This chapter reviews the existing evidence on the relationship between children's online engagement, activities, and their well-being and development. It explores key domains such as physical health, cognitive development and learning, as well as emotional well-being and mental health. The review highlights how the impact varies depending on the type of online activity and engagement, as well as the personal and environmental factors that either make children more vulnerable or protect them from possible adverse effects of digital activities on their well-being.
How's Life for Children in the Digital Age?
Abstract
Digital devices and the Internet provide access to a wide range of content, platforms, and applications, offering many opportunities for children to learn, play, stay connected with friends, and make new friends, as well as to find information that matters to them. They also offer a space for freedom that responds to adolescents’ desire to be trusted and gain some independence. On the flip side, the growing amount of time children, including very young ones, spend on digital devices raises concerns that excessive or premature exposure to screens and digital resources can negatively affect their health, learning ability, concentration, and psychological well-being. Children who spend too much time online may engage less in physical activity and real-world social interactions, which could lead to worse physical and mental health outcomes1 (OECD, 2021[1]; 2024[2]; 2018[3]; Burns and Gottschalk, 2019[4]). Moreover, the Internet and the online world are not inherently safe spaces and expose children to various risks related to the content they encounter and the behaviours they witness. The anonymity that often exists online can also encourage them to engage in risky or inappropriate behaviours toward others.
Globally, the scientific literature indicates that there is no single, linear relationship between the use of digital resources, screen time,2 and well-being outcomes for children and adolescents. These relationships vary depending on the child’s age and the specific outcome domain considered (e.g., physical health, cognitive development, learning outcomes, socio-emotional outcomes, psychological well-being, and mental health). Additionally, the relationship can change based on the amount of time spent on devices and the type of digital activity engaged in. For instance, evidence suggests an inverted U-shaped relationship between children’s social media use and their socio-emotional well-being, where both low and high levels of usage are associated with lower well-being, while moderate use is linked to higher well-being (Boer et al., 2020[5]; Boer et al., 2021[6]; Boniel-Nissim et al., 2022[7]; Orben et al., 2022[8]; Przybylski and Weinstein, 2017[9]; Ferguson, 2017[10]).
A major debate centres on whether children’s exposure to digital technologies has been driving a substantial shift in child socio-emotional development, and is behind a surge in mental health disorders and decrease in mental well-being observed among adolescents and youth in many countries3 (McGorry et al., 2024[11]; Cosma, 2023[12]). For instance, Haidt (2024[13]) attributes the rise in anxiety and mental health problems among younger generations to a combination of social, cultural, and technological changes. It is suggested that constant exposure to curated, idealised versions of others’ lives and the addictive nature of these platforms contribute to a heightened sense of inadequacy and fear among young people. A central argument is that social media platforms and smartphones have exacerbated feelings of anxiety and depression. However, the available evidence does not clearly support the claim that access to digital technologies is the primary driver of mental health trends (Odgers, 2024[14]; Lebedíková et al., 2024[15]; Ferguson, 2024[16]). There is no direct, strong, and unequivocal link between digital tool usage and its effects on developmental outcomes and adolescent well-being. Most findings that do suggest a link are based on correlational data that may not reflect causal relationships and, at best, show only moderate effects. These results cannot be generalised to the entire population, as they indicate that while some experiences are negative, others are positive or neutral for the majority of adolescents (Valkenburg, Beyens and Keijsers, 2024[17]). Moreover, the potential benefits of digital tools are less studied compared to the focus on their harms (Valkenburg et al., 2021[18]).
Debate also exists about the scale and significance of the identified associations, which are often small and comparable to other personal or family circumstances (Ferguson and Heene, 2021[19]; Orben and Przybylski, 2019[20]). For instance, in a notable study, Orben and Przybylski (2019[20]) estimate that the association between adolescent use of digital technology with their well-being is negative but small, explaining at the most 0.4% variation in well-being. In sum, the overall impact of digital technology is no higher than factors that are understood as having a neutral effect on well-being. The paper highlights that most studies in the field report correlational associations between digital technology use and well-being outcomes and not causal impacts.
Recent years have seen the body of evidence assessing the relationships between children’s digital practices and their well-being outcomes grow substantially. The many systematic reviews4 and meta-analyses available in this area provide a crucial information base, offering a critical synthesis of the available evidence.
This section reviews the available evidence on the relationship between the use of digital devices and children's physical health, cognitive development and learning outcomes, and social and emotional well-being. The data available for OECD countries are used to illustrate, when possible, differences in children’s experience with digital devices across and within countries depending on their socio-economic characteristics. While increasingly solid, the evidence base remains preliminary and only limited to relatively well-established digital technologies. Very little is understood about the impacts of new technologies, such as AI and Virtual Reality (Box 4.1).
Artificial intelligence (AI) is rapidly changing the way children and adolescents play, communicate, and learn. While it has potential to help solve complex problems, AI presents both significant opportunities and notable risks concerning child well-being (UNICEF, 2023[21]; 2020[22]; Munzer, 2024[23]; Tiches, 2023[24]).
On the opportunity side, AI can be interactive and fun for children, offering new ways to enjoy and explore their world. For some, this may be a life-enriching experience that opens new doors, enhances school performance, and helps prepare them for the challenges of adult life, by contributing to:
Educational enhancement: AI can provide personalised learning experiences, adapted to each child’s learning pace and style, thereby improving educational outcomes.
Creative engagement: Tools powered by AI can foster creativity by helping children generate stories, artwork, music, and even software with minimal coding skills.
Health and accessibility: AI can aid the early detection of health and developmental issues and offer enhanced accessibility features for children with disabilities, enabling better interaction with digital systems (UNICEF, 2023[21]; Munzer, 2024[23]).
Develop parasocial relationships, which are one-way emotional attachments that viewers or users form with media characters. A study involving a semi-intelligent robot prototype of Dora the Explorer found that children’s learning was influenced by their parasocial relationships and interactions with the character. Children’s interactions with an intelligent character prototype led to more contingent feedback on their math responses and scaffolding to enhance performance when mistakes were made – exceeding the support typically available in passive media experiences. As a result, children who had a strong parasocial bond with Dora showed faster response times in a math game, and they transferred what they had learned better when the Dora character had been present in the game. The beneficial impact of parasocial interactions on speed of response may be due in part to reduced processing demands as well as enhanced motivation when children feel emotionally close to a character (Calvert et al., 2020[25]; Tiches, 2023[24]).
For all the promise they hold, AI platforms can exacerbate the risks experienced online, including:
Exposure to mis- and disinformation: AI-generated content can include persuasive mis- and disinformation, making it difficult for children to discern truth from falsehood, thereby affecting their understanding and critical thinking.
Privacy and safety concerns: The data collected by AI systems can be misused, potentially compromising children’s privacy. Moreover, AI can be used to generate deepfake images or voices, posing risks of exploitation and cyberbullying.
Mental and emotional impact: Interaction with AI can influence children’s cognitive and social development. AI's unpredictable behaviours can create confusion, impacting how children perceive and interact with technology. However, as children grow older, they seem to become less likely to seek out devices when they feel lonely and are less prone to attribute human-like qualities to AI-enabled characters and devices (Tiches, 2023[24]). Around the age of seven, children begin to better distinguish between reality and fantasy, leading to a shift in their perception of AI. Yet, there is no definitive age at which all children clearly understand the limitations of AI characters, as this understanding can vary widely among individuals.
