Digital Wellbeing Literature Review

Navigating children’s safe passage through the digital world is one of the great challenges of modern parenthood – and it is a challenge undertaken, largely, without a roadmap. How much time should kids spend on devices? What does healthy device usage look like? What are the impacts of getting the screen time question wrong? How does parental screen time affect kids? What strategies work to bring a healthy balance to the way we raise our kids in a technological world?

These are questions no other generation of parents has faced. And getting it wrong can have significant consequences.

Nature Play WA, in conjunction with researchers from the Telethon Kids Institute, has created a ‘what you need to know’ guide for parents on the impacts of excessive screen time, highlighting new and relevant research in a clear and easy-to-understand manner.

You will find all the research used to create this guide has been referenced and listed at the back in case you want to follow up and read more.

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1. Stanczykiewicz B, Banik A, Knoll N, Keller J, Hohl DH, Rosinczuk J, et al. Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis. BMC public health. 2019; 19(1):459.

2. Vanderloo LM. Screen-viewing among preschoolers in childcare: a systematic review. BMC Pediatrics. 2014; 14:205.

3. Suchert V, Hanewinkel R, Isensee B. Sedentary behavior and indicators of mental health in school-aged children and adolescents: A systematic review. Preventive medicine. 2015;76:48-57.

4. Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. International journal of behavioral nutrition and physical activity. 2011;8(1):98.

5. Webster EK, Martin CK, Staiano AE. Fundamental motor skills, screen-time, and physical activity in preschoolers. Journal of Sport and Health Science. 2019;8(2):114-21.

6. Skalická V, Wold Hygen B, Stenseng F, Kårstad SB, Wichstrøm L. Screen time and the development of emotion understanding from age 4 to age 8: A community study. British Journal of Developmental Psychology. 2019.

7. Cliff DP, Hesketh KD, Vella SA, Hinkley T, Tsiros MD, Ridgers ND, et al. Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta‐ analysis. Obesity Reviews. 2016;17(4):330-44.

8. Dalene KE, Anderssen SA, Andersen LB, Steene-Johannessen J, Ekelund U, Hansen BH, et al. Cross-sectional and prospective associations between sleep, screen time, active school travel, sports/exercise participation and physical activity in children and adolescents. BMC public health. 2018;18(1):705.

9. Gao Z, Chen S, Pasco D, Pope Z. A meta‐analysis of active video games on health outcomes among children and adolescents. Obesity reviews. 2015;16(9):783-94.

10. Peracchia S, Curcio G. Exposure to video games: effects on sleep and on post-sleep cognitive abilities. A systematic review of experimental evidences. Sleep Science. 2018;11(4):302-14.

11. Stiglic N, Viner RM. Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ open. 2019;9(1):e023191.

12. Hale L, Guan S. Screen time and sleep among school-aged children and adolescents: a systematic literature review. Sleep medicine reviews. 2015;21:50-8.

13. Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study. Environmental research. 2018;164:149-57.

14. Adam EK, Snell EK, Pendry P. Sleep timing and quantity in ecological and family context: a nationally representative time-diary study. J Fam Psychol. 2007;21(1):419.

15. Cespedes EM, Gillman MW, Kleinman K, Rifas-Shiman SL, Redline S, Taveras EM. Television viewing, bedroom television, and sleep duration from infancy to mid-childhood. Pediatrics. 2014;133(5):e1163-71.

16. Chahal H, Fung C, Kuhle S, Veugelers PJ. Availability and night-time use of electronic entertainment and communication devices are associated with short sleep duration and obesity among Canadian children. Pediatric Obesity. 2013;8(1):42-51.

17. Wood B, Rea MS, Plitnick B, Figueiro MG. Light level and duration of exposure determine the impact of self-luminous tablets on melatonin suppression. Applied Ergonomics. 2013;44(2):237-40.

18. Wrobel A. Young children’s use of digital technologies: Risks and opportunities for early childhood development [CoLab Evidence Report]. 2019.

19. Ponti M, Belanger S, Grimes R, Heard J, Johnson M, Moreau E, et al. Screen time and young children: Promoting health and development in a digital world. Paediatrics and Child Health (Canada). 2017;22(8):461-77.

20. Kostyrka-Allchorne K, Cooper NR, Simpson A. The relationship between television exposure and children’s cognition and behaviour: A systematic review. Developmental Review. 2017;44:19-58.

21. Hoyos Cillero I, Jago R. Systematic review of correlates of screen-viewing among young children. Preventive Medicine. 2010;51(1):3-10.

