Submitted:
06 July 2026
Posted:
08 July 2026
You are already at the latest version
Abstract
Keywords:
1. Introduction
2. Literature Review
3. Methodology
3.1. Search Strategy and Study Selection
Screening and eligibility criteria
3.2. Data Extraction
3.3. Data Synthesis and Analytic Strategy
3.4. Publication Bias
3.5. Sensitivity Test
3.6. Meta-Regression
3.7. Quality Assessment
4. Results
4.1. Study Selection
4.2. Study Characteristics
4.3. Overall Pooled Effects
4.4. Subgroup Effects by Mediation Type
4.5. Effects by Outcome Domain
4.6. Moderation by Socioeconomic Status (SES)
4.7. Subgroup Analysis by Technology Type
4.8. Publication Bias Assessments
4.9. Sensitivity Analysis
4.10. Meta-Regression
4.11. Quality Assessment
5. Discussion
5.1. Mediation Quality as the Central Determinant of Developmental Outcomes
Technology Type and the Content-Context Interaction
Socioeconomic Status and the Digital Mediation Divide
Implications for Higher Education and CTL-Designed Professional Development
Limitations
Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Acknowledgments
AI Use Statement:
Conflicts of Interest
References
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| Database | Syntax | Results |
|---|---|---|
| PubMed/MEDLINE | (((((((("infant"[Title/Abstract] OR "toddler"[Title/Abstract] OR "early childhood"[Title/Abstract] OR "0-5 years old"[Title/Abstract] OR "baby"[Title/Abstract] OR "babies"[Title/Abstract] OR "preschool children"[Title/Abstract]) AND "screen time"[Title/Abstract]) OR "digital media"[Title/Abstract] OR "social media"[Title/Abstract] OR "tablet"[Title/Abstract] OR "smartphone"[Title/Abstract] OR "smart phone"[Title/Abstract] OR "television"[Title/Abstract] OR "tv"[Title/Abstract] OR "interactive media"[Title/Abstract]) AND "language"[Title/Abstract]) OR "vocabulary"[Title/Abstract] OR "social development"[Title/Abstract] OR "cognitive development"[Title/Abstract] OR "attention"[Title/Abstract] OR "executive function"[Title/Abstract] OR "sleep"[Title/Abstract]) AND "parental mediation"[Title/Abstract]) OR "socioeconomic status"[Title/Abstract] OR "digital inequality"[Title/Abstract] OR "digital divide"[Title/Abstract] OR "family context"[Title/Abstract] OR "childcare"[Title/Abstract] OR "child care"[Title/Abstract] OR "cultural context"[Title/Abstract]) AND ("loattrfree full text"[Filter] AND "medlinestatus medline"[All Fields] AND "humans"[MeSH Terms] AND ("female"[MeSH Terms] OR "male"[MeSH Terms]) AND "english"[Language] AND 1995/01/01:2025/12/31[Date - Publication])) AND ((ffrft[Filter]) AND (medline[Filter]) AND (humans[Filter]) AND (female[Filter] OR male[Filter]) AND (english[Filter]) AND (1995:2025[pdat])) | 24,739 |
| Web of science | (((((((((((((((((((((((TS = infant) AND (TS = Topic)) OR ((TS = toddler) AND (TS = Topic))) OR ((TS = early childhood) AND (TS = Topic))) AND (TS = Topic))) OR ((TS = 0-5 years old) AND (TS = Topic))) OR ((TS = baby) AND (TS = Topic))) OR ((((TS = preschool children) AND (TS = Topic)) AND (TS = digital media)) AND (TS = Topic))) OR ((TS = social media) AND (TS = Topic))) OR ((TS = tablet) AND (TS = Topic))) OR ((TS = smartphone) AND (TS = Topic))) OR ((TS = smart phone) AND (TS = Topic))) OR ((TS = television) AND (TS = Topic))) OR ((TS = tv) AND (TS = Topic))) OR ((((TS = interactive media) AND (TS = Topic)) AND (TS = language)) AND (TS = Topic))) OR ((TS = vocabulary) AND (TS = Topic))) OR ((TS = social development) AND (TS = Topic))) OR ((TS = cognitive development) AND (TS = Topic))) OR ((((TS = executive function) AND (TS = Topic)) AND (TS = parental mediation)) AND (TS = Topic))) OR ((((TS = socioeconomic status) AND (TS = Topic)) AND (TS = digital inequality)) AND (TS = Topic))) OR ((TS = digital divide) AND (TS = Topic))) OR ((TS = family context) AND (TS = Topic))) OR ((TS = childcare) AND (TS = Topic))) | 17,653 |
