Beyond screen time: co-viewing and parental verbal engagement in toddler language delay

Background

Early screen exposure has been linked to language developmental delay in early childhood, yet it remains unclear whether these associations vary across screen types and parenting context.

Methods

Data were drawn from the Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan since 2016, a prospective cohort study in Taipei (N = 900), with repeated assessments at 12, 24, and 36 months. Maternal-reported TV and smart-device use were dichotomized at the wave-specific 75th percentile, while total screen time was defined as > 60 min/day. Parental co-viewing and verbal engagement (content-related interaction during screen use) were categorized as both parents, mother only, father only, or neither. Suspected language delay at ages 1–3 years was examined using generalized estimating equations, adjusting for sociodemographic and family covariates.

Results

Higher screen use was associated with increased odds of suspected language delay, including TV (AOR = 1.42, 95% CI: 1.09–1.84), smart-device use (AOR = 1.41, 95% CI: 1.09–1.82), and total screen time >60 min/day (AOR = 1.35, 95% CI: 1.04–1.75). The association varied by parenting context: in the father-only co-viewing group, higher TV use remained associated with increased odds of delay (AOR = 2.21, 95% CI: 1.07–4.56), whereas absence of parental verbal engagement during smart-device use was associated with the highest odds (AOR = 2.86, 95% CI: 1.29–6.36). For total screen time, increased odds were observed when neither parent co-viewed. Null findings for suspected language delay in toddlers were observed among those exposed to both parental co-viewing or verbal engagement.

Conclusions

Overall, the developmental impact of screen use appears to depend more on parenting context than on exposure alone. Verbal engagement may be a key pathway linking early screen use to language development, supporting guidance that prioritizes parental co-engagement over screen time limits alone.

Key messages

• Early screen exposure was associated with increased odds of language delay, but this relationship varied by parenting context, with higher risks observed in the absence of parental co-engagement.

• Parental verbal engagement during screen use may mitigate developmental risks, supporting guidance that emphasizes active co-engagement rather than screen time limits alone.