AI-driven social media platforms and their recommendation algorithms can exacerbate negative self-perception in adolescents. Features like AI-enhanced filters and curated content often promote unrealistic body standards, which can contribute to body dysmorphia, anxiety, and unhealthy coping mechanisms, such as social withdrawal (Siriudomsait, 2023[26]).
Data driven systems and advanced technologies may also reinforce structural biases, favouring individuals from more privileged backgrounds (Selwyn and Jandrić, 2020[27]; OECD, 2021[1]). If the data used to train digital systems do not reflect the diverse backgrounds and characteristics of children in increasingly multicultural societies, built-in biases may further marginalise already disadvantaged children. Furthermore, limited understanding of algorithms can exclude individuals with low algorithmic awareness from various opportunities, thereby exacerbating existing social inequalities (Shin, Rasul and Fotiadis, 2022[28]).
The immersive and multisensory nature of Virtual Reality (VR) offers both significant potential and notable concerns, particularly for children due to their developmental plasticity (Kaufman et al., 2025[29]; Gray, Carter and Egliston, 2024[30]). VR can support positive experiences, such as enhanced learning and pain management during medical procedures,1 and is increasingly used in child psychiatry for assessment and treatment.2 However, risks include physiological harms like motion sickness, eye strain, and postural instability, especially for children under 13, due to hardware designed for adults (Yamada-Rice et al., 2017[31]).
VR may also amplify negative experiences, such as cyberbullying and harassment,3 isolation, and mental health concerns, while fast-paced content can deplete cognitive functions and hinder executive skill development (Kaufman et al., 2025[29]). The immersive nature of VR intersects with children’s cognitive development, affecting their ability to distinguish virtual experiences from reality4 (Gray, Carter and Egliston, 2024[30]; OECD, 2024[32]). While this skill improves with age, younger children tend to face greater challenges in making this distinction. Children’s developing impulse control increases susceptibility to excessive use (Gray, Carter and Egliston, 2024[30]). To mitigate risks, adult supervision, time limits, and regular breaks are essential.
1. Research on VR as a distraction tool with children 4 years and older has revealed effectiveness in a range of procedures, such as venipuncture, chemotherapy, burn wound care, dental treatments, and immunizations. By creating engaging and immersive virtual environments, VR diverts the child’s focus from the pain and anxiety associated with these procedures, reducing the need for sedatives and analgesics (Kaufman et al., 2025[29]).
2. For instance, neuropsychological VR testing is a valuable method for simulating real-life environments for assessment purposes. It offers a valid and reliable approach for evaluating neuropsychological conditions like ADHD and Acquired Brain Injury. Additionally, it serves as an effective tool for assessing attention performance more broadly, even when not linked to a specific neuropsychological diagnosis (Araiza-Alba et al., 2020[33]).
3. Virtual Reality can amplify cyberbullying and harassment due to its immersive and interactive nature, making negative interactions feel more personal and emotionally impactful. The anonymity of avatars emboldens perpetrators, while the simulated physical presence in VR intensifies violations like unwanted touching or invading personal space. Real-time voice and gesture tracking can escalate harassment, and the spontaneous, private nature of VR spaces complicates moderation. Social pressures, exclusion, and the betrayal of trust in perceived "safe spaces" further exacerbate harm, particularly for younger users who may lack the tools to cope. Limited protective features and prolonged exposure during immersive sessions add to the challenge, necessitating better safeguards in VR platforms.
4. As reported by Gray, Carter and Egliston (2024[30]), claims that children struggle to distinguish VR from reality are often associated with a 2009 false-memory study, which found that children aged 4-5 might confuse VR with mental imagery (such as imagining something), affecting their memory formation (Bailey and Bailenson, 2017[34]). However, this confusion seems to decrease with age, as it was not observed in children aged 6-7. The ability to distinguish all types of media from reality is a learned skill that develops as children’s cognitive skills advance and transform throughout various phases of childhood.
The development of digital resources, accessible via the Internet, platforms, and applications by children or their parents, presents both opportunities and risks for children's physical health (Table 4.1). Like adults, children can benefit from digital tools that offer numerous opportunities to support their healthy physical development. Digital tools make it easier, for example, for children and parents to access information on practices that promote the physical development of young children, including their nutritional needs, as well as height and weight standards, which serve as indicators of good child development. They also aid in disseminating information about available assistance near families' residences and facilitate access to health services. With regard to healthcare provision, the advancement of technology and the increasing digitisation of healthcare systems have opened new opportunities to transform the delivery of child health services (Siderius et al., 2023[35]; Ponti et al., 2017[36]). For instance, digitalised health care provision creates opportunities to ensure seamless data exchange and communication among healthcare entities, providers, institutions, households, and systems. For the former, it is necessary to strengthen the use of standardised data formats, coding systems, and to overcome the barriers stemming from using different data recording, quality check, and information sharing systems. Digital technologies, such as smartphones, mobile apps, websites, and text messaging, also hold the potential for innovative methods to enhance knowledge, deliver persuasive messages, modify behaviours, and support medical assistance and treatment delivery (Zeng, Ye and Mena, 2023[37]). A key challenge in developing these technological capabilities is ensuring data privacy, ensuring no unintended discrimination of children arising from the use of data, and establishing robust cybersecurity to protect against data breaches (OECD, 2024[38]).
At the same time, the use of digital tools poses a risk factor for children's health, particularly for school-age children and for teenagers when screen time intensifies. In particular, screen time before going to bed is likely to affect both the duration and quality of children's sleep (Box 4.2), and therefore can ultimately impact emotional regulation and quality of learning at school (Suni and Vyas, 2023[39]). As a result, managing screen time, particularly before bedtime, is crucial for fostering healthier sleep habits in children. Reducing screen exposure, especially in the evening, and promoting screen-free time before bed can significantly enhance both the quality and duration of sleep.
Excessive screen time is also a risk factor for other health outcomes, including greater obesity/ adiposity (i.e., body fat) and higher depressive symptoms, and lower healthy diet quality (Stiglic and Viner, 2019[40]; Zhang et al., 2022[41]; Li et al., 2020[42]). Also, the increasing presence of screens in children's lives is suspected to promote a sedentary lifestyle, reducing activity levels. The displacement hypothesis suggests that digital screen media use (DSMU) negatively impacts children’s health and development by reducing time for beneficial activities like sleep, physical activity, and in-person socialising (Tremblay et al., 2025[43]). For instance, according to data from the Health Behaviour of School-aged Children 2021-22 survey, approximately 16% of 11-years-old and 20% of 15 years-old adolescents using social media across the OECD reported that they regularly neglected other activities (e.g. hobbies, sport) because they wanted to use social media.However, evidence is mixed regarding DSMU displacing physical activity. A meta-analysis found small negative associations between physical activity and total screen time, Internet use, and television viewing, while computer use and video games showed no significant associations (Pearson et al., 2014[44]). In children aged 2-3 years, increased screen time was found to be linked to greater sedentary behaviour, reduced physical activity (Chen et al., 2020[45]), and less time spent playing with peers later in childhood (Putnick et al., 2022[46]). A recent clustered randomized controlled trial showed substantial increases in physical activity among children whose families reduced recreational screen media use (Pedersen et al., 2022[47]). However, a longitudinal study of 755 adolescents over three years found no overall evidence for the displacement hypothesis (Lizandra et al., 2019[48]). Gender differences emerged, with boys showing partial displacement linked to video game use and girls spending more time on smartphones. According to the authors, the portability of smartphones may allow simultaneous physical activity compared to more stationary screen types like computers and televisions, highlighting the importance of considering the type of screen use in displacement studies (Tremblay et al., 2025[43]).
