Dr. Wael Al-Dekrouri
Associate Professor, College of Medicine, Alfaisal University
Head of Communication Disorders Department, Mental Care Complex
American Board Certified and Fellow of the American Speech-Language-Hearing Association (CCC-SLP, ASHA Fellow)

In today’s world, smart devices have become an integral part of a child’s environment, from mobile phones and tablets to computers, raising a wide debate about their impact on development. The question is no longer whether children should be allowed to use technology, as complete restriction may isolate them from an important component of modern life and limit their acquisition of essential skills. Rather, the focus has shifted to how technology can be used consciously to support development instead of hindering it.

This article reviews recent research on the impact of technology on children’s language and social skills, and presents practical recommendations from leading health and professional organizations.

Negative Aspect: Risks of Excessive Use

Early childhood is a critical period for language acquisition, which relies primarily on direct face-to-face interaction. When children spend long periods in front of screens, they miss valuable opportunities for interaction with adults and peers, known as “interactive conversation” or “back-and-forth dialogue.” These interactions expose children to a wide range of vocabulary, teach them tone of voice, facial expressions, and body language, which together represent the largest component of human communication.

• Language Development Delay: Several studies have shown that excessive use of tablets and screen devices in preschool years is associated with delays in both expressive and receptive language development. A recent study published in the Journal of Speech, Language, and Hearing Research (JSLHR) found that high screen exposure is linked to slower language acquisition. In addition, non-educational or passive screen content does not stimulate the brain in the same way as human interaction, which can affect the child’s ability to process linguistic information effectively.

• Weak Social Skills: Social skills such as empathy, sharing, and conflict resolution are learned through direct interaction. When a child is engaged with a device, they become socially isolated from their environment. This limits their ability to understand non-verbal social cues such as facial expressions and body language, which may hinder their ability to form friendships and healthy relationships.

• Impact on Attention and Concentration: Fast-paced and constantly changing screen content trains the brain to expect continuous stimulation. This may lead to difficulties in sustaining attention on tasks that require prolonged focus, such as reading a book or listening to a teacher.

Key Recent Research Findings

• 2023 large cohort study (Japan, >7,000 children): Increased screen time at age 1 was associated with delays in communication and problem-solving skills at ages 2 and 4, with higher risk at 4+ hours/day.
• 2024 systematic review on early childhood screen contexts: Passive viewing and background television were linked to poorer cognitive and socio-emotional outcomes, while co-viewing with caregivers (co-use) was associated with better cognitive outcomes.
• 2024 public health journal study: One hour or more of mobile device screen time per day was associated with lower receptive and expressive language scores in young children, with partial protective effects from shared reading.
• 2018–2021 research on interactive conversation: Increased conversational exchanges between caregivers and children were associated with improved language skills and measurable changes in cortical brain development on neuroimaging, supporting the priority of human interaction over passive screen exposure.

Positive Aspect: Technology as a Supportive Tool

Despite the risks, technology can serve as a powerful tool to support child development when used in a strategic and intentional way.

• Educational tool:
  There are many high-quality educational applications that provide interactive content to enhance vocabulary and teach letters and numbers in an engaging way. These applications can complement traditional learning and provide additional support for children who need it.
• Augmentative and Alternative Communication (AAC):
  These tools represent a major advancement for children with significant speech and language difficulties, such as Autism Spectrum Disorder or cerebral palsy. Specialized devices and applications enable these children to communicate and express their thoughts and needs, thereby enhancing independence and improving quality of life.
• Communication with family and friends:
  Technologies such as video calls allow children to communicate with family members and friends who live far away. This helps maintain family connections and supports the development of language and social skills.

Recommendations from the American Speech-Language-Hearing Association (ASHA), the American Academy of Pediatrics (AAP), and other international organizations

Based on research and studies, leading professional organizations have provided clear recommendations for parents regarding the healthy use of technology.

