The research below covers:

• Screen Time and Brain Development

• P.O.W.E.R. Activities and "Human Skills"

• Screen Time and Child Development

• Screen Time and Early Childhood-Specific Concerns

Screen Time and Brain Development

The human brain is constantly developing, but experts refer to two "critical periods" for brain development: early childhood and adolescence.   During these periods of time, the brain builds and strengthens neuronal connections that are well-used, and it also prunes away connections that are not often utilized.  This is called synaptic pruning.  The phrase "USE IT OR LOSE IT" rings true for brain development! 

In fact, research has shown a thinning of certain brain structures, especially related to language and literacy, in children and adolescents exposed to excessive screen time.  More research needs to be done before we can know exactly why this is happening, but it is concerning to see the brain thinning in areas that should be growing during these critical periods.

Which brain connections do we want to help children build more of? Which connections do we not want to be pruned away?  Let's help children and families focus on the activities that have been proven through decades of research and experience to build strong, capable, resilient, critical-thinking, and creative-thinking brains!   

• Hutton JS, Dudley J, Horowitz-Kraus T, DeWitt T, Holland SK. Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children. JAMA Pediatrics. 2020.

• Hutton JS, Dudley J, DeWitt T, Horowitz-Kraus T. Associations between digital media use and brain surface structural measures in preschool-aged children. Scientific Reports. 2022.

• Mingyang Li, Dan Wu, et al., Causal Relationships Between Screen Use, Reading, and Brain Development in Early Adolescents, Advanced Science (2024). DOI: 10.1002/advs.202307540

• Tamana SK, Ezeugwu V, Chikuma J, Lefebvre DL, Azad MB, Moraes TJ, Subbarao P, Becker AB, Turvey SE, Sears MR, Dick BD, Carson V, Rasmussen C; CHILD study Investigators; Pei J, Mandhane PJ. Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study. PLoS One. 2019.

P.O.W.E.R. activities and "Human Skills"

Play

Play improves physical and mental health, builds resilience, and strengthens many foundational skills, such as: problem solving, critical thinking, creative thinking, and communication.

• Hesketh and Dodd. More play and fewer screens: a way to improve preschoolers’ mental health? Cross-sectional findings from the British Preschool-children’s Play Survey. The Lancet, 2023.

• Dodd HF, Nesbit RJ, FitzGibbon L. Child's Play: Examining the Association Between Time Spent Playing and Child Mental Health. Child Psychiatry & Human Development. 2023.

• Lee RLT, Lane SJ, Tang ACY, Leung C, Louie LHT, Browne G, Chan SWC. Effects of an Unstructured Free Play and Mindfulness Intervention on Wellbeing in Kindergarten Students. International Journal of Environmental Research and Public Health. 2020.

• Burdette HL, Whitaker RC. Resurrecting free play in young children: looking beyond fitness and fatness to attention, affiliation, and affect. Arch Pediatric Adolescent Medicine. 2005 

Outdoors

Outdoor time improves physical and mental health, mitigates the negative effects of screen time, strengthens cognition and academic learning, and builds communication and language skills.

• Sugiyama M, et al. Outdoor Play as a Mitigating Factor in the Association Between Screen Time for Young Children and Neurodevelopmental Outcomes. JAMA Pediatr. 2023.

• Burdette HL, Whitaker RC. Resurrecting free play in young children: looking beyond fitness and fatness to attention, affiliation, and affect. Arch Pediatr Adolesc Med. 2005

• Larouche R, et al. Determinants of Outdoor Time in Children and Youth: A Systematic Review of Longitudinal and Intervention Studies. International Journal of Environmental Research and Public Health. 2023

• Scott S, Gray T, Charlton J, Millard S. The Impact of Time Spent in Natural Outdoor Spaces on Children's Language, Communication and Social Skills: A Systematic Review Protocol. International Journal of Environmental Research and Public Health. 2022.

Work/Chores

Work and chores build useful life skills, a strong work ethic, self-esteem, resilience to frustration and adversity, and a sense of belonging.

• White EM, DeBoer MD, Scharf RJ. Associations Between Household Chores and Childhood Self-Competency. Journal of Developmental and Behavioral Pediatrics. 2019.

• American Academy of Child and Adolescent Psychiatry. Chores and Children. 2018.

• Haden, Jeff. "Want to Raise More Successful (and Happier) Kids? Harvard Research Says Give Them More Chores". Inc. 2024.

Engage

Engaging with others strengthens language, communication and interpersonal skills,  builds empathy and creates community.

• Brushe ME, Haag DG, Melhuish EC, Reilly S, Gregory T. Screen Time and Parent-Child Talk When Children Are Aged 12 to 36 Months. JAMA Pediatr. 2024.

• Jones, D et al. Early Social-Emotional Functioning and Public Health: The Relationship Between Kindergarten Social Competence and Future Wellness. American Journal of Public Health. 2015.

• Uhls, Y. et al. Five days at outdoor education camp without screens improves preteen skills with nonverbal emotion cues.  Computers in Human Behavior. 2014.

• Murphy, Bill. "Want to Be Truly Happy?  Here's the Only Thing Harvard Researchers Say you Really Need". Inc. 2016.

