Review Article

Screen Media Exposure in Early Childhood and Its Relation to Children’s Self-Regulation

Table 1

Summary of included studies.

StudyStudy designSampleCovariatesMeasurement of self-regulationMeasurement or manipulation of screen media useMain findingsQuality

[85]Cross-sectional correlationalA representative sample of 10,995 3-year-olds in the UKChild’s age, sex, birth weight, ethnicity, household income, country, parental age and educationChild Social Behavior Questionnaire which is adapted from the Adaptive Social Behavior Inventory (parental report)Amount of TV/video viewing (none, <1 hour, 1-3 hours, and >3 hours per day) (parent estimate)Higher amounts of TV/video watching predicted more emotional self-regulation problems (, ). Children who watched TV/videos more than 1 hour per day were more likely to be in the lowest emotional self-regulation quartile compared to children who watched TV/videos less than 1 hour per day (, )11/11

[114]Experimental78 American children aged between 29 and 35 months; 64% from middle-class backgroundsNone (groups did not differ on temperament, language exposure, experience with playing games on a touchscreen, and TV exposure)Sorting task (cognitive flexibility) and statue task (inhibitory control)Children assigned to touchscreen play, physical play, or drawing (control) conditions (for 9 minutes)Cognitive flexibility scores were higher in the physical play compared to the touchscreen play condition (, , ) and the control condition (, , )
Children who did not frequently initiate social interaction during touchscreen play performed worse in the sorting task compared to children in the physical play condition (, , ). Children who frequently initiated social interactions during touchscreen play performed similarly to the physical play group in the sorting task. There was no difference across groups in terms of inhibitory control
17/22

[110]Longitudinal correlational60 American children aged between 12 and 18 months at time 1 and aged 4 at time 2; parents were mostly middle class with high educationNone (no relation of EF to child sex, ethnicity, or SES)The Behavior Rating Inventory of Executive Functioning-Preschool Version (parental report), Shape school task (switching and inhibition)TV viewing amount and content (parent-reported 24-hour time diary)Adult-directed TV exposure in infancy predicted lower parental ratings of children’s global EF (, ). There was a significant main effect of adult-directed exposure during infancy on the Inhibitory Self-Control Index (, , ). Higher amount of household TV at age 4 was associated with poorer parental ratings of children’s global EF (, ). There was a significant main effect of total household television during preschool on the Inhibitory Self-Control Index (, , ). Controlling for parental education, high levels of adult-directed TV exposure at age 4 were related to worse performance on Shape school task (, , ). At both ages, child-directed TV exposure was not related to EFs10/14

[104]Longitudinal correlational228 American children aged 3 at time 1, 4 at time 2, and 5 at time 3; 51% of mothers had a college degreeFamily SES, child race, parental scaffolding, and home learning environmentAnimal Stroop task (inhibitory control), Kaufman assessment battery for children number recall test (working memory)TV viewing amount (parent estimate)TV viewing at age 3 (, ) and at age 4 (, ) was negatively correlated with composite EF score at age 5, but these relations became nonsignificant after controlling for covariates11/14

[91]Cross-sectional correlational100 Canadian children aged 30 to 59 months; 70% of parents had at least a bachelor’s degreeNoneNebraska Barnyard task (working memory), Fish-Shark Go/No-Go task (inhibitory control)TV, computer, and video game playing amount (parent estimate)No significant association between the amount of time children spent viewing TV, playing video games, and working memory and response inhibition8/11

[7]Longitudinal correlational2786 Australian children at 2 years and 3527 children at 4 and 6 years of age; parents were mostly from middle to upper-middle classChild’s age and sex, SES, and parenting hostilityA composite measure of self-regulation from a caregiver, teacher, and observer reportTV, computer, and electronic game playing amount (parent estimate)Lower total screen media exposure (; 95% CI: -0.08 to -0.01) and TV viewing (; 95% CI: -0.08 to -0.01) at age 2 predicted higher self-regulation at age 4, but not age 6. Lower self-regulation at age 4 predicted higher TV viewing (; 95% CI: -0.10 to -0.04), electronic game use (; 95% CI: -0.08 to -0.01), and total media exposure (; 95% CI: -0.09 to -0.03) at age 6. Screen media use at the age of 4 did not predict self-regulation at age 610/14

