Effect of Screen Time on Language Development Among Toddlers and Preschool Children in Al Qatif, Saudi Arabia.

Background Speech and language development in early childhood is essential for cognitive and social development. With increasing exposure to screens at younger ages, concerns have been raised about potential effects on early language development. Although international recommendations advise limiting screen exposure, awareness and adherence remain variable. Objectives The primary objective is to examine the association between screen exposure patterns and communication scores on the Arabic Ages and Stages Questionnaire, third edition (A-ASQ‑3), among toddlers and preschool‑aged children in the Al Qatif region, Saudi Arabia. The secondary objectives are to explore associations between children's communication scores and maternal education, parental supervision, and familiarity with parental guidance (PG) content ratings during screen use, and children's sleep duration and related sleep habits. Methods A cross‑sectional community‑based study with prospective data collection was conducted between February 2023 and July 2024. Children aged 1-66 months were included because the A-ASQ‑3 provides standardized age‑specific forms across this range, allowing consistent assessment of the communication domain in infants, toddlers, and preschool‑aged children. Data were collected using a parent‑completed questionnaire and analyzed using the IBM SPSS Statistics for Windows, Version 29 (Released 2022; IBM Corp., Armonk, New York, United States). The primary outcome was language development status assessed using the A-ASQ‑3 Communication domain (Arabic version). According to A-ASQ‑3 scoring guidelines, children were categorized as above the cut‑off, close to the cut‑off, or below the cut‑off. For interpretation, "language delay" referred to scores below the cut‑off on the communication domain. Results Among 98 children, 35 (36.1%) were introduced to electronic devices between one and two years of age. Daily screen use was most commonly one to two hours/day (33 children, 33.7%), followed by two to three hours/day (23 children, 23.5%). Thirty‑six parents (36.7%) reported implementing screen‑time restrictions. Televisions and smartphones were the most frequently available devices, and 74 children (75.5%) mainly watched children's entertainment shows. Higher language development scores were significantly associated with higher maternal education, caregiver familiarity with PG scores, children sleeping more than 10 hours per night, and parental supervision during screen use, whereas daily screen time duration alone was not significantly associated with scores. The prevalence of delayed language development (scores below the A-ASQ‑3 communication cut‑off) was 6.1%. Conclusion In this cross‑sectional study, language development scores were more favourable among children whose mothers had higher education levels, whose caregivers were familiar with content guidance ratings, who slept longer, and who received closer parental supervision during screen use. These findings support family counselling that emphasizes supervised screen use, age‑appropriate content, and healthy sleep routines, while raising awareness of language development milestones. Larger, longitudinal studies are required to clarify directionality and long‑term outcomes.