Summary: Greater exposure to screen time in infancy is associated with poorer self-regulation and cognitive immaturity at age eight.

Source: Science, Technology and Research Agency

Many children are now exposed to mobile digital devices at a young age as a means of entertainment and distraction.

A long-term cohort study in Singapore found that excessive screen time during infancy is associated with detrimental effects on cognitive function, which continue to be evident eight years later.

The research team looked at data from 506 children enrolled in the Growing Healthy Outcomes in Singapore (GUSTO) cohort study from birth.

When the children were 12 months old, parents were asked to report their average screen time on weekdays and weekends. Children were then divided into four groups based on daily screen time – less than one hour, one to two hours, two to four hours and more than four hours. At 18 months of age, brain activity was also collected using electroencephalography (EEG), a highly sensitive device that monitors changes in brain activity.

In addition to undergoing an EEG, each child participated in a variety of cognitive ability tests that measured attention and executive function at age nine.

The team first investigated the relationship between screen time and EEG brain activity. EEG readings showed that children exposed to longer screen time had more “low-frequency” waves, a condition associated with cognitive impairment.

To determine whether screen time and changes in brain activity have any negative effects in later childhood, the research team analyzed all data for the same children at three time points — at 12 months, 18 months and nine years. As screen time increased, altered brain activity and more cognitive deficits were measured.

Children with executive function deficits often have difficulty controlling impulses or emotions, maintaining concentration, following multi-step instructions, and keeping up with difficult tasks.

A child’s brain develops rapidly from birth to early childhood. However, the part of the brain that controls executive function, or the prefrontal cortex, has more advanced development.

Executive functions include the ability to maintain attention, process information, and regulate emotional states, all of which are important for learning and school performance. The benefit of this slow development in the prefrontal cortex is that the shaping and shaping of executive function skills can occur throughout the school years into higher education.

However, this part of the brain responsible for executive functioning skills is highly vulnerable to long-term environmental influences.

This research points to excessive screen time as one of the environmental influences that can hinder executive function development. Previous studies have shown that children have problems processing information on a two-dimensional screen.

When looking at a screen, the child experiences rapid movements, continuous flashing lights and scene changes, which require more cognitive resources to understand and process emotions. The brain becomes “overloaded” and cannot leave itself enough resources to mature in cognitive skills such as executive functions.

Researchers warn that families who allow very young children hours of screen time often face additional challenges. These include stressors such as food or housing insecurity and parental emotional problems. More work is needed to understand the causes of excessive screen time in young children.

Further efforts are needed to directly link infant screen use to family issues and to determine early screen use to executive function impairments.

The study was a collaborative effort involving researchers from the Yong Lo Lin School of Medicine, National University of Singapore (NUS Medicine), A*STAR Singapore Institute of Clinical Sciences (SICS), National Institute of Education, KK Women’s and Children’s Hospital, McGill University and Harvard Medical School. published in JAMA Pediatrics On January 31, 2023

This shows a little girl using a tablet
The team first investigated the relationship between screen time and EEG brain activity. The image is in the public domain.

Lead author Dr Evelyn Lowe, from NUS Medical and the CCS Translational Neuroscience Programme, said: “The study adds compelling evidence to existing research that our children’s screen time needs to be closely monitored, especially during early brain development.” Dr Low is a consultant in the Department of Developmental and Behavioral Pediatrics at Khoo Teck Puat – National University Institute of Paediatrics, National University Hospital.

NUS Dean of Medicine and Chief Clinical Officer CCS Professor Chong Yap Seng added: “These findings from the GUSTO study should not be taken lightly as they have implications for future generations and human capital development.

“With these results, we are one step closer to better understanding how environmental influences affect children’s health and development. This will allow us to make more informed decisions to improve the health and potential of every Singaporean by giving every child the best start in life.”

Professor Michael Meaney, Program Director of the Translational Neuroscience Program at SICS, said: “In a country like Singapore where parents work long hours and children are exposed to frequent screens, it is important to study and understand the impact of screen time on children’s brain development.”

About technology and brain development research news

Author: Sharmaine Loh
Source: Science, Technology and Research Agency
Contact: Sharmaine Loh – Science, Technology and Research Agency
Image: The image is in the public domain.

Preliminary study: Open Access.
Associations between infant screen use, electroencephalographic markers, and cognitive outcomes.” by Evelyn Law et al JAMA Pediatrics


Associations between infant screen use, electroencephalographic markers, and cognitive outcomes.


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There is increasing research evidence for a link between screen use in infants and negative cognitive outcomes related to attention and executive functions. The nature, duration, and persistence of screen time exposure on neural function are currently unknown. Electroencephalography (EEG) allows to explain the neural connections associated with cognitive disorders.


Mediation analysis with structural equation modeling to examine the relationship between infant screen time, EEG markers, and school-age cognitive outcomes.

Design, composition and participants

This prospective mother-child dyad cohort study included participants from the Growing Up for Healthy Outcomes (GUSTO) population-based study in Singapore. Pregnant women were enrolled in their first trimester from June 2009 to December 2010. A subset of children who completed neurodevelopmental visits at 12 months and 9 years of age had an EEG performed at 18 months of age. Data are reported from 3 time points at 12 months, 18 months, and 9 years. Mediation analyzes were used to examine how neural correlates were involved in the pathways from infant screen time to implicit attention and executive functions. Data for this study was collected from November 2010 to March 2020 and analyzed between October 2021 and May 2022.


Parent-reported screen time at 12 months.

Main results and measurements

Energy levels collected from EEGs over 18 months. Children’s attention and executive functions were measured by teacher-reported questionnaires and laboratory-based tasks at age 9 years.


In this sample of 437 children, the mean (SD) age at follow-up was 8.84 (0.07) years, and 227 children (51.9%) were male. Mean (SD) daily screen time was 2.01 (1.86) hours over the 12 months. Screen time at 12 months contributed to several 9-year measures of attention and executive functioning (η2, 0.03-0.16; Cohen d, 0.35–0.87). A group of 157 children underwent EEG at 18 months; EEG relative theta power and theta/beta ratio in frontal and parietal regions showed moderate correlations with 12-month screen use (R= 0.35-0.37). In a structural mathematical model, family income, frontocentral and parietal theta/beta ratios partially mediated the association between infant screen time and school age on executive functioning (exposure-mediator β, 0.41; 95% CI, 0.22 to 0.59; mediation-effect). β, -0.38; 95% CI, -0.64 to -0.11), constitutes an indirect path accounting for 39.4% of the association.

Conclusions and relevance

In this study, children’s screen use was associated with altered cortical EEG activity before 2 years of age. The identified EEG markers correlate the relationship between infant screen time and executive functions. Additional efforts are needed to identify direct associations of early childhood screen use versus family factors as determinants of early screen use on executive function impairments.

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