Sumudu R. Mallawaarachchi

Intergenerational studies suggest that the developmental foundations of children’s early relational health are seeded well before conception. Here, we present studies that report on associations between factors in the parental preconception life course (across childhood, adolescence, and young adulthood), and indicators of the child’s early relational ecology (e.g., infant-to-parent attachment, parent-to-infant bonds). We searched MEDLINE, PsycINFO and Embase databases for peer-reviewed articles, published in English, that reported on prospectively assessed factors at any stage of a parent’s life course prior to conception, and associations with offspring relational health from conception to end of age 3 years. No date restrictions were imposed. A total of 13,594 articles were screened of which 30 met inclusion criteria, reporting data from 17 separate cohorts. Next generation child relational health was assessed using both coded observations and parent reports, with most studies focused on the mother–child relationship (70%). Most preconception predictors were assessed at the individual level (63%) or within the family microsystem (53%) and were measured during adolescence (60%). Few studies assessed other microsystems or broader ecological systems, with no studies investigating workplaces, online interactions, or cultural belief systems as predictors of next generation relational health. We conclude that longitudinal cohorts that track individuals into parenthood can provide critical insights into the preconception origins of early relational health; however, the existing body of prospective studies is heterogeneous and reflects a nascent field of enquiry. We present five recommendations for future investment in public health approaches that promote early relational health.

Despite the vast array of app choices available to children and evidence of a high prevalence of persuasive design features (e.g., rewards, character pressure, and aesthetic manipulation) within these apps, little is known about how, and to what extent, these design elements influence children’s digital app play. The current study investigated the effects of app persuasive design and children’s self‐regulation, and their interaction, on children’s ability to disengage from digital devices. The study adopted a three‐arm acute experimental design, wherein 73 children, aged 3–5 years, were randomly assigned to engage with one of three apps (of high, moderate, or low persuasive design), with a novel “digital disengagement” paradigm that measured the time to disengage from app play and researcher‐rated degree of independent disengagement. Children’s self‐regulation outside of digital contexts was also assessed. General linear models were used to compare the main effects of and interaction between app condition and child self‐regulation on children’s digital disengagement. Given similar disengagement means in high and moderate conditions, these were collapsed and compared with the low condition. Significant interactions between persuasive design (moderate‐high and low) and self‐regulation (high and low) were found for disengagement time and degree of independent disengagement for one of the two self‐regulation measures. Young children with higher self‐regulation were able to disengage from the digital device regardless of persuasive design level (even at moderate‐high levels). Children with lower self‐regulation disengaged more easily and promptly under low persuasive design but took longer and needed more support to disengage when exposed to moderate‐high persuasive design. This first‐of‐its‐kind study offers novel insight into which children are more susceptible to extended digital engagement due to persuasive design. The study highlights the importance of considering the design elements within apps together with the child’s abilities to aid families make more informed digital choices.

Despite the increasing rates of early childhood smartphone and tablet use and the possible link to engagement-promoting persuasive digital environment design, there has been limited research examining persuasive design features in early childhood apps. The current content analysis aimed to systematically evaluate the prevalence of persuasive design features within popular early childhood apps. Comparisons in persuasive design features between free and paid apps, as well as ‘Teacher-Approved’ and other apps were also examined. A coding scheme, guided by the Fogg behavioral model (2009), was applied to 132 apps. Each persuasive feature belonged to either of the three main components; motivation, ability or prompts, and was dichotomously coded to indicate whether it was present. Of the 132 apps analyzed, a high prevalence of passive motivation features (vibrant colors and music), and ability features (in-game help suggestions and repetitive tasks) were noted across a majority of apps. Further, prompts were more prevalent in free apps compared to paid apps, while there were no differences between free and paid apps in other features. Teacher-Approved apps contained less advertising and fear-based motivation features compared to non-approved apps. These results outline the need to consider the developmental implications of persuasive design features in apps and to examine how they may contribute to problematic screen behaviors in early childhood.

Background: Exploring parental motives for providing smartphones and tablets to young children is important to better understand ways to optimise healthy use of mobile screens in early childhood. To date, no study has qualitatively examined the factors underpinning parental motives of providing mobile screens to young children, using a theoretically driven approach. Methods: We conducted 45 in-depth, semi structured online interviews with primary caregivers of toddlers and pre-schoolers from diverse family backgrounds who participated in a large online survey in Australia. Themes were generated from the transcribed interviews using template thematic analysis. The coding was completed deductively using the Theory of Planned Behaviour (TPB) and data-driven induction. Results: Participants consistently reported a spectrum of attitudes, subjective norms and perceived behavioural control aspects which drove their decision to provide or not provide a mobile screen device to their child. Five main descriptive themes were generated, guided by the TPB: (1) Convenience, connection, and non-traditional learning experience; (2) Negative behavioural consequences and potential activity displacement through mobile screens; (3) Influences of society and resources; (4) Managing and achieving a balance; (5) External challenges. Conclusions: Overall, the findings demonstrated that parents experienced cognitive dissonance between their attitudes and behaviour, primarily from perceived behavioural control and subjective norms negating the influence of attitudes on their motives to provide a device. These insights offer important avenues for public health messaging and resources to better involve and support parents in decision-making relating to mobile screens in everyday lives of young children.

The current study provides the first systematic review and meta-analysis of the associations of smartphone and tablet use with psychosocial, cognitive, and sleep-related factors in early childhood development. The meta-analysis aimed to provide an overall assessment of the evidence while the systematic review offered a rich overview of the methodological approaches adopted to assess these associations. Studies were included in the review if they examined the association of smartphone or tablet use with a measure of psychosocial development, cognitive development, or sleep in toddlers or preschoolers. Out of 1050 articles that were initially identified, 26 studies were included in the final sample of the systematic review, of which 19 were included in the meta-analysis. Data were screened, extracted, and synthesized according to PRISMA guidelines. A random-effects meta-analysis of correlations found a significant yet weak association of increased smartphone and tablet use with poorer overall child developmental factors. Additionally, a similar but stronger association was found between parental perceptions of problematic device use and poorer overall child factors. Meta-correlations with device use were significant for sleep, but not for psychosocial and cognitive factors. Overall, the results suggest that longitudinal cohort and experimental investigations would elucidate more causal relationships of child factors with smartphone and tablet use. Employing multiple methods of screen-use assessment, and considering the multiple levels of proximal and distal influences on child smartphone and tablet use, would also be useful. Adopting more rigorous research practices in the future, will facilitate deeper insights into the potential developmental implications of smartphone and tablet use in early childhood.