Reading

Reading opens new worlds of knowledge, strengthens focus and attention, increases brain connectivity, and builds empathy. Shared reading also strengthens attachment.

• Sheldon-Dean, Hannah, "Why is it important to Read to Your Child". Child Mind Institute. 2024.

• "Why Do Kids Need Books?" National Children's Book and Literacy Alliance.

• Bavishi A, Slade MD, Levy BR. A chapter a day: Association of book reading with longevity. Soc Sci Med. 2016.

• Horowitz-Kraus T, Hutton JS. Brain connectivity in children is increased by the time they spend reading books and decreased by the length of exposure to screen-based media. Acta Paediatr. 2018.

• Hutton, J.S., Dudley, J., Horowitz-Kraus, T. et al. Differences in functional brain network connectivity during stories presented in audio, illustrated, and animated format in preschool-age children. Brain Imaging and Behavior. 2020.

Reading/Writing on paper vs. screen:

• Children Derive Deeper Meaning from Printed Texts Than Screens, According to New Brain Study from Teachers College, Columbia University

• Reading from paper compared to screens: A systematic review and meta-analysis 

• The Importance of Cursive Handwriting Over Typewriting for Learning in the Classroom: A High-Density EEG Study of 12-Year-Old Children and Young Adult

• Middle-schoolers’ reading and processing depth in response to digital and print media: An N400 study (2023)

Screen Time and Child Development

Health Concerns

The following studies document screen time effects on physical, mental, social-emotional and cognitive health.

PHYSICAL HEALTH

including: obesity, eyesight,  cardiovascular, musculoskeletal and sleep health.

Obesity:

• Association of Physical Activity and Screen Time With Body Mass Index Among US Adolescents, 2023

Eyesight:

• Association of excessive screen time exposure with ocular changes leading to astigmatism in children, 2025.

• Digital Screen Time and Myopia, 2025.

Cardiovascular Health:

• Screen Time Is Associated With Cardiometabolic and Cardiovascular Disease Risk in Childhood and Adolescence, 2025.

Sleep:

• Role of Sleep and White Matter in the Link Between Screen Time and Depression in Childhood and Early Adolescence, 2025.

• Smartphone Ownership, Age of Smartphone Acquisition, and Health Outcomes in Early Adolescence, 2025.

• A Movement for Movement:  Screen time, physical activity and sleep: a new integrated approach for children

•  The impact of screen use on sleep health across the lifespan: A National Sleep Foundation consensus statement, 2024.

• Consequences of Screen Time on Sleep Quality in Children and Adolescents: A Scoping Review, 2025.

• The Impact of Screen Time on Sleep Patterns in School-Aged Children: A Cross-Sectional Analysis, 2024.

• Screen time, sleep, brain structural neurobiology, and sequential associations with child and adolescent psychopathology: Insights from the ABCD study, 2024.

Musculoskeletal:

• Association between excessive smartphone use and cervical disc degeneration in young patients suffering from chronic neck pain, 2021.

• Correlation of Cervical Spinal Degeneration with Rise in Smartphone Usage Time in Young Adults, 2020.

• The Effect of Technological Devices on Cervical Lordosis, 2018.

• Mobile touch screen device use and associations with musculoskeletal symptoms and visual health in a nationally representative sample of Singaporean adolescents, 2019.

MENTAL HEALTH

including: depression, anxiety, self-harm and suicide.

• Screen time and suicidal behaviors among U.S. children 9–11 years old: A prospective cohort study, 2023.

• Smartphone Ownership, Age of Smartphone Acquisition, and Health Outcomes in Early Adolescence, 2025. (depression, obesity, sleep)

• Screen Media Use and Mental Health of Children and Adolescents: A Secondary Analysis of a Randomized Clinical Trial | Media and Youth | JAMA Network Open | JAMA Network, 2024. 

• Increases in Depression, Self‐Harm, and Suicide Among U.S. Adolescents After 2012 and Links to Technology Use: Possible Mechanisms

• Pediatric Mental Health Hospitalizations at Acute Care Hospitals in the US, 2009-2019

• Sex- and Age-specific Increases in Suicide Attempts by Self-Poisoning in the United States among Youth and Young Adults from 2000 to 2018

• Association of Cyberbullying Experiences and Perpetration With Suicidality in Early Adolescence, 2022.

• Social media use and self-injurious thoughts and behaviors: A systematic review and meta-analysis, 2021.

• Brain structural co-development is associated with internalizing symptoms two years later in the ABCD cohort, 2023.

• Associations between screen time and internalizing disorder diagnoses among 9- to 10-year-olds, 2022

SOCIAL-EMOTIONAL HEALTH

including: self-esteem, relationships, social skills, understanding emotions and reading emotion cues.

• The relationship between addictive use of social media, narcissism, and self-esteem: Findings from a large national survey, 2017

• Electronic Screen Use and Children’s Socioemotional Problems: A Systematic Review and Meta-Analysis of Longitudinal Studies, 2025.