Higher durations/frequency of screen time and television viewing are associated with unfavourable body composition such as adiposity and overweight (Biddle, García Bengoechea and Wiesner, 2017[49]; Carson et al., 2016[50]). A vicious circle is also created, as poorer sleep in young people leads to increased tiredness, which in turn makes them more likely to prefer passive activities, such as watching television the next day.
In a meta-analysis of studies exploring the association between screen time and childhood obesity and overweight, Fang et al. (2019[51]) estimated that spending two hours or more per day on screens is associated with a 67% increase in the risk of overweight/obesity. The analysis suggests that television watching and computer use may be the primary drivers of this relationship. However, due to the cross-sectional design of the included studies, it is impossible to establish clear causality and determine whether higher screen time is a cause or a consequence of the individual or social experiences of overweight or obese children. Nevertheless, the relationship between screen time and obesity appears to be influenced by poor eating habits (Staiano et al., 2025[52]). A study analysing total media use – including television, computers, and video games – in 659 288 adolescents found that those who used screen media for six or more hours per day, compared to less than two hours per day, had higher odds of nighttime eating, inadequate sleep, poor dietary intake, and an increased risk of obesity (Stiglic and Viner, 2019[40]). Yet, one of the direct influences that screen time can have on children’s risk of overweight and obesity relates to the messages emanating from screens, such as advertisements for unhealthy foods, which can impact children’s eating behaviours and nutrition quality (Cabanas-Sánchez et al., 2019[53]; Harris et al., 2025[54]).5
Screen time also appears to encourage the development of musculoskeletal disorders in children, with an increased prevalence of neck and shoulder discomforts, wrist and hand pain, and lower back pain (Zhang et al., 2022[41]). Another concern of screen time is the risk of encouraging the development of vision problems in childhood, including myopia. The evidence on whether or not this risk is proven is, however, mixed, although it does seem to suggest that smart device exposure might be associated with an increased risk of myopia (Lanca and Saw, 2020[55]; Foreman et al., 2021[56]). Further research using observational data on screen time (as opposed to self-reported data) is deemed necessary by the authors of these systematic reviews to improve the quality of results and strengthen the conclusions in this area.
Research indicates that children with high levels of screen exposure during early childhood – i.e. among children less than 6 years of age, especially those with screens (television, computer, mobile phone) in their bedrooms, face increased risk of sleep disorders (Cespedes et al., 2014[57]; Nathanson, 2024[58]; Hale et al., 2025[59]). The primary mechanism involved is that exposure to screens before bedtime delays sleep onset by reducing melatonin production due to the blue light emitted by screens. Prolonged screen use can disrupt natural sleep-wake cycles, replace sleep time, and cause psychological stimulation. Evening screen time increases the risk of fewer sleep hours due to delayed bedtimes and difficulty falling asleep. Additionally, screen use in bedrooms can lead to fragmented sleep from notifications and device checking, potentially causing fatigue and false diagnoses of hyperactivity (American Academy of Pediatrics, 2016[60]).
Several systematic reviews and meta-analyses of scientific evidence confirm the association between excessive screen use by children and the quality of their sleep, including shortened sleep duration, falling asleep and waking up later than desired (Li et al., 2020[42]; Janssen et al., 2020[61]; Stiglic and Viner, 2019[40]; Zhang et al., 2022[41]; Hale and Guan, 2015[62]; de Sá et al., 2023[63]; Moorman, Morgan and Adams, 2019[64]; Lund et al., 2021[65]; Veldman et al., 2023[66]; Kokka et al., 2021[67]). This negative association is found across various types of screen time (television, computers, smartphones, video gaming) and is most evident in primary school-age children and adolescents, though it also affects infants, toddlers, and preschoolers (Li et al., 2020[42]; Janssen et al., 2020[61]; Moorman, Morgan and Adams, 2019[64]; Veldman et al., 2023[66]). Infants exposed to screen media in the evening have shorter nighttime sleep and more sleep fragmentation. Daytime nap duration is inversely associated with screen use, indicating delays in sleep consolidation.
Lund et al. (2021[65]) discuss how the strength of evidence regarding the impact of electronic media use on sleep varies with children's age. Across all ages, there is consistent evidence linking media use to shorter sleep duration. For preschoolers, television and tablet use are associated with difficulties falling asleep and shorter sleep duration, while heavier television use is linked to increased daytime napping. Among 6-12-year-olds, electronic media use, especially at bedtime and in the bedroom, leads to later bedtimes and shorter sleep duration. For 13-15-year-olds, total screen time, computer and mobile phone use are associated with less sleep and problems falling asleep, while social media is linked to poor sleep quality. More interactive forms of electronic media may have a greater impact on sleep than passive screen time, particularly for older children.
Exposure to screens in the evening, particularly at bedtime, consistently delays sleep and affects other sleep outcomes. While it's challenging to establish a precise threshold of screen time below which there is no effect on sleep, the impact is stronger with excessive screen time, typically defined as 2 hours or more per day. For example, Hale and Guan (2015[62]) suggest that for each additional hour of television screen time, there is an estimated 5-10 minute delay in bedtime. Li et al.’s meta-analysis indicates that children exposed to screens are 5% more likely to have shorter sleep periods compared to non-users, with those exceeding 1 hour of screen time being 42% more likely to have shorter sleep times. Moreover, children with more than 2 hours of screen time are over twice as likely to have shorter sleep times compared to those with less screen time.
These findings should be approached cautiously because the studies lack sufficient quality to definitely establish a causal link between screen time and sleep outcomes, owing to several potential factors. These factors include reverse causality, where individuals with less need for sleep might increase screen time. Factors like low physical activity or being overweight, or having a difficult temperament, could also contribute to both increased screen time and reduced sleep duration (Belmon et al., 2019[68]). Uncertainties in measuring screen use and sleep quality further complicate the issue, potentially limiting the reliability of the findings.1
1. Both self-reported and parent-reported data may be subject to uncertainty. For example, adolescents tend to over-report their sleep duration compared with objective measurements such as actigraphy or diary methods, and parents tend to report better sleep for adolescents compared with both self-reported and objective measurements.
The growing use of digital technologies at all stages of childhood brings with it opportunities and risks for children's cognitive development and learning (Table 4.2). This concerns the learning that occurs in early childhood, particularly regarding language development and cognitive functions. It also addresses the use of digital technologies for educational purposes and their role in fostering non-academic skills that certain digital activities can help develop.