22. Duch H, Fisher EM, Ensari I, Harrington A. Screen time use in children under 3 years old: a systematic review of correlates. International journal of behavioral nutrition and physical activity. 2013;10(1):102.

23. Downing KL, Hnatiuk J, Hesketh KD. Prevalence of sedentary behavior in children under 2 years: A systematic review. Preventive medicine. 2015;78:105-14.

24. Hinkley T, Salmon J, Okely AD, Trost SG. Correlates of sedentary behaviours in preschool children: a review. International Journal of Behavioral Nutrition and Physical Activity. 2010;7(1):66.

25. Domingues-Montanari S. Clinical and psychological effects of excessive screen time on children. Journal of Paediatrics & Child Health. 2017;53(4):333-8.

26. Padmapriya N, Aris IM, Tint MT, Loy SL, Cai S, Tan KH, et al. Sex-specific longitudinal associations of screen viewing time in children at 2-3 years with adiposity at 3-5 years. International Journal of Obesity. 2019; 43(7):1334-43.

27. Robinson LE, Stodden DF, Barnett LM, Lopes VP, Logan SW, Rodrigues LP, et al. Motor Competence and its Effect on Positive Developmental Trajectories of Health. Sports medicine. 2015;45(9):1273-84.

28. Cadoret G, Bigras N, Lemay L, Lehrer J, Lemire J. Relationship between screen-time and motor proficiency in children: a longitudinal study. Early Child Development and Care. 2018;188(2):231-9.

29. Page ZE, Barrington S, Edwards J, Barnett LM. Do active video games benefit the motor skill development of non-typically developing children and adolescents: A systematic review. Journal of Science & Medicine in Sport. 2017;20(12):1087-100.

30. Axford C, Joosten AV, Harris C. iPad applications that required a range of motor skills promoted motor coordination in children commencing primary school. Australian occupational therapy journal. 2018; 65(2):146-55.

31. Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput J-P, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Applied Physiology, Nutrition, and Metabolism. 2016;41(6):S240-S65.

32. Christakis DA, Liekweg K, Garrison MM, Wright JA. Infant Video Viewing and Salivary Cortisol Responses: A Randomized Experiment. The Journal of Pediatrics. 2013;162(5):1035-40.

33. Henderson M, Benedetti A, Barnett TA, Mathieu M-E, Deladoëy J, Gray-Donald K. Influence of Adiposity, Physical Activity, Fitness, and Screen Time on Insulin Dynamics Over 2 Years in Children. JAMA Pediatrics. 2016; 170(3):227-35.

34. Rechichi C, De Moja G, Aragona P. Video Game Vision Syndrome: A New Clinical Picture in Children? Journal of pediatric ophthalmology and strabismus. 2017;54(6):346-55.

35. Chastin SFM, Mandrichenko O, Skelton DA. The frequency of osteogenic activities and the pattern of intermittence between periods of physical activity and sedentary behaviour affects bone mineral content: the cross-sectional NHANES study. BMC Public Health. 2014;14(1):4.

36. Wu XY, Han LH, Zhang JH, Luo S, Hu JW, Sun K. The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review. PLoS One. 2017;12(11):e0187668.

37. Motamed-Gorji N, Qorbani M, Nikkho F, Asadi M, Motlagh ME, Safari O, et al. Association of screen time and physical activity with health-related quality of life in Iranian children and adolescents. Health & Quality of Life Outcomes. 2019;17(1):2.

38. Kremer P, Elshaug C, Leslie E, Toumbourou JW, Patton GC, Williams J. Physical activity, leisure-time screen use nand depression among children and young adolescents. Journal of science and medicine in sport. 2014; 17(2):183-7.

39. Liu M, Wu L, Yao S. Dose–response association of screen time-based sedentary behaviour in children and adolescents and depression: a meta-analysis of observational studies. British Journal of Sports Medicine. 2016;50(20):1252.

40. Allen MS, Walter EE, Swann C. Sedentary behaviour and risk of anxiety: A systematic review and meta-analysis. Journal of Affective Disorders. 2019;242:5-13.

41. LeBlanc AG, Spence JC, Carson V, Connor Gorber S, Dillman C, Janssen I, et al. Systematic review of sedentary behaviour and health indicators in the early years (aged 0–4 years). Applied Physiology, Nutrition, and Metabolism. 2012;37(4):753-72.

42. Courage ML, Howe ML. To watch or not to watch: Infants and toddlers in a brave new electronic world. Developmental Review. 2010;30(2):101-15.

