18 years or younger using an umbrella review methodology. Data Sources: Embase, MEDLINE, and PsycINFO databases were systematically searched from inception to November 25, 2025. Study Selection: Meta-analyses of population-based samples of children aged 18 years or younger that were published in English were included. Data Extraction and Synthesis: Data from 23 meta-analyses were extracted and synthesized. This umbrella review adhered to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Relevant data from each eligible meta-analysis were extracted by 2 independent reviewers at the meta-analytic level and the primary study level, with effect sizes converted to Pearson r for reanalysis. Main Outcomes and Measures: The primary outcomes were academic functioning, cognitive skills, socioemotional development, and mental health. Results: Data from 23 meta-analyses, representing 2 817 252 children from 64 countries, were extracted and synthesized. Screen-based media exposure was associated with lower academic achievement (r = -0.15; 95% CI, -0.23 to -0.07) and language skills (r = -0.14; 95% CI, -0.18 to -0.10) and with higher internalizing behavior (general screen use: r = 0.10; 95% CI, 0.07-0.13; social media use: r = 0.09; 95% CI, 0.06-0.12) and externalizing behavior (r = 0.11; 95% CI, 0.08-0.14), emotional problems (r = 0.30; 95% CI, 0.08-0.50), and peer problems (r = 0.28; 95% CI, 0.04-0.49). Screen-based media exposure was not associated with executive functioning (r = 0.01; 95% CI, -0.09 to 0.11), prosociality (r = -0.22; 95% CI, -0.43 to 0.01), or mathematics (r = -0.10; 95% CI, -0.23 to 0.03), science (r = -0.03; 95% CI, -0.15 to 0.11), or reading (r = -0.02; 95% CI, -0.12 to 0.09) scores. Screen type, subtype of behavior problems, publication year, and age moderated some of these associations. Conclusions and Relevance: This umbrella review identified associations between screen use and several domains of children's developmental health outcomes in population-based studies. These findings can inform the development and refinement of evidence-informed guidelines and policies on children's screen-based media use issued by medical and governmental organizations.