TY - JOUR
AU - Altındağ, Ahmet
AB - Introduction The early childhood period (0–78 months), extending from birth to preschool years, represents a critical phase in language development. During this age range, children rapidly acquire fundamental language skills, beginning with comprehension and expression capabilities, gradually progressing to sentence construction and understanding structural rules of language [1, 2]. This developmental process significantly influences not only linguistic abilities but also social, emotional, and cognitive development [3, 4]. Examining the theoretical foundations of language development, Piaget’s cognitive development theory and Vygotsky’s sociocultural approach are closely associated with the developmental characteristics of children aged 0–78 months. While Piaget emphasized the critical role of language skills in developing thinking, problem-solving, and analytical abilities during this age range [5, 6], Vygotsky highlighted the importance of language in social interaction, emphasizing its role in developing communication and emotional bonds [7, 8]. Furthermore, language functions as a crucial tool in children’s cultural identity formation and environmental interpretation during this early period [9, 10]. Contemporary neurobiological research reveals a strong connection between language processing and executive functions (EF) during early childhood (0–78 months) [11, 12]. Language development plays a crucial role in shaping children’s cognitive processes and expressing thoughts [13, 14]. Executive functions are critical in developing language abilities and interpreting complex linguistic structures [15–20]. During this critical developmental period, executive functions encompass higher-order cognitive abilities such as planning, goal setting, problem-solving, and memory, essential for regulating thought processes [21, 22]. Studies indicate that executive functions and language development mutually reinforce each other during this age range [23, 24]. Screen time can both positively and negatively impact language and cognitive development in children aged 0–78 months [25, 26]. While excessive screen time may delay language acquisition [27], moderate screen use with educational content and parental guidance can support language development and certain executive functions [28, 29]. There are varying interpretations regarding the definition and effects of screen time [30]. Given these mixed results, understanding this relationship is crucial for maximizing benefits while minimizing risks [31–33]. According to the World Health Organization, screen time refers to passive exposure to screen-based entertainment [34]. It is commonly defined as time spent accessing media through various devices, including television, mobile phones, DVDs, computers, and video games [35]. Research indicates that screen media has become a regular part of daily routines, particularly for children under 36 months [36, 37], with screen use frequency increasing for children aged 18–36 months [38]. Findings regarding screen use effects in this age group are contradictory. While some studies demonstrate potential benefits from educational content and moderate use [39–42], others reveal negative impacts on attention, working memory, and problem-solving skills, particularly with prolonged use [43–46]. Bukhalenkova and Almazova [46] conducted a study involving 772 mothers of children aged 5–6 and examined the relationship between active screen time factors such as time spent playing computer games and parental involvement in children’s computer games, concluded that long-term screen use limits children’s creativity and problem-solving skills. Involving 106 parents (aged 18 years or older) of children between 0 and 4 years residing in Australia, Halpin and their colleagues [47] argued that long-term screen use weakens children’s time management skills. Furthermore, prolonged screen exposure has been demonstrated to negatively affect children’s ability to focus and plan tasks [48], as well as their capacity to recognize and regulate their emotions [49]. McArthur, Tough & Madigan [50] involved 1994 mothers and their children in Calgary, Canada, they evaluated children’s screen time, behavior problems, developmental milestones, and vocabulary acquisition at 36 months based on maternal reports. Systematic reviews and meta-analyses have extensively examined the impact of screen time on child development in the 0–78-month age range. While Jing et al. [51] focused on screen media exposure and vocabulary development, McHarg et al. [52] and Likhitweerawong et al. [29] investigated the relationship between screen time and executive functions. Bustamante et al. [53] conducted a meta-analysis examining the impact of screen time on executive functions in children under 6 years, revealing the complex nature of this relationship. Li et al. [54] provided a broader perspective through their meta-analysis of early childhood screen use and health indicators. Shokrkon and Nicoladis [17], in their literature review examining the directionality between executive functions and language skills, emphasized the complexity of this bidirectional relationship, though they did not address the role of screen time in this interaction. Building on these foundations, several recent studies have further investigated specific aspects of screen time’s impact. Ponti [55], in a comprehensive review for the Canadian Pediatric Society, examined how digital media affects child development, emphasizing the need for age-appropriate content and guided interaction. Jannesar et al. [56], in their scoping review of screen time’s effects on children’s brain development, highlighted the importance of neurological impacts but did not specifically examine the interaction between language development and executive functions. Panjeti-Madan and Ranganathan [57] provided a detailed analysis of screen time’s impact on multiple developmental domains, including cognitive, language, physical, and social-emotional areas, but did not specifically examine the interrelationship between these domains. Regarding language development specifically, Bhutani et al. [58] conducted a scoping study examining how screen time affects children’s language development. Oktarina et al. [59] systematically reviewed the relationship between screen time and children’s language development, demonstrating how this relationship varies by age, content, and parental involvement. Their findings indicate a complex relationship mediated by multiple factors, though they did not investigate the role of executive functions in this relationship. Gowenlock et al. [60] further contributed to this understanding through their comprehensive review of video exposure’s impact on language development in children aged 3–11 years, emphasizing the importance of content quality and interaction patterns. Additionally, Aziz et al. [61] provided valuable insights in their study examining screen exposure’s impact on language development among toddlers and preschoolers, emphasizing the need for controlled screen time and quality content. Understanding the complex interaction between screen time, language development, and executive functions is critically important, particularly for children aged 0–78 months. While existing literature has typically examined these three factors in the context of binary relationships, their trilateral interaction remains insufficiently addressed, representing a significant research gap. This systematic review aims to fill this gap by synthesizing current evidence regarding the relationship between screen time and language development and executive functions in early childhood (0–78 months). The study’s findings will provide evidence-based guidance to parents and educators regarding optimal screen time use while contributing to the development of scientifically based guidelines for technology integration in preschool educational institutions. Another significant aspect of the study is providing evidence-based data needed for developing educational policies regarding technology use in early childhood. This data will enable the development of strategies that maximize positive effects while minimizing negative impacts of screen use. Purpose of the study and the research questions Although technology has many benefits and risks that can negatively affect children, completely excluding today’s children from the use of technology is like neglecting to teach an island child how to swim. It is of critical importance to understand the complex relationship between screen time, language development, and executive functions in early childhood in the context of the digital age. Given the virtual possibility of children interacting with technology, it is imperative for parents, caregivers, and teachers to be aware of potential consequences of technology on children’s development, and to act responsibly. Mantilla and Edwards [62] noted that digital technology has now become and is accepted as an integral part of young children’s daily life; setting from this point the way it is utilized by and with young children play a pivotal role in their well-being, safety, communication, and learning. This study is significant in terms of addressing the gap between cognitive psychology and the impact of technology on child development. The early childhood period is a critical period for brain development, during which basic language and executive function skills rapidly develop. Excessive screen time, which often replaces interactive and stimulating activities, has been shown to negatively affect these developmental processes [36, 53, 63, 64]. In contrast, purposeful and controlled screen time could support cognitive growth if appropriately integrated into educational frameworks [65, 66]. Given the pervasiveness of digital technology in the lives of young children, this research attempts to address the relationship between language development, executive function, and screen time by synthesizing existing findings from the literature to provide a comprehensive understanding of how these interactions influence developmental outcomes. The objective of this study is to present implications for parents, educators, and policy makers regarding the potential risks and benefits associated with the use of digital media. The findings can inform the development of balanced media consumption guidelines and interventions designed to support healthy development. The findings of this study are expected to contribute to the formulation of strategies that leverage the educational potential of technology while mitigating its adverse effects on the cognitive and language development of young children. The study’s focused examination of the relationship between language development, executive functions, and screen time renders it both timely and important. Consequently, the interplay among these three elements has been subjected to a comprehensive analysis. Accordingly, the overarching research question guiding the current study is formulated as below: What is the relationship between screen time, language development, and executive functions in children aged 0–78 months as reported in the present research literature? Purpose of the study and the research questions Although technology has many benefits and risks that can negatively affect children, completely excluding today’s children from the use of technology is like neglecting to teach an island child how to swim. It is of critical importance to understand the complex relationship between screen time, language development, and executive functions in early childhood in the context of the digital age. Given the virtual possibility of children interacting with technology, it is imperative for parents, caregivers, and teachers to be aware of potential consequences of technology on children’s development, and to act responsibly. Mantilla and Edwards [62] noted that digital technology has now become and is accepted as an integral part of young children’s daily life; setting from this point the way it is utilized by and with young children play a pivotal role in their well-being, safety, communication, and learning. This study is significant in terms of addressing the gap between cognitive psychology and the impact of technology on child development. The early childhood period is a critical period for brain development, during which basic language and executive function skills rapidly develop. Excessive screen time, which often replaces interactive and stimulating activities, has been shown to negatively affect these developmental processes [36, 53, 63, 64]. In contrast, purposeful and controlled screen time could support cognitive growth if appropriately integrated into educational frameworks [65, 66]. Given the pervasiveness of digital technology in the lives of young children, this research attempts to address the relationship between language development, executive function, and screen time by synthesizing existing findings from the literature to provide a comprehensive understanding of how these interactions influence developmental outcomes. The objective of this study is to present implications for parents, educators, and policy makers regarding the potential risks and benefits associated with the use of digital media. The findings can inform the development of balanced media consumption guidelines and interventions designed to support healthy development. The findings of this study are expected to contribute to the formulation of strategies that leverage the educational potential of technology while mitigating its adverse effects on the cognitive and language development of young children. The study’s focused examination of the relationship between language development, executive functions, and screen time renders it both timely and important. Consequently, the interplay among these three elements has been subjected to a comprehensive analysis. Accordingly, the overarching research question guiding the current study is formulated as below: What is the relationship between screen time, language development, and executive functions in children aged 0–78 months as reported in the present research literature? Materials and methods This study applied the principles of the PRISMA statement [67]. Additionally, the researchers used the CONSORT checklist adapted by Angosto, García-Fernández, Valantine, and Grimaldi-Puyana [68] to assess the reporting quality of the selected studies. The dataset used in this study is provided as S1 File. It is an Excel file containing all the necessary data to replicate the analyses and findings presented in this manuscript. The PRISMA checklist used in this study is provided as S2 File and outlines compliance with PRISMA guidelines. Both files have been deposited in the Open Science Framework (OSF) as supporting information. They can be accessed via the following link: https://osf.io/n7uc6/?view_only=8987e34f20da40ddba6c6c7c7009e84d. Search strategy There were no restrictions on the search timeframe. A comprehensive search was conducted until October 1, 2023, for studies completed up to that date. To locate articles for systematic review, the researchers concentrated on studies published in English language, in journals indexed in a variety of databases, including Web of Science, Scopus, Education Resources Information Center (ERIC), EBSCO, and PubMed. In the preliminary search, experts employed specific keywords. The keywords used in the systematic search included "Language Development," "Language Skill," "Language Teaching," "Language Education," "Executive Function," "Screen Time," "Children," "Pre-school Children," and "Early Childhood." These terms were combined using "AND" and "OR" conjunctions, and the population of interest was limited to preschool-aged children. The term “screen time” is used since it encapsulates a broad spectrum of devices (e.g., computers, televisions, phones) and their diverse uses (e.g., gaming, social communication) [69]. Our search strategy was designed to capture studies that fall within this expansive scope, assessing the impact of “screen time” on children’s language development and executive functions. We used the term “screen time” to focus on the duration of engagement with electronic devices. This term is expected to encompass much of the extensive literature in this domain due to its representation of the time spent using electronic devices. Eligibility criteria This systematic review examines all peer-reviewed empirical studies that specifically investigate the relationship between executive