Learning
According to recent studies, touch screen usage may interfere with infant and toddler learning development. In fact, young children need direct first-hand experience with materials and equipment that challenge their thinking and problem solving skills. Moreover, no substitute for direct interaction with parents has been found [11].
On the other hand, children younger than 3 years old can learn words through video if specific conditions are fulfilled. In details, children would be able to learn from video when the experimenter/parent/caregiver provide additional verbal and non-verbal information during the live action sequences [12]. In particular, speaker’s eye gaze is an important communicative signal of non-verbal caregiver-children interaction [13].
Mobile phones could be a tool to reinforce what children are already learning at school. In particular, using well-designed educational apps promote learning among preschool and early-elementary-aged children [14]. Unfortunately, most of the downloaded apps are not designed for a dual audience (both parent and child), targets only rote academy skills and are not based on established criteria from developmental specialist or educators.
Better policies for the evaluation of content in various app stores could be a means to create high quality educational apps for kids [14].
Development
Children’s development is also influenced by background television: it has been proven to have negative effects in young children’s brain development, reducing the amount and quality of parents-children dyad interactions [5].
As reported by Pagani et al. high rates of screen time are related to decrements in math and attention scores but also to peer rejection experiences [4].
Drawing is an activity that allows child thinking and creation of his own prospective of things [15, 16]. In this context, drawing apps can play a positive role in child development [17]. Drawing apps can be used as a supplement to traditional crayons and chalk as they are safe and easily to use [18].
Media devices use has been associated to task inefficiency, loss of attention, and safety hazards [3]. Thus, media use by children and toddlers could have positive effects only with right contents and parents’ interaction presence [19].
Well-being
Electronic media use during early childhood for more than 2 h per day has been linked to increased weight status and to behavioral problems. In particular, well-being can be conceptualized as constituting positive and adverse psychological and social attributes and behaviors. Poor levels of well-being during early childhood are associated with later outcomes, such as depression and hostile and aggressive behavior [20]. Television viewing and videogames are related to increased rates of obesity, sedentary behaviors during childhood and wrong dietary behaviors [21].
Some evidence suggested that there is an association between physical discomfort and tablets usage, especially involving neck and shoulders. In particular, children as young as 8 years old are being treated for headaches, neck and shoulder pain and poor posture as they spend more time with screens, including mobile phones. The Australian Physiotherapists Association agreed that there is an emerging of physical problems among children related to an abuse of media usage: the right balance between screen time and physical activity should be obtained [22].
Sleep
Media usage may interfere with sleep quality through the increase of psychophysiological arousal caused by stimulating content watched, or through bright light exposure [23]. Bright light may impact sleep by delaying the circadian rhythm when exposure takes place in the evening and also by causing an immediate activation in itself [24, 25]. According to the model exposed, sleep may also be negatively impacted by electromagnetic radiation [23]. Another mechanism relates to physical discomfort, such as muscular pain and headache, caused by prolonged media use and inappropriate neck posture during activities such as game playing [26]. Furthermore, screen use over two hours per day is significantly associated with long sleep onset latency especially in children that use more devices at the same time compared with those using only one device [27].
A recent study, conclude that among children aged between 1 to 4 years old, the presence of a television in the bedroom is associated with significantly reduced sleep quality, sleep terrors, nightmares, and sleep talking [28].
Sight
A reduced blink rate during continuous smartphone use causes faster evaporation of the tear film, which may then lead to dry eye disease. Moreover, smartphones are used with short watching distances due to their small LED screens, thus inducing ocular fatigue, glare, and irritation [29].
Excessive smartphone use at a close reading distance might influence the development of a condition called acute acquired comitant exotropia that is an unusual presentation of exotropia in older children. It can potentially be induced by an increased tonus of medial rectus muscles resulting from disrupted accommodation and vergence by video Display work. In these cases, avoid smartphone usage can decrease the amount of esodeviation leading to successful management of residual exotropia and restoration of binocularity [30].
Listening
The early and prolonged exposition of eardrums to intense levels leads to a dangerous sound immersion without a break period for ears. In fact, in this context, speech and language development may be compromised. Difficulties in socializing, communicating and interacting with other kids may be possible side effects [31].
Caregiver-child interaction
Early and adequate children-caregivers interactions contribute to behavioral and neurocognitive system development. Eye contact, mutual gaze, or joint visual attention between children and caregivers during emotionally charged discussion are related to autonomous regulation and development of healthy attachment relationships [32]. Media use causes fewer verbal and nonverbal interactions between parents and children dyad, parent-child conflict oppositional defiant disorder and callous unemotional behaviors [32,33,34].
In this scenario, parents’ background television and mobile devices usage, distracts from parent–child interactions, child play and may affect child cognitive development and concentration [5, 35].