[96]Cross-sectional correlational42 Brazilian low-SES children aged between 3 and 5; 51% of the parents were unemployed; most mothers (72%) did not complete high schoolNoneEarly Years Toolbox, Go/No-Go task (accuracy of No Go trials for inhibitory control)Amount of use of TV, computer, smartphones, and electronics games (parent estimate)
Children were classified as compliant with screen time recommendations of the World Health Organization if they had (a) ≤1 h/day screen time for 3- and 4-years-olds or (b) ≤2 h/day screen time for the 5 years-olds
A network analysis showed that compliance with the screen time recommendation was negatively associated with No Go accuracy (-0.26)5/11

[123]Experimental141 low-SES American children aged 2 to 5 enrolled in Head Start programsBaseline self-regulation scoresTask persistence and participation in classroom routines such as circle time and cleanup time observed by researchers in classroom settings for 12 weeks in the baseline and 8 weeks in the experimental periodChildren assigned to one of four intervention programs which include watching neutral content, prosocial content, prosocial content with related materials, and prosocial content with related materials and teacher instruction for 8 weeks (media exposure lasted for 14-20 minutes in each session)Children’s pre- and post-self-regulation scores did not differ significantly among conditions16/25

[122]Experimental97 American children aged between 3.8 and 5.5; on average, parents had some university educationNoneRule obedience, tolerance of delay, and task persistence observed by researchers in school settings for 3 weeks in the baseline, 4 weeks in the experimental, and 2 weeks in the postviewing periodChildren exposed to aggressive (for 20 minutes), prosocial (for 28 minutes), or neutral (for 10-15 minutes) content for 4 weeksTolerance of delay decreased from pre- to posttest in the aggressive condition and increased in other conditions (, . Task persistence and rule obedience did not significantly change17/25

[102]Longitudinal correlational1644 Canadian children aged 3 at time 1 and aged 5 at time 2; 76% of mothers had partial or complete university/college or trade degree, and 33% of household income was 150,000 or aboveHousehold income, maternal mental health (maternal depression and anxiety), child age and sex, maternal age, child care (spending more than 10 hours a week outside the home in child care), and positive and negative parenting styles measured by National Longitudinal Study of Children and YouthBehavior Assessment System for Children (for the three elements of self-regulation including inattention, emotional control, and behavioral control) (parent estimate)Amount of TV/movie viewing and video game playing (parent estimate)Excess screen time (>1 h per day) at age 3 was related to poor self-regulation at age 5. One additional hour of screen time per day was associated with a 1.23 increased odds of any element of poor self-regulation (95% CI: 1.03-1.47) and a 1.42 increased odds of inattention (95% CI: 1.13-1.79)10/14

[87]Cross-sectional correlational558 Chinese preschoolers (mean age: 6.12) from different socioeconomic backgrounds (advanced, average, and below average)Family SES, child’s age and gender, and TV/computer in child’s bedroomHead-Toes-Knees-Shoulders task (rule switching and inhibition), Social Skills Improvement System-Rating Scales (parental report of social skills including self-control)TV and computer use amount and content (parent estimate)Children’s TV viewing time (, ) and the frequency of watching nonkid shows on the computer (, ) were negatively associated with their cognitive skills (note: HKTS score was taken as part of children’s cognitive skills)
Children’s TV viewing time (, ) and frequency of watching cartoons on the computer (, ) were negatively related to their social skills. The frequency of TV-based educational puzzle games (, ) and computer viewing time (, ) was positively associated with social skills. Parental restrictions on children’s TV time (, ) and content (, ) were positively related to children’s cognitive skills. Similarly, restrictions on children’s TV time (, ) and content (, ) were positively related to children’s social skills
9/11

