The associations between screen time, executive function, and mental health in primary school children

Background: Rising screen time among children contributes to global physical inactivity and health issues.

Purpose: this study aims to explore the associations between early-life screen time, executive function and mental health in middle childhood.

Methods: This study included 1193 children (49.1% boys) from the Dutch GECKO Drenthe birth cohort. Parents reported TV and computer time at age 3-4 and 10-11. EF was assessed at age 10-11 using the BRIEF questionnaire, and mental health at age 5-6 and 10-11 using the SDQ questionnaire. Analysis included Spearman’s correlation and multiple linear regression, adjusting for BMI, outdoor playtime, and maternal education.

Results: Increased TV time at age 3-4 correlated with increased TV time at age 10-11 (p<0.001), while greater computer time at age 3-4 was linked to increased computer time at age 10-11 (p=0.022). TV time was not related with EF. However, more daily computer time at age 10-11 was associated with higher scores in total EF (b=1.41, 0.54 to 2.3), behavioral regulation index (b=1.15, 0.30 to 1.99), and metacognition index (b=1.50, 0.62 to 2.4) in girls, not in boys, indicating worse EF. No such associations were found with computer time at age 3-4. For mental health, more computer time at age 10-11 was associated with poorer prosocial behaviors (r=-0.13, p=0.009) in boys, and more emotional problems (r=0.11, p=0.023) in girls.

Conclusions: Children who spent more time in TV and computer tend to continue this pattern into middle childhood. While TV and computer time at age 3-4 were not associated with EF in school-aged children, girls with more computer time at age 10-11 showed poorer EF. Boys with more computer time at age 10-11 might display poorer prosocial behavior, while girls may have emotional problems.

Practical implications: This study provides evidence for strategies to reduce screen time and promote physical activity.