Behavioral impact of early smart device usage on toddlers: Importance of mother–child interaction

Abstract Background: In recent years, smart devices have become seamlessly integrated into human life. However, longitudinal studies focusing on their impact on toddlers are lacking. Accordingly, the present study examined the influence of early screen usage time and media content exposure on toddlers’ behavioral performance, along with the positive effects of mother–child interactions on this association. Method: We analyzed 276 children born between November 2016 and July 2020 participating in an ongoing prospective follow-up study at five hospitals in Taipei, Taiwan. In particular, data from maternal reports regarding these the children’s conditions and parental self-reported data over postpartum years 1–3 were analyzed. Group-based trajectory modeling and multiple linear regression were employed for statistical analyses. Results: Compared with a slight increase, a considerable increase in screen time during the ages of 1–3 was significantly associated with less favorable behavioral outcomes at age 3, including somatic complaints [adjusted beta coefficient (aβ) = 2.17, 95% confidence interval (CI) = 0.39–3.95], withdrawal (aβ = 2.42, 95% CI = 0.15–4.69), and aggressive behavior (aβ = 6.53, 95% CI = 0.25–12.81). This outcome was evident in children with relatively low mother–child interaction levels. Nevertheless, improved mother–child interactions alleviated most of the adverse effects. In addition, an increase in game and cartoon exposure was associated with less favorable behavioral outcomes in all children except those with positive mother–child interaction. Early mother-child interactions can mitigate behavioral issues in toddlers exposed to prolonged screen time and high game and cartoon content