High-dose electronic media use in five-year-olds and its association with their psychosocial symptoms: A cohort study

Janette Niiranen, Olli Kiviruusu, Riitta Vornanen, Outi Saarenpää-Heikkilä, E. Juulia Paavonen

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Objectives This study investigated the frequency of electronic media (e-media) usage by preschool children and the risks of high-dose e-media use on young children's psychosocial well-being. Design Longitudinal associations between e-media use at 18 months and psychosocial symptoms at 5 years of age were studied, as well as cross-sectional associations between e-media use and psychosocial symptoms at 5 years. Setting Between 2011 and 2017 in Finland. Participants Children aged 5 years (n=699). Primary and secondary outcome measures Children's psychosocial symptoms were determined at the age of 5 years using the parent-reported questionnaires Five-to-Fifteen (FTF) and the Strengths and Difficulties Questionnaire (SDQ). Results Based on our results, 95% of the preschool children exceeded the daily recommended use of e-media set by health professionals. Our results indicate that increased screen time at 5 years of age is associated with a risk of multiple psychosocial symptoms (OR 1.53-2.18, 95% CI 1.05 to 3.34, p<0.05), while increased levels of e-media use at 18 months was only associated with FTF peer problems (OR 1.59, 95% CI 1.04 to 2.41, p=0.03). Moreover, high-dose use of electronic games at the age of 5 years seems to be associated with fewer risks for psychosocial well-being than programme viewing, as it was only associated with SDQ hyperactivity (OR 1.65, 95% CI 1.08 to 2.51, p=0.02). Conclusion Increased screen time has multiple risks for children's psychosocial well-being. These risk factors seem to be significant in the long term, and are related to problems in children's socio-emotional development later on. Health professionals and paediatricians have an important role as communicators of the current research results on the safe usage time of e-media for families, and enhancing parents' skills as regulators of children's safe e-media use. More research is needed on the family conditions of high-dose e-media users.

Original languageEnglish
Article numbere040848
JournalBmj Open
Issue number3
Publication statusPublished - 2021
Publication typeA1 Journal article-refereed


  • child & adolescent psychiatry
  • community child health
  • epidemiology

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Medicine(all)


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