Spending time on digital media, especially social media, tends to be consistently associated with developmental disorders in children and teens. A large-scale review of existing research suggests that although video games may modestly improve certain mental skills, heavy use of digital media generally corresponds to increased depression, behavioral problems, and drug use. The survey results are JAMA Pediatrics.
Digital media has become deeply ingrained in children’s daily lives, with usage steadily increasing across all age groups, from infancy to adolescence. Much of the debate surrounding this topic relies on cross-sectional studies. Because cross-sectional studies look at data at one point in time, it’s impossible to determine whether screen time is causing the problem or just related to the problem.
To get a clearer picture, the authors of the new study wanted to focus entirely on longitudinal studies. Longitudinal studies follow the same individuals over a period of time and observe their habits before measuring health outcomes.
“Debate about children’s digital media use is fierce, but most of the supporting evidence comes from studies that look at a single snapshot in time. We don’t know if screen time is actually causing the problem or just contributing to the problem. We wanted to change that,” said study author Sam Teague, senior research fellow at James Cook University and head of the JCU Digital Wellbeing Group.
“By focusing exclusively on longitudinal studies that track children’s media use before measuring health outcomes, we were able to begin to map the direction of these relationships. And to provide a comprehensive picture rather than narrow parts of the story, we intentionally cast a wide net, looking at all types of digital media use and all outcomes, both positive and negative.”
Previous research reviews are often highly fragmented. Many past studies aggregated all digital engagement into a broad measure of screen time, failing to differentiate between TV viewing and interaction on social platforms. Other reviews focused too narrowly on specific outcomes, such as academic performance, without considering children’s broader physical or emotional development. The researchers wanted to address these gaps by examining a variety of specific media types and outcomes.
Researchers conducted a systematic review and meta-analysis. Meta-analysis is a method of combining and analyzing data from multiple independent studies to find common trends. They searched major academic databases for longitudinal observational studies published from January 2000 to August 2024. The final analysis included 153 studies representing 115 unique people groups.
Overall, the data included approximately 360,000 participants from around the world, with sample sizes for individual studies ranging from 26 to 54,908 children. Participants’ ages ranged from 2 to 19 years. The gender breakdown was almost even, with 53.8% girls and 46.2% boys. Most of the included studies were conducted in Europe and North America, with fewer studies from Asia, Australia, and Latin America.
The researchers extracted data on how often children use different types of digital media. They categorized exposure into social media, video games, and other media such as messaging platforms, educational applications, and general internet usage. They then compared these habits to 26 developmental subdomains. These subdomains were grouped into four broad categories including social-emotional, cognitive, physical, and motor development. Study periods ranged from 1 day to 22 years, with an average follow-up period of approximately 2.5 years.
Researchers have found that social media use is consistently associated with multiple social and emotional difficulties. We found evidence that increased social media engagement increases depression, anxiety, behavioral problems, self-harm, and problematic internet use. It was also associated with lower academic performance, less positive development, and lower self-awareness.
In the area of physical health, social media use tended to coincide with higher rates of substance use. This association included alcohol, tobacco, and cannabis, and did not differ significantly by substance type.
Video game use showed a slightly different pattern in the data. Playing video games was associated with increased aggression and externalizing behaviors, which are externalized behaviors such as rule-breaking and hostility.
At the same time, the data showed a small positive association between gaming and improvements in attention and executive function. Executive function refers to mental skills that include working memory, flexible thinking, and self-control. Use of other media, such as messaging applications and the use of digital devices in general, was associated with depression and poorer overall health.
“The most obvious finding is that digital media use, especially social media, is consistently associated with worse outcomes for children and young people,” Teague told SciPost. “Social media stood out. In every area we looked at, from mental health and social development to physical health, social media was associated with worse outcomes. The only bright spot was video games, which showed a modest association with improvements in executive functions such as attention and mental organization.”
The researchers also conducted a moderation analysis to see if factors such as age, gender, and year of study influenced the results. They found that the association between social media and depression was stronger in early adolescence than in school-age children.
Additionally, studies conducted since 2012, when smartphones became popular, have shown a stronger link between social media and drug use. The researchers noted that the effects may continue to change as digital platforms evolve and become more immersive.
Overall, the negative association between digital media use and child development was small to moderate. In fact, researchers explain that these statistical effects are similar to those of other common lifestyle factors, such as poor diet and low physical activity. However, even modest effects can increase over time. Teague said the sheer volume of data showing exactly the same results makes these subtle changes more important.
“The keywords have been consistent: In more than 100 studies involving approximately 360,000 children around the world, a pattern continued to emerge,” Teague told PsyPost. “This is not a problem that families can solve on their own by simply setting better rules around screen time. The scale of the evidence shows the need for action by policymakers and technology companies to make online environments truly safe for children.”
Teague was particularly struck by the apparent discrepancy between the positive experiences families frequently described and the lack of supporting evidence found in the data.
“Families often refer to digital media as a source of creativity and stronger friendships,” Teague explained. “But these benefits are simply not present in the longitudinal literature,” she says. “We looked for them diligently. For example, we analyzed whether social media and gaming were associated with improved relationships with colleagues, and we found no such association.”
“And areas like creativity, empathy, and imagination have not been studied rigorously in this way at all. The lack of evidence is important. It doesn’t mean the benefits aren’t real, but it means we can’t confirm them. We really need more research tracking these potential benefits.”
The main limitation of this study is that it cannot conclusively prove causality. Longitudinal studies provide stronger evidence than snapshots in time, but other underlying factors may explain the association. Additionally, the majority of studies were from upper-middle income countries, limiting the ability to apply these findings to more diverse global populations.
“The most important thing is that we can’t prove causation,” Teague noted. “Longitudinal studies provide stronger evidence than a single snapshot. Although we are looking at media use before the results emerge, other explanations remain possible. For example, children who are already struggling with their mental health may interact differently with social media.”
“Alternatively, there may be underlying factors, such as a difficult home environment, that cause increased social media use and poor mental health at the same time. It was helpful because we pooled studies that controlled for some of these factors, but they were inconsistent across all studies. Future studies should control for baseline health status to uncover more robust causal relationships.”
Researchers now want to understand how children’s digital habits will change as countries begin to introduce age-based restrictions on social media platforms. “With social media bans for children currently in place in Australia and spreading globally, we want to understand how children’s digital habits change in response, and in particular what role AI may play as access to other platforms becomes more difficult,” Teague said.
The researchers also plan to take a closer look at early childhood habits. “We’re seeing children exceeding recommended screen time across all age groups, suggesting there may be more room for intervention sooner than we think,” Teague explained. “If we can understand how media habits formed in early childhood track into adolescence, we can better support families to build healthier habits from the beginning.”
The study, “Digital media use and child health and development: A systematic review and meta-analysis,” was authored by Samantha Teague, Claire Somolay, and Adrian Chatte.