Digital technologies and early language and cognitive development
For younger children, e-books and digital applications can add a playful and interactive dimension to learning and can be used by parents to support early language development and emergent literacy skills (Liu et al., 2024[69]). Numerous studies suggest that e-books can help in developing print knowledge during the early years (i.e., understanding the distinction between print and pictures, the distinction between letters and numbers, as well as the conventions of print, such as knowing that words are separated by spaces and that writing follows a linear arrangement), while the use of tablets and digital spelling games can be effective to help develop alphabet knowledge and phonological awareness.
Research on digital media use initially focused on duration, particularly television, and its potential negative effects on cognitive and language development through the “displacement hypothesis”, where media use replaces beneficial activities like family interaction, homework, creative play, and reading (Dore et al., 2025[70]; Kirkorian et al., 2025[71]), (Box 4.6). Studies reveal a small-to-medium negative association between media duration and early language skills. Recently, attention has shifted to content (type of media), context (who media is used with), and interactivity (e.g., videos vs. interactive apps), as well as “technoference” (adult technology use around children). Educational content and co-viewing with adults are linked to better language skills, and interactive media may also support language development, though further research is needed (Dore et al., 2025[70]).
When it comes to infants, toddlers, and preschoolers, the focal point of the debate revolves around the perceived risks of screen use on neurocognitive development, primarily because the high level of brain plasticity and vulnerability during the early years of life (Box 4.3). The available evidence suggests that excessive and passive screen exposure can alter children’s neurocognitive development. Passive screen time, particularly television watching, as well as prolonged screen time across various media types, are consistently found to reduce a child's verbal activity and can lead to delays in language acquisition6 (Massaroni et al., 2023[72]; Madigan et al., 2020[73]). However, this effect can be mitigated by various factors, including the family environment. For instance, when the screen time is interactively used with parents and caregivers, it can contribute to children's vocabulary growth and development of their literacy skills.
In their recent review of research on digital media and early cognitive development, Kirkorian et al. (2025[71]) highlight that infants’ cognitive constraints, such as attention skills and working memory, limit their comprehension of digital media, and they tend to learn less from on-screen demonstrations compared to real-life interactions. This “transfer deficit” peaks around age 2. However, repeated on-screen demonstrations can aid learning. As children grow, they better understand the link between on-screen and real-life events, and by early adolescence, they can learn from child-directed media and display knowledge gains from carefully designed content.
Neural responses help explain why infants learn differently from video versus real-life demonstrations. Electroencephalogram studies show faster object recognition and more social learning when infants engage with objects in person (Kirkorian et al., 2025[71]). As children grow, neural connectivity varies based on media formats, such as stories with audio and visuals, and potentially between interactive media like games and videos. Current research suggests that young brains process information differently depending on the media type, with potential implications for how they learn.
However, the effects of media use on young children depend on factors such as content, design features, and context (Kirkorian et al., 2025[71]). Educational media are found to generally have positive or neutral effects on cognitive skills, while non-educational or adult-directed content may have negative impacts. Features like “hot spots”1 in touchscreen applications and digital books can support learning if they align with the lesson, but engagement-promoting features like autoplay might be disruptive. Parenting style, media use context, and family factors also influence the outcomes of media exposure, highlighting the importance of considering the broader family and ecological context.
Several studies and systematic reviews have explored the effect of screen time2 on child neurodevelopmental and cognitive outcomes, underlining the risks that excessive and passive3 screen time can have (Hutton et al., 2024[74]; Guellai et al., 2022[75]; Cucalon-Benito, Perez-Palao and Fernandez-Valero, 2023[76]). However, the impact of screen exposure varies across different neurodevelopmental outcome domains (e.g. visual processing, language development, memory development, social cognition), with personal, familial, and other contextual factors playing both an influential and mitigating role. These factors encompass the behaviour of adult caregivers during viewing, the appropriateness of the content for the child's age, the level of interactivity of the screen, and whether the screen is in the background or actively engaged with. Depending on these factors combined, screen viewing can have positive, neutral, or negative effects on children’s cognition under age 3 (Guellai et al., 2022[75]) and executive functions in children4 under age 10 (Cucalon-Benito, Perez-Palao and Fernandez-Valero, 2023[76]).
Digital use begins to influence early childhood during a period of rapid brain development and heightened neural plasticity (Hutton et al., 2024[74]). Several socio-demographic characteristics, including a child’s age, sex, socio-economic status, and temperament, also influence the brain’s susceptibility to digital media. Higher screen use in very young children is mostly found to be associated with delayed language development,5 working memory internalising and externalising behaviours6 (Hutton et al., 2024[74]; Guellai et al., 2022[75]; Cucalon-Benito, Perez-Palao and Fernandez-Valero, 2023[76]; Eirich et al., 2022[77]). Excessive screen time in the first year of life may also cause delays in children’s fine motor and communication and problem-solving skills (Takahashi et al., 2023[78]). Problematic media use, such as excessive preoccupation, sneaking media, or distress when media are removed, can develop in children as young as four, and be linked to negative cognitive outcomes, including hyperactivity and inattention (Kirkorian et al., 2025[71]).
Research indicates that the association between screen use and children’s cognition may be weak only. For instance, a study using data from the French longitudinal cohort study of 13 763 children aged 2-5.5-years-old found generally negative associations with cognitive development that were small in magnitude. The study controlled for socio-demographic factors, birth outcomes, and lifestyle confounders (Yang et al., 2023[79]). Significantly, when adjusted for child cognitive scores at age 3.5, the negative association of screen use at age 3.5 in the child development index score at age 5.5 disappeared. This may suggest that the true causal effect of screen use on cognitive development is likely to be small. Together, with inconsistent effects across cognitive measures, the small size of the effects is unlikely to have major implications for children's cognitive development at the individual level. The authors suggest some degree of vigilance is justified, nonetheless.
The same study suggests that all types of screen activities do not have the same impact on child cognitive outcomes, and that, for instance, the effect of watching TV during meals on cognitive scores at age two was more than 10 times higher than the effect of a 1-hour increase in screen time daily. The main explanation for this finding is that having TV on in the background interferes with the quality and quantity of parent-child interactions that are crucial for language acquisition in early childhood.
The viewing context matters a lot. Screen viewing is associated with lower cognitive development when unsupervised, when the content is not age-appropriate, or when the screen is in the background and with limited parent-child interactions (Guellai et al., 2022[75]). For example, a recently published Australian prospective cohort study found that at 12 and 36 months of age increases in screen time were associated with decreases in parent-child talk (adult words, child vocalisations, and conversational turns) across all variables and ages (Brushe et al., 2024[80]).
Joint media engagement, where adults co-use media with children, may support language development by providing opportunities for conversation, offsetting potential negative effects of digital media (Dore et al., 2025[70]). Laboratory studies show that children learn more from media when adults engage in conversations around the content. However, research indicates that parents often do not engage in language-rich conversations during media use, with language quality typically decreasing in favour of functional remarks about the media format. Reduced adult-child conversations may explain the negative link between television and preschoolers’ language growth, highlighting adult language input as a critical factor for interventions. High-quality engagement, such as asking questions to enhance understanding, better supports language development. Well-designed media, like interactive e-books with prompts for parent-child interaction, can promote richer language exchanges. Media may also inspire discussions on related topics after use, further fostering language skills. However, technoference, including background television and adults’ use of mobile devices during interactions with children, can disrupt parent-child interactions and negatively impact language development (Dore et al., 2025[70]). Parents frequently become distracted by digital devices, leading to reduced sensitivity and fewer verbal interactions. For instance, an experimental study showed that children failed to learn new words when a teaching moment was interrupted by a short phone call (Reed, Hirsh-Pasek and Golinkoff, 2017[81]). Technoference may hinder language development by disrupting key mechanisms like parental responsiveness, gaze-following, and joint attention (Dore et al., 2025[70]).
