Screen Time and Language Development in Toddlers Assessed With the Bayley-4

NCT07731386 | Completed

• 1 other identifier: Etik C.D.No:561(Kayseri CH)
• Study Type: observational
• Target: 153
• Locations: 1 country
• Sites: 1

Brief Summary

This cross-sectional study investigated whether caregiver-reported daily screen time is associated with language development in toddlers aged 12 to 42 months, measured with the Bayley-4. Receptive language was the primary outcome; expressive language, cognitive, and motor scaled scores were secondary. The study was conducted at the pediatric outpatient clinics of a tertiary care city hospital in Türkiye.

Conditions

Language Development; Screen Time; Child Development

Keywords

screen time; language development; Bayley-4; toddler; receptive language; expressive language; cross-sectional study; early childhood; parental attitude

Outcome Measures

Primary Outcomes (1)

• Bayley-4 Receptive Communication Scaled Score

  Receptive Communication subscale scaled score of the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4), administered once per participant by a certified examiner. Scaled scores are reported on the Bayley-4 normative metric (population mean 10, standard deviation 3). Higher scores indicate stronger receptive language performance.

  At enrollment (single cross-sectional assessment)

Secondary Outcomes (2)

• Bayley-4 Expressive Communication Scaled Score

  At enrollment (single cross-sectional assessment)

• Bayley-4 Cognitive, Fine Motor, and Gross Motor Scaled Scores

  At enrollment (single cross-sectional assessment)

Study Arms (4)

Group 1 "0-30 min/day screen exposure"

0-30 minutes/day of screen exposure (n=41) - lowest exposure category; single Bayley-4 assessment.

Other: Daily Screen Media Exposure; Diagnostic Test: Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4)

Group 2 "30-60 min/day screen exposure"

30-60 minutes/day of screen exposure (n=42) - single Bayley-4 assessment.

Other: Daily Screen Media Exposure; Diagnostic Test: Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4)

Group 3 "60-120 min/day screen exposure"

60-120 minutes/day of screen exposure (n=42) - single Bayley-4 assessment.

Other: Daily Screen Media Exposure; Diagnostic Test: Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4)

Group 4 ">120 min/day screen exposure"

More than 120 minutes/day of screen exposure (n=26) - highest exposure category; single Bayley-4 assessment.

Other: Daily Screen Media Exposure; Diagnostic Test: Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4)

Interventions

Daily Screen Media Exposure OTHER

Caregiver-reported total daily screen media exposure recorded on a four-level ordinal scale (0-30, 30-60, 60-120, and more than 120 minutes per day) using a structured questionnaire administered at the study visit. No exposure was assigned, allocated, or manipulated by the investigators. Applies to Cohorts 1-4.

Group 1 "0-30 min/day screen exposure"; Group 2 "30-60 min/day screen exposure"; Group 3 "60-120 min/day screen exposure"; Group 4 ">120 min/day screen exposure"

Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4) DIAGNOSTIC_TEST

A single standardized developmental assessment administered to each participant by one certified child development specialist in a dedicated, distraction-free examination room with the caregiver present, per Bayley-4 protocol. Mean administration time was 60-90 minutes. Receptive Communication, Expressive Communication, Cognitive, Fine Motor, and Gross Motor scaled scores were recorded. Applies to Cohorts 1-4.

Group 1 "0-30 min/day screen exposure"; Group 2 "30-60 min/day screen exposure"; Group 3 "60-120 min/day screen exposure"; Group 4 ">120 min/day screen exposure"

Eligibility Criteria

• Age: 12 Months - 42 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

Community-based sample of children aged 12 to 42 months who presented consecutively to the pediatric outpatient clinics of a tertiary care city hospital in Türkiye between August 2025 and January 2026, each accompanied by a primary caregiver. Children were enrolled irrespective of the reason for the outpatient visit provided they met the eligibility criteria. The upper age limit of 42 months reflects the normative ceiling of the Bayley-4. Of 153 screened records, 2 were excluded for missing covariate data, yielding an analytical sample of 151.

You may qualify if:

• Age 12 to 42 months at the time of assessment
• Accompanied by a primary caregiver able to provide written informed consent
• Caregiver able to complete the screen-time and background questionnaire
• Turkish-speaking household
• Complete Bayley-4 developmental assessment record

You may not qualify if:

• Confirmed diagnosis of a neurodevelopmental disorder
• Confirmed genetic disorder
• Confirmed metabolic disorder
• Confirmed chronic disease
• Non-Turkish-speaking household
• Incomplete assessment record or missing covariate data

Sponsors & Collaborators

• Kayseri City Hospital: lead

Study Sites (1)

Kayseri City Hospital, Pediatric Outpatient Clinics

Kayseri, 38080, Turkey (Türkiye)

Location

Related Publications (7)

• Bayley N, Aylward GP. Bayley Scales of Infant and Toddler Development, Fourth Edition: Technical Manual. Bloomington, MN: NCS Pearson; 2019.

  RESULT

• Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 Years of Age. Geneva: World Health Organization; 2019. Available from http://www.ncbi.nlm.nih.gov/books/NBK541170/

  PMID: 31091057 RESULT

• Gastaud LM, Trettim JP, Scholl CC, Rubin BB, Coelho FT, Krause GB, Ferreira NM, de Matos MB, Pinheiro RT, de Avila Quevedo L. Screen time: Implications for early childhood cognitive development. Early Hum Dev. 2023 Aug;183:105792. doi: 10.1016/j.earlhumdev.2023.105792. Epub 2023 May 26.

  PMID: 37352820 RESULT

• McArthur BA, Browne D, McDonald S, Tough S, Madigan S. Longitudinal Associations Between Screen Use and Reading in Preschool-Aged Children. Pediatrics. 2021 Jun;147(6):e2020011429. doi: 10.1542/peds.2020-011429. Epub 2021 May 24.

  PMID: 34031229 RESULT

• Torras-Mana M, Guillamon-Valenzuela M, Ramirez-Mallafre A, Brun-Gasca C, Fornieles-Deu A. Usefulness of the Bayley scales of infant and toddler development,third edition, in the early diagnosis of language disorder. Psicothema. 2014;26(3):349-56. doi: 10.7334/psicothema2014.29.

  PMID: 25069554 RESULT

• Brushe ME, Haag DG, Melhuish EC, Reilly S, Gregory T. Screen Time and Parent-Child Talk When Children Are Aged 12 to 36 Months. JAMA Pediatr. 2024 Apr 1;178(4):369-375. doi: 10.1001/jamapediatrics.2023.6790.

  PMID: 38436942 RESULT

• Madigan S, McArthur BA, Anhorn C, Eirich R, Christakis DA. Associations Between Screen Use and Child Language Skills: A Systematic Review and Meta-analysis. JAMA Pediatr. 2020 Jul 1;174(7):665-675. doi: 10.1001/jamapediatrics.2020.0327.

  PMID: 32202633 RESULT

Study Officials

• Agah B ÖZTÜRK, MD

  Kayseri City Hospital, Kayseri, Türkiye

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Department of Pediatrics

Study Record Dates

• First Submitted: July 22, 2026
• First Posted: July 28, 2026
• Study Start: August 5, 2025
• Primary Completion: May 1, 2026
• Study Completion: May 1, 2026
• Last Updated: July 28, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
• Time Frame: Beginning after publication of the main results and continuing for 5 years thereafter
• Access Criteria: Reasonable request to the corresponding author, subject to approval by the local ethics committee for secondary use

Locations

TU (1)