43. Courage ML, Setliff AE. When babies watch television: Attention-getting, attention-holding, and the implications for learning from video material. Developmental Review. 2010;30(2):220-38.

44. Lapierre MA, Piotrowski JT, Linebarger DL. Background television in the homes of US children. Pediatrics. 2012;130(5):839-46.

45. Lillard AS, Li H, Boguszewski K. Television and children’s executive function. Advances in child development and behavior. 2015;48:219-48.

46. Pagani LS, Fitzpatrick C, Barnett TA, Dubow E. Prospective associations between early childhood television exposure and academic, psychosocial, and physical well-being by middle childhood. Archives of pediatrics & adolescent medicine. 2010;164(5):425-31.

47. Tamana SK, Ezeugwu V, Chikuma J, Lefebvre DL, Azad MB, Moraes TJ, et al. Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study. PLoS ONE. 2019;14 (4) (no pagination)(e0213995).

48. Christakis DA, Zimmerman FJ, DiGiuseppe DL, McCarty CA. Early Television Exposure and Subsequent Attentional Problems in Children. Pediatrics. 2004;113(4):708.

49. Gentile DA, Swing EL, Lim CG, Khoo A. Video game playing, attention problems, and impulsiveness: Evidence of bidirectional causality. Psychology of Popular Media Culture. 2012;1(1):62-70.

50. Swing EL, Gentile DA, Anderson CA, Walsh DA. Television and Video Game Exposure and the Development of Attention Problems. Pediatrics. 2010;126(2):214.

51. Chan PA, Rabinowitz T. A cross-sectional analysis of video games and attention deficit hyperactivity disorder symptoms in adolescents. Annals of general psychiatry. 2006;5:16-.

52. Sharif I, Wills TA, Sargent JD. Effect of visual media use on school performance: a prospective study. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2010;46(1):52-61.

53. Maass A, Kollhörster K, Riediger A, MacDonald V, Lohaus A. Effects of violent and non-violent computer game content on memory performance in adolescents. European Journal of Psychology of Education. 2011;26:339-53.

54. Herodotou C. Young children and tablets: A systematic review of effects on learning and development. Journal of Computer Assisted Learning. 2018;34(1):1-9.
55. Teepe RC, Molenaar I, Verhoeven L. Technology-enhanced storytelling stimulating parent–child interaction and preschool children’s vocabulary knowledge. Journal of Computer Assisted Learning. 2017;33(2):123-36.

56. Walter-Laager C, Brandenberg K, Tinguely L, Schwarz J, Pfiffner MR, Moschner B. Media-assisted language learning for young children: Effects of a word-learning app on the vocabulary acquisition of two-year-olds. British Journal of Educational Technology. 2017;48(4):1062-72.

57. Bai Y, Chen S, Laurson KR, Kim Y, Saint-Maurice PF, Welk GJ. The associations of youth physical activity and screen time with fatness and fitness: The 2012 NHANES national youth fitness survey. PLoS ONE. 2016;11 (1) (no pagination)(e0148038).

58. Thakkar RR, Garrison MM, Christakis DA. A systematic review for the effects of television viewing by infants and preschoolers. Pediatrics. 2006;118(5):2025-31.

59. Radesky JS, Schumacher J, Zuckerman B. Mobile and Interactive Media Use by Young Children: The Good, the Bad, and the Unknown. Pediatrics. 2015;135(1):1.

60. Roseberry S, Hirsh-Pasek K, Golinkoff RM. Skype me! Socially contingent interactions help toddlers learn language. Child development. 2014;85(3):956-70.

61. Nichols D, Walker D. Infants’ and Toddlers’ Television Viewing and Language Outcomes. American Behavioral Scientist. 2005;48.

62. Kucirkova N. iPads in early education: separating assumptions and evidence. Frontiers in psychology. 2014;5:715-.

63. Radesky JS, Schumacher J, Zuckerman B. Mobile and interactive media use by young children: The good, the bad, and the unknown. Pediatrics. 2015;135(1):1-3.

64. Moody A, M Justice L, Cabell S. Electronic versus traditional storybooks: Relative influence on preschool children’s engagement and communication. Journal of Early Childhood Literacy. 2010;10:294-313.

65. Reich SM, Yau JC, Warschauer M. Tablet-Based eBooks for Young Children: What Does the Research Say? Journal of developmental and behavioral pediatrics : JDBP. 2016;37(7):585-91.

66. Parish-Morris J, Mahajan N, Hirsh-Pasek K, Golinkoff RM, Collins MF. Once Upon a Time: Parent–Child Dialogue and Storybook Reading in the Electronic Era. Mind, Brain, and Education. 2013;7(3):200-11.

