January 16, 2026
2 min read
Key takeaways:
- High infant screen time was linked to accelerated maturation of the visual cognitive control network.
- This accelerated network maturation was associated with negative cognitive and mental health outcomes.
High levels of screen time before age 2 years were linked to slower decision-making and increased anxiety in teenage years, according to an observational cohort study published in The Lancet.
“Early screen exposure may matter not only for short-term behavior, but also for longer-term brain development and mental health,” study author Ai Peng Tan, MD, FRCR, MMed, principal scientist from the Translational Neuroscience program at the A*STAR Institute for Human Development and Potential and an assistant professor at the NUS Yong Loo Lin School of Medicine in Singapore, told Healio.
The study followed 168 children, 54.2% of whom were male, enrolled in the Growing Up in Singapore Towards Healthy Outcomes longitudinal birth cohort.
The program enrolled women in their first trimester of pregnancy between June 2009 and December 2010 and has been following the parents and their children to examine how developmental factors shape health outcomes later in life.
The researchers gathered data on infant screen time from parental questionnaires administered when the children were aged 1 and 2 years.
Tan and colleagues assessed participants’ brain development via diffusion MRIs at 4.5, 6 and 7.5 years, decision-making performance using the Cambridge Gambling Task at 8.5 years and anxiety symptoms using the Multidimensional Anxiety Scale for Children, 2nd Edition test, at 13 years.
High screen time as an infant predicted a steeper decline in visual-cognitive network integration between 4.5 and 7.5 years (P < .0003), indicating a pattern consistent with accelerated maturation of these networks, according to the researchers. High screen time in children aged 3 to 4 years was not associated with such changes within the visual-cognitive network.
“We might expect ongoing or cumulative exposure to matter most, but instead we saw the clearest associations during the earliest period of life,” Tan said. “This reinforced the idea that infancy is a particularly sensitive window for brain development, when environmental inputs may have longer-lasting implications.”
The accelerated network trajectory was associated with longer deliberation times during the Cambridge Gambling Test, which in turn associated with increased anxiety at age 13 years (P = .006).
“Our findings … highlight early screen exposure as a potentially modifiable environmental factor that may be relevant to long-term neurodevelopment and mental health,” Tan said. “For physicians, this means that conversations about media use — especially during infancy — can be a meaningful part of routine anticipatory guidance and developmental assessments, alongside discussions about sleep, nutrition and caregiver interaction,” she continued.
Tan and colleagues acknowledged several study limitations, including that participants’ decision-making and anxiety were measured at limited intervals and that the study only considered the amount of time spent on screens, and not the context or content of the screen time, as well as potentially confounding variables like parent-child interaction.
The findings build on a 2024 study published in Psychological Medicine by the same team of researchers, which found that high infant screen time was associated with changes in the brain networks that regulate emotion, but that time spent parent-child reading could mitigate the change.
“An important next step is to continue following participants into adulthood to better understand how these early neural and behavioral differences translate into later mental health outcomes,” Tan said.
For more information:
Ai Peng Tan, MD, FRCR, MMed, can be reached at psychiatry@healio.com.
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