Outdoor play is also a factor that can mitigate the association between increased screen time and suboptimal neurodevelopment. One study supporting this idea comes from a longitudinal study conducted in Japan. It found that higher screen time at age two was associated with a decrease in daily living skills at age four. Frequency of outdoor play mediated 18% of this association. The study highlights the potential to mitigate the impact of screen time on communication skills through increasing the frequency of outdoor play (Sugiyama et al., 2023[82]).
Finally, an emerging line of research examines a potential association between exposure to screens and diagnoses of developmental cognitive disorders, such as Autism Spectrum Disorder (ASD). A few studies have been carried out to explore this issue, and a systematic review of 11 papers found an association between screen exposure and the risk of an ASD diagnosis (Sarfraz et al., 2023[83]). However, research on digital media effects in children with autism and/or ADHD is limited by small sample sizes, short-term studies, and a lack of demographic and longitudinal representation, often focusing on white, socioeconomically privileged populations in industrialised countries (Alper et al., 2025[84]). Studies frequently exclude children with intellectual disabilities or those who do not use spoken language, and they often rely on parental reports rather than child perspectives, providing an incomplete picture. Additionally, developmental age, rather than chronological age, may better explain technology use and content preferences for children with significant communication or intellectual challenges.
While media use rates for children with autism or ADHD are similar to or higher than those of neurotypical peers, their motivations, usage patterns, and sensory sensitivities differ, which can have varying impacts on their outcomes. For instance, autistic adolescents may prioritise use of digital media for entertainment over in-person social interaction (Alper et al., 2025[84]). Additionally, autistic children with limited social connections may use video games and social media to engage with peers with less pressure than what they experience during in-person interactions (Pavlopoulou, Usher and Pearson, 2022[85]; Alper, 2023[86]). However, individual use of digital media and mobile devices can be associated with social isolation, particularly when autistic children have limited opportunities for in-person community engagement and recreational activities (Alper, 2023[86]). Further exploration with more longitudinal and observational data is needed to better understand these findings.
1. "Hot spots" in touchscreen applications and digital books refer to interactive areas in the content that respond to user input, such as tapping or swiping. These features are designed to engage users by offering additional information or actions, like highlighting a word when clicked or triggering animations. They are generally intended to enhance learning by focusing on key aspects of the content. However, their effectiveness depends on whether they support or distract from the main educational goals of the application or book.
2. Screen time is defined as the time spent in front of a screen, whatever its nature (i.e., television, computer, cell phone, video games, or tablet.
3. Passive screen time and active screen time are distinguished based on the use of electronic devices and the level of physical and cognitive engagement involved in the interaction with the screen. In passive screen time, there is little to no physical involvement or cognitive effort, and the individual does not actively engage with the screen (e.g., watching television). In contrast, active screen time requires greater cognitive and physical resources, as the individual interacts with what is happening on the screen (e.g., playing video games).
4. Executive functions in children a set of developing cognitive skills, including inhibition, working memory, cognitive flexibility, planning and organisation, and self-monitoring, that help children manage their thoughts, emotions, and behaviours to achieve goals.
5. Hutton et al. (2024[74]) note that there is conflicting evidence regarding the impact of digital media use on child language development, though younger ages appear to be at greater risk. Research suggests that infants learn phonemes through human interaction, not screen-based instruction, with mechanisms like social "gating" of speech cues and joint attention playing critical roles. Interpersonal interactions, such as shared book reading or play, support language acquisition by fostering social engagement and scaffolding that digital devices cannot replicate. Language development aligns with the maturation of white-matter tracts, which peak in plasticity during the first three years, emphasising the importance of nurturing human-mediated language experiences in early childhood.
6. Internalising behaviours refer to emotional or psychological struggles that are directed inward. These behaviours are often characterized by anxiety, depression, withdrawal, and low self-esteem. Children exhibiting internalising behaviours might seem shy or withdrawn, and they may have difficulty expressing their feelings. On the other hand, externalising behaviours are directed outward and are typically more visible and disruptive. These behaviours can include aggression, defiance, hyperactivity, and antisocial actions. Children who externalise their emotions might engage in confrontational behaviours, have difficulties with authority, or struggle with impulse control. This can lead to challenges in school and relationships due to the disruptive nature of their actions. In a systematic review and meta-analysis of 87 studies (98 independent samples) including 159 425 children 12 years or younger, Elrich et al. (2022[77]) found that greater duration of screen time was weakly but significantly correlated with externalising (e.g., aggression, inattention) and internalising (e.g., anxiety, depression) behaviour problems. The authors conclude that the correlations between screen time and child outcomes, such as language skills and academic performance, are comparable to those found in studies of other family and child factors (e.g., socioeconomic status) and internalising or externalising problems. While the effect sizes are small, their population-level impact could be significant, especially given that a large proportion of children under 5 years exceed recommended screen time guidelines (McArthur et al., 2022[87]).
Digital devices and attention deficits
For preschool and school-age children, the impact of screen time on their ability to concentrate and be attentive is emphasised as one of the primary risks that can affect children's learning. The available evidence in this area suggests that there is a correlation between screen time and attention difficulties, although causality is not always clearly established, and the mechanisms are not well understood (Box 4.4).
Two recent systematic reviews on the impact of screen exposure on children’s attention abilities and cognitive control suggest an association between excessive screen time1 and attention difficulties of school-age children7 (Santos et al., 2022[88]), and preschoolers2 (Jourdren, Bucaille and Ropars, 2023[89]). Many studies find that high exposure to screens during early childhood is predictive of attention problems later in childhood, regardless of whether children watch TV, videos or play video games.3 However the studies reviewed frequently do not properly account for important confounders, such as child temperament, parental education and parenting stress nor do they properly address the bidirectional relationship between screen use and attentional functions (Jourdren, Bucaille and Ropars, 2023[89]). For instance, some studies report that children with social-emotional and attention difficulties are exposed to mobile technologies by their parents to calm them. Other studies demonstrate that attention problems tend to precede pathologic gaming behaviours defined as the persistent and recurrent inability to control gaming habits (Ferguson and Ceranoglu, 2014[90]), and that screen time predicts lower scores on developmental screening tests but not the reverse. More research is therefore required to answer this important question.
The underlying mechanisms linking attention skills and screen time exposure are also still not well established. On one hand, some experimental evidence suggests the existence of neurobiological foundations. For instance, Horowitz-Kraus and Hutton (2018[91]) evaluated the connectivity between the language-related area and other brain regions, in children aged 8 to 12, during reading time and screen time. Screen time is negatively correlated with functional connectivity between brain regions related to language and visual and cognitive processing and control of the brain, whereas reading is related to greater connectivity in the same regions. For younger children, Hutton et al. (2020[92]) reported evidence from magnetic resonance imaging showing harmful links between screen time and the microstructural integrity of white matter tracts. These tracts are involved in executive functions, literacy, and other cognitive processes, including attention. Other determinants besides neurobiological factors also matter for the impact of screens on children’s attention abilities and cognitive control including confounding factors (e.g. child sex, birth weight, gestational age, etc.) and also less-well-understood factors such as parental education, parental care, maternal primiparity, parenting stress, and child temperament (Jourdren, Bucaille and Ropars, 2023[89]). The context of screen use is also very important; there is significant improvement in children’s visual attention after interventions involving interaction with people and exposure to screens (Santos et al., 2022[88]).