function, language development, and screen time during early childhood. Inclusion and exclusion criteria were established for the selection of studies to ensure that the identified articles were relevant to the purpose of the study. Duplicate studies were excluded. Table 1 presents the criteria in detail. Download: PPT PowerPoint slide PNG larger image TIFF original image Table 1. Inclusion and exclusion criteria. https://doi.org/10.1371/journal.pone.0314540.t001 The article selection process took place in two stages. The first stage involved screening studies based on titles, abstracts, and full texts. Two experts (MB and AGKA) independently conducted the selection and screening process, being unaware of each other’s decisions. The second stage involved a thorough review of the selected articles to ensure compliance with the inclusion criteria. Disagreements between the two reviewers were resolved by a third expert (GŞTC) acting as a reviewer. Studies that did not address the relationship between language development, executive function and screen time in early childhood were excluded because they did not meet the eligibility criteria. Search and selection process For this systematic analysis, a total of 310 studies were initially identified. Of these, only 191 English articles were included in the study. Among these, 83 duplicate articles were identified and excluded. After reviewing the titles, 54 articles were excluded as they were irrelevant. Similarly, abstracts were analyzed, and 27 articles were excluded. The full texts of the remaining 23 articles were analyzed. Of the 9 studies, 5 were excluded as reviews and 2 were excluded because they did not meet the relevant criteria. After applying the exclusion criteria, a total of 14 articles [19, 66, 70–81] met all the specified criteria. To ensure transparency and reproducibility, a detailed table documenting the evaluation process has been prepared and uploaded to the OSF for public access as supporting information. The table, entitled "S1 Table" presents a complete list of the studies reviewed during the screening stages, their classification as either "included" or "excluded," and providing rationale for their exclusion at various stages of the evaluation process. Furthermore, the table provides essential details such as the titles of the studies, digital object identifiers (DOIs) or uniform resource locators (URLs), the stages of the evaluation process, and the final inclusion or exclusion status of the studies. The aforementioned table can be accessed via the OSF at the following link: https://osf.io/n7uc6/?view_only=8987e34f20da40ddba6c6c7c7009e84d. Data extraction processes for analysis In the final review, 14 articles were included, and a table was created to facilitate understanding of the information for the articles (see Table 2). The data presented in the table details the following: (a) authors; (b) year; (c) main focus of the study; (d) research questions; (e) measured variables, (f) methodology, and (g) participant characteristics covered in the studies. Download: PPT PowerPoint slide PNG larger image TIFF original image Table 2. Descriptive register of articles. https://doi.org/10.1371/journal.pone.0314540.t002 To further ensure transparency and reproducibility, an additional table titled "S2 Table" has been prepared and uploaded to the OSF as supporting information. Table 2 provides detailed insights into the studies included in the review, whereas S2 Table is concerned with documenting the process of data extraction. The table includes the following: (a) the names of the data extractors; (b) the dates of data extraction; (c) confirmation of eligibility for inclusion; and (d) the extracted data variables necessary to replicate the analyses. This S2 Table is accessible on OSF at https://osf.io/n7uc6/?view_only=8987e34f20da40ddba6c6c7c7009e84d. Additionally, the methodological quality and evidence strength of the included studies were evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system, which assesses study limitations, inconsistency, indirectness, imprecision, and publication bias. Detailed GRADE ratings are provided in "S3 Table" as supporting information. S3 Table is available on the OSF at https://osf.io/n7uc6/?view_only=8987e34f20da40ddba6c6c7c7009e84d. Review of the quality of reporting The articles included in this study were all quantitative in nature. The selected studies were initially reviewed using an adapted version of the Consolidated Standards of Reporting Trials (CONSORT) checklist by Angosto, García-Fernández, Valantine, & Grimaldi-Puyana [68], originally designed by Schultz et al. [82]. The original CONSORT statement [82] consists of 25 items and provides a general standard for reporting randomized controlled trials (RCTs). The adapted version incorporates methodological enhancements and expansions. Furthermore, the range and reliability of the data collection tools have been subjected to additional scrutiny. It provides a more suitable framework for evaluating different data collection tools and enhancing the reliability of the results. Additionally, the adapted version has been tailored to specific contexts and topics, making it more appropriate for the objectives of this study. The study aims to analyze the complex relationship between screen time, language development, and executive functions. The adapted version has allowed for a review of the reporting quality in the analyzed studies, with the goal of increasing the validity and reliability of the study findings. The tool includes a total of 20 items in the categories of "title and summary", "introduction", "methods", "results", "discussion", and "other information”. The interrater agreement for the CONSORT protocol ratings in our systematic review study was high across the various items assessed. Each study was independently scored by two researchers who evaluated the sections they reviewed and rated each item with a score of 1, indicating whether the study satisfied the criterion or whether the item was applicable to the study. There was disagreement between the researchers in the evaluation of three studies. Disagreements were resolved by checking and discussing the original study until consensus was reached between the researchers. The first researcher is an expert in the field of language development in the preschool period, and the second researcher is an experienced researcher in the field of instructional technology. The agreement rates, as reported in the last row of Table 3, indicate a range from 85% to 100% among the different studies evaluated. Specifically, seven studies achieved an agreement rate of 90%, three studies achieved a rate of 95%, two studies reached 85%, and two studies attained a perfect agreement rate of 100%. This high level of agreement demonstrates the consistency and reliability of the ratings provided by the reviewers. Download: PPT PowerPoint slide PNG larger image TIFF original image Table 3. Reporting quality of the articles. https://doi.org/10.1371/journal.pone.0314540.t003 To check the quality of reporting of the studies, the quality of reporting of the 14 quantitative studies evaluated in the research was evaluated out of 20 points, presented in Table 3: As shown in Table 3, 1 article received 20 points [71], 2 articles received 19 points [72, 80], 2 articles received 18 points [66, 77], 4 articles received 17 points [19, 74–76], 4 articles received 16 points [70, 73, 79, 81], 1 article received 15 points [78]. Based on these data, all the articles have a value equal to or greater than 15 points. The average score of the articles was 17.21. In the majority of cases, the studies were in accordance with the standards for acceptable reporting, in terms of the design, methodology and implementation. Data collection tools also provide information about the quality of reporting of the studies. The studies employed varying numbers of data collection tools as follows: 1 [73, 77], 2 [19, 66, 72, 78, 81], 3 [70, 75, 76, 80], 4 [71], and 6 [74]. Most of the studies utilized multiple data collection tools, indicating potentially higher reliability of the articles. Search strategy There were no restrictions on the search timeframe. A comprehensive search was conducted until October 1, 2023, for studies completed up to that date. To locate articles for systematic review, the researchers concentrated on studies published in English language, in journals indexed in a variety of databases, including Web of Science, Scopus, Education Resources Information Center (ERIC), EBSCO, and PubMed. In the preliminary search, experts employed specific keywords. The keywords used in the systematic search included "Language Development," "Language Skill," "Language Teaching," "Language Education," "Executive Function," "Screen Time," "Children," "Pre-school Children," and "Early Childhood." These terms were combined using "AND" and "OR" conjunctions, and the population of interest was limited to preschool-aged children. The term “screen time” is used since it encapsulates a broad spectrum of devices (e.g., computers, televisions, phones) and their diverse uses (e.g., gaming, social communication) [69]. Our search strategy was designed to capture studies that fall within this expansive scope, assessing the impact of “screen time” on children’s language development and executive functions. We used the term “screen time” to focus on the duration of engagement with electronic devices. This term is expected to encompass much of the extensive literature in this domain due to its representation of the time spent using electronic devices. Eligibility criteria This systematic review examines all peer-reviewed empirical studies that specifically investigate the relationship between executive function, language development, and screen time during early childhood. Inclusion and exclusion criteria were established for the selection of studies to ensure that the identified articles were relevant to the purpose of the study. Duplicate studies were excluded. Table 1 presents the criteria in detail. Download: PPT PowerPoint slide PNG larger image TIFF original image Table 1. Inclusion and exclusion criteria. https://doi.org/10.1371/journal.pone.0314540.t001 The article selection process took place in two stages. The first stage involved screening studies based on titles, abstracts, and full texts. Two experts (MB and AGKA) independently conducted the selection and screening process, being unaware of each other’s decisions. The second stage involved a thorough review of the selected articles to ensure compliance with the inclusion criteria. Disagreements between the two reviewers were resolved by a third expert (GŞTC) acting as a reviewer. Studies that did not address the relationship between language development, executive function and screen time in early childhood were excluded because they did not meet the eligibility criteria. Search and selection process For this systematic analysis, a total of 310 studies were initially identified. Of these, only 191 English articles were included in the study. Among these, 83 duplicate articles were identified and excluded. After reviewing the titles, 54 articles were excluded as they were irrelevant. Similarly, abstracts were analyzed, and 27 articles were excluded. The full texts of the remaining 23 articles were analyzed. Of the 9 studies, 5 were excluded as reviews and 2 were excluded because they did not meet the relevant criteria. After applying the exclusion criteria, a total of 14 articles [19, 66, 70–81] met all the specified criteria. To ensure transparency and reproducibility, a detailed table documenting the evaluation process has been prepared and uploaded to the OSF for public access as supporting information. The table, entitled "S1 Table" presents a complete list of the studies reviewed during the screening stages, their classification as either "included" or "excluded," and providing rationale for their exclusion at various stages of the evaluation process. Furthermore, the table provides essential details such as the titles of the studies, digital object identifiers (DOIs) or uniform resource locators (URLs), the stages of the evaluation process, and the final inclusion or exclusion status of the studies. The aforementioned table can be accessed via the OSF at the following link: https://osf.io/n7uc6/?view_only=8987e34f20da40ddba6c6c7c7009e84d. Data extraction processes for analysis In the final review, 14 articles were included, and a table was created to facilitate understanding of the information for the articles (see Table 2). The data presented in the table details the following: (a) authors; (b) year; (c) main focus of the study; (d) research questions; (e) measured variables, (f) methodology, and (g) participant characteristics covered in the studies. Download: PPT PowerPoint slide PNG larger image TIFF original image Table 2. Descriptive register of articles. https://doi.org/10.1371/journal.pone.0314540.t002 To further ensure transparency and reproducibility, an additional table titled "S2 Table" has been prepared and uploaded to the OSF as supporting information. Table 2 provides detailed insights into the studies included in the review, whereas S2 Table is concerned with documenting the process of data extraction. The table includes the following: (a) the names of the data extractors; (b) the dates of data extraction; (c) confirmation of eligibility for inclusion; and (d) the extracted data variables necessary to replicate the analyses. This S2 Table is accessible on OSF at https://osf.io/n7uc6/?view_only=8987e34f20da40ddba6c6c7c7009e84d. Additionally, the methodological quality and evidence strength of the included studies were evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system, which assesses study limitations, inconsistency, indirectness, imprecision, and publication bias. Detailed GRADE ratings are provided in "S3 Table" as supporting information. S3 Table is available on the OSF at https://osf.io/n7uc6/?view_only=8987e34f20da40ddba6c6c7c7009e84d. Review of the quality of reporting The articles included in this study were all quantitative in nature. The selected studies were initially reviewed using an adapted version of the Consolidated Standards of Reporting Trials (CONSORT) checklist by Angosto, García-Fernández, Valantine, & Grimaldi-Puyana [68], originally designed by Schultz et al. [82]. The original CONSORT statement [82] consists of 25 items and provides a general standard for reporting randomized controlled trials (RCTs). The adapted version incorporates methodological enhancements and expansions. Furthermore, the range and reliability of the data collection tools have been subjected to additional scrutiny. It provides a more suitable framework for evaluating different data collection tools and enhancing the reliability of the results. Additionally, the adapted version has been tailored to specific contexts and topics, making it more appropriate for the objectives of this study. The study aims to analyze the complex relationship between screen time, language development, and executive functions. The adapted version has allowed for a review of the reporting quality in the analyzed studies, with the goal of increasing the validity and reliability of the study findings. The tool includes a total of 20 items in the categories of "title and summary", "introduction", "methods", "results", "discussion", and "other information”. The interrater agreement for the CONSORT protocol ratings in our systematic review study was high across the various items assessed. Each study was independently scored by two researchers who evaluated the sections they reviewed and rated each item with a score of 1, indicating whether the study satisfied the criterion or whether the item was applicable to the study. There was disagreement between the researchers in the evaluation of three studies. Disagreements were resolved by checking and discussing the original study until consensus was reached between the researchers. The first researcher is an expert in the field of language development in the preschool period, and the second researcher is an experienced researcher in the field of instructional technology. The agreement rates, as reported in the last row of Table 3, indicate a range from 85% to 100% among the different studies evaluated. Specifically, seven studies achieved an agreement rate of 90%, three studies achieved a rate of 95%, two studies reached 85%, and two studies attained a perfect agreement rate of 100%. This high level of agreement demonstrates the