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Associations Between Screen Use and Child Language Skills: A Systematic Review and Meta-analysis
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Importance: There is considerable public and scientific debate as to whether screen use helps or hinders early child development, particularly the development of language skills. Objective: To examine via meta-analyses the associations between quantity (duration of screen time and background television), quality (educational programming and co-viewing), and onset of screen use and children's language skills. Data Sources: Searches were conducted in MEDLINE, Embase, and PsycINFO in March 2019. The search strategy included a publication date limit from 1960 through March 2019. Study Selection: Inclusion criteria were a measure of screen use; a measure of language skills; and statistical data that could be transformed into an effect size. Exclusion criteria were qualitative studies; child age older than 12 years; and language assessment preverbal. Data Extraction and Synthesis: The following variables were extracted: effect size, child age and sex, screen measure type, study publication year, and study design. All studies were independently coded by 2 coders and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Main Outcomes and Measures: Based on a priori study criteria, quantity of screen use included duration of screen time and background television, quality of screen use included co-viewing and exposure to educational programs, and onset of screen use was defined as the age children first began viewing screens. The child language outcome included assessments of receptive and/or expressive language. Results: Participants totaled 18 905 from 42 studies included. Effect sizes were measured as correlations (r). Greater quantity of screen use (hours per use) was associated with lower language skills (screen time [n = 38; r = -0.14; 95% CI, -0.18 to -0.10]; background television [n = 5; r = -0.19; 95% CI, -0.33 to -0.05]), while better-quality screen use (educational programs [n = 13; r = 0.13; 95% CI, 0.02-0.24]; co-viewing [n = 12; r = 0.16; 95% CI, 0.07-.24]) were associated with stronger child language skills. Later age at screen use onset was also associated with stronger child language skills [n = 4; r = 0.17; 95% CI, 0.07-0.27]. Conclusions and Relevance: The findings of this meta-analysis support pediatric recommendations to limit children's duration of screen exposure, to select high-quality programming, and to co-view when possible.
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“Siblings can also co-view digital media, which might provide an added benefit for younger siblings.75”
From Digital Ecosystems, Children, and Adolescents: Technical Report (2026) · cites this paper as [75]
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“Conversely, the co-use of screen media between caregivers and children, better-quality content, such as educational programming, and later screen exposure during childhood have been positively associated with cognitive and language development [88, 89].”
From Scrolling through adolescence: a systematic review of the impact of TikTok on adolescent mental health (2025) · cites this paper as [89]
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“For example, in one meta-analysis,75 the quantity of digital media is associated with poorer language skills.”
From Digital Ecosystems, Children, and Adolescents: Technical Report (2026) · cites this paper as [75]
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Metadata
- Authors
- Madigan, S., McArthur, B. A., Anhorn, C., Eirich, R., & Christakis, D. A.
- Affiliations
- University of Calgary (CA)
- Seattle Children's Hospital (US)
- Corresponding author
- Madigan, Sheri
- Venue
- JAMA Pediatrics
- Publisher
- American Medical Association (AMA)
- Published
- 2020-07-01
- Volume
- 174
- Issue
- 7
- Pages
- 665
- ISSN
- 1072-4710 (ISSN-L)
- 2168-6203
- PMC
- PMC7091394
- OpenAlex
- W3012867415
- Cited by
- 489
- References
- 97
- Citations by year
- 2026: 113 · 2025: 93 · 2024: 100 · 2023: 74 · 2022: 50 · 2021: 45 · 2020: 13
- FWCI
- 14.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Child Development and Digital Technology
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Social Sciences › Education › Early Childhood Education and Development
- Keywords
- screen time, child language acquisition, receptive language, expressive language, educational programming, co-viewing, early childhood, digital media effects on children
- MeSH terms
- Child, Child Language, Humans, Parents, Television
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