Marciano et al. (2025[93]) centred their review on evidence related to adolescents, highlighting that adolescence is a pivotal phase of brain development marked by significant changes in brain networks driven by both biological and environmental influences. During this time, socio-emotional reward processing networks mature earlier than cognitive control regions, leading to an imbalance that makes adolescents more susceptible to social influences and rewards. Cognitive control, the ability to regulate behaviour to align with goals, develops later, with the prefrontal cortex (PFC) playing a key role in this maturation. The PFC and other brain regions involved in cognitive and emotional regulation continue to develop into the mid-20s. This delayed development of cognitive control makes adolescents more sensitive to socio-affective information, such as rewards and peer influences, which can strongly affect their decisions and behaviour. Digital media use is particularly influential during windows of developmental sensitivity, which vary by sex and age, with common susceptibility observed in late adolescence around 19 years (Marciano et al., 2025[93]).
Research on the neural correlates of digital media use in adolescents is in its early stages, but findings suggest that frequent and problematic use is linked to diminished functional and structural connectivity in brain regions responsible for cognitive control, such as the default mode network (DMN) and central executive network (CEN) (Marciano et al., 2025[93]). Simultaneously, increased activity in reward-related regions, like the striatum and ventral tegmental area (VTA), aligns with adolescents’ preference for instant rewards, akin to the gratification of receiving “likes” on social media. Studies also indicate structural changes in areas like the prefrontal cortex, anterior and posterior cingulate cortex, and insula, which may heighten susceptibility to compulsive behaviours. Large-scale studies, such as the Adolescent Brain Cognitive Development (ABCD) study, have linked screen time to greater maturation of sensory-related brain regions but also found associations with externalising symptoms like rule-breaking and aggression. These findings underline the complex relationship between digital media use and adolescent brain development.
1. The studies in these reviews defined screen time in various ways, ranging from traditional activities like watching television and playing video games to broader definitions including computer use, tablets, and smartphones. Some studies used specific formats, such as predefined story video sessions, while others assessed daily touchscreen usage and the type of activity (e.g., gaming, educational programs). Definitions also varied in scope, with some including media and technology use like texting and online activities but excluding TV or video games in certain cases.
2. Jourden et al. (2023[89])’s review included five cross-sectional studies: all reported significant, positive associations between high levels of screen exposure and attention difficulties. High levels of screen exposure were defined in various ways, including time spent watching TV, miscellaneous screen use, or regular use of mobile devices (>1 hour/day) compared to non-regular use. Ten longitudinal studies were included: six found a significant impact of earlier screen exposure on subsequent attentional function and four found no relationship. For example, Christakis et al. (2004[94]) showed that television viewing at ages one and three had a proportional impact on attention problems at age seven. Several other studies, including Cheng et al. (2010[95]), Gueron-Sela and Gordon-Hacker (2020[96]), and Verlinden et al. (2012[97]), found a positive link between screen exposure at 18 months and higher attention difficulties at various later ages. Tamana et al. showed that children exposed to more than two hours of screen time at age three had significantly higher inattention scores at age five. However, four studies found no significant association between screen time and attention problems. Eight of the studies included evaluated the direction of the relationship between screen exposure and attentional difficulties: seven suggested the relationship is bidirectional.
3. Most studies analysed by Santos et al. (2022[88]) found associations between exposure to different types of screen-based devices and attention in children. For instance, Swing et al. (2010[98]) found that watching television and playing video games similarly were correlated with attention outcomes in children from 4 to 8 years old and late in adolescence. Gueron-Sela & Gordon-Hacker (2020[96]) suggest a decrease in attention skills in young children when considering the total screen time exposure. However, a survey conducted with Japanese children (Sugawara et al., 2015[99]) found no relationship between screen time and attention problems, contrasting with other findings.
Digital resources for learning inside and outside school
Digital technologies and media offer diverse resources that enhance access to educational content, creating opportunities to positively influence both school-based and family-based learning (Barr, 2019[100]). The resources that offer these opportunities can include educational apps, e-learning platforms, or interactive learning materials. However, adolescents from more advantaged socio-economic backgrounds tend to benefit more from moderate levels of digital use and from engaging in learning-oriented digital activities than their counterparts with lower socioeconomic status (Bohnert and Gracia, 2022[101]).
PISA data show large disparities in the proportion of 15-year-olds who spend two hours or more per week using digital devices to learn something outside of school (e.g., consulting tutorials or using educational applications), depending on gender (Figure 4.1, Panel A) and socio-economic status (Panel B). More girls than boys use digital resources to learn outside of school, with an average difference of 6 percentage points. Teenagers from high socio-economic backgrounds are 16% more likely to use digital resources for learning purposes than their peers from lower backgrounds. In Japan, girls and boys make the least use of digital resources for learning during the week, and the disparities according to socio-economic status are very significant. Conversely, over 96% of girls and 92% of boys use digital resources for learning in Estonia.
Percentage of 15-year-old students who report spending over two hours per week using digital resources for learning activities outside of school
Note: *The difference between boys and girls, and students with high and low socio-economic status is statistically significant at the 5% level.
15-year-old students were asked two questions: "This school year, about how many hours a day do you usually use digital resources in the following situations? (Please think of different kinds of digital resources such as desktop computers, laptops and tablets as well as educational software and other digital learning tools.)" with respect to 1) "For learning activities before and after school" and 2) "For learning activities on weekends". For each question, they were presented with response options ranging from "None", "Up to 1 hour" to "More than 6 hours and up to 7 hours" and "More than 7 hours". The mid-points of the response categories were used to sum total use for learning outside of school per week per student, assuming 5 weekdays and 2 weekend days. Data refer to the percentage of students with values greater than 2 hours per week.
Source: OECD Secretariat calculations based on OECD (2022[102]), PISA 2022 Database, https://www.oecd.org/en/data/datasets/pisa-2022-database.html.
The use of digital tools for learning at school expanded in many countries following the COVID-19 crisis. On average in the OECD, 15-year-olds spend two hours per day on digital devices for learning at school, on top of the five hours spent in standard teaching. Whether the use of digital tools in the classroom is conducive to better learning outcomes is open to debate; digital tools can be a means of engaging in more interactive learning, yet they can be a source of distraction in the classroom that can be detrimental to learning.
