Associations Between Caregiver Smartphone Use in a Child's Presence and Motor Skills and Executive Function in Preschoolers: SUNRISE International Study.
Marcelo Toledo-Vargas, Kar Hau Chong, Elina Engberg and 25 others
How often a caregiver uses a smartphone during play, meals or walks was not associated with a preschooler's motor skills or working memory in 2,232 children across 27 countries, after adjusting for age and other factors.
Key findings
1After adjusting for child sex, age, urban/rural residence, caregiver education, screen time, outdoor time and sleep, no significant association was found between caregiver smartphone use frequency and gross motor skills, fine motor skills, working memory, or inhibition (all p > 0.05).
2Two small positive associations appeared in sensitivity analyses: playtime smartphone use and working memory (β = 0.04, 95% CI 0.004 to 0.07, p = 0.028), and fine motor skills after removing influential cases (β = 0.04, 95% CI 0.00 to 0.07, p = 0.047). The authors note the coefficients were small and the confidence intervals close to zero.
3The null finding was consistent across country income levels and held when CSUCP items were analysed separately, gross motor tests examined individually, and influential cases excluded.
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What it does not show
Cross-sectional design: no causal inference can be drawn from the associations (or lack of them). Convenience sampling from ECEC centres and community facilities; the sample is not representative of each country's population. The exposure was measured by a 5-item frequency questionnaire (how often, on a 6-point scale). It does not capture duration of phone use, the specific activity, whether an interaction was actually interrupted, or whether the use was co-use (e.g., watching a video together). Brief, purposeful phone use (checking the time, taking a photo) is treated the same as prolonged disengagement in the measure. Social desirability bias may have led caregivers to underreport their phone use. No household-level socioeconomic data were available. Children were recruited primarily from ECEC settings, where they may already receive sufficient cognitive and motor stimulation to buffer any effect of brief caregiver unavailability. The study did not measure caregiver responsiveness, sensitivity, or the quality of the parent-child relationship, which prior work suggests may moderate the effect of phone use.
Declared interests
No funding was received for the pooled analysis. The authors declare no conflicts of interest. Funding sources for each individual country's data collection are listed in the Supporting Information.
The easy way to misread this
Do not read the small positive association between playtime phone use and working memory (β = 0.04, 95% CI 0.004 to 0.07) as evidence that phone use benefits a child's memory. It appeared only in a sensitivity analysis, the confidence interval nearly touches zero, and the main adjusted model for working memory showed no association (p = 0.112).
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