• Associations between screen time and emotional and behavioral problems among children and adolescents in US, National Health Interview Survey (NHIS), 2022

• Screen time and the development of emotion understanding from age 4 to age 8: A community study, 2019

• Five days at outdoor education camp without screens improves preteen skills with nonverbal emotion cues, 2014.

• IMPACT OF SCREEN TIME ON SOCIAL SKILLS DEVELOPMENT IN YOUNG CHILDREN: AN OBSERVATIONAL STUDY, 2024.

COGNITIVE HEALTH

including: lower cortical thickness, less brain connectivity, and executive functioning.

Brain development (also see above):

• Feeds, Feelings, and Focus: A Systematic Review and Meta-Analysis Examining the Cognitive and Mental Health Correlates of Short-Form Video Use, 2025.

• Youth Screen Media Activity Patterns and Associations With Behavioral Developmental Measures and Resting-state Brain Functional Connectivity, 2023.  

• Brain connectivity in children is increased by the time they spend reading books and decreased by the length of exposure to screen-based media, 2018.

• Functional connectivity changes in the brain of adolescents with internet addiction: A systematic literature review of imaging studies, 2024. 

• Differences in functional brain network connectivity during stories presented in audio, illustrated, and animated format in preschool-age children, 2018.

• Screen media activity and brain structure in youth: Evidence for diverse structural correlation networks from the ABCD study, 2019.

• Digital Media and Developing Brains: Concerns and Opportunities, 2024.

• www.psychologytoday.com/us/blog/mental-wealth/201402/gray-matters-too-much-screen-time-damages-the-brain

Executive functioning development:

• Association of screen time with attention-deficit/hyperactivity disorder symptoms and their development: the mediating role of brain structure, 2025.

• Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management, 2023.

• In an era of split attention, there is more than one type of ADHD, 2025.

Addicition:

• Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths, 2025.

• Functional connectivity changes in the brain of adolescents with internet addiction: A systematic literature review of imaging studies, 2024.

• Brain structural covariation linked to screen media activity and externalizing behaviors in children, 2022.

• Association of Habitual Checking Behaviors on Social Media With Longitudinal Functional Brain Development, 2023.

Screen Time and Early Childhood-Specific Concerns

including: attachment, language development, emotion regulation, executive functioning, sleep, and sensory procesing.

• Parental Technology Use in a Child’s Presence and Health and Development in the Early Years: A Systematic Review and Meta-Analysi, 2025.

•  Law EC, Han MX, Lai Z, Lim S, Ong ZY, Ng V, Gabard-Durnam LJ, Wilkinson CL, Levin AR, Rifkin Graboi A, Daniel LM, Gluckman PD, Chong YS, Meaney MJ, Nelson CA. Associations Between Infant Screen Use, Electroencephalography Markers, and Cognitive Outcomes.  JAMA Pediatrics. 2023.

• Fitzpatrick C, Pan PM, Lemieux A, Harvey E, Rocha FA, Garon-Carrier G. Early-Childhood Tablet Use and Outbursts of Anger. JAMA Pediatrics. 2024.

• Radesky JS, Kaciroti N, Weeks HM, Schaller A, Miller AL. Longitudinal Associations Between Use of Mobile Devices for Calming and Emotional Reactivity and Executive Functioning in Children Aged 3 to 5 Years. JAMA Pediatrics. 2023.

• McHarg G, Ribner AD, Devine RT, Hughes C. Screen Time and Executive Function in Toddlerhood: A Longitudinal Study. Frontiers in Psychology. 2020.

• Heffler KF, Acharya B, Subedi K, Bennett DS. Early-Life Digital Media Experiences and Development of Atypical Sensory Processing. JAMA Pediatrics. 2023.

• van den Heuvel M, Ma J, Borkhoff CM, Koroshegyi C, Dai DWH, Parkin PC, Maguire JL, Birken CS; TARGet Kids! Collaboration. Mobile Media Device Use is Associated with Expressive Language Delay in 18-Month-Old Children. Journal of Developmental and Behavioral Pediatrics. 2019.

• Brushe ME, Haag DG, Melhuish EC, Reilly S, Gregory T. Screen Time and Parent-Child Talk When Children Are Aged 12 to 36 Months. JAMA Pediatrics. 2024.

• Avalrez Gutierrez S, Ventura AK. Associations Between Maternal Technology Use, Perceptions of Infant Temperament, and Indicators of Mother-to-infant Attachment Quality. Early Human Development. 2021

• Yael Rozenblatt-Perkal, Michael Davidovitch, Noa Gueron-Sela. Infants' Physiological and Behavioral Reactivity to Maternal Mobile Phone Use - An Experimental Study. Computers in Human Behavior. 2022

• Lin Y, Zhang X, Jia Z, Chen J, Hou W, Zhao L, Wang G. Zhu J. Relationships Between Screen Viewing and Sleep Quality for Infants and Toddlers in China: A Cross-Sectional Study. Frontiers in Pediatrics. 2022.

• Yamamoto M, Mezawa H, Sakurai K, Mori C; Japan Environment and Children's Study Group.Screen Time and Developmental Performance Among Children at 1-3 Years of Age in the Japan Environment and Children's Study. JAMA Pediatrics. 2023.