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Screens and Child Cognitive Development: Exposure Time is Not the Only Factor to Consider

13 Sep 2023 | By Inserm (Newsroom) | Public health

Enfant déjeunant en regardant l'écran d'un ordinateur portableTo what extent does early or excessive screen exposure affect children’s cognitive development? © AdobeStock

To what extent does early or excessive screen exposure affect children’s cognitive development? This is a question that is currently dividing scientists. A team led by Inserm researcher Jonathan Bernard at the Center for Research in Epidemiology and Statistics (Inserm/INRAE/Université Paris Cité/Université Sorbonne Paris Nord) studied the data of nearly 14,000 children from the French Elfe cohort[1] for each child from the age of 2 to 5.5 years. While this is not the first study to show a negative relationship between exposure time and development, it also highlights that this relationship is not true for all domains of cognition and is much weaker when the family context is properly taken into account. Its findings also confirm[2] a non-negligible negative relationship between exposure to television during family meals and early language development. This research, published in The Journal of Child Psychology and Psychiatry, suggests that while screen time is important, the context of exposure also matters.

In the face of rapid changes in the use of screens and their growing place in everyday life, one question continues to divide scientists: to what extent does too early and/or excessive exposure to screens influence child development? With the majority of studies having focused on language development, less attention has been paid to other cognitive domains. The same applies to the potential influence of the family environment, as well as the child’s daily activities.

The team led by Inserm researcher Jonathan Bernard at the Center for Research in Epidemiology and Statistics (Inserm/INRAE/Université Paris Cité/Université Sorbonne Paris Nord) sought to evaluate the associations between screen use and cognitive development in early childhood, taking into account factors related to social, perinatal, family, and lifestyle conditions. To do this, it looked at data from nearly 14,000 children from the French cohort Elfe, collected for each child from the age of 2 to 5.5 years, between 2013 and 2017.

The parents reported their children’s daily screen time at ages 2, 3.5 and 5.5 years. They were also asked to report whether they had the television on during family meals in their children’s second year. Many factors related to the children’s lifestyle and daily activities also had to be specified. Finally, various cognitive domains were evaluated: language development at age 2, non-verbal reasoning at age 3.5 and overall cognitive development at ages 3.5 and 5.5.

The research team observed that at ages 3.5 and 5.5, screen exposure was associated with lower overall cognitive development scores, particularly in the areas of fine motor, language and autonomy. However, when lifestyle factors likely to influence cognitive development were taken into account in the statistical models, the negative relationship decreased and became of small magnitude.

The results of the study also show that, regardless of exposure time, having the television on during family meals at age 2 (which concerned 41% of children) was associated with lower language development scores at the same age. These children also had poorer overall cognitive development at age 3.5.

“This could be explained by the fact that television, by capturing the attention of family members, interferes with the quality and quantity of interactions between parents and child. Yet such interaction is crucial at this age for the acquisition of language,” explains Shuai Yang, PhD student and first author of the study. He continues: In addition, television adds background noise to family discussions that makes it difficult for the child to decipher sounds and limits verbal understanding and expression. “

These findings suggest that screen time is not the only factor to consider: the context in which screen use takes place could also be an important factor. It is also suggested that not all areas of cognition would be affected in a similar way.

“The first years of life are decisive, not just for cognitive development but also for the establishment of lifestyle habits, adds Bernard. When a child uses a screen excessively, they do so at the expense of other social activities or interactions that are essential for their development. “

The robustness of this study is due to the large number of participants, but also the consideration of factors related to the social profile of the families and the activities of the children.

“While our findings suggest that the harmful effects of screen use in early childhood have a low impact on cognitive development at the individual level and can be compensated for in the years that follow, they do however justify remaining vigilant at population level. When it comes to public health, these little things all add up,” explains Bernard. He added that more long-term studies are needed to evaluate the cumulative impact of these effects from early childhood to adolescence.

The research by his team is continuing through the follow-up of the children in the Elfe cohort in order to answer these questions.


[1]Elfe is France’s first national, longitudinal study dedicated to the follow-up of children from birth to adulthood. More than 18,000 children born in metropolitan France in 2011 were enrolled in it (i.e. one in every 50 children born in 2011). Since the first contact with the families during the maternity stay, the participating parents are regularly interviewed in order to better understand how the environment, family setting and living conditions influence the development, health and socialization of the children. The ELFE study mobilizes around 150 researchers from a variety of scientific disciplines.

[2]See our press release from June 8, 2021: Television During Meals Linked to Poorer Language Development in Young Children

Researcher Contact

Jonathan Bernard

Inserm researcher

Unit 1153 Inserm/INRAE/Université Paris Cité/Université Sorbonne Paris Nord, Center for Research in Epidemiology and Statistics

Early health determinants research team


Press Contact



Associations of screen use with cognitive development in early childhood: the ELFE birth cohort


Shuai Yang1, MSc, Mélèa Saïd1, MSc, Hugo Peyre2,3,4, MD, PhD, Franck Ramus2, PhD, Marion Taine5, MD, PhD, Evelyn C. Law6,7,8, MD, PhD, Marie-Noëlle Dufourg9, MD, PhD, Barbara Heude1, PhD, Marie-Aline Charles1,9, MD, PhD, Jonathan Y. Bernard1,6, PhD

  1. Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), F-75004 Paris, France;
  2. Laboratoire de Sciences Cognitives et Psycholinguistique (ENS, EHESS, CNRS), Ecole Normale Supérieure, PSL University, Paris, France;
  3. Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France.
  4. Centre de Ressources Autisme Languedoc-Roussillon et Centre d’Excellence sur l’Autisme et les Troubles Neuro-développementaux, CHU Montpellier, 39 Avenue Charles Flahault, 34295 Montpellier cedex 05, France
  5. EPI-PHARE (French National Agency for Medicines and Health Products Safety, ANSM; and French National Health Insurance, CNAM), Saint-Denis, France.
  6. Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore;
  7. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 21 Lower Kent Ridge Road, Singapore, 119077, Singapore;
  8. Department of Paediatrics, Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore.
  9. Unité mixte Inserm-Ined-EFS ELFE, Ined, F-93300, Aubervilliers, France.


The Journal of Child Psychology and Psychiatry :