consistency and reliability of the ratings provided by the reviewers. Download: PPT PowerPoint slide PNG larger image TIFF original image Table 3. Reporting quality of the articles. https://doi.org/10.1371/journal.pone.0314540.t003 To check the quality of reporting of the studies, the quality of reporting of the 14 quantitative studies evaluated in the research was evaluated out of 20 points, presented in Table 3: As shown in Table 3, 1 article received 20 points [71], 2 articles received 19 points [72, 80], 2 articles received 18 points [66, 77], 4 articles received 17 points [19, 74–76], 4 articles received 16 points [70, 73, 79, 81], 1 article received 15 points [78]. Based on these data, all the articles have a value equal to or greater than 15 points. The average score of the articles was 17.21. In the majority of cases, the studies were in accordance with the standards for acceptable reporting, in terms of the design, methodology and implementation. Data collection tools also provide information about the quality of reporting of the studies. The studies employed varying numbers of data collection tools as follows: 1 [73, 77], 2 [19, 66, 72, 78, 81], 3 [70, 75, 76, 80], 4 [71], and 6 [74]. Most of the studies utilized multiple data collection tools, indicating potentially higher reliability of the articles. Results Study flow Fig 1 shows the flowchart of the current review, illustrating the process from 310 studies to the inclusion of 14 articles in the analysis. Download: PPT PowerPoint slide PNG larger image TIFF original image Fig 1. https://doi.org/10.1371/journal.pone.0314540.g001 Thematic analysis. Selected studies on the relationship between language development, executive function, and screen time are synthesized to explain this complex relationship. Before presenting the identified themes, it is important to define key concepts that recur throughout our analysis. Educational media. It is defined as content specifically designed with learning objectives in mind, including formats such as educational TV, apps, and games. While educational TV typically involves passive viewing, educational apps and games require active engagement from the user, such as completing tasks or interacting with the content to facilitate cognitive development (e.g., Zhang et al. [66]; Hutton et al. [75]). Interactive media. It is noteworthy to distinguish between two types of interactivities; physical and social. Physical interactivity involves the user’s direct engagement with the media, such as tapping or swiping, whereas social interactivity entails contingent social responses, either with another person through the media or in reaction to prompts within the media itself (Hutton et al. [75]; Ribner et al. [79]; Zhang et al. [66]). Following these definitions, the analysis identified the following key themes: (1) screen content and adherence to guidelines, (2) parent-child interaction and family context, (3) passive and active screen time, and (4) attention issues. These themes reflect specific areas where the relationship between screen time and developmental outcomes is most evident and were extracted from the analyses of the reviewed studies. The subsequent section presents each thematic area in detail. Screen content and adherence to guidelines. The nature of screen media and the way children interact with it are of critical importance when considering the effects of children’s screen time. Interactive and educational media content has been found to have positive effects on children’s language development and executive functions. Dolgikh et al. [72] investigated the impact of attending extra classes on the development of language development and executive functions with 124 children, with 60 attending extra classes (e.g., music, art, language) twice a week for 4 hours, and 64 not attending any extra classes. In this study, screen time was assessed through a questionnaire administered to the mothers of the participating children. The questionnaire specifically asked about the average amount of screen time the children engaged in per week. The study compared screen time between two groups: children attending extra classes and those who did not. Although the difference in screen time between the groups was not statistically significant, it was noted that children in the extra classes group had slightly lower screen time (approximately 1016 minutes per week) compared to the no extra classes group (approximately 1299 minutes per week). This screen time data was considered in the analysis of the children’s executive functions, ensuring that its potential impact on cognitive development was accounted for in the study’s findings. They observed the positive effects of extra preschool lessons on verbal working memory, highlighting how educational content can support language development. The results indicated that children who participated in extra classes exhibited significantly higher development in verbal working memory over a year compared to those who did not while they report the absence of statistically significant differences between groups who attend extra classes and who do not in terms of executive function development. The difference in the development rate of verbal working memory seems to be directly associated with participation in extra classes. It has been observed that there is a significant positive correlation between active screen time and cognitive development as well as social development. In this study, no specific data was collected regarding the use of screen time for educational purposes during the extra classes. In other words, the relationship between extra classes and screen use was not directly examined. The study concluded that participation in extra classes had a positive impact on the development of children’s executive functions. Therefore, the study does not provide definitive conclusions on whether the supplementary classes balance out the negative effects of high screen time. On the other hand, the article did examine screen time as a factor related to the development of children’s executive functions, emphasizing that excessive screen time could have negative effects on the development of executive functions. Additionally, the study noted that children not attending extra classes had higher screen time and lower maternal education levels, both of which are known to negatively impact executive function development. These findings suggest that structured extra classes can mitigate some of the negative effects of high screen time, enhancing language development and executive functions in preschool children. These findings indicate that interactive and educational screen content supports children’s language development and cognitive skills. Parents’ adherence to screen time recommendations also enables beneficial characteristics of screen media which refers to the positive attributes of screen media when used in a controlled and appropriate manner, particularly in alignment with established screen time guidelines, it was linked to better working memory [66]. The "beneficial characteristics" of screen media include educational content and structured use, which support cognitive development when screen time is kept within recommended limits, unlike excessive use that may harm cognitive functions like working memory as stated in the study [66]. The authors investigated the impact of screen time on cognitive development of preschoolers aged 36 to 60 months in Canada by means of a parental questionnaire assessing screen time and cognitive development via Early Years Toolbox. They observed positive effects of screen time in compliance with the recommended guidelines on cognitive skills and language development, particularly noting that educational content and interactive applications support these positive effects. However, they did not find a significant relationship between screen time and expressive vocabulary in preschool children. The findings suggest that screen time, regardless of its type, may not be related with expressive vocabulary. This implies that children’s verbal expression abilities may not be directly affected by screen time. In addition, the relationship between screen time and executive functions, excluding verbal working memory, indicates that both screen time and maternal education level are associated with all executive functions. Controlling screen time and ensuring access to quality content can encourage active participation in learning processes, thus enhancing critical thinking and problem-solving skills. Zhang et al. [66] also emphasize that not only the amount but also the quality of screen time is important. The significance of adhering to screen time guidelines was underscored by Hutton et al. [75] as well. The authors examined the associations between screen media use and the integrity of brain white matter tracts supporting language and literacy skills in preschooler healthy children aged 3 to 5 years in US. They identified a relationship between excessive screen-based media use beyond the guidelines and reduced microstructural integrity of brain white matter tracts that support language and emergent literacy skills in preschool-aged children. Higher screen time scores are associated with higher resistance to diffusion (RD) in white matter bundles related to language, executive function and developing literacy abilities. The findings indicate that higher ScreenQ scores, 15-item measure of screen-based media use, are significantly associated with lower fractional anisotropy (FA) and higher radial diffusivity (RD) in various white matter tracts across the whole brain. These correlations were observed after controlling for child age and household income, and the results remained statistically significant. This was evidenced by lower scores on related cognitive assessments. White matter tracts are known to facilitate communication between nerve cells and form the basis of cognitive functions. Preserving the integrity of these tracts is critical for cognitive development, especially during early childhood. Hutton et al.’s [75] study shows that screen-based media use can positively impact these tracts as long as screen time guidelines are followed and supporting the development of language and literacy skills despite many of the relationships between screen time and children’s cognitive development being deemed insignificant. Screen time’s impact manifests simultaneously on both language development and executive functions, with the nature of content playing a crucial role. Dolgikh et al. [72]’s study demonstrated this interconnected relationship: children attending extra classes showed enhanced verbal working memory (a component of both language development and executive functions) despite similar screen time exposure. This finding suggests that structured educational content can support both developmental domains concurrently. Zhang et al. [66] further reinforced this dual impact, showing that adherence to screen time guidelines was associated with improvements in both working memory and language skills, highlighting how appropriate screen use can simultaneously benefit both areas. Hutton et al. [75]’s neuroimaging findings provided biological evidence for this interconnection, showing how excessive screen time affects white matter tracts that support both language processing and executive function development. Parent-child interaction and the family context. Among the examined studies six of them explored the relationship between language development, executive function, and screen time in terms of parent-child interaction from various aspects. Exposure to screen media has been associated with a reduction in the quality of parent-child interactions, particularly when parents do not engage in sufficient conversation with their children. Supanitayanon et al. [80] conducted research to investigate the associations between the age of onset of screen media exposure, cumulative high media exposure, and verbal interaction during the screen time in the first two years of life, and the cognitive development of 4-year-old children with 274 healthy participants by collecting screen media data at specific ages, evaluating cognition at ages 2, 3, and 4 years, while considering parenting behaviors. Findings of this study indicated that children with earlier screen exposure, more screen time and less verbal interaction during screen time in the first two years of life had lower cognitive and language development in preschool. Furthermore, it is found out that excessive screen media exposure and lack of verbal interaction were associated with lower fine motor skills and lower visual reception. As children need continuous verbal stimulation to develop their language skills and cognitive abilities, increased verbal interactions between parents and children can support these developmental processes. In a similar vein, Carson and Kuzik [70] examined the association between parent-child interference across various devices and measured cognitive development and social-emotional development in preschool-aged children with 100 participants in Canada. They emphasized potential risks and negative impact of electronic devices on early childhood development, parent-child technology interference could interrupt parent-child interactions during the day. Higher parent-child interference was associated with lower response inhibition and emotional self-regulation. To illustrate, when children seek emotional support and guidance, they may be unable to meet these needs due to parental distractions. These findings indicate that parents should regulate their technology use besides from children’s screen time and make it interactive. Cultural and socioeconomic factors have been found to be critical factors that affect parent-child interaction. Three studies measured how those factors could influence parent-child interaction when they examine the relationship between language development, executive functions, and screen time. Studying the role of cultural and socioeconomic factors on the relationship between language development, executive functions and screen time, Zhang et al. [81] stated that the effects of screen time are largely shaped by several factors, including the life conditions of children and the educational levels of their parents. For instance, in families with higher socioeconomic status, children often have access to more educational resources and parents are better able to manage their children’s screen time. This can mitigate the adverse effects of screen time and facilitate children’s cognitive and language development. The authors found out that children who adhered to the screen time guidelines showed greater improvement in intellectual skills over time, especially in language development and vocabulary knowledge, compared to those who did not follow the screen time recommendations. Medawar et al. [77] also reached comparable conclusions in their study, which examined the effect of mothers’ home literacy beliefs and practices and the quantity and quality of screen media exposure to Argentinian children aged 18 months to 36 months. Their findings pointed out that higher parental education levels were associated with better language development in children, literacy beliefs and practices, particularly those of mothers, were significantly associated with better language outcomes in children. The findings of the study suggest that the quality of parent-child verbal interactions during shared media use contributes significantly to language development by creating an opportunity for dialog and vocabulary learning. The type and quality of screen media exposure were found to have different impacts on language development. Higher SES families often had better access to high-quality educational content and engaged more in joint media engagement, which positively influenced language outcomes. Conversely, passive screen exposure (e.g., TV) was more prevalent in lower SES families and was negatively associated with language development. Lastly, they noted that higher SES parents were more likely to engage in verbal scaffolding and joint media engagement with their children, which further supported language development. Besides, Hu et al. [74] also emphasized that parent-child interaction plays a pivotal role in enhancing language development through shared media usage, as suggested by their findings. In families with a lower socioeconomic status, parents may frequently be required to work longer hours, which may result in a reduction in the quality of time they are able