[86]Cross-sectional correlational579 Chinese 5-year-olds from different socioeconomic backgrounds (advanced, average, and below average)Family socioeconomic status, child’s age and sexHead-Toes-Knees-Shoulders task (rule switching and inhibition), Social Skills Improvement System-Rating Scales (parental report of social development including self-control)Passive (TV/video) and active (computers, tablets, and smartphones) screen time (parent estimate)Passive screen time negatively predicted children’s EF (, ) and social skills (, ), whereas active screen time was not related to EF and social skills8/11

[111]Experimental96 middle- to upper-middle-SES Australian children aged 24 to 48 monthsTask order, age, and baseline EFPretest includes Spin the Pots (visuospatial working memory) and Reverse Categorization (switching and response inhibition) tasks
Posttest additionally includes the Gift Delay Task (inhibitory control)
Children assigned to watching a cartoon, playing an educational app, or watching an educational program condition (for 9 minutes)Scores in the Spin the Pots task were higher in the educational application compared to educational TV and cartoon watching conditions, but this held true only when this task was presented after the Reverse Categorization task (, , )
There were no group differences in the Reverse Categorization task. When age was controlled, children were more likely to pass the Gift Delay task in the educational application condition compared to cartoon watching condition 95% CI:1.69- 40.92 (, . Other group differences were not significant for this task
18/22

[88]Longitudinal correlationalA nationally representative sample of 32,439 Japanese children aged 3 at time 1, 4 at time 2, and 5 at time 3Child’s sex and hyperactivity, parental age, education, smoking, and employment statusParental report of self-regulation (6-item self-regulation survey created for this study)TV and video game playing amount (parent estimate)Boys who watched more than 5 hours of TV at age 3 were more likely to have self-regulation problems at age 5 than boys who watched TV 1 to 2 hours per day (OR 1.77, 95% CI: 1.06-2.93). Boys who played video games for 1 hour or less at age 3 were less likely to have self-regulation problems at age 5 than boys who did not play any video games (OR 0.53, CI: 0.37-0.76). At age 4, boys who watched TV for 4-5 hours per day were more likely to have subsequent self-regulation problems than boys who watched TV for 1-2 hours per day (OR 1.79, CI: 1.22-2.64). At age 4, girls who had longer TV viewing durations were at a higher risk for later self-regulation problems (2-3 h: OR 1.40, CI: 1.03-1.90; 3-4 h: OR 1.65, CI: 1.13-2.40; 4-5 h: OR 2.59, CI: 1.59-4.22)8/14

[115]Experimental143 Chinese children aged between 5 and 6.5, mostly from middle-class families with most mothers having at least a bachelor’s degreeSES (groups did not differ in age, language development, TV viewing amount, parental education, and pretest EF)Pretest includes the Children Behavior Questionnaire-Short Form
Posttest includes NIH Toolbox App: Flanker Inhibitory Control and Attention Test, the DCCS Task (cognitive flexibility), and the List Sorting Working Memory tasks
Children assigned to high, mid, or low amount of fantasy cartoon conditions (for 12 minutes)Children in the low fantasy condition had the highest inhibitory control (, , ) and cognitive flexibility scores (, ) compared to the children in other conditions. For both inhibitory control and cognitive flexibility, scores were higher in the high fantasy compared to mid-fantasy condition. There was no difference in working memory across conditions17/22

[92]Cross-sectional correlational190 Lithuanian children in 4- and 5-year-olds; 77% of mothers and 60% of fathers had university-level educationParental education, child’s ageShape school task (mental set shifting), missing scan task (working memory), and head and feet task (inhibitory control)TV, smartphone, tablet, and computer use amount (parent estimate)No significant association between different EF components and the use of any type of screen (note: analyses were conducted separately for different devices)8/11

[120]Experimental187 children from the UK aged 42 to 62 months; 50% of children from low SESAge, pretest EFBoth pre- and posttest include the Day/Night task (inhibitory control)Children assigned to fast-realistic, slow-realistic, fast-unrealistic, or slow-unrealistic TV conditions (for ~5-6 minutes)Inhibitory control scores were higher after watching unrealistic compared to realistic content (, , ). Pace did not have a significant effect18/22

