The research, led by Erdembileg Sundarimaa from the Child Development Unit (CDU), Khoo Teck Puat-National University Children’s Medical Institute, Singapore, highlights the growing concern about early screen use among young children.
The study examined 5,336 typically developing children aged 17 to 24 months from a multi-ethnic population-based sample in Singapore, including Chinese (64.2%), Malay (23.9%), and Indian (5.8%) participants. Caregivers reported daily screen time through questionnaires, and children were assessed using the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F). The average daily screen exposure in the cohort was 1.31 hours.
The analysis revealed the following findings:
- Children with daily screen time exceeding 1.31 hours had a 24% higher likelihood of testing positive on the M-CHAT-R/F (OR 1.24).
- The association between screen time and positive M-CHAT-R/F results was strongest for social-communication-related items.
- No significant links were found between screen time and motor skills or sensory aversion.
- Structural equation modeling confirmed that increased screen time directly influenced both the overall M-CHAT-R/F score and the screening outcome.
“Our findings suggest that higher screen time in toddlers may be associated with early signs of autism, especially difficulties in social interaction and communication,” the researchers noted. They emphasized that while motor and sensory concerns did not show a clear connection to screen exposure, the consistent link with social-communication symptoms warrants attention.
The study underlines the importance of monitoring screen use in young children. “Parents and caregivers should be aware of the potential impact of extended screen exposure on toddlers’ social and communication development,” Sundarimaa and colleagues stated. They recommend that the evaluation of children who screen positive for autism should include guidance on limiting screen time and promoting interactive play to support social skills.
While the research provides valuable insights, the authors acknowledged certain limitations. The study relied on caregiver-reported screen time, which may be subject to recall bias, and its cross-sectional design does not establish causality. Nonetheless, the large, multi-ethnic sample strengthens the relevance of the findings for population-level recommendations.
This study adds to a growing body of evidence suggesting that early-life screen exposure may influence neurodevelopmental outcomes. Clinicians and parents alike may benefit from incorporating screen time assessment and reduction strategies into early childhood care, particularly for children identified as at risk for autism spectrum disorder.
The Singapore-based research highlights a significant association between higher screen time and early autism symptoms in toddlers, with social-communication difficulties being most affected.
"Reducing screen exposure and encouraging interactive play may help mitigate these risks while supporting healthy developmental trajectories in young children," the authors concluded.
Reference:
Sundarimaa, E., Chan, S.P., Zheng, R.M. et al. Association Between Screen Time Exposure and Scores on the Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F) in Children From a Multi-ethnic Population-Based Sample in Singapore. J Autism Dev Disord (2025). https://doi.org/10.1007/s10803-025-07066-6
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