[Is early childhood screen exposure harmful to children's mental health?].

Children's average screen time at 18 months of age was 85.7 minutes per day, with 37.5% exceeding 60 minutes daily.

• Data drawn from the Cohort '18 Growing Up in Hungary representative longitudinal study (n = 2547).
• Screen time was measured at approximately 18 months of age.
• More than one-third of children (37.5%) already exceeded the commonly recommended 60-minute daily limit at 18 months.

Daily screen time exceeding one hour at 18 months of age predicted psychological difficulties at three years of age.

• Outcome was measured using the Strengths and Difficulties Questionnaire (SDQ) at three years of age.
• The association held even after controlling for early socio-emotional vulnerability, child's sex, maternal depressive symptoms, hostility, and multiple socio-demographic factors.
• Multivariate logistic regression models were used to assess the predictive effect.
• Control variables including lower maternal educational attainment, disadvantaged area of residence, younger maternal age, single parent status, financial hardship, and data collection during the COVID-19 pandemic also independently contributed to psychological difficulties at three years.

Accounting for early socio-emotional and social vulnerability reduced the independent effect of screen exposure on children's mental health outcomes.

• When early socio-emotional vulnerability was included in the multivariate models, the independent contribution of screen exposure was attenuated.
• This suggests screen exposure interacts with pre-existing environmental, familial, and individual characteristics rather than acting as a purely isolated risk factor.
• The authors interpret early screen exposure as operating 'through its interaction with existing environmental, familial, and individual characteristics.'

Passive, unsupervised media consumption not tailored to children's developmental level poses increased developmental risks for physical and mental health in infancy and early childhood.

• This framing was established in the background of the study as motivation for investigating early screen exposure.
• The study specifically targeted the period of approximately 18 months, a sensitive developmental window.
• The study design was longitudinal, allowing examination of prospective effects from 18 months to 3 years of age.

Multiple maternal and socio-demographic risk factors independently contributed to psychological difficulties at three years of age.

• Risk factors controlled for included lower maternal educational attainment, disadvantaged area of residence, younger maternal age, single parent status, and financial hardship.
• Maternal depressive symptoms and hostility were also included as parental characteristics in the multivariate models.
• Data collection timing during the COVID-19 pandemic was additionally controlled for as a contextual factor.