[116]ExperimentalStudy 1: 90 Chinese preschoolers between the ages 4 and 6, mostly from working- and middle-class annual household incomesChildren’s hyperactivity level and ageBackward Digit Span Task (working memory), Day–Night Task (inhibitory control), and Flexible Item Selection Task (cognitive flexibility)Children assigned to one of these three conditions: viewing a video episode with high fantasy (46 fantastical events) for 18 minutes, viewing a video episode with low fantasy (17 fantastical events) for 19 minutes, and no viewing (usual classroom activities for 18-19 minutes)There was an immediate negative effect of watching frequent fantastical events on children’s composite EF score (, , )
Children watching video programs with a high frequency of fantastical events had lower EF than children watching video programs with a low frequency fantastical events (, , ) and children in the control group (, , ). The low fantasy and control groups did not differ
16/22
Study 2: 20 Chinese preschoolers between the ages 4 and 6, from the same public preschool where study 1 was conductedChildren’s hyperactivity levelBackward Digit Span Task (working memory), Day–Night Task (inhibitory control), and Flexible Item Selection Task (cognitive flexibility) and tracking of eye movementsHigh and low fantasy conditionsThe high fantasy group demonstrated lower performance on the behavioral EF tasks than the low fantasy group (, , )
Analyses regarding eye tracking data showed that compared to the low fantasy group, the high fantasy group had more (, , ), but shorter (, , ) fixations
16/22
Study 3: 20 Chinese preschoolers between the ages of 4 and 6, mainly from middle-class familiesChildren’s hyperactivity levelBackward Digit Span Task (working memory), Day–Night Task (inhibitory control), and Flexible Item Selection Task (cognitive flexibility) and fNIRS technology to measure cerebral blood flow to PFCHigh and low fantasy conditionsHigh fantasy group did more poorly on behavioral measures of EF (, , )
Analyses regarding fNIRS data showed that there were two epochs in which high fantasy group significantly exceeded the other in prefrontal processing (, , ) for the first epoch and (, , ) for the second epoch)
16/22

[118]ExperimentalStudy 1: 72 Chinese children (36 children with a mean age of 55.9 months and 36 children with a mean age of 75.3 months), mostly from middle-class families with high educationNoneGo/No-Go task (inhibitory control) in pre- and posttestChildren assigned to playing a fantastical video game or watching a video clip of the same game conditions (for 11 minutes)In the condition where children watched a video clip of the fantastical game, inhibitory control decreased from pre- to posttest (, , ). There was not a significant change in the video game playing condition13/22
Study 2: 19 Chinese children with a mean age of 72.5 months (final sample: 17 participants)NoneGo/No-Go task (inhibitory control) and fNIRS measurement in pre- and posttestChildren assigned to playing a fantastical video game or watching a video clip of the same game conditions (for 5 minutes)Inhibitory control decreased from pre- to posttest in the video viewing condition (, , ) but showed no change in the video game play condition
Posttest fNIRS activation was greater compared to pretest activation in the video viewing condition (channel 11: , , ; channel 20: , , )
16/25
Study 3: 72 Chinese children (36 children with a mean age of 54 months and 36 children with a mean age of 76 months)NoneGo/No-Go task (inhibitory control) in pre- and posttestChildren assigned to playing a realistic video game or watching a video clip of the same game conditions (for 11 minutes)For both conditions, children’s postinhibition scores were higher than baseline scores (for accuracy: , , ; for reaction time: , , ; and for response sensitivity: , , ). There was not a significant difference between conditions14/22