PISA 2022 data suggest a positive association between academic performance and moderate use of digital technology for learning activities. On average across the OECD, 15-year-olds who dedicated up to one hour per day to digital learning activities at school scored 14 points higher in mathematics compared to those who did not, even after adjusting for the socio-economic backgrounds of both students and schools. This positive association is evident in more than half of all countries with available data (OECD, 2023[103]). The relationship between digital devices and learning outcomes turns negative when more than one hour per day is spent on digital devices for learning at school. These relationships are not straightforward to interpret, as top-performing students may be subject to stricter rules regarding digital tool usage (top-performing students are more likely to have up to one hour of digital time for learning or leisure at school) (OECD, 2024[104]). Interestingly, top-performing students are more likely to spend up to five hours on digital leisure activities before and after school, whereas those with the lowest performance in mathematics are more likely have none or only up to one hour of digital leisure time outside of school8 (OECD, 2024[104]). This suggests that substantial amount of digital time for leisure activities outside of school has become a widespread practice, even among students with good academic results. However, a more detailed analysis that distinguishes digital time by activity type would be essential, as students with stronger academic performance likely exhibit distinct digital activity profiles. A systematic review of 58 cross-sectional studies found that television viewing and video game playing – but not overall screen media use – were inversely associated with the academic performance of children and adolescents (Adelantado-Renau et al., 2019[105]).
Digital devices can be a source of distraction in the classroom, with consequences for learning outcomes. On average across OECD countries, around 30% of 15-year-olds report that, in most or every mathematics lessons, they get, distracted by other students using digital devices. Twenty-five percent of 15-year-olds get distracted by others using digital devices in most or every lesson (OECD, 2023[103]). Those students who reported being distracted by classmates using digital devices during mathematics lessons scored 15 points lower in mathematics in PISA than those who reported being rarely or never distracted, even after socio-economic factors were taken into account for both students and schools.
Children need digital skills to foster their ability to seek information online for homework and also for everyday purposes. PISA data show that 15-year-olds’ use of digital tools for searching for practical information varies substantially, both across countries and within countries based on socio-economic status (Figure 4.2). Searching for practical information during a typical week is much less frequent in Japan (around 72% of 15-year-olds do so) and most frequent in Poland (92%). Significant differences according to socio-economic status are noticeable, with an average of 81% of adolescents of low socio-economic status and 87% of adolescents of high socio-economic status looking for practical information online at least weekly (Figure 4.2, Panel A). Socio-economic status influences the use of digital devices for learning during leisure time in some countries. For instance, in Japan and Lithuania, a relatively high percentage of 15-year-old students from high socio-economic backgrounds report using digital devices for this purpose (Figure 4.2, Panel B).
15-year-old students who report engaging in digital leisure activities during a typical week, by socio-economic status
Note: *The difference between students with high and low socio-economic status is statistically significant at the 5% level.
15-year-old students were asked "During a typical weekday/weekend day, how much time do you spend doing the following leisure activities?" Panel A: "Look for practical information online (e.g. find a place, book a train ticket, buy a product)" and Panel B: "Read, listen to or view informational materials to learn how to do something (e.g. tutorial, podcast)". For both questions, students were presented with the response options "No time at all", "Less than 1 hour a day", "Between 1 and 3 hours a day", "More than 3 hours and up to 5 hours a day", "More than 5 hours and up to 7 hours a day", "More than 7 hours a day". Data refer to the percent responding to look for practical information online on a typical weekday and/or on a typical weekend day.
Source: OECD Secretariat calculations based on OECD (2022[102]), PISA 2022 Database, https://www.oecd.org/en/data/datasets/pisa-2022-database.html.
Digital technologies and the development of soft skills
In addition to school-based learning, the growing presence of digital technologies in childhood can foster the development of “soft skills”,9 including self-questioning, self-monitoring, problem solving and critical thinking. For instance, a literature review by Haddock et al. (2022[106]) reports evidence that, for adolescents, video games can support perceived control and agency, foster initiative, and provide opportunities to virtually experience different identities and situations that can promote self-exploration and goal adoption. Benefits of video games are also identified on learning outcomes such as self-efficacy, knowledge retention, learning motivation, and collaborative skills (Clark, Tanner-Smith and Killingsworth, 2016[107]). Social media use is also found to be linked to key developmental processes in adolescence, namely attachments outside the family, identity, attention, and emotional regulation, and can be a way to enhance adolescents’ self-actualization (Shankleman, Hammond and Jones, 2021[108]). Gaining digital skills is also found to have other beneficial outcomes, such as orientation to technology, coping behaviours and civic participation (Livingstone, Mascheroni and Stoilova, 2023[109]).
Research suggests a negative relationship between digital media exposure and children’s creativity and imaginative play, particularly with receptive media like television and videos (Richert et al., 2025[110]). Heavy television viewing has been linked to reduced pretend play, and greater time with digital media correlates with decreased mental imagery, even after accounting for factors like memory and vocabulary. Technological distractions, such as background television or parental use of mobile devices ("technoference"), can diminish the quality and quantity of both solitary and parent-child play. One potential mechanism is that media may disrupt the mental focus required for imagination, though this has not been directly tested. However, the content of programmes and games also matters; children inclined toward imaginative play often gravitate to educational programs that may foster creativity, raising questions about the role of media content and child temperament in shaping imagination (Richert et al., 2025[110]).
Access to the Internet, video games, art education platforms and apps, tutorials, etc. offer opportunities for creativity,10 self-expression, and artistic development. Some evidence suggests that when accompanied by appropriate scaffolding and support, the inclusion of digital technologies in early learning settings provides opportunities for children to demonstrate personal choice and freedom, to exercise their curiosity, as well as to proactively experiment practices and solution when playing, creating content or learning to code (Marsh et al., 2018[111]; Fielding and Murcia, 2022[112]). By fostering interactivity and trial-and-error play, with an attractive and fun design, digital tools help children learning to think in a solution-oriented way and find original problem-solving strategies (Ott and Pozzi, 2012[113]).
International data on children's creative online activities is scarce. The Global Kids Online Survey asked children aged 9 to 17 how often they had engaged in two creative activities: creating their own videos or music and uploading them to share, and creating a blog, story, or website online. Depending on the country, between 10% and 30% of Internet-using children reported participating in creative online activities weekly (Kardefelt Winther, Livingstone and Saeed, 2019[114]). Finally, digital skills help children to become more creative and innovative. Through digital media and technology, young people can express themselves and share their ideas with the world. Whether it's creating a video, designing a website, or programming an app, digital skills can unleash the children’s creativity and enable them to make a positive impact on their communities and the world.
According to PISA data, around seven out of ten 15-year-old students use their digital resources during leisure time to create or edit personal digital content, such as pictures, videos, music, or computer programs. However, there are substantial variations across countries (Figure 4.3). Within countries, differences based on socio-economic status are generally small (Panel A). It is also noticeable that in most countries where differences do exist, children of lower socio-economic status tend to engage in this type of activity more frequently than others – with some exceptions as for instance in Türkiye (Figure 4.3, Panel A). Consistently across countries, children from migrant families (identified here by the fact that the teenager does not speak the language of the PISA test at home) are more likely to create or edit their own content than others (Figure 4.3, Panel B). This is possibly due to the fact that digital resources offer a particularly valuable opportunity for migrant populations to express their cultural heritage,11 connect with their community (Katz, 2010[115]), as well as to maintain ties with their home countries while helping them integrate in their new countries12 (Diminescu, 2018[116]; McAuliffe, Blower and Beduschi, 2021[117]).
15-year-old students who report creating or editing their own digital content during a typical week
Note: *The difference between students with high and low socio-economic status, and between groups according to the language spoken at home is statistically significant at the 5% level.
