Early-Childhood Tablet Use and Outbursts of Anger

Importance Tablet use continues to increase in preschool-aged children. The use of mobile devices has been linked to child emotional dysregulation. However, few studies have been able to show a clear direction of association between child tablet use and the development of self-regulation skills. In addition, few studies have modeled within-person associations over time. Objective To estimate how child tablet use contributes to expressions of anger and frustration across the ages of 3.5 to 5.5 years at the within-person level. The study team also examined the extent to which associations are bidirectional to clarify the direction of the correlations. Design, Setting, and participants This prospective, community-based convenience sample of 315 parents of preschool-aged children from Nova Scotia, Canada, was studied repeatedly at the ages of 3.5 (2020), 4.5 (2021), and 5.5 years (2022) during the COVID-19 pandemic. All analyses were conducted between October 5, 2023, and December 15, 2023. Exposure Parent-reported tablet use at the ages of 3.5, 4.5, and 5.5 years. Main outcome and measures Parents reported child expressions of anger/frustration at the ages of 3.5, 4.5, and 5.5 years using the Children’s Behavior Questionnaire. Results The sample was equally distributed across child sex (171 were identified by parents as being born boys [54%] and 144 as girls [46%]). Most reported being Canadian (287 [91.0%]) and married (258 [82.0%]). A random-intercept cross-lagged panel model revealed that a 1-SD increase in tablet use at 3.5 years (corresponding to 1.15 hours per day) was associated with a 22% SD scale increase in anger/frustration at age 4.5 years (standardized coefficient = 0.22; 95% CI, 0.01-0.44). A 1 SD scale increase in anger and frustration at 4.5 years was associated with a 22% SD (corresponding to 0.28 hours per day) increase in tablet use at 5.5 years (standardized coefficient = 0.22; 95% CI, 0.01-0.43). Conclusion and relevance In this study, child tablet use at age 3.5 years was associated with more expressions of anger and frustration by the age of 4.5 years. Child proneness to anger/frustration at age 4.5 years was then associated with more use of tablets by age 5.5 years. These results suggest that early-childhood tablet use may contribute to a cycle that is deleterious for emotional regulation.