[117]ExperimentalStudy 1: 160 American 4-year-olds (48-66 months) and 6-year-olds (67-91 months), mostly from middle-class familiesNone (no group differences in children’s screen media use amount and their scores in the Strengths and Difficulties Questionnaire)Hot EF task: delay of gratification (inhibitory control)
Cool EF tasks: Tower of Hanoi (planning), Head Toes Knees Shoulders (rule switching and inhibition), and Woodcock-Johnson III Test of Cognitive Abilities (auditory working memory)
Children assigned to fast-fantastical cartoon, slow-realistic cartoon, or playing (control) conditions (for 11 minutes)In both age groups, children in the fast-fantastical cartoon condition had higher composite cool EF scores compared to children in the control condition (, , )
Children in the slow-realistic cartoon condition were better in the delay of gratification task compared to children in the control condition (, , )
17/22
Study 2: 60 children aged 47 to 67 months, mostly from middle-class familiesNone (groups did not differ on temperament, vocabulary, and TV exposure)Woodcock-Johnson III Test of Cognitive Abilities (auditory working memory), Tower of Hanoi (planning), Dimensional Change Card Sort (DCCS) task (cognitive flexibility), and Luria’s Hand Game (inhibitory control)Children assigned to watching a fantastical cartoon, watching an educational cartoon, or listening to an educational picture book conditions (for 22 minutes)Children in the educational book condition had higher composite EF scores than educational and fantastical cartoon viewing conditions (, , )17/22
Study 3: 80 American children aged 47 to 60 monthsPretest EF (across groups, children did not differ on temperament and screen media exposure)Pretests include the Executive Function Scale for Preschoolers (the scale version of the DCCS to measure cognitive flexibility), Hand Game (inhibitory control), Woodcock-Johnson III Test of Cognitive Abilities (auditory Working Memory), and Gift Wrap Delay (inhibitory control) tasks
Posttests include Head Toes Knees Shoulders (rule switching and inhibition), Day/Night task (inhibitory control), Auditory Working Memory Span subtest, Forbidden Toy (inhibitory control was not included in the composite EF score), and Tower of Hanoi (planning) tasks
Children assigned to fast- and slow-paced cartoon with rare or abundant fantasy events (i.e., four conditions in total)Children who watched fantastical cartoons had lower composite EF scores than children who watched realistic cartoons (, , ). Controlling for pretest working memory, posttest working memory scores were higher in the conditions with rare fantasy events and lower in the condition with abundant fantasy events (, , )17/22

[121]Experimental60 middle- to upper-middle-SES 4-year-olds from the USAChildren’s TV/DVD viewing amount (parent estimate), the Strengths and Difficulties Questionnaire, and ageTower of Hanoi (planning), Head Toes Knees Shoulders (rule switching and inhibition), Backward Digit Span (working memory), and Delay of gratification (inhibitory control, not included in the composite EF score)Children assigned to fast-paced cartoon, slow-paced cartoon, or drawing (control) conditions (for 9 minutes)Composite EF scores were lower in the fast-paced cartoon condition compared to the control condition (, ). Children’s delay of gratification was significantly lower in the fast-paced cartoon condition compared to the control () and slow-paced cartoon conditions (, )19/22

[97]Cross-sectional correlational161 children aged between 18 and 36 months in southern Taiwan; most mothers (73%) graduated from a college or aboveChild’s age and sex, prematurity, single-child family, primary caregiver (mother, father, grandparents, and others), and parental educationChild Behavior Checklist for ages 1.5–5 (primary caregiver’s report)Onset age and amount of touchscreen devices use, purpose of using touchscreen devices (education, soothing, recreation, or other), and type of use (playing games, watching films, using educational programs, or other) (primary caregiver estimate)Children spending more time on touchscreen devices were more likely to have self-regulatory problems with emotion (, , 95% CI: 0.28–1.52), attention (, , 95% CI: 0.43–1.27), and aggression (, , 95% CI: 0.97–3.98)7/11

[112]Cross-sectional correlationalA nationally representative sample of 788 American children aged between 2 and 5 years and 391 American children aged between 6 and 8 yearsChild’s birth order, participation in child care, and vocabularyBehavior Assessment System for Children-Second Edition (parental report)Foreground/background TV amount, TV content (parent-reported 24-hour time diary)For high-risk preschool-aged children, exposure to background TV was negatively associated with EF (, , ). For preschool-aged children in the low-risk group, foreground watching of narrative-based programs predicted higher EF (, , )9/11

