Background This study examined the relationship between touchscreen exposure and developmental outcomes in early childhood using the Ages and Stages Questionnaire, Third Edition (ASQ-3), a widely-used developmental screening tool. Methods During a well-child visit, parents of 51 children aged 18-36 months completed the ASQ-3 and a survey on their child's touchscreen habits (timing of introduction, daily usage duration, independent use, engagement in creative activities). Medical records were reviewed for developmental diagnoses and health conditions. Analysis One-way analysis of variances (ANOVAs) examined differences in ASQ-3 domain scores (problem-solving, personal-social, communication, gross motor, fine motor) based on the age of touchscreen introduction and average daily usage time. Independent t-tests compared scores between groups defined by independent touchscreen use and creative activity engagement. Effect sizes were calculated for significant differences. Results In the problem-solving domain, children introduced to touchscreens before 12 months of age scored significantly higher than those introduced later, with a statistical significance of p<0.05 and an effect size of d=0.45. However, there were no significant differences in scores based on the duration of daily touchscreen usage. In the personal-social domain, children introduced to touchscreens at 12 months or later scored significantly higher than those introduced before 12 months, with a significance of p<0.05 and an effect size of d=0.51. Moderate daily usage of 30-90 minutes was associated with higher scores compared to lower usage of less than 30 minutes or higher usage of more than 90 minutes (p<0.05). Additionally, children who used touchscreens independently had significantly higher scores, with a significance of p<0.01 and an effect size of d=0.76. Those who engaged in activities such as coloring or crafting also had significantly higher scores, with a significance of p<0.01 and an effect size of d=0.82. In other domains, such as communication, gross motor, and fine motor, no significant effects of touchscreen exposure were observed. Discussion Earlier touchscreen introduction may facilitate problem-solving skills like experimentation and cognitive flexibility through interactive digital play. However, excessive touchscreen use (greater than 90 minutes per day) before 12 months could interfere with pivotal social-emotional learning from real-world interactions, impeding personal-social development. Moderate, supervised touchscreen exposure combined with creative hands-on activities appears optimal for fostering strong personal-social competencies like cooperation and emotional understanding during the toddler years. Conclusion Timing, duration, context, and content of touchscreen experiences in early childhood relate differently to specific developmental domains. Guidelines should consider these nuances to support overall healthy child development in our digital world. Larger longitudinal studies using multi-method assessments are needed.
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