The Hidden Dangers of Screen Time in Children Under Five: An Occupational Therapist’s Perspective

In today’s digital world, screens are everywhere — from TVs and tablets to smartphones and even smart toys. While these devices may offer educational content and entertainment, research continues to reveal alarming effects of excessive screen time on children under five. As an occupational therapist, I’ve witnessed firsthand how prolonged screen exposure can significantly impact children’s development, behavior, and attention. Understanding these risks is crucial for parents striving to foster healthy growth in their young children.

Studies have repeatedly shown a connection between increased screen time and behavioral concerns in young children. Research published in JAMA Pediatrics found that preschoolers who spent more than two hours a day on screens were over five times more likely to exhibit behavioral issues such as hyperactivity, aggression, and poor impulse control. Screen exposure limits opportunities for children to practice essential social-emotional skills like patience, frustration tolerance, and self-regulation. Instead of learning to navigate emotions through face-to-face interactions, they may rely on screens to soothe discomfort, which can lead to greater emotional outbursts when technology is unavailable.

Excessive screen time has been linked to reduced attention spans in young children. According to research from the Journal of the American Medical Association, early exposure to fast-paced, overstimulating media can overstretch a child’s developing brain, making it harder for them to concentrate during less stimulating activities like reading, puzzles, or social play. This overstimulation can condition a child’s brain to crave constant visual and auditory input, resulting in frustration or restlessness when required to engage in slower-paced tasks.

The early years are critical for developing fine motor skills, sensory integration, and language. Screen time can take away from the real-world exploration children need to build these foundational abilities. A study in Pediatrics revealed that children aged two to three who had more than three hours of daily screen time were significantly more likely to show delays in communication, social skills, and problem-solving abilities. As an occupational therapist, I often observe that children who spend excessive time on screens struggle with tasks requiring bilateral coordination, hand strength, and visual-motor integration — skills that are best developed through hands-on activities like drawing, climbing, and manipulating toys.

Screen exposure before bedtime can interfere with the body’s natural sleep-wake cycle. Blue light emitted from screens suppresses melatonin production, making it harder for children to fall and stay asleep. Research in Sleep Health found that preschoolers with evening screen exposure experienced more frequent night wakings and reduced overall sleep duration. Poor sleep directly impacts a child’s mood, behavior, and ability to manage sensory input — all critical components for success in their daily activities.

As an occupational therapist, I encourage parents to adopt intentional strategies for screen use. The American Academy of Pediatrics recommends no more than one hour of high-quality screen content per day for children ages two to five, with a focus on co-viewing to promote interaction and learning. Encouraging hands-on play, outdoor exploration, and family engagement strengthens vital skills that screens cannot provide. Additionally, establishing screen-free routines — such as screen-free meals and a 60-minute screen cutoff before bedtime — can improve attention, emotional regulation, and overall well-being.

While screens are an inevitable part of modern life, understanding their risks empowers parents to make informed decisions. By prioritizing active play, social connection, and real-world experiences, families can foster stronger developmental outcomes for children under five. As an occupational therapist, I believe that thoughtful screen use combined with enriching experiences can help children thrive in all aspects of their growth.