Screen Time Risks for Preschoolers

Question: Are there any risks associated for a 4-year-old with screen time with age-appropriate programming? 

Answer: This is a great question to ask! Prioritizing age-appropriate programming is an excellent start. Even with age-appropriate programming, though, there can be risks for young children if screen time is frequent or replaces sleep, play, reading, or time with caregivers. The biggest factors are what your child watches, and when and why screens are used. We’ll discuss why it is important to help keep screen time intentional and balanced.  

What matters most when it comes to content? Age-Appropriate vs. High-Quality  

When we think about content, there can be an important difference between “age-appropriate” and “high-quality.” Age-appropriate generally refers to the absence of inappropriate content (such as rude/aggressive, mature, violent, sexual, etc.), whereas high-quality refers to what is present on the screen.  

High-quality content is specifically made with care, meaning it takes a child-centered approach to actively support young children’s wellbeing and development. Examples like PBS KIDS, Ms. Rachel, Bluey, or Daniel Tiger’s Neighborhood are all high-quality programs that, for example, use developmentally-aligned teaching approaches, role model positive behavior, and don’t include habit-forming designs or product placement. Lower quality content that’s still age-appropriate may not be explicitly risky or inappropriate, but it might be more focused on making money off your child’s attention instead of their wellbeing.  

It can feel tricky to spot differences in quality! We have created this stoplight resource to help you identify content that’s right for your family.  

What are the biggest risks? The “When and Why” of Screens 

Crowding Out: Getting in the way of other important activities
One of the biggest concerns associated with screens for young children is what other activities media might be getting in the way of. This is a big age for children to play, move their bodies, explore nature, look at books, and chat with siblings and parents – activities help them learn essential social and brain skills. When used for too long each day, screens can get in the way of these activities, which limits their opportunity to learn and grow confidence with those skills. For this reason, the AAP recommends less than 1-2 hours per day of entertainment screen time per day for 4-year-olds.  

Calming: Skills for managing big feelings
Another important question is why screens are being used. Preschoolers are still learning how to manage big feelings like frustration, sadness, and boredom. That can be hard – for children and for caregivers. But these moments are also important changes to practice calming down with support. When possible, try other strategies first, like comforting your child, naming the feeling, taking a break together, or offering a quiet activity. If screens are used often to calm a child, they may have fewer chances to build those coping skills over time.  

Cognition, Language, and Sleep 

Research suggests that high-quality content can support learning, but too much screen time overall may be linked with challenges with attention, behavior, language, and sleep. Here are a few examples: 

• High-quality content may support learning and language. Research suggests that what children watch matters, but so does how much they watch. According to a meta-analysis of 64 studies, high-quality content was linked with stronger early literacy and social-emotional skills. At the same time, more total program viewing overall was associated with more difficulties with attention, behavior, and other thinking skills. A similar pattern was found in a meta-analysis of 42 studies on language: high-quality content may support language development, but higher total screen time was associated with weaker language skills overall. 
• There is also some evidence that preschoolers with more total screen time may have more difficulty with mental imagery, or picturing things in their minds. This skill helps children imagine, compare, and think through ideas.  
• Higher screen time may also affect sleep. In a meta-analysis of 31 studies of children under 5, greater total screen time was associated with poorer sleep quality and taking longer to fall asleep. 

Taken together, these studies suggest that screen time is not all good or all bad—it depends a lot on how it is used. What matters most is choosing high-quality content and making sure screens do not replace sleep, play, physical activity, reading, or time with caregivers. If you would like to explore more about screen time and brain development, check out this past portal question. 

Finding Balance 

To help keep screen time intentional and balanced, we suggest these tips: 

• Co-viewing: Watching and engaging in programs with your child can help boost their learning during it and enrich your relationship with them. Talk to them about what they see in videos, ‘good’ and ‘bad’ behavior in characters, or advertisements. If your child is watching something interesting, talk about it!  
• Set Boundaries: Avoid letting your child have open access to a device, and set time boundaries that fit your family’s needs and routine. An example could be keeping the hour before bed screen-free.  
• Build in Alternatives: Healthy, non-screen activities can be great opportunities for your child to learn and grow. You can even consider doing something related to a show or movie your child likes, such as reading a book or playing make-believe. If your child needs help calming down, you can check out our Calm Toolbox full of non-screen ideas to manage big emotions.  
• Role Model Tech Habits: Young children are very observant, and they often look to you for clues on how to navigate their world. When you demonstrate balance in your own habits, such as putting your phone away before bed or during conversations, you help model for them what that behavior looks like. This can help them learn and feel motivated to follow your example. 

For more details, check out our 5 Cs of Media Use for Toddlers and Preschoolers or our Early Childhood Development and Screen Time Toolkit.  

References 

• Hutton, J. S., Dudley, J., Horowitz-Kraus, T., DeWitt, T., & Holland, S. K. (2020). Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children. JAMA Pediatrics, 174(1), e193869.  
• Janssen, X., Martin, A., Hughes, A. R., Hill, C. M., Kotronoulas, G., & Hesketh, K. R. (2020). Associations of screen time, sedentary time and physical activity with sleep in under 5s: A systematic review and meta-analysis. Sleep Medicine Reviews, 49, 101226.  
• Madigan, S., McArthur, B. A., Anhorn, C., Eirich, R., & Christakis, D. A. (2020). Associations Between Screen Use and Child Language Skills: A Systematic Review and Meta-analysis. JAMA Pediatrics, 174(7), 665–675.  
• Mallawaarachchi, S., Burley, J., Mavilidi, M., Howard, S. J., Straker, L., Kervin, L., Staton, S., Hayes, N., Machell, A., Torjinski, M., Brady, B., Thomas, G., Horwood, S., White, S. L. J., Zabatiero, J., Rivera, C., & Cliff, D. (2024). Early Childhood Screen Use Contexts and Cognitive and Psychosocial Outcomes: A Systematic Review and Meta-analysis. JAMA Pediatrics, 178(10), 1017–1026.  
• Radesky, J. S., Kaciroti, N., Weeks, H. M., Schaller, A., & Miller, A. L. (2022). Longitudinal Associations Between Use of Mobile Devices for Calming and Emotional Reactivity and Executive Functioning in Children Aged 3 to 5 Years. JAMA Pediatrics, e224793.  
• Suggate, S. P., & Martzog, P. (2022). Preschool screen-media usage predicts mental imagery two years later. Early Child Development and Care, 192(10), 1659–1672.  

Age: 2-6  

Topics: Screen Time, preschool 

Role: Parent/Caregiver