For permission to reprint or reproduce multiple copies, please see our copyright policy. The digital landscape is evolving more quickly than research on the effects of screen media on the development, learning and family life of young children. This statement examines the potential benefits and risks of screen media in children younger than 5 years, focusing on developmental, psychosocial and physical health.
Knowing how young children learn and develop informs best practice strategies for health care providers. Exposure to digital media in Canadian family life is increasing, as are concerns about how screen time affects children and families. This statement examines potential benefits and risks of screen exposure and use on children younger than 5 years, and provides evidence-based guidance for health professionals to help families. A literature search  into the effects of screen media on children younger than 5 years included systematic reviews, guidelines and policy statements on screen media exposure and use.
Potential benefits and risks were categorized into developmental, psychosocial and physical domains.
SCREENING & SURVEILLANCE
Recommendations are based on evidence and expert consensus. Screen time in older children and adolescents, children with neurodevelopmental disorders and environmental health concerns are beyond the scope of this statement. Whether early exposure to screen media changes the developing brain is not known, and published research on how and how much children younger than 5 years of age actually learn from screens remains limited   — .
Still, studies show that while babies do not absorb content from TV, it can catch and hold their attention. They can imitate specific actions they see on screen between 6 and 14 months, and remember brief sequences by 18 months .
Children begin to understand content by the end of their second year  . There is solid evidence that infants and toddlers have difficulty transferring new learning from a 2D representation to a 3D object e.
Preschooler ( years old) | CDC
By contrast, they learn intensely through face-to-face interaction with parents and caregivers. Early learning is easier, more enriching and developmentally more efficient when experienced live, interactively, in real time and space, and with real people  — . Beginning at about 2 years, quality TV—well-designed, age-appropriate programs with specific educational goals—can provide an additional route to early language and literacy for children .
Quality programming also fosters aspects of cognitive development, including positive racial attitudes and imaginative play . Early evidence suggests that interactive media, specifically applications that involve contingent responses from an adult i. This responsiveness, when coupled with age-appropriate content, timing and intensity of action, can teach new words to month-olds   .
However, while screens may help with language learning when quality content is co-viewed and discussed with a parent or caregiver  , preschoolers learn best i. Evidence of an association between screen time and attentional difficulties is mixed, with negative effects only clearly apparent when exposure is extremely high i.
Appendix 3 : Tools to assist in health surveillance and monitoring
High exposure to background TV has been found to negatively affect language use and acquisition, attention, cognitive development and executive function in children younger than 5 years. It also reduces the amount and quality of parent—child interaction and distracts from play    . Further, e-book sound effects and animation can interfere with story comprehension and event sequencing in preschoolers, when compared with paper books   — . Some studies associate prolonged TV viewing with lower cognitive abilities, especially related to short-term memory, early reading and math skills and language development    — .
Fast-paced or violent content can negatively impact executive function   , and these effects may be cumulative. The inability of young children especially those younger than 2 years to distinguish everyday reality from what happens on screen, along with their efforts to make sense of competing experiential realms, may interfere with and impede executive function  .
Minimizing screen time leaves more time for face-to-face interactions, which is how young children learn best. When children watch educational, age-appropriate content with an engaged adult, screen time can be a positive learning experience. When adults mitigate screen time, they:. In , the Canadian Radio-television and Telecommunications Commission pledged to provide Internet access as a basic service for all Canadians .
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However, even as screen-based educational content becomes increasingly accessible to all families, a new gap may be opening. Children whose parents have the ability to mentor and curate screen encounters may reap benefits that are less accessible in families with fewer financial resources or parents who cannot be as involved. Health providers should be alert to this gap, which may be reflected in other parent—child interactions .
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Television research shows that socioeconomic factors can shape the content and mediation of screen use. Further, TV viewing has been found to be negatively associated with school readiness skills, especially as family income decreases . However, the time spent viewing—across diverse middle-income households, for example—is stable   . In fact, socioeconomic status appears to have little bearing on the degree to which families comply with current screen guidelines . Raising awareness around how children learn best and their need for screen time limits is important for all families, regardless of economic circumstances.
Quality content can enhance social and language skills for all children aged 2 years and older, particularly for children living in poverty or who are otherwise disadvantaged  . Educational TV reaches children in lower-income homes almost as much as higher-income homes, and among children whose families own a laptop or mobile device, barriers to accessing and using educational content have almost disappeared .
Well-designed, age-appropriate educational programs and screen activities can be powerfully pro-social, helping children to learn antiviolence attitudes, empathy, tolerance and respect  . Appropriately used, screen time can calm a child who is overexcited or distressed e.
But screen learning can affect behaviour both positively and negatively, so ensuring quality content is crucial . Ideally, planning begins prenatally; accounts for the health, education and entertainment needs of each child and family member; includes screen-based activities in child care; and is reviewed periodically. Setting meaningful limits when children are young and sharing them as a family is far easier than cutting back screen time when children are older. For children—and parents—off-screen time is critical for developing essential life skills such as self-regulation  , creativity and learning through physical and imaginative play.
A recent study of smartphone use in fast-food restaurants observed that as time spent by parents on their phones increased, so too did the likelihood of children acting out to gain attention, often leading to negative interactions  . Another study found that parents who allow 1- to 4-year-old children to use their smartphones frequently also report offering the phone to reward or distract more often. Consequently, their children ask for the phone—and become upset if refused—more often . Parents report that their own use of mobile technology demands more intense attention than other distractions, such as reading books or watching TV.
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