The American Academy of Pediatrics (AAP) recommends limits on screen-time for children, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown.

To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged children, John S. Hutton, MS, MD; Jonathan Dudley, PhD; Tzipi Horowitz-Kraus, PhD, and colleagues examined children (aged 3 to 5) who completed cognitive testing followed by diffusion tensor imaging (DTI). Parents then completed a ScreenQ survey.

Of the 69 children recruited, 47 (among whom 27 [57%] were girls, and the mean [SD] age was 54.3 [7.5] months) completed DTI. Mean (SD; range) ScreenQ score was 8.6 (4.8; 1-19) points. Mean (SD; range) CTOPP-2 score was 9.4 (3.3; 2-15) points, EVT-2 score was 113.1 (16.6; 88-144) points, and GRTR score was 19.0 (5.9; 5-25) points. ScreenQ scores were negatively correlated with EVT-2 (F2,43 = 5.14; R2 = 0.19; P < .01), CTOPP-2 (F2,35 = 6.64; R2 = 0.28; P < .01), and GRTR (F2,44 = 17.08; R2 = 0.44; P < .01) scores, controlling for child age. Higher ScreenQ scores were correlated with lower FA and higher RD in tracts involved with language, executive function, and emergent literacy abilities (P < .05, familywise error–corrected), controlling for child age and household income.

This study found an association between increased screen-based media use, compared with the AAP guidelines, and lower microstructural integrity of brain white matter tracts supporting language and emergent literacy skills in prekindergarten children.