Abstract
Background The use of mobile devices by young children has increased considerably over the last decade and especially after the COVID-19 pandemic. However, high-level evidence on whether the use of digital mobile devices can help or hinder the development of language in early childhood is still lacking. Exposure to mobile devices is a modifiable environmental factor and having a greater understanding of this issue is essential to better guide both policy and practice.
Objectives To investigate the extent to which mobile media exposure (smartphones and tablets) in early childhood (the first five years of life) affects the development of language in typically developing children.
Methods A systematic review (SR) was performed in July 2020 using the Medline, Embase, PsycINFO and Web of Science databases. The search was limited to the English and Portuguese languages and to the last ten years. Articles were reviewed against the inclusion and exclusion criteria. A comprehensive quality assessment tool was developed by combining the recommendations of three previously established guides and the internal and external validity of the selected studies were assessed qualitatively. A narrative approach was used to synthesise the data extracted.
Results The search strategy retrieved 4,443 articles of which 3 met the inclusion and exclusion criteria. The studies included were cross-sectional, published between 2019 and 2020. Their sample size ranged from 117 to 893 participants. The mean age of children varied around 18.7 and 54 months at the time of screen and language assessments. In all studies, boys accounted for approximately 54% of the participants. Different tools were used to assess language and to measure screen time, although all studies assessed both expressive and receptive language. Results of the quality assessment showed that the overall quality rate for all studies was poor. Limitations of the studies were discussed, and confounding variables related to the child, the family and the pattern of mobile device use were analysed. Overall, findings were heterogeneous and placing a dichotomous label for the effects of mobile device use on children’s language development was not possible.
Conclusions The findings from this SR show that based on the current literature, it is not possible to categorise the effects of mobile device exposure on children’s language development as either beneficial or detrimental, since strong evidence addressing these potential associations is lacking and since there are many covariates around them. Longitudinal studies are needed to clarify cause-and-effect relations and to elucidate the long-term effects of such exposure. Moreover, in order to reduce the risk of information bias, future studies should assess language skills professionally and measure mobile media use electronically rather than rely on parents’ reports. In addition, future research should also take into account the content children watch and the quality of parent-child interactions during mobile screen use. Multicentre and cross-cultural studies should be conducted so that the external validity of findings can be increased. Certainly, paediatric societies and policymakers should consider all these factors while issuing recommendations and guidelines.
