New study links early childhood tablet use to anger outbursts

Virtually every parent of young children has experienced outbursts of anger and frustration from their toddlers, whether it’s time to get up, go to bed or eat a sandwich without the crusts cut off.
According to a new study, there’s another possible reason for the frequency of their outbursts: tablet use.
The new study, published in the journal JAMA Pediatrics, shows that child tablet use at 3.5 years old was associated with a higher number of expressions of anger and frustration a year later. In addition, children who were more prone to anger and frustration at 4.5 years old were more likely to have higher tablet use a year later (at 5.5 years old). Early childhood tablet use “may contribute to a cycle” of problems in emotional regulation, the authors wrote.
I wanted to get more context on this speaking with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University and previously served as Baltimore’s health commissioner. Just as importantly, she is the mother of two young kids.
Dr. Leana Wen: This study was a survey of 315 parents of preschool-aged children from Nova Scotia. The same parents took part in the study when their kids were 3.5 years old (in 2020), 4.5 years old (in 2021) and 5.5 years old (2022). They self-reported tablet use in their kids and then assessed their children’s expression of anger using a standard questionnaire called the Children’s Behavior Questionnaire.
The researchers found an association between tablet use at 3.5 years and an increase in anger and frustration at age 4.5 years. They noted that the association between tablet use and anger was bidirectional, as children whose parents noted a higher anger and frustration level at 4.5 years also had higher tablet use at 5.5 years. That means the effects might go both ways.
It is important to consider that this study occurred during the peak years of the COVID-19 pandemic. Researchers noted this context and the fact that the pandemic introduced higher stress and disruptions to routine. Still, the bidirectional association between tablet use and expression of anger and frustration was significant and should be a warning to parents to be aware of screen time.
Wen: Not at all. There have been other studies that have come up with similar results.
One paper published just this year sheds some light as to why tablet use could be related to anger outbursts. Researchers found that among kids two- to five-years old, those whose parents often used technology to manage their negative emotions were more likely to show poor anger and frustration management a year later. These kids were also less capable of deciding on a deliberate response over an automatic reaction.
One reason is that children need to learn to deal with their own negative emotions themselves. They need to go through the process as part of their childhood development, aided by their parents, caregivers and teachers. If, instead, they are given a tablet, computer or smartphone in an effort to soothe them, they won’t learn to manage these emotions themselves. This could result in problems later in childhood and adulthood, including with anger management.
CNN: Does this research mean that parents should avoid tablets for their kids altogether?
Wen: Not necessarily. There are some apps that can aid in learning, and many schools use tablets in their teaching curriculum. I think the new JAMA Pediatrics study, as well as other research, illustrates that tablets, smartphones and other electronics shouldn’t be used as pacifiers. They shouldn’t be given to kids when they are crying and upset to try to calm them down.
A recent study showed that child tablet use at 3.5 years old was associated with a higher number of expressions of anger and frustration a year later. (martin-dm/E+/Getty Images via CNN Newsource)
They also shouldn’t be used as a babysitter that takes the place of an adult interacting with the child. Children learn through active social engagement with others, and a big problem with screens — whether it’s playing with apps or watching movies or TV shows — is that they replace the face-to-face interaction with other kids and adults.
Wen: I try hard to limit screen time. My kids, ages 4 and almost 7, can watch an hour total of a movie on weekends. Their weekday screen use is limited to when one of them has an asthma exacerbation and needs to use the nebulizer machine; I allow them to watch a show for no more than 10 minutes to finish the breathing treatment.
We do have tablets that I let them use on special occasions. For example, we just had a long trans-Atlantic flight to visit my husband’s family in South Africa. The kids were allowed to use their tablets on the flight. Also, if they are over at a friend’s house and other kids are playing with a tablet, we wouldn’t prohibit them from also playing with it. And of course, they are allowed to use tablets at school if it is required.
Still, I really understand the temptation to give tablets to kids. My little one went through a period of terrible tantrums, and I knew that she would calm down if I played a show or let her use her tablet. It’s also really hard at times when childcare falls through and my husband or I need a sitter.
On several occasions, when I’ve had virtual meetings and no babysitter, I have had to buckle and let the kids watch a movie while I took the meeting. I try to make these situations the exception and not the rule, as I want to limit the potential impacts of tablet use on my children.
Wen: There has been a lot of research on this topic that has culminated in US Surgeon General Vivek Murthy issuing an advisory warning parents of the dangers of social media. Earlier this year, Murthy stated that he would like to add a warning label to social media apps, akin to warning labels on cigarettes and alcohol.
In one study, girls who spent two hours or more on social media were more likely to report depression and self-harm compared to those who used it less. Another large study involving three data sets found that adolescents who used social media for five or more hours a day were 171 per cent more likely to be unhappy compared to those who used it for less than an hour a day. This is in the context of near-universal use of social media, with up to 95 per cent of kids ages 13 to 17 reporting using social media. American teens report spending a shocking amount of time — nearly five hours each day—on YouTube, TikTok, Instagram and other social media apps.
There are a number of problems with this level of social media use, one of which is what this time is replacing. Kids who are glued to their phones and tablets for this amount of time are not participating in sports and getting enough physical activity. They are not interacting in real life with one another. And they are not getting adequate asleep. All of these are detrimental to physical and mental well-being.
Wen: I’d recommend the following four things. First, for those who kids are still young, delay smartphone and social media use for as long as possible. This works best if you can coordinate with other parents, as peer pressure is a big reason why kids start.
Second, as mentioned before, parents should try not to resort to screens and tablets as a way to stop tantrums. For young children, tantrums are a normal part of development. Parents who are concerned about the frequency or duration of tantrums should consult their pediatrician.
Third, for those whose kids already have smartphones and use social media apps, speak with them about the impact of social media on them. Some of them may recognize the addictive potential of their devices and want to cut down themselves. Others could be convinced to reduce their time on screens in favor of other activities, such as in-person time with friends.
Fourth, set limits. These should include no phones in the bedroom overnight and places that should be free of devices — such as the classroom and dining room table. Parents, too, should abide by these limits and set a good example. It’s no surprise that studies have also shown that parents who spend a lot of time glued to their devices are more likely to have kids who do as well.