| Scopus | TITLE-ABS-KEY ( ( infant* OR toddler* OR "early childhood" OR "0-5 years" OR baby OR babies OR preschool* ) AND ( "screen time" OR "digital media" OR tablet* OR smartphone* OR "smart phone" OR touchscreen* OR television OR tv OR streaming OR "interactive media" OR video* ) AND ( LANGUAGE OR vocabulary OR "social development" OR "cognitive development" OR attachment OR attention OR "executive function" OR sleep ) AND ( "parental mediation" OR "socioeconomic status" OR ses OR "digital inequality" OR "digital divide" OR "family context" OR childcare OR "child care" OR "cultural context" ) ) AND PUBYEAR > 1994 AND PUBYEAR < 2026 AND ( LIMIT-TO ( LANGUAGE , "English" ) ) | 503 |
| Embase | ((('infant':ab,ti OR 'baby':ab,ti OR 'toddler':ab,ti OR 'early childhood':ab,ti OR 'preschool children':ab,ti) AND 'social media':ab,ti OR 'social media':ab,ti OR 'tablet':ab,ti OR 'smartphone':ab,ti OR 'television':ab,ti) AND 'language':ab,ti OR 'vocabulary':ab,ti OR 'social evolution':ab,ti OR 'cognitive development':ab,ti OR 'executive function':ab,ti OR 'parental behavior':ab,ti OR 'social status':ab,ti OR 'digital divide':ab,ti) AND 'child care':ab,ti AND english:la AND [1996-2025]/py | 138 |
| Google Scholar | "infant" OR "toddler" OR "early childhood" OR “0-5 years old” OR “baby” OR “preschool children” AND “digital media” OR “social media” OR “tablet” OR “smartphone” OR “smart phone” OR “television” OR “tv’ OR “interactive media” AND “language” OR “vocabulary” OR “social development” OR ‘cognitive development” OR “executive function” OR “parental mediation’ OR “socioeconomic status” OR “digital inequality” OR “digital divide” OR “family context” OR “childcare” | 43,500 |
| ID | Author (Year) | Country | Design | NO. Sample Size | Age Range (months) | Technology Type | Mediation Type | Outcome Domain |
|---|---|---|---|---|---|---|---|---|
| 1 | Zimmerman et al. (2007) | USA | Longitudinal | 1,009 | 18–30 | Background TV | Unmediated/solo | Language/Vocabulary |
| 2 | Linebarger & Walker (2005) | USA | Experimental | 51 | 24–36 | Educational TV | Unmediated/solo | Language/Vocabulary |
| 3 | Schmidt et al. (2009) | USA | Longitudinal | 872 | 24–48 | Background TV | Unmediated/solo | Language/Vocabulary |
| 4 | Tomopoulos et al. (2010) | USA | Longitudinal | 277 | 6–24 | Background TV | Unmediated/solo | Language/Vocabulary |
| 5 | Radesky et al. (2014) | USA | Observational | 55 | 24–48 | Smartphone | Unmediated/solo | Social-Emotional |
| 6 | Hinkley et al. (2014) | Australia | Longitudinal | 1,459 | 0–60 | General screen time | Unmediated/solo | Social-Emotional |
| 7 | Kirkorian et al. (2009) | USA | Experimental | 51 | 18–36 | Background TV | Unmediated/solo | Language/Vocabulary |
| 8 | Barr et al. (2010) | USA | Experimental | 160 | 12–24 | Educational TV | Unmediated/solo | Language/Vocabulary |
| 9 | Madigan et al. (2019) | Canada | Longitudinal | 2,441 | 24–60 | General screen time | Unmediated/solo | Cognitive/Executive Function |
| 10 | Valkenburg et al. (1999) | Netherlands | Cross-sectional | 471 | 24–60 | Educational TV | Active co-use | Language/Vocabulary |
| 11 | Cristia & Seidl (2015) | USA | Cross-sectional | 843 | 6–48 | Interactive tablet | Mixed strategies | Language/Vocabulary |
| 12 | Roseberry et al. (2014) | USA | Experimental | 36 | 24–30 | Interactive tablet | Active co-use | Language/Vocabulary |