[101]Longitudinal correlational416 children from the UK, US, and the Netherlands, aged 4 months at time 1 and 14 months at time 2; 37% of mothers had a bachelor’s degree, 32% had a master’s degree, and 13% had a doctoral degreeParent age at the time of childbirth, educational attainment, general well-being, anxiety, depression, life satisfaction, self-efficacy in the nurturing role, couple’s satisfaction, social support, child’s sex, attention, temperament, and countryProhibition task (inhibitory control), Three Boxes task (working memory), and Ball Run task (cognitive flexibility)Screen media viewing amount (TV/DVD, tablet, and computer) (parent estimate)Early screen media exposure was negatively associated with later inhibitory control (, ) but not with working memory and cognitive flexibility12/14

[100]Longitudinal correlational179 children from the UK, aged 24 months at time 1 and 36 months at time 2; 42% of mothers had a bachelor’s degreeChild’s age, sex and receptive vocabulary, parent’s subjective social status, age at childbirth, and having a bachelor’s degreeMulti-Location Search task (working memory), Ball Run task (cognitive flexibility), and Baby Stroop task (inhibitory control) at time 1
Spin the Pots task (working memory), Dimensional Change Card
Sorting task (cognitive flexibility), Stroop task (inhibitory control), and Self-Ordered Pointing task (working memory) at time 2
Screen time (TV or DVDs, tablets, phones, and computers) (average time of maternal and paternal estimate)Screen time at time 1 was negatively associated with composite EF score at time 2 (, )
Composite EF score at time 1 was not related to screen time at time 2. No significant association between concurrent screen time and composite EF score
10/14

[103]Longitudinal correlationalA nationally representative sample of 185 Australian children aged between 3 and 5 at time 1 and between 4 and 6 at time 2Child’s age, sex, average sleep, physical activity and sports participation, quality of the home learning environment, SES, and parental educationMr. Ant task (spatial working memory), Not This task (phonological working memory), Go/No-Go task (inhibitory control), and Dimensional Change Card Sort task (cognitive flexibility)Total number of electronic media devices at home, availability of these devices to the child, and amount of use of traditional devices (TV/DVD) and nontraditional devices (tablet, computer, laptop, mobile phone, hand-held game system, and console games) (parent estimate)Total electronic media use and program viewing at time 1 were not significantly related to different EF components at time 2.Controlling for total program viewing, high-dose application users (≥30 min/day) had lower inhibition scores at time 2 compared to low-dose application users (<30 min/day) (, 95% CI: -0.09–0; , )12/14

[98]Cross-sectional correlational541 American preschoolers (mean age: 4.1); 52% of mothers had more than high school educationChild’s age and sex; parent’s age, education, and marital status; income-to-needs ratio; number of adults in the household; parental depressive symptoms; parenting sensitivityDelay of gratification task (inhibitory control), Social Competence and Behavior Evaluation (teacher report), and Child Behavior Questionnaire (parental report)Foreground/background TV amount, amount of playing video games, presence of TV in child’s bedroom, and frequency of watching TV with meals (parent estimate)Higher exposure to daily screen media (, ) and background TV (, ) was associated with shorter waiting times on the delay of gratification task
The frequency of background TV (, ) and watching TV with meals (, ) was related to greater parent-reported difficult temperament
If parents had greater depressive symptoms, presence of TV in the bedroom predicted greater parent-reported difficult temperament (, ). No association between any of the screen media exposure variables and teacher report of self-regulation
9/11

[6]Cross-sectional correlational107 American children aged between 38 and 74 months; 59% of the participants were from low- to middle-income familiesChild’s age, attendance in preschool, vocabulary, sleep duration, and parental education and incomeGrass/snow task, Whisper task, Tower task (inhibitory control), and Backward digit span task (working memory)Foreground/background TV amount, onset age of TV viewing, and channel and genre viewing (parent estimate)Children who began watching TV at an earlier age had a lower composite EF score than children with a later onset age of TV viewing (, ). Controlling for the onset age of TV viewing, background TV was not associated with EF. Yet, controlling for the onset age of TV viewing and cumulative background TV, foreground TV was negatively associated with EF (, )
Controlling for cumulative background and foreground TV, watching educational cartoons was associated with lower EF performance (, ), and viewing of Public Broadcasting Service channel was positively associated with the performance on EF tasks (, )
8/11

