Screen-based media and verbal communication in toddlers with autism: a narrative review of content specific impacts

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder increasingly diagnosed in early childhood. Concurrently, screen time exposure among young children has risen, prompting global concern. Understanding the potential association between early screen exposure and ASD risk is vital for informing parental guidance and policy. A narrative review was conducted using electronic databases including PubMed, Scopus, and Google Scholar. Studies published between 2010 and 2024 that assessed screen time exposure in children under five and its association with ASD or ASD-like symptoms were included. The review considered observational studies, meta-analyses, and systematic reviews. Socio-economic status, parental education, and urban-rural differences were evaluated as confounding factors where data allowed. Most studies indicated a potential association between excessive screen time (particularly passive screen use beyond 2 hours per day) and ASD-like symptoms or delayed verbal communication in children under five. However, the evidence remains inconclusive due to variability in study designs and measurement tools. Socio-economic background emerged as a significant moderator, with children from lower-income families showing higher screen exposure and reduced interactive parenting. While excessive screen time may be associated with ASD-related developmental concerns, causality cannot be established due to potential confounders. Public health interventions should focus on promoting balanced screen use and parent-child interaction, especially in socio-economically disadvantaged settings. Further longitudinal research is needed to clarify causation and guide early intervention strategies.