Cross-Sectional Associations of Screen Media Use Patterns with Executive Functioning and Emotional Self-Regulation Among U.S. Preschool-Aged Children.

Background: Children's screen media use increases substantially during the preschool years, a period of rapid development in executive functioning and emotional self-regulation. Greater screen time has been associated with difficulties in both domains, but most studies have focused on total screen time. This approach may obscure distinct associations with developmental domains because screen media use varies in activity (video viewing vs. digital game playing) and device type (mobile devices vs. television). We examined whether associations between screen media use and executive functioning and emotional self-regulation differed by activity and device type among preschool-aged children. Methods: A study design was cross-sectional. The study sample consisted of 238 mother-child dyads with children aged 3-4 years participating in the Behavioral and Emotional Development in Early Childhood Study (BEES). Mothers reported child media use using the Media Assessment Questionnaire, which assessed daily minutes spent viewing video content and playing digital games on mobile devices and television, along with background television and reasons for allowing screen use. Primary outcomes were executive-function difficulty measured using the Childhood Executive Functioning Inventory and emotional self-regulation difficulty using the Emotion Regulation Checklist. Multivariable linear regression models estimated associations between screen media use and the outcomes, adjusted for child age, child sex, maternal education, and neighborhood opportunity. Results: Children averaged 109 minutes/day (SD = 92) of screen time, including 60 minutes/day (SD = 40) of television video viewing, 30 minutes/day (SD = 39) of mobile video viewing, 13 minutes/day (SD = 25) of mobile game playing, and 6 minutes/day (SD = 20) of television game playing. Total video viewing was correlated with background television (ρ = 0.48; p < 0.001), and mobile video viewing was correlated with parental use of screens to calm the child (ρ = 0.50; p < 0.001). Each additional 30 minutes/day of total screen time was associated with greater executive-function difficulty (B = 0.03; 95% CI = 0.01, 0.06), but not emotional-regulation difficulty. In decomposition analyses, longer video viewing was associated with greater executive-function difficulty (B = 0.06; 95% CI = 0.01, 0.11), whereas longer mobile-device use was associated with greater emotional-regulation difficulty (B = 0.05; 95% CI = 0.01, 0.08). Conclusions: In this cross-sectional examination of U.S. preschool-aged children, greater video viewing was associated with greater executive-function difficulty, whereas greater mobile-device use was associated with greater emotional-regulation difficulty. Findings highlight the importance of considering activity and device type when examining the impact of screen media use on child development.