| 13 | Sosa (2016) | USA | RCT | 26 | 12–18 | Interactive tablet | Active co-use | Language/Vocabulary |
| 14 | Strouse & Ganea (2017) | USA | Experimental | 72 | 18–24 | Interactive tablet | Active co-use | Language/Vocabulary |
| 15 | Troseth et al. (2006) | USA | Experimental | 48 | 24 | Educational TV | Active co-use | Language/Vocabulary |
| 16 | Nikken & Schols (2015) | Netherlands | Cross-sectional | 626 | 24–60 | General screen time | Active co-use | Language/Vocabulary |
| 17 | Livingstone & Helsper (2008) | UK | Cross-sectional | 1,511 | 36–60 | General screen time | Active co-use | Social-Emotional |
| 18 | Palaiologou (2016) | UK | Mixed-methods | 394 | 36–60 | General screen time | Active co-use | Cognitive/Executive Function |
| 19 | Anderson & Pempek (2005) | USA | Experimental | 40 | 12–36 | Background TV | Unmediated/solo | Cognitive/Executive Function |
| 20 | Plowman et al. (2012) | UK | Observational | 24 | 24–48 | General screen time | Unmediated/solo | Language/Vocabulary |
| 21 | Sundqvist et al. (2018) | Sweden | Longitudinal | 524 | 12–48 | Streaming/algorithm | Unmediated/solo | Language/Vocabulary |
| 22 | van den Heuvel et al. (2019) | Netherlands | Cross-sectional | 1,812 | 18–42 | Smartphone | Unmediated/solo | Language/Vocabulary |
| 23 | Kabali et al. (2015) | USA | Cross-sectional | 350 | 6–48 | Smartphone | Unmediated/solo | Language/Vocabulary |
| 24 | Supanitayanon et al. (2020) | Thailand | Longitudinal | 274 | 6-48 | General screen time | Active co-use | Cognitive/Executive Function |
| 25 | McHarg et al. (2020) | UK | Longitudinal | 163 | 24-36 | General screen time | Unmediated/solo | Cognitive/Executive Function |
| 26 | Richert et al. (2011) | USA | Experimental | 96 | 18–30 | Educational TV | Active co-use | Language/Vocabulary |
| 27 | Nathanson et al. (2014) | USA | Cross-sectional | 484 | 24–60 | Educational TV | Active co-use | Language/Vocabulary |
| 28 | Krcmar & Grela (2007) | USA | Experimental | 72 | 18–30 | Educational TV | Active co-use | Language/Vocabulary |
| 29 | Courage et al. (2010) | Canada | Experimental | 89 | 6–18 | Educational TV | Active co-use | Language/Vocabulary |
| 30 | Mendelsohn et al. (2010) | USA | Longitudinal | 253 | 6–14 | Educational TV | Active co-use | Language/Vocabulary |
| 31 | Przybylski & Weinstein (2019) | UK | Cross-sectional | 19,957 | 36–60 | General screen time | Technical mediation | Social-Emotional |
| Author (Year) | NIH Quality Score (1–14) | NIH Quality Rating (Good/Fair/Poor) | Risk of Bias Category (Low/Moderate/Serious/Critical) |
|---|---|---|---|
| Zimmerman et al. (2007) | 11 | Good | Low |
| Schmidt et al. (2009) | 10 | Fair | Moderate |
| Tomopoulos et al. (2010) | 12 | Good | Low |
| Radesky et al. (2014) | 9 | Fair | Moderate |
| Hinkley et al. (2014) | 11 | Good | Low |
| Madigan et al. (2019) | 13 | Good | Low |
| Valkenburg et al. (1999) | 10 | Fair | Moderate |
| Cristia & Seidl (2015) | 10 | Fair | Moderate |
| Nikken & Schols (2015) | 10 | Fair | Moderate |
| Livingstone & Helsper (2008) | 10 | Fair | Moderate |
| Palaiologou (2016) | 9 | Fair | Moderate |
| Plowman et al. (2012) | 8 | Poor | Serious |
| Sundqvist et al. (2018) | 11 | Good | Low |
| van den Heuvel et al. (2019) | 10 | Fair | Moderate |
| Kabali et al. (2015) | 10 | Fair | Moderate |
| Supanitayanon et al. (2020) | 10 | Fair | Moderate |
| McHarg et al. (2020) | 10 | Fair | Moderate |
| Nathanson et al. (2014) | 10 | Fair | Moderate |
| Mendelsohn et al. (2010) | 10 | Fair | Moderate |
| Przybylski & Weinstein (2019) | 11 | Good | Low |
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