From Infancy to Adolescence: The Path Between Screen Time, Decisions, and Anxiety

Excessive screen time in early childhood is on the rise and is a concern for experts, as this period is crucial for brain development. This study followed children from infancy to adolescence and showed that longer screen time between the ages of one and two is associated with changes in the development of brain networks responsible for visual and cognitive control. These changes were linked to greater difficulty in decision-making in childhood and higher levels of anxiety in adolescence.

Screens, such as cell phones, tablets, televisions, and computers, are part of the daily lives of modern society, and their use continues to grow. Worldwide, increasingly younger children are spending a lot of time in front of screens. Many babies spend between two and three hours a day exposed to screens, which far exceeds the time recommended by the World Health Organization.

This excess has worried experts, so much so that health authorities in the United States and Singapore have recently issued warnings urging parents to delay children's contact with digital media, limit screen time, and closely monitor what is being consumed.

This concern is even greater because the first two years of life are an extremely important period for brain development. During this time, the brain grows rapidly: it doubles in size in the first year of life and continues to grow intensely in the second.

Furthermore, the connections between different regions of the brain undergo major transformations. These changes help build the foundations for future skills such as language, emotional control, attention, learning, and behavior.

Several studies have already shown that excessive screen use in childhood can affect brain development. Research using brain imaging indicates changes in white matter, which is made up of fibers that connect different brain areas and are essential for skills such as reading, language, and sensory processing.

Other studies have observed changes in how brain networks responsible for cognitive control and emotion processing communicate with each other. However, most of these studies analyzed the brain at only one point in life, which does not allow for tracking how these changes occur over time.

Brain development is a continuous and dynamic process. Therefore, following the same children over several years, using repeated brain imaging exams, is fundamental to understanding how screen time influences brain maturation.

Furthermore, many studies focus only on structural changes in the brain, such as the size or thickness of specific regions, which is limited when trying to understand complex behaviors such as decision-making and anxiety.

It is known that excessive screen time in childhood is associated with several negative effects, including a higher risk of anxiety. However, it was not yet clear how these changes in the brain connect to behavior and emotions throughout development.

The aim of this study was to investigate whether screen time in the early years of life influences how brain networks are organized, how this affects decision-making ability, and whether these factors contribute to anxiety symptoms in adolescence.

To this end, researchers followed children from early childhood to adolescence, using data from a large study conducted in Singapore. Daily screen time was recorded when the children were between one and two years old. Between the ages of four and seven, they underwent magnetic resonance imaging (MRI) scans to analyze how brain networks connect.

Later, they were assessed for decision-making using a task that measures how long a child takes to decide in the face of risk, and, in adolescence, anxiety symptoms were assessed using standardized psychological questionnaires.

The results showed that children with greater screen time in early childhood exhibited faster and more pronounced changes in brain networks linked to visual and cognitive control.

These changes were associated with a greater delay in decision-making during childhood, which, in turn, was related to higher levels of anxiety in adolescence. These findings suggest that excessive screen use may accelerate certain aspects of brain maturation in an unfavorable way, affecting sensory processing, behavior, and long-term emotional health, and indicate that reducing screen time in the early years of life may be an important target for early prevention.

Therefore, public health strategies to reduce screen time in childhood may generate significant benefits for children's cognitive development and mental health. However, more mechanistic studies are needed to corroborate this finding.

It is essential that the importance of these findings not be underestimated, as they represent a significant advance in knowledge, with implications for prevention and intervention.

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Neurobehavioural links from infant screen time to anxiety

Pei Huang, Shi Yu Chan, Kathy Xinzhuo Zhou, Jasmine Chuah, Aisleen Mariz, Arellano Manahan, Evelyn Chung Ning Law, Shefaly Shorey, Helen Juan Zhou, Marielle Valerie Fortiera, Yap-Seng Chonga, Michael Joseph Meaney, and Ai Peng Tan

EBioMedicine. Volume 123106093, January 2026

DOI: 10.1016/j.ebiom.2025.106093 

Abstract:

Infant screen time is linked to many negative outcomes, including anxiety, but the underlying neural correlates and pathways remains understudied. We aimed to assess the directional association between infant screen time, development of brain network topology, decision-making behaviour and anxiety symptoms in adolescence. Using data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study, we examined the effects of total daily screen time for infants on developmental outcomes using structural equation modelling. Specifically, we looked at the developmental slopes of network integration for the seven major brain cortical networks between ages 4.5, 6.0, and 7.5, decision-making behaviour assessed using the Cambridge Gambling Task (CGT) and anxiety symptoms assessed using the Multidimensional Anxiety Scale for Children, 2nd Edition (MASC). This study included 168 children from the GUSTO cohort with data on infant screen time (ages 1–2), diffusion MRI (ages 4.5–7.5), data on decision-making performance (CGT at age 8.5), and anxiety symptoms (MASC at age 13). Brain network integration was derived from diffusion MRI and each participant's developmental slopes were modelled using latent growth models. Structural equation modelling assessed pathways linking early screen time to adolescent anxiety, mediated by brain network development and decision-making. Higher infant screen time was associated with a steeper decline in visual-cognitive control network integration from ages 4.5–7.5 years (β = −1.03 (−1.61, −0.46)), which mediated increased CGT deliberation time at age 8.5. Deliberation time, in turn, was associated with greater anxiety symptoms at age 13. A full serial mediation pathway was significant, linking infant screen time to later anxiety via accelerated brain network maturation and decision-making behaviour (β = 0.033 (0.002, 0.160)). Higher infant screen time is linked to accelerated topological maturation of the visual and cognitive control networks, leading to prolonged decision latency and increased adolescent anxiety. Sensory processing impairment may underlie this novel neurodevelopmental pathway, highlighting a potential target for early intervention. This research was supported by the Singapore National Research Foundation, Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore, Institute for Human Development and Potential, Agency for Science, Technology and Research, Singapore, the Hope for Depression Research Foundation, USA, the Toxic Stress Network of the JPB Foundation, USA, and the Jacobs Foundation, Switzerland.