[95]Cross-sectional correlational402 American 3-, 4-, and 5-year-olds; on average, mothers received some college educationChild’s age and sex, mother’s employment status, number of days child attends child care, mother’s education, household income, and child’s overall TV viewing and evening TV viewingEarly Childhood Behavior Questionnaire (parental report)Tablet and hand-held game player use amount (parent estimate)Tablet use was negatively associated with EC (, ), but hand-held game player use was positively associated with EC (, ). EC was negatively associated with tablet use only when children received less sleep (, 95% CI: 0.0001–0.0013). EC was positively associated with hand-held game player use only when children slept more (, 95% CI: 0.0001–0.0017)9/11

[124]Cross-sectional correlational107 American children aged between 38 and 74 months; 59% of the participants were from low- to middle-income familiesChild’s age, parental education and incomeGrass/snow task, Whisper task, Tower task (inhibitory control), and Backward digit span task (working memory)Foreground/background TV amount (parent estimate), presence of TV in child’s bedroomChildren’s composite EF scores were negatively associated with evening TV view (, ), background TV during daytime (, ), and TV in child’s bedroom (, )8/11

[109]Longitudinal correlationalA nationally representative sample of 7,450 American children aged 9 months at time 1 and 2 years at time 2Child’s race/ethnicity, and age, sex, 9-month Bayley Mental and Motor scores, birth weight, parent-rated child health, hours per week in child care, maternal and paternal age, SES, maternal marital status, general health, and depression, prenatal use of tobacco and alcohol, violence against the mother, single-parent household, number of siblings, language spoken at home, neighborhood quality for raising kids, urban household, and parent-child interactions at homeInfant Toddler Symptom Checklist (parental report)TV/video viewing amount (parent estimate)Children’s self-regulation problems at time 1 were related to increased TV viewing at time 2 (; 95% CI: 0.02–0.28). Persistent self-regulation difficulties at both time 1 and time 2 predicted more media use at time 2 (; 95% CI = 1.14–1.71). A decrease in children’s self-regulation skills was negatively associated with media use (; 95% CI = 1.04–1.56)10/14

[119]Experimental80 children from the UK with a mean age of 71 monthsNone (groups did not differ on TV viewing duration and TV content)Both pretest and posttest include the Day/Night task (inhibitory control), Backward Digit Span (working memory), Dimensional Change Card Sort (cognitive flexibility), and Tower of Hanoi (planning)Children assigned to fantastical cartoon or nonfantastical cartoon conditions (for 23 minutes)Inhibitory control scores in the fantastical and nonfantastical cartoon conditions were similar in pretest but lower in the fantastical condition in the posttest (, , ). Similar findings were obtained for working memory (, , ) and cognitive flexibility (, , )
The decrease in the thinking time to plan a solution in the Tower of Hanoi task was greater in the nonfantastical cartoon compared to the fantastical cartoon condition (, , )
17/22

[113]Cross-sectional correlationalA nationally representative sample of 922 American children aged 3 to 7 yearsChild’s age and sex, cumulative risk (low family income, single-adult caregiver household, low maternal education, maternal age under 18 at childbirth, and minority background), and child’s participation in child care and book readingBehavioral Assessment for Children-Second Edition (parental report)Foreground/background TV amount, TV content (parent-reported 24-hour time diary)Watching entertainment TV (, p = 0.011) and background TV (, ) was positively related to self-regulation problems. Educational TV was not associated with self-regulation problems10/11

[89]Cross-sectional correlational807 American children (mean age: 68.6 months) from diverse socioeconomic backgroundsChild’s age, sex, and general intelligenceHearts and flowers task, Flanker task (inhibitory control), and NIH Toolbox version of the Dimensional Change Card Sort task (cognitive flexibility)TV amount (parent estimate)Daily TV viewing was negatively related to children’s performance on EF tasks, but this relationship held particularly true for children below (, , , 95% CI:-0.28 to -0.07, ) or at the sample mean of the families’ income-to-needs ratio (, , , 95% CI: -0.32 to -0.08, ). For families above the income-to-needs ratio mean, there was no significant association between television viewing and EF9/11

