Associations between duration and type of electronic screen use and cognition in US children

This study investigated associations between screen-use (time and type) and cognition in children and tested the hypothesis that across all screen types, time spent on screens is negatively associated with cognition. Methods This study presents cross-sectional data from 11,875 US children aged 9–10 years. Exposures were self-reported daily recreational screen-use. The primary outcome was global cognition measured by the Youth NIH Toolbox®. Covariates included child education, pubertal development, parental education, household income, race/ethnicity, physical activity, and sleep duration. Findings The mean (SD) daily recreational screen time was 3.8 (3.1) hours and 99.7% of children reported using some form of screen daily. More screen time was accumulated on weekends compared to weekdays [4.6 (3.6) vs. 3.5 (3.1) hours, d = 0.34, p < 0.001], and boys reported more screen time than girls [4.1 (3.1) vs. 3.4 (3.0) hours, d = 0.22, p < 0.001]. Children in the high (7.2 h/day; β = −1.76 [-2.12, −1.40]) and middle (2.9 h/day; β = −0.82 [-1.15, −0.48]) daily screen time tertiles had lower measures of cognition compared to children in the low tertile (1.2 h/day). Children in the high tertile for TV watching (2.5 h/day; β = −0.99 [-1.55, −0.64]), video watching (2.3 h/day; β = −1.05 [-1.43, −0.67]), and social media (1.4 h/day; β = −0.79 [-1.14, −0.44]) had lower measures of cognition compared to children in the low tertile for each variable (0.3 h/day, 0.1 h/day, and 0.0 h/day, respectively). Higher video game time was positively associated with cognition compared to the low tertile (β = 0.12 [-0.25, 0.48], p = 0.53). Conclusions Higher daily screen time is associated with lower cognition in children. These findings suggest moderating screen-use for promoting cognitive development in children.