Screen Use and Child and Adolescent Development and Mental Health Outcomes: A Quantitative Umbrella Review
Elizabeth Al-Jbouri, et al. JAMA Pediatr. 2026 Sep 28:e264339.
Abstract
This quantitative umbrella review published in JAMA Pediatrics synthesized existing meta-analyses to examine the associations between screen-based media use among children and adolescents aged 18 years or younger and academic, cognitive, socioemotional, and mental health outcomes.
The researchers systematically searched Embase, MEDLINE, and PsycINFO through November 25, 2025. A total of 23 meta-analyses were included, representing 2,817,252 children from 64 countries.
Greater screen-based media exposure was associated with lower overall academic achievement and language skills, with correlation coefficients of −0.15 and −0.14, respectively. Higher levels of screen use were also associated with greater internalizing and externalizing behavior problems, emotional problems, and peer problems. Social media use was additionally associated with higher levels of internalizing problems.
In contrast, screen-based media exposure was not clearly associated with executive functioning, prosociality, or mathematics, science, or reading scores.
Several factors moderated some of these associations, including screen type, subtype of behavior problems, child age, and publication year.
Overall, the findings indicate that screen use is associated with multiple developmental and mental health outcomes among children and adolescents. However, these findings primarily reflect statistical associations and should not be interpreted as evidence of causality. The results may help inform the development and refinement of evidence-informed guidelines and policies regarding screen-based media use among children and adolescents.
Commentary
The greatest value of this quantitative umbrella review published in JAMA Pediatrics is that it encourages us to rethink a seemingly simple but actually quite complex question: How much does screen use really affect children?
By synthesizing 23 meta-analyses involving more than 2.81 million children under 18 years of age across 64 countries, the study found that greater screen-based media exposure was associated with lower overall academic achievement and language skills, as well as higher levels of internalizing and externalizing behavior problems, emotional problems, and peer problems. These findings certainly deserve the attention of parents and educators.
However, the most important message of this study may not be that “screens are harmful,” but rather that different types of screen use may have different meanings and consequences.
The study also found no clear associations between screen use and executive functioning, prosocial behavior, or performance in mathematics, science, and reading. In other words, not all screen activities should be treated as if they were the same. Spending an hour reading an e-book, watching educational content with a parent, creating a video, and mindlessly scrolling through social media for an hour may represent very different psychological and developmental experiences for a child.
Furthermore, this study is an evidence synthesis, and many of the underlying studies were observational. Therefore, we still cannot conclude that screen use causes emotional or learning problems in children. The direction of causality could even be reversed: children who already experience emotional, behavioral, or social difficulties may be more likely to turn to screens for entertainment or as a way of coping or escaping. At the same time, factors such as family stress, socioeconomic background, parenting practices, sleep, and the school environment may influence both screen use and child development.
Therefore, at PI-Union Medical Science, we believe that the most important takeaway for parents is not another number telling them that children should be allowed only a certain number of hours of screen time each day. Instead, we should ask more meaningful questions: What are children watching or doing, why are they doing it, how are they using screens, and what happens afterward? If screen use displaces sleep, physical activity, learning, parent–child interaction, or real-world social relationships, it is worth reconsidering and adjusting. In contrast, age-appropriate, educational, and interactive digital activities should not necessarily be treated in the same way as all other forms of screen use.
Digital technology has already become part of the environment in which children grow and develop. What we may truly need to avoid is not all screen use, but screen use that lacks purpose, meaningful interaction, and balance with everyday life. This study reminds us that when addressing children’s digital health, rather than reducing the issue to “Should we ban screens or not?”, we should learn to manage the content, context, and quality of screen use more precisely.
Reviewer: PI-Union Medical Science Ltd.
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