Infant Screen Exposure Leads to Slower Decision-Making In Childhood, Anxiety in Adolescence

A new study published in eBioMedicine by The Lancet analyzed 168 children from Singapore for over a decade and found that increased screen time as an infant (0-2) is associated with slower decision-making for children at age 8.5 and higher anxiety at the age of 13. Researchers conducted brain scans at three time points (ages 4.5, 6, and 7.5) to track how brain networks developed. Specifically, children who had higher screen time as infants had “accelerated topological maturation of the visual and cognitive control networks, leading to prolonged decision latency and increased adolescent anxiety.”

Brain networks matured more quickly as a result of infant screen time, but this faster development led to “a steeper decline in visual-cognitive control network integration.” Children took longer to “deliberate” or make decisions compared to their counterparts who had less screen time exposure as infants.

“Accelerated maturation happens when certain brain networks develop too fast, often in response to adversity or other stimuli,” said Dr Huang Pei, the study’s first author. “During normal development, brain networks gradually become more specialised over time. However, in children with high screen exposure, the networks controlling vision and cognition specialised faster, before they had developed the efficient connections needed for complex thinking. This can limit flexibility and resilience, leaving the child less able to adapt later in life.”

The authors did not find the same association for children who were exposed to screens at the ages of 3 and 4, suggesting infant screen exposure is particularly impactful on development and can lead to slower decision-making and anxiety more than a decade later. Anxiety and suicidality among teenagers has risen starkly with Gen Z (born between 1997 and 2012). Approximately 30% of adolescents will experience an anxiety disorder, and that continues to increase. The number of hospital visits for suicidal teenagers has doubled over the last decade.

During this same time frame, the number of teens and young adults getting antidepressants has also risen. Between 2016 and 2022, the number of prescriptions for individuals aged 12-25 increased by 66.3%. Screen time and social media usage have also been linked to worse mental health outcomes for teenagers who use these technologies more than previous generations 

Tech company CEOs like Mark Zuckerberg have frequently downplayed the mental health risks to teenagers who use social media and screens. Companies have not made direct statements about screen time for babies, but there is YouTube content and Play Store apps marketed to babies. Popular kids content creator Ms. Rachel has a video for babies – first words, songs, and nursery rhymes – which has 1.7 billion views. Ms. Rachel has several other videos for babies, with tens of millions to hundreds of millions of views 

The Google Play Store has an app for baby games with more than 50 million downloads, and there are several other apps for babies on the platform. Although some sources report that the American Academy of Pediatrics recommends zero screen time for infants, their website says screen time and media should be “very limited,” and any media used should be “high-quality” and viewed while the parent is also watching.

75-80% of parents express concerns about the harms of screen time for children, but the latest data shows that about 40% of all kids have their own tablet by the age of 2, and all children of this age group average one hour and three minutes of daily screen time. 66% of parents say that screens help occupy their children so they can do other things or take a break. 17% of parents say their children use screens to calm down after feeling sad or angry. 47% of parents use screens as a reward for good behavior.

Other studies have examined the role of screen time for young children and the ability to regulate emotions. A JAMA study found that tablet use at age 3.5 was associated with increased anger expression at age 4.5, which was also associated with increased screen use at age 5.5. This suggests a cycle exists whereby screen usage increases feelings of anger, and screen usage is utilized as a solution to calm down the children after expressing anger. Using screen time as a reward has also been shown to increase usage of screen time because it is seen as more valuable.

Instead of using screens to occupy young children, some suggested alternatives are providing toys, books, coloring, and other activities that improve childhood development without the negative effects associated with screens.

In addition to the increasing anxiety rates among teenagers, there have been noticeable drops in school assessments based on the most recent Nation’s Report Card released earlier this year. The 2024 report card found declines between 2019 and 2024 in 4th, 8th, and 12th-grade reading and math. There was also a decline in scores for 8th-grade science. The previous report in 2019 was conducted before the onset of the COVID-19 pandemic and subsequent lockdowns. While the lockdowns played a role, it is unknown how much increased screen time across all age groups could be contributing to worsening educational outcomes.

“The Nation’s Report Card represents the gold standard in assessment,” said Martin R. West, Vice Chair of the National Assessment Governing Board. “Today’s results, along with earlier NAEP releases, shine a light on a clear and concerning pattern — there are drops in achievement overall, but these are largely driven by big declines among the lowest-performing students. It would be a mistake to dismiss or ignore this critical education data. Leaders should use it to guide their policies and practices, really focusing on struggling learners.”