Child Development, Language Development, Screen Time
Conditions
Keywords
screen time, language development, Bayley-4, toddler, receptive language, expressive language, cross-sectional study, early childhood, parental attitude
Brief summary
This cross-sectional study investigated whether caregiver-reported daily screen time is associated with language development in toddlers aged 12 to 42 months, measured with the Bayley-4. Receptive language was the primary outcome; expressive language, cognitive, and motor scaled scores were secondary. The study was conducted at the pediatric outpatient clinics of a tertiary care city hospital in Türkiye.
Detailed description
This observational, cross-sectional study examined the association between caregiver-reported daily screen time and language development, assessed with the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4), in children aged 12 to 42 months attending the pediatric outpatient clinics of a tertiary care city hospital in Türkiye. The primary outcome was the Bayley-4 Receptive Communication scaled score; the Expressive Communication scaled score was the principal secondary outcome, and Cognitive, Fine Motor, and Gross Motor scaled scores were examined to assess domain specificity. Daily screen exposure was recorded on a four-level ordinal scale (0-30, 30-60, 60-120, and more than 120 minutes per day). The study was approved for children aged 1 to 4 years (12 to 48 months); enrollment was restricted to 12 to 42 months because the Bayley-4 normative range ends at 42 months, so children aged 43 to 48 months could not be scored against the instrument norms. No intervention was assigned; screen exposure was observed, not manipulated.
Interventions
OTHERDaily Screen Media Exposure
Caregiver-reported total daily screen media exposure recorded on a four-level ordinal scale (0-30, 30-60, 60-120, and more than 120 minutes per day) using a structured questionnaire administered at the study visit. No exposure was assigned, allocated, or manipulated by the investigators. Applies to Cohorts 1-4.
A single standardized developmental assessment administered to each participant by one certified child development specialist in a dedicated, distraction-free examination room with the caregiver present, per Bayley-4 protocol. Mean administration time was 60-90 minutes. Receptive Communication, Expressive Communication, Cognitive, Fine Motor, and Gross Motor scaled scores were recorded. Applies to Cohorts 1-4.
Sponsors
Kayseri City Hospital
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
12 Months to 42 Months
Healthy volunteers
Yes
Inclusion criteria
* Age 12 to 42 months at the time of assessment * Accompanied by a primary caregiver able to provide written informed consent * Caregiver able to complete the screen-time and background questionnaire * Turkish-speaking household * Complete Bayley-4 developmental assessment record
Exclusion criteria
* Confirmed diagnosis of a neurodevelopmental disorder * Confirmed genetic disorder * Confirmed metabolic disorder * Confirmed chronic disease * Non-Turkish-speaking household * Incomplete assessment record or missing covariate data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bayley-4 Receptive Communication Scaled Score | At enrollment (single cross-sectional assessment) | Receptive Communication subscale scaled score of the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4), administered once per participant by a certified examiner. Scaled scores are reported on the Bayley-4 normative metric (population mean 10, standard deviation 3). Higher scores indicate stronger receptive language performance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bayley-4 Expressive Communication Scaled Score | At enrollment (single cross-sectional assessment) | Expressive Communication subscale scaled score of the Bayley-4, administered once per participant by a certified examiner, reported on the Bayley-4 normative metric (population mean 10, standard deviation 3). Higher scores indicate stronger expressive language performance. |
| Bayley-4 Cognitive, Fine Motor, and Gross Motor Scaled Scores | At enrollment (single cross-sectional assessment) | Cognitive, Fine Motor, and Gross Motor subscale scaled scores of the Bayley-4, administered once per participant by a certified examiner and reported on the Bayley-4 normative metric (population mean 10, standard deviation 3). These non-language domains were recorded to characterize the domain specificity of the exposure-outcome association. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORAgah B ÖZTÜRK, MD
Kayseri City Hospital, Kayseri, Türkiye
Outcome results
None listed