[90]Cross-sectional correlational381 American children aged between 5 and 12; maternal education distributed proportionally in all levels (high school graduation, college degree, further education)Maternal education, child’s age and sexA Developmental Neuropsychological Assessment-Second Edition (NEPSY-II) including six domains: Attention and Executive Functioning, Language, Memory and Learning, Social Perception, Sensorimotor, and Visuospatial ProcessingTV and computer use amount (parent estimate)Children’s TV viewing was negatively associated with Attention and Executive Functioning scores (, , , ). No significant relation between children’s computer use and Attention and Executive Functioning scores8/11

[99]Cross-sectional correlationalA representative sample of 9,361 American preschoolers aged 2 to 5 years and 30,976 children aged 6 to 17 yearsChild’s race, sex, and age, household adults’ education, family poverty ratio, and family structure (living with two biological/adoptive parents or not)A composite measure of self-regulation from a caregiver, teacher, and observer reportScreen time (smartphones, computers, electronic games, TV, and electronic devices) (parent estimate)For children aged 2 to 5 years, high (7+ h/day) and moderate use (4 h/day) of screens predicted lower self-control than low screen use (1 h/day) (, ; , , respectively). Compared to low users, high (RR 1.99, CI: 1.44–2.77, , ) and moderate users (RR 1.33, CI: 1.02–1.72, , ) were more likely to lose their temper7/11

[105]Longitudinal correlational4983 Australian children aged 4-5 years at time 1 and 6-7 years at time 2; 22% of mothers with incomplete high school education and 28% of mothers with university educationEarlier self-regulation, child’s gender, age of assessment at baseline, birth weight, whether or not the child had ever been breastfed, Aboriginal and Torres Strait Islander status, non-English speaking home background, maternal education level, and household income bracketA composite score of self-regulation from parent, teacher, and observer reports with a 20-item survey including constructs of impulsive aggression, hyperactivity, lack of persistence/inattention, and impulsivityTV and computer use amount (parent estimate)No significant association between TV and computer use at time 1 and self-regulation at time 28/14

[93]Cross-sectional correlational119 Chinese children aged between 3 and 6 years; 67% of mothers were college educated, and nearly 70% of participants’ household income was above the national average incomeChild’s age, sex, and vocabulary, maternal education, and family incomeBackward Digit Span task, Spatial Span task (working memory), Boy-Girl Stroop, Simon task, Flanker task (inhibitory control), and Tower of Hanoi task (planning)Onset age and amount of TV viewing, channel and genre viewing (parent estimate)Higher TV viewing amount predicted better composite EF (, , Cohen’s ). Controlling for children’s TV viewing amount, watching classical cartoons (, , ) predicted better composite EF, whereas parental restrictive approach predicted worse EF (, , ). Both watching classical cartoons (, , 95% CI: 0.08–0.53) and live educational shows (, , 95% CI: 0.01–0.29) acted as mediators between TV viewing amount and EF. Parental restrictive approach moderated the direct relationship between TV time and EF such that TV viewing amount had a positive effect on EF only at the low level of restrictive approach (, , 95% CI: 0.10– 1.42). Only when parental restrictive approach was at a low or moderate level, TV time had a positive indirect effect on EF via watching classical cartoons (, , 95% CI: -0.47 to -0.003)8/11

[94]Cross-sectional correlational119 Chinese children aged between 3 and 6 years; 67% of mothers were college educated.Child’s age and gender and family SESBackward Digit Span task, Spatial Span task (working memory), Boy-Girl Stroop, Simon task, Flanker task (inhibitory control), and Tower of Hanoi task (ToH) (planning)Electronic game play time on smartphone, tablet, computer, and game console (none, <1 hour, 1-2 hours, and >2 hours for each platform) electronic game content (parent estimate)Electronic game playing time predicted better composite EF scores (, , , ). Game playing time predicted better scores on the backward digit span (, ), on the ToH (, ), and on the Simon task (, )
Action game content was negatively associated with inhibitory control in flanker task (, p = 0.012) but not significantly associated with working memory or planning. Both prosocial and action content were not associated with composite EF
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Note: EF: executive function; SES: socioeconomic status.