Have we found directionality? Longitudinal associations between screen use and executive function in children. A scoping review

Excessive screen use and Executive Function (EF) deficits are each associated with a range of adverse life outcomes. This review aims to examine whether longitudinal associations exist between children’s screen use and their EF, to determine the direction of these potential relationships, and to explore current measurement approaches, including associated outcomes, to inform future research. Six electronic databases were searched for studies published between 2013 and December 2024 that investigated longitudinal associations between screen use and EF in participants between 0 and 18 years of age, resulting in the inclusion of 58 studies. We found at least one significant negative longitudinal relationship between screen use and EF in 81% (n = 47) of the studies. Thirty-four of the studies found that earlier screen use negatively predicted later EF, nine found that earlier EF difficulties predicted later problematic or higher screen use, and four studies found a bidirectional relationship. Five of the studies found both significant positive and negative longitudinal relationships, as they examined multiple EF outcomes. All eight neuroimaging studies in this review found higher levels of screen use predicted longitudinal functional or structural changes in brain regions implicated in EF. Overall, consistent evidence for longitudinal associations between screen use and EF was found in both directions, with earlier screen use predicting later EF difficulties and earlier EF difficulties predicting greater screen use. This suggests a concerning potential for lasting impacts on child development; however, further investigation is needed to understand the exact relationships, and the role of potential confounds.