Ecological Momentary Assessment Study of Digital Technology Use and Child Well-Being

Importance Current guidelines recommend screen time limitations for young children in favor of their ongoing development and well-being. Distinguishing momentary patterns of screen use in relation to childhood well-being will further inform screen time recommendations to better reflect contemporary childhood digital experiences. Objective To investigate the associations between momentary children’s screen use, parent-child interactions, emotions, and externalizing behavior. Design, Setting, and Participants In this ecological momentary assessment (EMA) study, parent-reported methodology was used to measure children’s screen-based experiences. Reporting on the last hour, assessments were provided up to 3 times per weekday and 5 times per weekend day, across a 2-week period from May to November 2024. Parents completed momentary assessments in their everyday environments, capturing typical fluctuations in children’s habits, emotions, and behaviors. Participants identified as parents of children in the first 3 years of formal schooling. Exposure Children’s use of screens including screen use, duration, activities, and solo vs co-use details. Main Outcomes and Measures Children’s momentary affect, externalizing behaviors, and parent-child interactions were measured using subsets of items from the Positive and Negative Affect Schedule Short form, the Strengths and Difficulties Questionnaire, and the Child Parent Relationship Scale—Short form, respectively. Results A total of 934 momentary assessments from 42 parents (mean [SD] age, 38.7 [4.9] years; 33 female [79%]) of children (mean [SD] age, 6.4 [1.2] years; 24 male [57%];) were included in analyses. Multilevel modeling indicated screen use duration was associated with lower levels of both positive affect ( b = −0.16; 95% CI, −0.30 to −0.02; estimating screen time b = −0.05; 95% CI, −0.08 to −0.01) and negative affect ( b = −0.12; 95% CI, −0.24 to −0.01; estimating screen time b = −0.10; 95% CI, −0.15 to −0.06). Interactive activities ( b = 0.26; 95% CI, 0.04-0.47) and co-use ( b = 0.17; 95% CI, 0-0.34) were significantly associated with positive affect. Parent-child interactions negatively estimated screen use duration ( b = −0.07; 95% CI, −0.13 to −0.02). Conclusions and Relevance Results of this study suggest that the associations between children’s digital experiences and well-being are complex and bidirectional. The momentary associations found in this study provide evidence for moving beyond duration-focused recommendations toward context-sensitive guidelines that consider the dynamic nature of children’s digital experiences.