Recommendations from the American Speech-Language-Hearing Association (ASHA):

ASHA emphasizes that screen time should be “interactive time” rather than “passive time.” Their key recommendations include:

• Children under 2 years of age: The use of smart devices is not recommended for any purpose other than interactive video calls (such as communicating with grandparents), preferably in the presence of parents.
• Children aged 2 to 5 years: Screen time should be limited to one hour per day, with the requirement that parents actively participate in viewing the content with the child and discuss it. This helps transform the experience from passive to interactive.
• Turning screens into a communication tool: Speech and language experts recommend using devices to encourage dialogue. For example, parents can ask questions such as: “What do you see in the picture?” or “What is this cartoon doing?” This helps strengthen listening, comprehension, and expressive language skills.

Recommendations from the American Academy of Pediatrics (AAP):

The AAP emphasizes the importance of developing family media plans that establish clear rules for screen use, shifting from a rigid “hours-based limit” approach to a more individualized and interactive strategy that fits each child’s family context. This approach considers the child, content, sleep routines, and the displacement of essential activities.

Key recommendations include:

• Setting time limits and appropriate content: Establish specific times for device use and select age-appropriate, educational content.
• Screen-free zones: Certain areas of the home, such as bedrooms and mealtimes, should be completely free of devices to encourage family interaction.
• Parental role modeling: Parents are encouraged to model healthy technology use, as excessive parental screen time can reduce the quality of family interaction.
• Prioritizing non-digital play: Encouraging outdoor play, reading, and creative activities, which are essential for physical, cognitive, and social development.
• In educational settings: Active, task-based learning through technology is more beneficial than passive consumption.

World Health Organization (WHO) Recommendations for Children Under 5 Years:

The WHO emphasizes reducing sedentary behavior associated with screen use, increasing physical activity, and ensuring adequate sleep. It provides age-specific recommendations for children under 1 year, 1–2 years, and 3–4 years, including limits on total screen exposure.

Canadian Paediatric Society (CPS) Recommendations:

The CPS recommends that parents remain present and engaged during screen use, prioritize interactive educational content, and ensure that reading and physical activity remain top priorities in a child’s daily routine.

Royal College of Paediatrics and Child Health (RCPCH):

The RCPCH focuses on the quality of screen use rather than strict time limits, emphasizing its impact on family routines, sleep patterns, and overall well-being.

Practical Updated Recommendations

• Prioritize daily interactive conversation: Reading aloud, describing daily activities, and asking open-ended questions. Any screen use should be turned into a conversation (e.g., “What do you notice? What do you think will happen?”). This significantly enhances language development and reduces the negative impact of screen exposure.
• For ages 2–5 years: Aim for up to 60 minutes of high-quality content per day, with active parental participation. Avoid background screen exposure (continuous TV or devices running in the background). For children under 18–24 months, only interactive video calls with a caregiver are recommended.
• Choose “active use” over passive viewing: Prefer interactive applications and creative, task-based media over passive watching.
• Establish a structured home routine: Set screen-free zones and times (such as bedrooms and mealtimes), and avoid background television.
• Protect sleep and physical activity: Follow WHO guidelines for movement and sleep, as late or excessive screen exposure may negatively affect sleep quality and reduce free play.
• For children with communication needs (AAC): Use devices and applications as part of a structured therapeutic plan supervised by a speech-language pathologist. Train families to turn every use into functional communication (requesting, choosing, commenting), ensuring communication remains purposeful and interactive.
• Monitor “displacement”: If you notice reduced reading, free play, sleep quality, or family interaction due to screen use, reduce screen time immediately.

Conclusion: Toward Balanced and Conscious Use

Technology is not inherently harmful; its impact depends largely on how it is used. Parents play a key role as guides and role models, understanding that smart devices cannot replace real human interaction, which forms the foundation of a child’s language and social development.

By applying professional recommendations, families can achieve a healthy balance that allows children to benefit from the digital age without compromising their essential language, social, and developmental skills.