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Beyond Screen Time: A Scoping Review of Screen Exposure and Early Childhood Development

Mshari Alghadier, Ragab K Elnaggar, Abdulaziz Ghandurah, Nouf Alhisony · 21 Sept 2026

Abstract

This scoping review aims to systematically map and synthesize the existing peer-reviewed evidence on the multidimensional nature of screen exposure (SE) and its associations with developmental outcomes among children aged 0–5 years. The review moves beyond the traditional focus on total screen time and considers screen exposure as a multidimensional construct encompassing duration and quantity, content quality and type, context of use, interactivity, caregiver mediation, device type, background exposure, age of onset, and exposure trajectories. The review will examine evidence across three main developmental domains: (1) language and communication development, including receptive and expressive language and vocabulary; (2) cognitive development and executive function, including attention, inhibitory control, working memory, and general cognitive abilities; and (3) socio-emotional development and behavior, including emotional regulation, behavioral difficulties, prosocial behavior, and peer relationships. The review will follow established scoping review methodology, including the methodological framework described by Arksey and O’Malley and updated guidance from the Joanna Briggs Institute (JBI). Reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The eligibility framework will be structured using Population, Concept, and Context (PCC). The population will include children aged 0–5 years, including typically developing children and community-based samples. Studies focused exclusively on clinical populations without normative or community-based data will be excluded. The concept of interest is multidimensional screen exposure and its relationship with developmental outcomes. No geographic restrictions will be applied, although evidence from the Middle East and North Africa (MENA) region will be specifically identified and examined. A systematic search will be conducted in PubMed, Scopus, Web of Science, and Google Scholar for English-language publications published from January 2016 through July 2026. Eligible studies will include primary empirical research using quantitative measures of screen exposure and validated developmental outcome assessments, as well as relevant observational, experimental, qualitative, and mixed-methods studies. Reviews, editorials, opinion articles, conference abstracts without full text, dissertations, theses, government reports, and other grey literature will be excluded. Study selection will involve independent title/abstract and full-text screening by two reviewers, with disagreements resolved through discussion and consultation with a third reviewer when necessary. Cohen’s kappa will be used to assess inter-rater reliability. Data will be extracted using a standardized and piloted extraction form, including study characteristics, participant characteristics, screen exposure measures, developmental outcome measures, and key findings. Due to expected heterogeneity across study designs, populations, exposure measures, and developmental outcomes, findings will be synthesized narratively and organized according to the three developmental domains. The expected outcome of this review is a comprehensive map of how different dimensions of screen exposure have been investigated in relation to early childhood development. The review is expected to identify consistent and inconsistent patterns across developmental domains, clarify the roles of content, context, caregiver mediation, and exposure trajectories, and highlight important evidence gaps. Particular attention will be given to the limited evidence available from Saudi Arabia and the wider MENA region. Ultimately, the findings are expected to inform future research and support the development of culturally relevant, multidimensional approaches to assessing screen exposure among young children. The review will also provide an evidence base for the development of a multidimensional screen exposure measurement tool appropriate for use with children in the Saudi Arabian context and potentially the broader Middle Eastern region.