to spend with their children. This can have a negative impact on children’s language development. Furthermore, these families may be constrained in their ability and opportunity to access educational content, which can impede children’s learning opportunities. It is possible that families with low socioeconomic status may utilize screen time as a form of childcare, which could result in increased screen time and negative effects. In parallel with these two studies, Hendry et al. [73] observed a consistent negative association between low socioeconomic status and screen time. Furthermore, the authors proposed that these families may be more vulnerable to the adverse effects of prolonged screen exposure. The relationship between screen time, language development, and executive functions is significantly mediated through parent-child interactions. Supanitayanon et al. [80] demonstrated how early screen exposure combined with reduced verbal interaction impacts both cognitive domains: children with earlier screen exposure and less verbal interaction showed lower performance in both language skills and cognitive functions. Carson and Kuzik [70] extended this understanding by showing how parent-child technology interference simultaneously affects response inhibition (an executive function) and emotional self-regulation, which in turn influences language learning opportunities. The socioeconomic context further shapes this three-way relationship. Zhang et al. [81] found that higher socioeconomic status families could better manage screen time while providing educational resources that support both language and cognitive development. Medawar et al. [77]’s findings reinforced this, showing how maternal literacy beliefs and practices influence both language outcomes and executive functioning through quality screen time management. Hu et al. [74] and Hendry et al. [73] further demonstrated how socioeconomic status affects both developmental domains through screen time exposure patterns and parent-child interaction quality. Passive and active screen time. In examining the relationship between language development, executive functions, and screen time, it is essential to consider the way children are exposed to screens. Four of the studies focused on how children were exposed to screen media. Medawar et al. [77] figured out that passive screen exposure (TV viewing) has a detrimental impact on language and literacy abilities, and that these effects are linked to self-regulation challenges in their study, which involved 465 mothers of Argentinian children aged 18–36 months. They reported that the continuous presence of television in the background can act as a distraction, impeding the development of language and literacy skills in children. A constant stream of auditory or visual stimuli in the background can impede children’s ability to maintain attention and concentration, thereby negatively affecting their learning process. Self-regulation difficulties can impede children’s capacity to focus their attention, regulate their emotions, and control their behavior, which can negatively impact their academic and social achievement. Another study conducted by Hu et al. [74] investigates the role of active and passive screen time on Chinese children’s social and cognitive development with 579 children aged 5. They found that passive screen time (TV viewing) is significantly and negatively associated with children’s executive functioning and social skills while there exists a meaningful and positive correlation between children’s active screen time and receptive language skills. Executive functions encompass a range of higher-order cognitive abilities, including planning, problem solving, attention control, and flexibility. The development of these critical skills may be inhibited by passive screen time. Furthermore, television viewing may impede children’s opportunities for social interaction, thereby hindering their capacity to develop social skills. It is evident that children require face-to-face interactions to develop their social skills. Therefore, based on the findings of study, it could be concluded that television viewing cannot replace these interactions and may prevent children from developing skills such as empathy, emotional expression, and understanding social cues. Veraksa et al. [19] demonstrated that passive screen time, particularly television viewing, is negatively associated with children’s ability to process verbal information effectively, development of executive functions, and social skills in their study conducted with 122 preschool children aged 5–6 in Russia whereas they noted. They found that passive screen time has negative effect on preschoolers’ phonological memory development, especially for those who engage in longer daily periods of television viewing. The capacity to process verbal information is of critical importance for children’s ability to learn and comprehend language; therefore, it could be argued that television viewing or passive engagement with digital devices may prevent children from using and developing these skills based these findings. Another study that showed the negative effects of passive screen time was conducted by Kim and Chung [76]. To investigate the association between exposure to TV or video and children’s language development and school achievement in childhood, Kim and Chung [76] conducted annual assessments from birth to 87.9 months, providing a comprehensive analysis of the longitudinal impact of screen time on child development. They have emphasized the negative effects of early screen exposure on language development. Their research shows that prolonged television exposure at age two negatively impacts children’s language development and school achievement. At this age, children lay the foundations of their language skills and are greatly influenced by the speech and interactions in their environment. Excessive television use can reduce these critical interactions, adversely affecting children’s language acquisition processes, and passive screen time can limit children’s active participation and interaction, restricting the natural learning opportunities that support language development. Furthermore, passive screen time can impede the interactions that facilitate children’s vocabulary and language comprehension development. Constant background television can weaken children’s ability to focus, negatively impacting their capacity for deep thinking and complex problem-solving. In line with these studies, Ribner et al. [79] conducted a nationally representative study with children ages from 3 to 7 in USA which aims to investigate the effect of the foreground TV exposure (educational, entertainment television), and background TV on self-regulation problems, language, and literacy skills. They observed that background and entertainment TV were negatively associated with language and literacy skills while educational TV was not. Furthermore, self-regulation problems might serve as a mechanism linking TV exposure to language and literacy skills. Likewise self-regulation problems, emotional lability is one aspect that has been found to have a negative relationship between screen time. Oflu et al. [78] observed that prolonged screen time can lead to emotional lability and attention problems in children in their study which examines excessive screen time associated with emotional lability in preschool children aged 2 to 5 years in Türkiye. As screen time increases, children’s ability to control and regulate their emotional responses may weaken. This can lead to negative outcomes in children’s social relationships and school performance. To illustrate, children with poor emotional regulation skills may struggle to concentrate in the classroom and complete academic tasks. In addition, Kim and Chung [76] highlighted the negative effects of screen time on self-regulation skills in early childhood. Self-regulation skills encompass the ability to control one’s thoughts, emotions, and behaviors. The development of these skills in early childhood is critical for academic and social success later in life. Prolonged screen time can hinder children’s development of these skills and weaken their ability to control themselves. These findings indicate that screen time can have negative effects on children’s emotional regulation skills, which can indirectly impact language development and other cognitive functions. It is important to carefully manage screen time and support children’s self-regulation skills. The use of passive screen time can impede the development of critical cognitive and language skills in children, including attention, executive functioning, and social skills. Nevertheless, the promotion of active and interactive screen content may serve to mitigate these negative effects. The distinction between passive and active screen time reveals crucial differences in their impact on both language development and executive functions. Medawar et al. [77] found that passive screen exposure negatively affects both language acquisition and self-regulation abilities. This finding was corroborated by Hu et al. [74], who showed that while passive screen time negatively impacted executive functioning and social skills, active screen time positively correlated with receptive language skills, demonstrating the differential effects of screen engagement types on both developmental domains. Veraksa et al. [19] provided further evidence of this interconnection, showing how passive screen time simultaneously affects verbal information processing and executive functions. Kim and Chung [76]’s longitudinal study demonstrated how early screen exposure impacts both language development and academic achievement through shared cognitive mechanisms. Ribner et al. [79] extended this understanding by showing how background and entertainment TV affect both language and literacy skills through self-regulation pathways. Oflu et al. [78] and Kim and Chung [76] highlighted how emotional regulation, influenced by screen time, acts as a bridge between language development and executive functioning. Attention issues. Excessive screen time can negatively impact children’s working memory, executive functions, and language development. Therefore, it emphasizes the importance of high-quality content and adherence to recommended guidelines. Zhang et al. [81] and Hendry et al. [73] emphasize the negative effects of total screen time, particularly television watching, on children’s working memory and executive functions. Working memory is defined as the capacity to store and process information in the short term, playing a critical role in children’s learning and problem-solving abilities. Zhang et al. [81] investigated longitudinal associations of subjectively measured physical activity and screen time with multiple domains of cognitive development in children aged 2.5 to 5 years old and excluded the ones who have conditions limiting physical activity or affecting cognitive performance. They figured out that using screen media in accordance with guidelines is associated with better intellectual ability and language development. Besides, Hendry et al. [71] investigated how variability in the home environment before and during the 2020 pandemic in the United Kingdom, involving 575 children aged 8 to 36 months in a parent-reported study. The authors noted that not only the amount but also the content of screen time has a significant impact on children’s attention and focus skills. This study found that higher screen time in early childhood was associated with lower cognitive outcomes, specifically in executive function and regulation skills. The findings of this theme showed that screen use, particularly in infants, negatively affected cognitive executive function (CEF) and regulation, and it mediated the relationship between socioeconomic status (SES) and these cognitive outcomes. Specifically, fast-paced and distracting content can shorten children’s attention spans and weaken their ability to concentrate. The findings suggest that exposure to such content may lead children to seek similar levels of constant stimulation in real life, making it difficult for them to maintain focus in classroom settings and other learning environments. It is shown that with increased screen time, a significant decline in children’s working memory capacity has been observed. This decline can lead to increased forgetfulness in daily life, difficulties in learning new information, and challenges in completing complex tasks. The impact of screen time on attention serves as a crucial link between language development and executive functions. Zhang et al. [81] and Hendry et al. [73] demonstrated how screen time affects working memory and executive functions, which in turn influence language processing and acquisition. Their research showed that adherence to screen time guidelines benefits both intellectual ability and language development through shared attention and cognitive control mechanisms. Specifically, Hendry et al. [74] found that excessive screen time negatively impacts cognitive executive function (CEF) and regulation, which serve as foundational skills for both language processing and executive control. The research highlighted how attention capacity, affected by screen exposure, serves as a common pathway influencing both language acquisition and executive function development. Study flow Fig 1 shows the flowchart of the current review, illustrating the process from 310 studies to the inclusion of 14 articles in the analysis. Download: PPT PowerPoint slide PNG larger image TIFF original image Fig 1. https://doi.org/10.1371/journal.pone.0314540.g001 Thematic analysis. Selected studies on the relationship between language development, executive function, and screen time are synthesized to explain this complex relationship. Before presenting the identified themes, it is important to define key concepts that recur throughout our analysis. Educational media. It is defined as content specifically designed with learning objectives in mind, including formats such as educational TV, apps, and games. While educational TV typically involves passive viewing, educational apps and games require active engagement from the user, such as completing tasks or interacting with the content to facilitate cognitive development (e.g., Zhang et al. [66]; Hutton et al. [75]). Interactive media. It is noteworthy to distinguish between two types of interactivities; physical and social. Physical interactivity involves the user’s direct engagement with the media, such as tapping or swiping, whereas social interactivity entails contingent social responses, either with another person through the media or in reaction to prompts within the media itself (Hutton et al. [75]; Ribner et al. [79]; Zhang et al. [66]). Following these definitions, the analysis identified the following key themes: (1) screen content and adherence to guidelines, (2) parent-child interaction and family context, (3) passive and active screen time, and (4) attention issues. These themes reflect specific areas where the relationship between screen time and developmental outcomes is most evident and were extracted from the analyses of the reviewed studies. The subsequent section presents each thematic area in detail. Screen content and adherence to guidelines. The nature of screen media and the way children interact with it are of critical importance when considering the effects of children’s screen time. Interactive and educational media content has been found to have positive effects on children’s language development and executive functions. Dolgikh et al. [72] investigated the impact of attending extra classes on the development of language development and executive functions with 124 children, with 60 attending extra classes (e.g., music, art, language) twice a week for 4 hours, and 64 not attending any extra classes. In this study, screen time was assessed through a questionnaire administered to the mothers of the participating children. The questionnaire specifically asked about the average amount of screen time the children engaged in per week. The study compared screen time between two groups: children attending extra classes and those who did not. Although the difference in screen time between the groups was not statistically significant, it was noted that children in the extra classes group had slightly lower screen time (approximately 1016 minutes per week) compared to the no extra classes group (approximately 1299 minutes per week). This screen