Early Exposure to Electronic Devices on Neurodevelopment: Data from the NASCITA Study.

Purpose. National and international guidelines recommend no screen exposure before age two and limited passive exposure (≤ 1 hour/day) between ages two and four. Yet, these guidelines are still widely unattended. Our goal was to describe trends in screen time in an Italian cohort, and identify possible developmental outcomes. Methods. In the NASCITA cohort, we investigated 2,302 children’s screen exposure and device use during the first three years of life and their impact on developmental milestones at 3 years as measured by a 38-question checklist. A comparison of the number of failed items by degree of exposure was performed by using the analysis of variance, and through a linear regression model adjusted for several covariates. Results. At 36 months, 95% of children watched videos (20% of whom exposed > 1 hour/day) and 80% interacted frequently with devices. Children in the South of Italy, with lower parental education and maternal unemployment, had higher screen exposure/device use. Failures in neurodevelopmental assessment increased for screen exposure from 3.39 ( SD  = 4.29) in the low exposure to 3.87 ( SD  = 4.18) in the high exposure group (p = 0.004); for interaction with devices, from 3.42 ( SD  = 3.89) in the low interaction to 4.53 ( SD  = 4.96) in the high interaction group (p < 0.0001). Linear regression confirmed that greater device interactions were associated with more failures (β = 0.76; 95%CI = 0.33, 1.19), while passive exposure was not. Conclusions. Screen time, and in particular direct device use, may affect developmental milestones typically learned through face-to-face interactions. Our results highlight the importance of early interactions and environment for optimal development.