67. Radesky JS, Christakis DA. Increased Screen Time: Implications for Early Childhood Development and Behavior. Pediatric Clinics of North America. 2016;63(5):827-39.

68. Bittman M, Rutherford L, Brown J, Unsworth L. ‘Digital natives’?: New and old media and children’s outcomes. Australian Journal of Education. 2011;55:73-87.

69. Racine EF, DeBate RD, Gabriel KP, High RR. The relationship between media use and psychological and physical assets among third- to fifth-grade girls. The Journal of school health. 2011;81(12):749-55.

70. Russ SA, Larson K, Franke TM, Halfon N. Associations between media use and health in US children. Academic pediatrics. 2009;9(5):300-6.

71. Hinkley T, Brown H, Carson V, Teychenne M. Cross sectional associations of screen time and outdoor play with social skills in preschool children. PLoS ONE [Electronic Resource]. 2018;13(4):e0193700.

72. Paudel S, Jancey J, Subedi N, Leavy J. Correlates of mobile screen media use among children aged 0–8: a systematic review. BMJ open. 2017;7(10):e014585.

73. Troseth GL, Russo CE, Strouse GA. What’s next for research on young children’s interactive media? Journal of Children and Media. 2016;10(1):54-62.

74. Beschorner B, Hutchison A. IPads as a literacy teaching tool in early childhood. International Journal of Education in Mathematics, Science and Technology. 2013;1:16-24.

75. Pons F, Harris PL, de Rosnay M. Emotion comprehension between 3 and 11 years: Developmental periods and hierarchical organization. European Journal of Developmental Psychology. 2004;1(2):127-52.

76. Nathanson AI, Fries PT. Television Exposure, Sleep Time, and Neuropsychological Function Among Preschoolers. Media Psychology. 2014;17(3):237-61.

77. Parent J, Sanders W, Forehand R. Youth Screen Time and Behavioral Health Problems: The Role of Sleep Duration and Disturbances. Journal of developmental and behavioral pediatrics : JDBP. 2016;37(4):277-84.

78. Paik H, Comstock G. The effects of television violence on antisocial behavior: A meta-analysis. Communication Research. 1994;21(4):516-46.

79. Livingstone S, Smith PK. Annual research review: Harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age. Journal of child psychology and psychiatry, and allied disciplines. 2014;55(6):635-54.

80. Huesmann LR, Moise-Titus J, Podolski C-L, Eron LD. Longitudinal relations between children’s exposure to TV violence and their aggressive and violent behavior in young adulthood: 1977-1992. Developmental Psychology. 2003;39(2):201-21.

81. Radesky JS, Kistin CJ, Zuckerman BD, Nitzberg K, Gross J, Kaplan-Sanoff M, et al. Patterns of mobile device use by caregivers and children during meals in fast food restaurants. Pediatrics. 2014;133(4).

82. Lerner C, Barr R. Screen Sense: Setting the Record Straight; Research-Based Guidelines for Screen Use for Children Under 3 Years Old 2014 [Available from:
83. Roy R, G. P. Smartphone Use in the Daily Interactions Between Parents and Young Children. Philadelphia: Society for Research in Child Development (poster) 2015 [Available from:

84. Parkes A, Sweeting H, Wight D, Henderson M. Do television and electronic games predict children's psychosocial adjustment? Longitudinal research using the UK Millennium Cohort Study. Archives of Disease in Childhood. 2013;98(5):341.

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86. Schoeppe S, Rebar AL, Short CE, Alley S, Van Lippevelde W, Vandelanotte C. How is adults’ screen time behaviour influencing their views on screen time restrictions for children? A cross-sectional study. BMC Public Health. 2016;16(1):201.

87. Lovato SB, Waxman SR. Young Children Learning from Touch Screens: Taking a Wider View. Frontiers in psychology. 2016;7:1078-.

88. Hadders-Algra M. Interactive media use and early childhood development. Jornal de pediatria. 2019.

89. Ye S, Chen L, Wang Q, Li Q. Correlates of screen time among 8–19-year-old students in China. BMC public health. 2018;18(1):467.

90. Mendelsohn AL, Dreyer BP, Brockmeyer CA, Berkule-Silberman SB, Huberman HS, Tomopoulos S. Randomized controlled trial of primary care pediatric parenting programs: effect on reduced media exposure in infants, mediated through enhanced parent-child interaction. Archives of pediatrics & adolescent medicine. 2011; 165(1):42-8.

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