time data was considered in the analysis of the children’s executive functions, ensuring that its potential impact on cognitive development was accounted for in the study’s findings. They observed the positive effects of extra preschool lessons on verbal working memory, highlighting how educational content can support language development. The results indicated that children who participated in extra classes exhibited significantly higher development in verbal working memory over a year compared to those who did not while they report the absence of statistically significant differences between groups who attend extra classes and who do not in terms of executive function development. The difference in the development rate of verbal working memory seems to be directly associated with participation in extra classes. It has been observed that there is a significant positive correlation between active screen time and cognitive development as well as social development. In this study, no specific data was collected regarding the use of screen time for educational purposes during the extra classes. In other words, the relationship between extra classes and screen use was not directly examined. The study concluded that participation in extra classes had a positive impact on the development of children’s executive functions. Therefore, the study does not provide definitive conclusions on whether the supplementary classes balance out the negative effects of high screen time. On the other hand, the article did examine screen time as a factor related to the development of children’s executive functions, emphasizing that excessive screen time could have negative effects on the development of executive functions. Additionally, the study noted that children not attending extra classes had higher screen time and lower maternal education levels, both of which are known to negatively impact executive function development. These findings suggest that structured extra classes can mitigate some of the negative effects of high screen time, enhancing language development and executive functions in preschool children. These findings indicate that interactive and educational screen content supports children’s language development and cognitive skills. Parents’ adherence to screen time recommendations also enables beneficial characteristics of screen media which refers to the positive attributes of screen media when used in a controlled and appropriate manner, particularly in alignment with established screen time guidelines, it was linked to better working memory [66]. The "beneficial characteristics" of screen media include educational content and structured use, which support cognitive development when screen time is kept within recommended limits, unlike excessive use that may harm cognitive functions like working memory as stated in the study [66]. The authors investigated the impact of screen time on cognitive development of preschoolers aged 36 to 60 months in Canada by means of a parental questionnaire assessing screen time and cognitive development via Early Years Toolbox. They observed positive effects of screen time in compliance with the recommended guidelines on cognitive skills and language development, particularly noting that educational content and interactive applications support these positive effects. However, they did not find a significant relationship between screen time and expressive vocabulary in preschool children. The findings suggest that screen time, regardless of its type, may not be related with expressive vocabulary. This implies that children’s verbal expression abilities may not be directly affected by screen time. In addition, the relationship between screen time and executive functions, excluding verbal working memory, indicates that both screen time and maternal education level are associated with all executive functions. Controlling screen time and ensuring access to quality content can encourage active participation in learning processes, thus enhancing critical thinking and problem-solving skills. Zhang et al. [66] also emphasize that not only the amount but also the quality of screen time is important. The significance of adhering to screen time guidelines was underscored by Hutton et al. [75] as well. The authors examined the associations between screen media use and the integrity of brain white matter tracts supporting language and literacy skills in preschooler healthy children aged 3 to 5 years in US. They identified a relationship between excessive screen-based media use beyond the guidelines and reduced microstructural integrity of brain white matter tracts that support language and emergent literacy skills in preschool-aged children. Higher screen time scores are associated with higher resistance to diffusion (RD) in white matter bundles related to language, executive function and developing literacy abilities. The findings indicate that higher ScreenQ scores, 15-item measure of screen-based media use, are significantly associated with lower fractional anisotropy (FA) and higher radial diffusivity (RD) in various white matter tracts across the whole brain. These correlations were observed after controlling for child age and household income, and the results remained statistically significant. This was evidenced by lower scores on related cognitive assessments. White matter tracts are known to facilitate communication between nerve cells and form the basis of cognitive functions. Preserving the integrity of these tracts is critical for cognitive development, especially during early childhood. Hutton et al.’s [75] study shows that screen-based media use can positively impact these tracts as long as screen time guidelines are followed and supporting the development of language and literacy skills despite many of the relationships between screen time and children’s cognitive development being deemed insignificant. Screen time’s impact manifests simultaneously on both language development and executive functions, with the nature of content playing a crucial role. Dolgikh et al. [72]’s study demonstrated this interconnected relationship: children attending extra classes showed enhanced verbal working memory (a component of both language development and executive functions) despite similar screen time exposure. This finding suggests that structured educational content can support both developmental domains concurrently. Zhang et al. [66] further reinforced this dual impact, showing that adherence to screen time guidelines was associated with improvements in both working memory and language skills, highlighting how appropriate screen use can simultaneously benefit both areas. Hutton et al. [75]’s neuroimaging findings provided biological evidence for this interconnection, showing how excessive screen time affects white matter tracts that support both language processing and executive function development. Parent-child interaction and the family context. Among the examined studies six of them explored the relationship between language development, executive function, and screen time in terms of parent-child interaction from various aspects. Exposure to screen media has been associated with a reduction in the quality of parent-child interactions, particularly when parents do not engage in sufficient conversation with their children. Supanitayanon et al. [80] conducted research to investigate the associations between the age of onset of screen media exposure, cumulative high media exposure, and verbal interaction during the screen time in the first two years of life, and the cognitive development of 4-year-old children with 274 healthy participants by collecting screen media data at specific ages, evaluating cognition at ages 2, 3, and 4 years, while considering parenting behaviors. Findings of this study indicated that children with earlier screen exposure, more screen time and less verbal interaction during screen time in the first two years of life had lower cognitive and language development in preschool. Furthermore, it is found out that excessive screen media exposure and lack of verbal interaction were associated with lower fine motor skills and lower visual reception. As children need continuous verbal stimulation to develop their language skills and cognitive abilities, increased verbal interactions between parents and children can support these developmental processes. In a similar vein, Carson and Kuzik [70] examined the association between parent-child interference across various devices and measured cognitive development and social-emotional development in preschool-aged children with 100 participants in Canada. They emphasized potential risks and negative impact of electronic devices on early childhood development, parent-child technology interference could interrupt parent-child interactions during the day. Higher parent-child interference was associated with lower response inhibition and emotional self-regulation. To illustrate, when children seek emotional support and guidance, they may be unable to meet these needs due to parental distractions. These findings indicate that parents should regulate their technology use besides from children’s screen time and make it interactive. Cultural and socioeconomic factors have been found to be critical factors that affect parent-child interaction. Three studies measured how those factors could influence parent-child interaction when they examine the relationship between language development, executive functions, and screen time. Studying the role of cultural and socioeconomic factors on the relationship between language development, executive functions and screen time, Zhang et al. [81] stated that the effects of screen time are largely shaped by several factors, including the life conditions of children and the educational levels of their parents. For instance, in families with higher socioeconomic status, children often have access to more educational resources and parents are better able to manage their children’s screen time. This can mitigate the adverse effects of screen time and facilitate children’s cognitive and language development. The authors found out that children who adhered to the screen time guidelines showed greater improvement in intellectual skills over time, especially in language development and vocabulary knowledge, compared to those who did not follow the screen time recommendations. Medawar et al. [77] also reached comparable conclusions in their study, which examined the effect of mothers’ home literacy beliefs and practices and the quantity and quality of screen media exposure to Argentinian children aged 18 months to 36 months. Their findings pointed out that higher parental education levels were associated with better language development in children, literacy beliefs and practices, particularly those of mothers, were significantly associated with better language outcomes in children. The findings of the study suggest that the quality of parent-child verbal interactions during shared media use contributes significantly to language development by creating an opportunity for dialog and vocabulary learning. The type and quality of screen media exposure were found to have different impacts on language development. Higher SES families often had better access to high-quality educational content and engaged more in joint media engagement, which positively influenced language outcomes. Conversely, passive screen exposure (e.g., TV) was more prevalent in lower SES families and was negatively associated with language development. Lastly, they noted that higher SES parents were more likely to engage in verbal scaffolding and joint media engagement with their children, which further supported language development. Besides, Hu et al. [74] also emphasized that parent-child interaction plays a pivotal role in enhancing language development through shared media usage, as suggested by their findings. In families with a lower socioeconomic status, parents may frequently be required to work longer hours, which may result in a reduction in the quality of time they are able to spend with their children. This can have a negative impact on children’s language development. Furthermore, these families may be constrained in their ability and opportunity to access educational content, which can impede children’s learning opportunities. It is possible that families with low socioeconomic status may utilize screen time as a form of childcare, which could result in increased screen time and negative effects. In parallel with these two studies, Hendry et al. [73] observed a consistent negative association between low socioeconomic status and screen time. Furthermore, the authors proposed that these families may be more vulnerable to the adverse effects of prolonged screen exposure. The relationship between screen time, language development, and executive functions is significantly mediated through parent-child interactions. Supanitayanon et al. [80] demonstrated how early screen exposure combined with reduced verbal interaction impacts both cognitive domains: children with earlier screen exposure and less verbal interaction showed lower performance in both language skills and cognitive functions. Carson and Kuzik [70] extended this understanding by showing how parent-child technology interference simultaneously affects response inhibition (an executive function) and emotional self-regulation, which in turn influences language learning opportunities. The socioeconomic context further shapes this three-way relationship. Zhang et al. [81] found that higher socioeconomic status families could better manage screen time while providing educational resources that support both language and cognitive development. Medawar et al. [77]’s findings reinforced this, showing how maternal literacy beliefs and practices influence both language outcomes and executive functioning through quality screen time management. Hu et al. [74] and Hendry et al. [73] further demonstrated how socioeconomic status affects both developmental domains through screen time exposure patterns and parent-child interaction quality. Passive and active screen time. In examining the relationship between language development, executive functions, and screen time, it is essential to consider the way children are exposed to screens. Four of the studies focused on how children were exposed to screen media. Medawar et al. [77] figured out that passive screen exposure (TV viewing) has a detrimental impact on language and literacy abilities, and that these effects are linked to self-regulation challenges in their study, which involved 465 mothers of Argentinian children aged 18–36 months. They reported that the continuous presence of television in the background can act as a distraction, impeding the development of language and literacy skills in children. A constant stream of auditory or visual stimuli in the background can impede children’s ability to maintain attention and concentration, thereby negatively affecting their learning process. Self-regulation difficulties can impede children’s capacity to focus their attention, regulate their emotions, and control their behavior, which can negatively impact their academic and social achievement. Another study conducted by Hu et al. [74] investigates the role of active and passive screen time on Chinese children’s social and cognitive development with 579 children aged 5. They found that passive screen time (TV viewing) is significantly and negatively associated with children’s executive functioning and social skills while there exists a meaningful and positive correlation between children’s active screen time and receptive language skills. Executive functions encompass a range of higher-order cognitive abilities, including planning, problem solving, attention control, and flexibility. The development of these critical skills may be inhibited by passive screen time. Furthermore, television viewing may impede children’s opportunities for social interaction, thereby hindering their capacity to develop social skills. It is evident that children require face-to-face interactions to develop their social skills. Therefore, based on the findings of study, it could be concluded that television viewing cannot replace these interactions and may prevent children from developing skills such as empathy, emotional expression, and understanding social cues. Veraksa et al. [19] demonstrated that passive screen time, particularly television viewing, is negatively associated with children’s ability to process verbal information