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Association Between Screen Media Use and Academic Performance Among Children and AdolescentsA Systematic Review and Meta-analysis

Educational Objective
To estimate the association of time spent on screen-based activities with specific academic performance areas in children and adolescents and to examine this association separately in these populations.
1 Credit CME
Key Points

Question  What is the association between screen-based activities and academic performance areas among children and adolescents?

Findings  In this systematic review and meta-analysis of 58 cross-sectional studies, television viewing and video game playing (but not overall screen media) were inversely associated with the academic performance of children and adolescents. In addition, the negative association between these screen-based activities and academic performance seemed greater for adolescents than for children.

Meaning  This study suggests that education and public health professionals should consider screen media use supervision and reduction as strategies to improve the academic success of children and adolescents.


Importance  The health consequences of excessive screen media use in children and adolescents are increasingly being recognized; however, the association between screen media use and academic performance remains to be elucidated.

Objectives  To estimate the association of time spent on screen-based activities with specific academic performance areas in children and adolescents and to examine this association separately in these populations.

Data Sources  MEDLINE, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and ERIC were searched from database inception through September 2018.

Study Selection  Cross-sectional studies of the association between time or frequency of screen media use and academic performance in children and adolescents were independently screened by 2 researchers. A total of 5599 studies, published between 1958 and 2018 from 23 countries, were identified.

Data Extraction and Synthesis  Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effects models were used to estimate the pooled effect size (ES).

Main Outcomes and Measures  Academic performance areas included composite scores, language, and mathematics. Screen media measurements included time or frequency of computer, internet, mobile phone, television, video game, and overall screen media use.

Results  In total, 58 cross-sectional studies (1.0%) of 5599 articles were included in the systematic review, of which 30 (52%) were included in the meta-analysis. The systematic review studies involved 480 479 participants aged 4 to 18 years, ranging from 30 to 192 000 people per study, and the meta-analysis studies involved 106 653 total participants, ranging from 70 to 42 041 people per study. Across studies, the amount of time spent on overall screen media use was not associated with academic performance (ES = −0.29; 95% CI, −0.65 to 0.08). Individually, television viewing was inversely associated with composite academic performance scores (ES = −0.19; 95% CI, −0.29 to −0.09), language (ES = −0.18; 95% CI, −0.36 to −0.01), and mathematics (ES = −0.25; 95% CI, −0.33 to −0.16). Video game playing was inversely associated with composite scores (ES = −0.15; 95% CI, −0.22 to −0.08). Subgroup analyses found that television viewing was inversely associated with language only in children (ES = −0.20; 95% CI, −0.26 to −0.15), whereas both television viewing (ES = −0.19; 95% CI, −0.30 to −0.07) and video game playing (ES = −0.16; 95% CI, −0.24 to −0.09) were inversely associated with composite scores only in adolescents.

Conclusions and Relevance  Findings from this study suggest that each screen-based activity should be analyzed individually for its association with academic performance, particularly television viewing and video game playing, which appeared to be the activities most negatively associated with academic outcomes. Education and public health professionals should consider supervision and reduction to improve the academic performance of children and adolescents exposed to these activities.

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Article Information

Accepted for Publication: May 29, 2019.

Corresponding Author: Mireia Adelantado-Renau, MSc, LIFE Research Group, University Jaume I, Av Vicent Sos Baynat, Castellon PC 12071, Spain (adelantm@uji.es).

Published Online: September 23, 2019. doi:10.1001/jamapediatrics.2019.3176

Author Contributions: Ms Adelantado-Renau and Dr Álvarez-Bueno had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Adelantado-Renau, Moliner-Urdiales, Beltran-Valls, Martínez-Vizcaíno, Álvarez-Bueno.

Acquisition, analysis, or interpretation of data: Adelantado-Renau, Moliner-Urdiales, Cavero-Redondo, Martínez-Vizcaíno, Álvarez-Bueno.

Drafting of the manuscript: Adelantado-Renau, Martínez-Vizcaíno, Álvarez-Bueno.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Adelantado-Renau, Cavero-Redondo, Martínez-Vizcaíno, Álvarez-Bueno.

Obtained funding: Moliner-Urdiales.

Administrative, technical, or material support: Moliner-Urdiales, Beltran-Valls.

Supervision: Moliner-Urdiales, Beltran-Valls, Martínez-Vizcaíno, Álvarez-Bueno.

Conflict of Interest Disclosures: None reported.

Funding/Support: Ms Adelantado-Renau was funded by predoctoral research grant PREDOC/2015/13 from the University Jaume I.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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