effectively, development of executive functions, and social skills in their study conducted with 122 preschool children aged 5–6 in Russia whereas they noted. They found that passive screen time has negative effect on preschoolers’ phonological memory development, especially for those who engage in longer daily periods of television viewing. The capacity to process verbal information is of critical importance for children’s ability to learn and comprehend language; therefore, it could be argued that television viewing or passive engagement with digital devices may prevent children from using and developing these skills based these findings. Another study that showed the negative effects of passive screen time was conducted by Kim and Chung [76]. To investigate the association between exposure to TV or video and children’s language development and school achievement in childhood, Kim and Chung [76] conducted annual assessments from birth to 87.9 months, providing a comprehensive analysis of the longitudinal impact of screen time on child development. They have emphasized the negative effects of early screen exposure on language development. Their research shows that prolonged television exposure at age two negatively impacts children’s language development and school achievement. At this age, children lay the foundations of their language skills and are greatly influenced by the speech and interactions in their environment. Excessive television use can reduce these critical interactions, adversely affecting children’s language acquisition processes, and passive screen time can limit children’s active participation and interaction, restricting the natural learning opportunities that support language development. Furthermore, passive screen time can impede the interactions that facilitate children’s vocabulary and language comprehension development. Constant background television can weaken children’s ability to focus, negatively impacting their capacity for deep thinking and complex problem-solving. In line with these studies, Ribner et al. [79] conducted a nationally representative study with children ages from 3 to 7 in USA which aims to investigate the effect of the foreground TV exposure (educational, entertainment television), and background TV on self-regulation problems, language, and literacy skills. They observed that background and entertainment TV were negatively associated with language and literacy skills while educational TV was not. Furthermore, self-regulation problems might serve as a mechanism linking TV exposure to language and literacy skills. Likewise self-regulation problems, emotional lability is one aspect that has been found to have a negative relationship between screen time. Oflu et al. [78] observed that prolonged screen time can lead to emotional lability and attention problems in children in their study which examines excessive screen time associated with emotional lability in preschool children aged 2 to 5 years in Türkiye. As screen time increases, children’s ability to control and regulate their emotional responses may weaken. This can lead to negative outcomes in children’s social relationships and school performance. To illustrate, children with poor emotional regulation skills may struggle to concentrate in the classroom and complete academic tasks. In addition, Kim and Chung [76] highlighted the negative effects of screen time on self-regulation skills in early childhood. Self-regulation skills encompass the ability to control one’s thoughts, emotions, and behaviors. The development of these skills in early childhood is critical for academic and social success later in life. Prolonged screen time can hinder children’s development of these skills and weaken their ability to control themselves. These findings indicate that screen time can have negative effects on children’s emotional regulation skills, which can indirectly impact language development and other cognitive functions. It is important to carefully manage screen time and support children’s self-regulation skills. The use of passive screen time can impede the development of critical cognitive and language skills in children, including attention, executive functioning, and social skills. Nevertheless, the promotion of active and interactive screen content may serve to mitigate these negative effects. The distinction between passive and active screen time reveals crucial differences in their impact on both language development and executive functions. Medawar et al. [77] found that passive screen exposure negatively affects both language acquisition and self-regulation abilities. This finding was corroborated by Hu et al. [74], who showed that while passive screen time negatively impacted executive functioning and social skills, active screen time positively correlated with receptive language skills, demonstrating the differential effects of screen engagement types on both developmental domains. Veraksa et al. [19] provided further evidence of this interconnection, showing how passive screen time simultaneously affects verbal information processing and executive functions. Kim and Chung [76]’s longitudinal study demonstrated how early screen exposure impacts both language development and academic achievement through shared cognitive mechanisms. Ribner et al. [79] extended this understanding by showing how background and entertainment TV affect both language and literacy skills through self-regulation pathways. Oflu et al. [78] and Kim and Chung [76] highlighted how emotional regulation, influenced by screen time, acts as a bridge between language development and executive functioning. Attention issues. Excessive screen time can negatively impact children’s working memory, executive functions, and language development. Therefore, it emphasizes the importance of high-quality content and adherence to recommended guidelines. Zhang et al. [81] and Hendry et al. [73] emphasize the negative effects of total screen time, particularly television watching, on children’s working memory and executive functions. Working memory is defined as the capacity to store and process information in the short term, playing a critical role in children’s learning and problem-solving abilities. Zhang et al. [81] investigated longitudinal associations of subjectively measured physical activity and screen time with multiple domains of cognitive development in children aged 2.5 to 5 years old and excluded the ones who have conditions limiting physical activity or affecting cognitive performance. They figured out that using screen media in accordance with guidelines is associated with better intellectual ability and language development. Besides, Hendry et al. [71] investigated how variability in the home environment before and during the 2020 pandemic in the United Kingdom, involving 575 children aged 8 to 36 months in a parent-reported study. The authors noted that not only the amount but also the content of screen time has a significant impact on children’s attention and focus skills. This study found that higher screen time in early childhood was associated with lower cognitive outcomes, specifically in executive function and regulation skills. The findings of this theme showed that screen use, particularly in infants, negatively affected cognitive executive function (CEF) and regulation, and it mediated the relationship between socioeconomic status (SES) and these cognitive outcomes. Specifically, fast-paced and distracting content can shorten children’s attention spans and weaken their ability to concentrate. The findings suggest that exposure to such content may lead children to seek similar levels of constant stimulation in real life, making it difficult for them to maintain focus in classroom settings and other learning environments. It is shown that with increased screen time, a significant decline in children’s working memory capacity has been observed. This decline can lead to increased forgetfulness in daily life, difficulties in learning new information, and challenges in completing complex tasks. The impact of screen time on attention serves as a crucial link between language development and executive functions. Zhang et al. [81] and Hendry et al. [73] demonstrated how screen time affects working memory and executive functions, which in turn influence language processing and acquisition. Their research showed that adherence to screen time guidelines benefits both intellectual ability and language development through shared attention and cognitive control mechanisms. Specifically, Hendry et al. [74] found that excessive screen time negatively impacts cognitive executive function (CEF) and regulation, which serve as foundational skills for both language processing and executive control. The research highlighted how attention capacity, affected by screen exposure, serves as a common pathway influencing both language acquisition and executive function development. Thematic analysis. Selected studies on the relationship between language development, executive function, and screen time are synthesized to explain this complex relationship. Before presenting the identified themes, it is important to define key concepts that recur throughout our analysis. Educational media. It is defined as content specifically designed with learning objectives in mind, including formats such as educational TV, apps, and games. While educational TV typically involves passive viewing, educational apps and games require active engagement from the user, such as completing tasks or interacting with the content to facilitate cognitive development (e.g., Zhang et al. [66]; Hutton et al. [75]). Interactive media. It is noteworthy to distinguish between two types of interactivities; physical and social. Physical interactivity involves the user’s direct engagement with the media, such as tapping or swiping, whereas social interactivity entails contingent social responses, either with another person through the media or in reaction to prompts within the media itself (Hutton et al. [75]; Ribner et al. [79]; Zhang et al. [66]). Following these definitions, the analysis identified the following key themes: (1) screen content and adherence to guidelines, (2) parent-child interaction and family context, (3) passive and active screen time, and (4) attention issues. These themes reflect specific areas where the relationship between screen time and developmental outcomes is most evident and were extracted from the analyses of the reviewed studies. The subsequent section presents each thematic area in detail. Screen content and adherence to guidelines. The nature of screen media and the way children interact with it are of critical importance when considering the effects of children’s screen time. Interactive and educational media content has been found to have positive effects on children’s language development and executive functions. Dolgikh et al. [72] investigated the impact of attending extra classes on the development of language development and executive functions with 124 children, with 60 attending extra classes (e.g., music, art, language) twice a week for 4 hours, and 64 not attending any extra classes. In this study, screen time was assessed through a questionnaire administered to the mothers of the participating children. The questionnaire specifically asked about the average amount of screen time the children engaged in per week. The study compared screen time between two groups: children attending extra classes and those who did not. Although the difference in screen time between the groups was not statistically significant, it was noted that children in the extra classes group had slightly lower screen time (approximately 1016 minutes per week) compared to the no extra classes group (approximately 1299 minutes per week). This screen time data was considered in the analysis of the children’s executive functions, ensuring that its potential impact on cognitive development was accounted for in the study’s findings. They observed the positive effects of extra preschool lessons on verbal working memory, highlighting how educational content can support language development. The results indicated that children who participated in extra classes exhibited significantly higher development in verbal working memory over a year compared to those who did not while they report the absence of statistically significant differences between groups who attend extra classes and who do not in terms of executive function development. The difference in the development rate of verbal working memory seems to be directly associated with participation in extra classes. It has been observed that there is a significant positive correlation between active screen time and cognitive development as well as social development. In this study, no specific data was collected regarding the use of screen time for educational purposes during the extra classes. In other words, the relationship between extra classes and screen use was not directly examined. The study concluded that participation in extra classes had a positive impact on the development of children’s executive functions. Therefore, the study does not provide definitive conclusions on whether the supplementary classes balance out the negative effects of high screen time. On the other hand, the article did examine screen time as a factor related to the development of children’s executive functions, emphasizing that excessive screen time could have negative effects on the development of executive functions. Additionally, the study noted that children not attending extra classes had higher screen time and lower maternal education levels, both of which are known to negatively impact executive function development. These findings suggest that structured extra classes can mitigate some of the negative effects of high screen time, enhancing language development and executive functions in preschool children. These findings indicate that interactive and educational screen content supports children’s language development and cognitive skills. Parents’ adherence to screen time recommendations also enables beneficial characteristics of screen media which refers to the positive attributes of screen media when used in a controlled and appropriate manner, particularly in alignment with established screen time guidelines, it was linked to better working memory [66]. The "beneficial characteristics" of screen media include educational content and structured use, which support cognitive development when screen time is kept within recommended limits, unlike excessive use that may harm cognitive functions like working memory as stated in the study [66]. The authors investigated the impact of screen time on cognitive development of preschoolers aged 36 to 60 months in Canada by means of a parental questionnaire assessing screen time and cognitive development via Early Years Toolbox. They observed positive effects of screen time in compliance with the recommended guidelines on cognitive skills and language development, particularly noting that educational content and interactive applications support these positive effects. However, they did not find a significant relationship between screen time and expressive vocabulary in preschool children. The findings suggest that screen time, regardless of its type, may not be related with expressive vocabulary. This implies that children’s verbal expression abilities may not be directly affected by screen time. In addition, the relationship between screen time and executive functions, excluding verbal working memory, indicates that both screen time and maternal education level are associated with all executive functions. Controlling screen time and ensuring access to quality content can encourage active participation in learning processes, thus enhancing critical thinking and problem-solving skills. Zhang et al. [66] also emphasize that not only the amount but also the quality of screen time is important. The significance of adhering to screen time guidelines was underscored by Hutton et al. [75] as well. The authors examined the associations between screen media use and the integrity of brain white matter tracts supporting language and literacy skills in preschooler healthy children aged 3 to 5 years in US. They identified a relationship between excessive screen-based media use beyond the guidelines and reduced microstructural integrity of brain white matter tracts that support language and emergent literacy skills in preschool-aged children. Higher screen time scores are associated with higher resistance to diffusion (RD) in white matter bundles related to language, executive function and developing literacy abilities. The findings indicate that higher ScreenQ scores, 15-item measure of screen-based media use, are significantly associated with lower fractional anisotropy (FA) and higher radial diffusivity (RD) in various white matter tracts across the whole brain. These correlations were observed after controlling for child age and household income, and the results remained statistically significant. This was evidenced by lower scores on related cognitive assessments. White matter tracts are known to facilitate communication between nerve cells and form the basis of cognitive functions. Preserving the integrity of these tracts is critical for cognitive development, especially during early childhood. Hutton et al.’s [75] study shows that screen-based media use can positively impact these tracts as long as screen time guidelines are followed and supporting the development of language and literacy skills despite many of the relationships between screen time and children’s cognitive development being deemed insignificant. Screen time’s impact manifests simultaneously on both language development and executive functions, with the nature of content playing a crucial role. Dolgikh et al. [72]’s study demonstrated this interconnected relationship: children attending extra classes showed enhanced verbal working memory (a component of both language development and executive functions) despite similar screen time exposure. This finding suggests that structured educational content can support both developmental domains concurrently. Zhang et al. [66] further reinforced this dual impact, showing that adherence to screen time guidelines was associated with improvements in both working memory and language skills, highlighting how appropriate screen use can simultaneously benefit both areas. Hutton et al. [75]’s neuroimaging findings provided biological evidence for this interconnection, showing how excessive screen time affects white matter tracts that support both language processing and executive function development. Parent-child interaction and the family context. Among the examined studies six of them explored the relationship between language development, executive function, and screen time in terms of parent-child interaction from various aspects. Exposure to screen media has been associated with a reduction in the quality of parent-child interactions, particularly when parents do not engage in sufficient conversation with their children. Supanitayanon et al. [80] conducted research to investigate the associations between the age of onset of screen media exposure, cumulative high media exposure, and verbal interaction during the screen time in the first two years of life, and the cognitive development of 4-year-old children with 274 healthy participants by collecting screen media data at specific ages, evaluating cognition at ages 2, 3, and 4 years, while considering parenting behaviors. Findings of this study indicated that children with earlier screen exposure, more screen time and less verbal interaction during screen time in the first two years of life had lower cognitive and language development in preschool. Furthermore, it is found out that excessive screen media exposure and lack of verbal interaction were associated with lower fine motor skills and lower visual reception. As children need continuous verbal stimulation to develop their language skills and cognitive abilities, increased verbal interactions between parents and children can support these developmental processes. In a similar vein, Carson and Kuzik [70] examined the association between parent-child interference across various devices and measured cognitive development and social-emotional development in preschool-aged children with 100 participants in Canada. They emphasized potential risks and negative impact of electronic devices on early childhood development, parent-child technology interference could interrupt parent-child interactions during the day. Higher parent-child interference was associated with lower response inhibition and emotional self-regulation. To illustrate, when children seek emotional support and guidance, they may be unable to meet these needs due to parental distractions. These findings indicate that parents should regulate their technology use besides from children’s screen time and make it interactive. Cultural and socioeconomic factors have been found to be critical factors that affect parent-child interaction. Three studies measured how those factors could influence parent-child interaction when they examine the relationship between language development, executive functions, and screen time. Studying the role of cultural and socioeconomic factors on the relationship between language development, executive functions and screen time, Zhang et al. [81] stated that the effects of screen time are largely shaped by several factors, including the life conditions of children and the educational levels of their parents. For instance, in families with higher socioeconomic status, children often have access to more educational resources and parents are better able to manage their children’s screen time. This can mitigate the adverse effects of screen time and facilitate children’s cognitive and language development. The authors found out that children who adhered to the screen time guidelines showed greater improvement in intellectual skills over time, especially in language development and vocabulary knowledge, compared to those who did not follow the screen time recommendations. Medawar et al. [77] also reached comparable conclusions in their study, which examined the effect of mothers’ home literacy beliefs and practices and the quantity and quality of screen media exposure to Argentinian children aged 18 months to 36 months. Their findings pointed out that higher parental education levels were associated with better language development in children, literacy beliefs and practices, particularly those of mothers, were significantly associated with better language outcomes in children. The findings of the study suggest that the quality of parent-child verbal interactions during shared media use contributes significantly to language development by creating an opportunity for dialog and vocabulary learning. The type and quality of screen media exposure were found to have different impacts on language development. Higher SES families often had better access to high-quality educational content and engaged more in joint media engagement, which positively influenced language outcomes. Conversely, passive screen exposure (e.g., TV) was more prevalent in lower SES families and was negatively associated with language development. Lastly, they noted that higher SES parents were more likely to engage in verbal scaffolding and joint media engagement with their children, which further supported language development. Besides, Hu et al. [74] also emphasized that parent-child interaction plays a pivotal role in enhancing language development through shared media usage, as suggested by their findings. In families with a lower socioeconomic status, parents may frequently be required to work longer hours, which may result in a reduction in the quality of time they are able to spend with their children. This can have a negative impact on children’s language development. Furthermore, these families may be constrained in their ability and opportunity to access educational content, which can impede children’s learning opportunities. It is possible that families with low socioeconomic status may utilize screen time as a form of childcare, which could result in increased screen time and negative effects. In parallel with these two studies, Hendry et al. [73] observed a consistent negative association between low socioeconomic status and screen time. Furthermore, the authors proposed that these families may be more vulnerable to the adverse effects of prolonged screen exposure. The relationship between screen time, language development, and executive functions is significantly mediated through parent-child interactions. Supanitayanon et al. [80] demonstrated how early screen exposure combined with reduced verbal interaction impacts both cognitive domains: children with earlier screen exposure and less verbal interaction showed lower performance in both language skills and cognitive functions. Carson and Kuzik [70] extended this understanding by showing how parent-child technology interference simultaneously affects response inhibition (an executive function) and emotional self-regulation, which in turn influences language learning opportunities. The socioeconomic context further shapes this three-way relationship. Zhang et al. [81] found that higher socioeconomic status families could better manage screen time while providing educational resources that support both language and cognitive development. Medawar et al. [77]’s findings reinforced this, showing how maternal literacy beliefs and practices influence both language outcomes and executive functioning through quality screen time management. Hu et al. [74] and Hendry et al. [73] further demonstrated how socioeconomic status affects both developmental domains through screen time exposure patterns and parent-child interaction quality. Passive and active screen time. In examining the relationship between language development, executive functions, and screen time, it is essential to consider the way children are exposed to screens. Four of the studies focused on how children were exposed to screen media. Medawar et al. [77] figured out that passive screen exposure (TV viewing) has a detrimental impact on language and literacy abilities, and that these effects are linked to self-regulation challenges in their study, which involved 465 mothers of Argentinian children aged 18–36 months. They reported that the continuous presence of television in the background can act as a distraction, impeding the development of language and literacy skills in children. A constant stream of auditory or visual stimuli in the background can impede children’s ability to maintain attention and concentration, thereby negatively affecting their learning process. Self-regulation difficulties can impede children’s capacity to focus their attention, regulate their emotions, and control their behavior, which can negatively impact their academic and social achievement. Another study conducted by Hu et al. [74] investigates the role of active and passive screen time on Chinese children’s social and cognitive development with 579 children aged 5. They found that passive screen time (TV viewing) is significantly and negatively associated with children’s executive functioning and social skills while there exists a meaningful and positive correlation between children’s active screen time and receptive language skills. Executive functions encompass a range of higher-order cognitive abilities, including planning, problem solving, attention control, and flexibility. The development of these critical skills may be inhibited by passive screen time. Furthermore, television viewing may impede children’s opportunities for social interaction, thereby hindering their capacity to develop social skills. It is evident that children require face-to-face interactions to develop their social skills. Therefore, based on the findings of study, it could be concluded that television viewing cannot replace these interactions and may prevent children from developing skills such as empathy, emotional expression, and understanding social cues. Veraksa et al. [19] demonstrated that passive screen time, particularly television viewing, is negatively associated with children’s ability to process verbal information effectively, development of executive functions, and social skills in their study conducted with 122 preschool children aged 5–6 in Russia whereas they noted. They found that passive screen time has negative effect on preschoolers’ phonological memory development, especially for those who engage in longer daily periods of television viewing. The capacity to process verbal information is of critical importance for children’s ability to learn and comprehend language; therefore, it could be argued that television viewing or passive engagement with digital devices may prevent children from using and developing these skills based these findings. Another study that showed the negative effects of passive screen time was conducted by Kim and Chung [76]. To investigate the association between exposure to TV or video and children’s language development and school achievement in childhood, Kim and Chung [76] conducted annual assessments from birth to 87.9 months, providing a comprehensive analysis of the longitudinal impact of screen time on child development. They have emphasized the negative effects of early screen exposure on language development. Their research shows that prolonged television exposure at age two negatively impacts children’s language development and school achievement. At this age, children lay the foundations of their language skills and are greatly influenced by the speech and interactions in their environment. Excessive television use can reduce these critical interactions, adversely affecting children’s language acquisition processes, and passive screen time can limit children’s active participation and interaction, restricting the natural learning opportunities that support language development. Furthermore, passive screen time can impede the interactions that facilitate children’s vocabulary and language comprehension development. Constant background television can weaken children’s ability to focus, negatively impacting their capacity for deep thinking and complex problem-solving. In line with these studies, Ribner et al. [79] conducted a nationally representative study with children ages from 3 to 7 in USA which aims to investigate the effect of the foreground TV exposure (educational, entertainment television), and background TV on self-regulation problems, language, and literacy skills. They observed that background and entertainment TV were negatively associated with language and literacy skills while educational TV was not. Furthermore, self-regulation problems might serve as a mechanism linking TV exposure to language and literacy skills. Likewise self-regulation problems, emotional lability is one aspect that has been found to have a negative relationship between screen time. Oflu et al. [78] observed that prolonged screen time can lead to emotional lability and attention problems in children in their study which examines excessive screen time associated with emotional lability in preschool children aged 2 to 5 years in Türkiye. As screen time increases, children’s ability to control and regulate their emotional responses may weaken. This can lead to negative outcomes in children’s social relationships and school performance. To illustrate, children with poor emotional regulation skills may struggle to concentrate in the classroom and complete academic tasks. In addition, Kim and Chung [76] highlighted the negative effects of screen time on self-regulation skills in early childhood. Self-regulation skills encompass the ability to control one’s thoughts, emotions, and behaviors. The development of these skills in early childhood is critical for academic and social success later in life. Prolonged screen time can hinder children’s development of these skills and weaken their ability to control themselves. These findings indicate that screen time can have negative effects on children’s emotional regulation skills, which can indirectly impact language development and other cognitive functions. It is important to carefully manage screen time and support children’s self-regulation skills. The use of passive screen time can impede the development of critical cognitive and language skills in children, including attention, executive functioning, and social skills. Nevertheless, the promotion of active and interactive screen content may serve to mitigate these negative effects. The distinction between passive and active screen time reveals crucial differences in their impact on both language development and executive functions. Medawar et al. [77] found that passive screen exposure negatively affects both language acquisition and self-regulation abilities. This finding was corroborated by Hu et al. [74], who showed that while passive screen time negatively impacted executive functioning and social skills, active screen time positively correlated with receptive language skills, demonstrating the differential effects of screen engagement types on both developmental domains. Veraksa et al. [19] provided further evidence of this interconnection, showing how passive screen time simultaneously affects verbal information processing and executive functions. Kim and Chung [76]’s longitudinal study demonstrated how early screen exposure impacts both language development and academic achievement through shared cognitive mechanisms. Ribner et al. [79] extended this understanding by showing how background and entertainment TV affect both language and literacy skills through self-regulation pathways. Oflu et al. [78] and Kim and Chung [76] highlighted how emotional regulation, influenced by screen time, acts as a bridge between language development and executive functioning. Attention issues. Excessive screen time can negatively impact children’s working memory, executive functions, and language development. Therefore, it emphasizes the importance of high-quality content and adherence to recommended guidelines. Zhang et al. [81] and Hendry et al. [73] emphasize the negative effects of total screen time, particularly television watching, on children’s working memory and executive functions. Working memory is defined as the capacity to store and process information in the short term, playing a critical role in children’s learning and problem-solving abilities. Zhang et al. [81] investigated longitudinal associations of subjectively measured physical activity and screen time with multiple domains of cognitive development in children aged 2.5 to 5 years old and excluded the ones who have conditions limiting physical activity or affecting cognitive performance. They figured out that using screen media in accordance with guidelines is associated with better intellectual ability and language development. Besides, Hendry et al. [71] investigated how variability in the home environment before and during the 2020 pandemic in the United Kingdom, involving 575 children aged 8 to 36 months in a parent-reported study. The authors noted that not only the amount but also the content of screen time has a significant impact on children’s attention and focus skills. This study found that higher screen time in early childhood was associated with lower cognitive outcomes, specifically in executive function and regulation skills. The findings of this theme showed that screen use, particularly in infants, negatively affected cognitive executive function (CEF) and regulation, and it mediated the relationship between socioeconomic status (SES) and these cognitive outcomes. Specifically, fast-paced and distracting content can shorten children’s attention spans and weaken their ability to concentrate. The findings suggest that exposure to such content may lead children to seek similar levels of constant stimulation in real life, making it difficult for them to maintain focus in classroom settings and other learning environments. It is shown that with increased screen time, a significant decline in children’s working memory capacity has been observed. This decline can lead to increased forgetfulness in daily life, difficulties in learning new information, and challenges in completing complex tasks. The impact of screen time on attention serves as a crucial link between language development and executive functions. Zhang et al. [81] and Hendry et al. [73] demonstrated how screen time affects working memory and executive functions, which in turn influence language processing and acquisition. Their research showed that adherence to screen time guidelines benefits both intellectual ability and language development through shared attention and cognitive control mechanisms. Specifically, Hendry et al. [74] found that excessive screen time negatively impacts cognitive executive function (CEF) and regulation, which serve as foundational skills for both language processing and executive control. The research highlighted how attention capacity, affected by screen exposure, serves as a common pathway influencing both language acquisition and executive function development. Discussion The purpose of this study was to investigate the interconnected relationship between language development, executive function, and screen time in children aged 0–78 months through a systematic review. This relationship is particularly complex during this developmental period, as executive functions and language development are mutually influential- executive functions support language acquisition while language skills facilitate executive control development. Given the pervasiveness of digital tools in contemporary society, understanding how screen time affects both these developmental domains simultaneously is crucial for this age group. Chan & Rao [83] and Cumming et al. [84] emphasize this interconnection, noting how executive functions and language development co-develop and mutually influence each other during early childhood (0–78 months). This relationship has been extensively studied in both typically developing children [85] and those with developmental challenges [86–89], revealing how executive functions support various language skills including vocabulary acquisition [90], new word learning [91], and reading comprehension [92–96] while language skills in turn scaffold executive control development. The gaps identified by Filipe et al. [97] and Hartanto et al. [98] regarding specific cognitive-language relationships and executive function-screen time connections in children aged 0–78 months underscore the importance of examining these domains together. Previous reviews like Karani et al. [49] and Bustamante et al. [53] have examined these relationships separately, finding negative impacts of prolonged screen time on language development but inconclusive results for executive functions in this age group. Our study uniquely contributes to literature by examining how screen time simultaneously affects both domains during this critical period (0–78 months), building on Streegan et al.’s [99] work with older children. Our thematic analysis revealed four interconnected themes that demonstrate how screen time influences both language development and executive functions in children aged 0–78 months. Regarding screen content and adherence to guidelines, we found that educational content can simultaneously support both domains during this developmental period- enhancing language skills while developing executive control through structured learning experiences. The quality of interaction during screen time emerged as crucial for this age group, as parental involvement creates opportunities for both language learning and executive function development through guided engagement. The role of parent-child interaction and family context revealed how screen time’s impact on both developmental domains is mediated through social interaction in children aged 0–78 months. Two critical findings emerged: First, insufficient parent-child interaction during screen time impairs both language development and executive control processes that rely on social scaffolding at this age. The literature emphasizes parents’ crucial role in mitigating negative effects of screen exposure on both domains [100–102]. Wong et al. [103] extended this understanding by showing how parents’ own device use can disrupt parent-child interaction during these crucial early years, negatively affecting both language learning opportunities and executive function development. This finding particularly matters since quality interaction supports both domains simultaneously during this period. Second, socioeconomic factors influence access to educational resources and parents’ ability to manage screen time, affecting both domains simultaneously in children aged 0–78 months. Studies like Slobodin et al. [104] and Hoffman et al. [105] support these findings, showing how socioeconomic status moderates screen time’s impact on both language and cognitive development during early childhood. The distinction between passive and active screen time provided crucial insights into how different types of engagement affect both developmental domains in children aged 0–78 months. Passive screen exposure negatively impacts both language processing and executive functions, particularly attention and social skills [106–108] during this period. Conversely, active screen time with educational and interactive content can positively influence both domains [109–112], as demonstrated by studies showing improvements in both vocabulary and executive function skills [51, 52, 113] in this age group. The attention issues theme highlighted how screen time affects cognitive processes fundamental to both language development and executive functions during this critical period (0–78 months). Excessive screen time impairs attention control in young children, which simultaneously affects language learning processes and broadens executive functions. This creates a cascade effect where attention deficits disrupt both vocabulary acquisition and cognitive control development during these formative years. Studies by Kebir and Özkaya [114] and Schwarzer et al. This interconnected impact was supported by [115], showing how excessive screen time simultaneously affects cognitive, language, and socio-emotional skills in children aged 0–78 months. The diversity in findings across studies reflects the complex nature of how screen time influences both developmental domains during early childhood (0–78 months). Factors such as content interactivity, parental involvement, and developmental timing all contribute to whether screen time supports or hinders the co-development of language and executive functions at this age. This complexity is further illustrated by contrasting findings from studies such as Taylor et al. [116] and Dore et al. [117], who found no significant relationships in this age group, with other studies showing clear impacts on both domains. Our findings emphasize the need to consider language development and executive functions as interrelated processes when studying screen time’s impact on children aged 0–78 months. Future research should focus on understanding how different types of screen engagement can be optimized to support both domains simultaneously during this crucial developmental period. Additionally, more attention should be paid to how socioeconomic and cultural factors moderate screen time’s impact on these interconnected developmental processes in early childhood. Limitation Several limitations were considered when interpreting the findings of this study. The systematic review was limited to the Web of Science, Scopus, ERIC, EBSCO, and Pub-Med databases and selected keywords in the search process. While these databases were chosen in line with the research’s purpose, this limitation may have affected the comprehensiveness of the study. In addition, the analysis was conducted with the articles written in English-language only, which represents another limitation to be considered. Excluding various scientific documents may lead to an incomplete interpretation of the literature. It is important to recognize that the assessments of the quality of reporting of studies based on the findings of this systematic analysis may be constrained by the limitations identified within the analysis itself. The sample size was limited to 14 articles, which may limit the generalizability of the results and may not fully encompass the entire body of literature in this field. Conclusion Our study’s findings provide valuable insights into the complex relationships between children’s language development, executive functions, and screen time. It emphasizes the importance of considering these three variables together, particularly in the preschool period. The results of this study are consistent with previous research indicating that educational and interactive screen content has a positive impact on children’s cognitive and language development. Excessive and passive screen use has been shown to have a negative effect. Additionally, the study demonstrates that parent-child interaction and socioeconomic factors play a significant role in this relationship. These findings are expected to inform important strategies for parents, educators, and policymakers in managing and guiding children’s screen use. In conclusion, the quality of time children spends in front of screens and the way parents manage this process have a significant impact on language development and executive functions. Implications The implications of these findings are significant for parents, educators, and policymakers. For parents, it is crucial to carefully select interactive and educational screen content to support children’s language and cognitive development. Adherence to recommended screen time guidelines can minimize potential negative effects on executive functions and language skills. Engaging in screen media activities with children enhances interaction and supports developmental processes. Limiting passive screen time and ensuring that screen use is balanced with real-world interactions and play opportunities are also essential. For educators, integrating educational and interactive screen content into the curriculum can support language and cognitive skills development. Educating parents on the importance of managing screen time and selecting high-quality content is also crucial. Additionally, promoting activities that reduce passive screen time and encourage active learning and interaction among children is beneficial. For policymakers, it is important to develop and promote guidelines for screen time that emphasize the importance of content quality and interactive use. Supporting initiatives that provide access to high-quality educational media for families from all socioeconomic backgrounds and implementing programs that educate parents about the impact of screen time on child development and strategies for managing screen media use effectively are also key steps. By addressing these areas, it is possible to harness the potential benefits of screen media while mitigating its negative impacts on children’s development. Carefully managing screen time not only supports children’s language and cognitive development but also helps them develop healthy digital habits. Parents can teach their children how to use digital media safely and effectively, improving their digital literacy skills, which is a critical skill for future success in the digital world. In an era where digital technology is becoming increasingly prevalent, it is of paramount importance to gain a deeper understanding of the relationship between screen time, language development, and executive function. Consequently, it is recommended that future systematic reviews expand their research scope to include methodological quality. Supporting information S1 File. Dataset. This Excel file contains the data used in this study, including all variables and analyses reported in the manuscript. It is publicly available and can be accessed directly from the OSF repository. https://doi.org/10.1371/journal.pone.0314540.s001 (XLSX) S2 File. PRISMA checklist. The PRISMA checklist outlines the systematic review process and compliance with reporting standards. https://doi.org/10.1371/journal.pone.0314540.s002 (PDF) S3 File. Handling missing data. This document outlines the methodological approach used to handle missing data in the systematic review, ensuring rigor and comprehensiveness at every stage of the analysis. https://doi.org/10.1371/journal.pone.0314540.s003 (DOCX) S1 Table. Evaluation process of studies identified in systematic review. This table summarizes the evaluation process of studies identified in the systematic review. https://doi.org/10.1371/journal.pone.0314540.s004 (DOCX) S2 Table. Data extraction summary. This table provides details on the data extracted from the included studies. https://doi.org/10.1371/journal.pone.0314540.s005 (DOCX) S3 Table. Risk of bias and quality/certainty assessments. This table presents the GRADE assessment of included studies. https://doi.org/10.1371/journal.pone.0314540.s006 (DOCX)
TI - Examining the relationship between language development, executive function, and screen time: A systematic review
JF - PLoS ONE
DO - 10.1371/journal.pone.0314540
DA - 2024-12-26
UR - https://www.deepdyve.com/lp/public-library-of-science-plos-journal/examining-the-relationship-between-language-development-executive-9VZQRK5MoT
SP - e0314540
VL - 19
IS - 12
DP - DeepDyve
ER -