15-year-old students were asked "During a typical weekday/weekend day, how much time do you spend doing the following leisure activities? ... Create or edit my own digital content (pictures, videos, music, computer programs)", and presented with the response options "No time at all", "Less than 1 hour a day", "Between 1 and 3 hours a day", "More than 3 hours and up to 5 hours a day", "More than 5 hours and up to 7 hours a day", "More than 7 hours a day". Data refer to the percent responding to create or edit their own digital content on a typical weekday and/or on a typical weekend day.
Source: OECD Secretariat calculations based on OECD (2022[102]), PISA 2022 Database, https://www.oecd.org/en/data/datasets/pisa-2022-database.html.
Finally, digital tools and the Internet provide children and adolescents with the opportunity to explore things beyond what is accessible in the physical world and to be exposed to diverse perspectives and views which may not be present among their circle of friends and peers. A 2018 Pew Research Center survey of U.S. teens aged 13 to 17 found that about two-thirds of teenagers believe that these platforms facilitate interactions with individuals from various backgrounds, enable exploration of differing viewpoints, and allow for expression of support for causes or issues (Anderson and Jingjing, 2018[118]). Moreover, 77% indicate that they have participated in online groups and forums at some point and that it confronts them with greater diversity, helping them to connect with their friends and interact with others who share similar interests.
Strong debate centres around the issue of the impact of the digital environment on child social-emotional development (Table 4.3), especially on rising levels of poor mental health. There are a lot of concerns that digital transformation has dramatically – and negatively – changed the face of modern childhood and made the transition into young adulthood even more arduous. Young people today have disproportionately poorer mental health outcomes than in the past. Evidence for several OECD countries shows a deterioration in youth mental health since the early 2010s, which has gotten worse again since the COVID-19 pandemic (The Lancet Psychiatry Commission on youth mental health, 2024[119]; Stevens, 2024[120]; Cosma et al., 2024[121]). Usage of digital technologies features heavily as a factor coinciding with this decline (Odgers and Jensen, 2020[122]). However, the evidence base linking digital technology use to poorer mental health is not definitive. Research often shows only moderate effects and is mainly correlational, and therefore lacking clear causal relationships. While some studies suggest negative impacts, others indicate some positive effects or no effects for the majority of adolescents.
Garnering attention is the idea of the “great rewiring of childhood” which posits that digital technologies have rewired children’s brains and caused an epidemic of mental illness. According to Haidt (2024[13]), the widespread use of smartphones, social media, and digital technologies has fundamentally altered childhood by reshaping how kids interact, learn, and develop emotionally. This rewiring operates by immersing children in online environments that encourage constant social comparison, fear of missing out, and exposure to unfiltered content, leading to rising rates of anxiety, depression, and social disconnection among Generation Z adolescents (i.e., those born in the early 2000s). Certainly, digital devices can have downsides for child social and emotional well-being, especially when usage becomes excessive, uncontrolled, interferes with daily life and takes children away from their other activities (Nutley and Thorell, 2022[123]). The risks children can encounter online, such as cyberbullying and offensive messages and content, have known and recognised negative impacts on child and adolescent social-emotional development (section 3.3). Nonetheless, associations are correlational, and when long-term links are identified, they suggest that social media use does not predict or cause depression. Instead, it is suggested that causality may be revered or bidirectional; young people with pre-existing mental health issues tend to use these platforms more frequently or in more problematic ways than their peers, which may further exacerbate their initial well-being issues (Odgers, 2024[14]; Heffer et al., 2019[124]). Furthermore, what is behind the upsurge in poor child and adolescent mental health is more complicated than the changes associated with digital transformation, with many established genetic, environmental and economic factors, and indeed children and young people’s level of confidence in the future, coming into play (Odgers, 2024[14]). Overall, while evidence indicates some negative associations between digital technology use and adolescent socio-emotional well-being, these links are modest and do not strongly suggest that technology is the main driver of the rise in youth mental health issues.
Global impact of the digital world on social and emotional well-being
Clear empirical evidence is still lacking to determine whether overall, and in which circumstances, the benefits of children's access to digital technology for their social-emotional well-being and mental health outweigh the negative experiences that children may encounter online. When the use of digital tools is considered globally, some studies point to a low-magnitude negative association with subjective well-being outcomes. However, these associations are not consistently confirmed when looking at individual trajectories based on longitudinal data, which suggests that poorer psychological well-being is likely to be a cause behind problematic use of digital devices more than its main consequence (Dienlin and Johannes, 2020[125]; Orben and Przybylski, 2019[20]).
Five reviews of findings suggest that most research to date has been correlational, and has generated a mix of often conflicting small positive, negative and null associations between the use of digital technologies by adolescents and socio-emotional and mental health outcomes (Dienlin and Johannes, 2020[125]; Odgers and Jensen, 2020[122]; Hancock et al., 2022[126]; Ferguson et al., 2021[127]; Gabrielle, Sonne and Indolo, 2024[128]),(Box 4.5). Although the results argue against population-level harms, more detailed analyses regarding specific platforms, technologies, and demographic groups may yield more nuanced answers. It is also suggested that the influence of digital technologies, if any, varies based on the type of use (Dienlin and Johannes, 2020[125]). For instance, procrastination and passive activities (e.g., web surfing) are linked to more negative effects, while social and active uses aimed at creating meaningful social connections are linked to more positive outcomes. Taken as a whole, digital technology use seems to have a stronger impact on hedonic well-being (e.g., negative effect) than on eudemonic well-being (e.g., life satisfaction). It also appears that both low and excessive use are related to decreased well-being, whereas moderate use is related to increased well-being (Dienlin and Johannes, 2020[125]).
Taking video gaming as an example, the available evidence suggests an association with positive emotional experiences for engaged children. Scientific evidence suggests that video games can help promote mental “healthiness”, support perceived control and agency, relieve stress and create contexts that can help satisfy basic psychological needs (e.g.; competence, autonomy, relatedness) (Haddock et al., 2022[106]). However, the evidence suggests great variability in the associations according to the intensity of involvement in video-gaming. For instance, Przybylski (2014[129]) investigated the link between video game engagement and psychosocial adjustment (including prosocial behaviour, life satisfaction, and internalizing and externalizing problems) in a longitudinal sample of 4 899 children aged 10-15 from England, Northern Ireland, Scotland, and Wales. The study found small but statistically significant positive associations between low levels of video game play (less than one hour per day) and better psychosocial adjustment, such as higher life satisfaction and prosocial behaviour, along with fewer peer problems and emotional issues. In contrast, longer periods of video gaming were associated with no or negative outcomes.13
The influence of contextual factors emphasises the need for a nuanced, context-specific approach to understanding the impact of social media on adolescent mental health and identifying which factors increase certain adolescents’ vulnerability to the negative effects of digital technologies. For example, older adolescents (around age 16 and over) and girls tend to be more susceptible to the harmful effects of social media, particularly when pre-existing vulnerabilities, such as poor-quality offline relationships or a lack of a supportive family environment, are present (Gabrielle, Sonne and Indolo, 2024[128]), (Box 4.5). Adolescents with pre-existing mental health issues, including anxiety or depression, are also especially prone to the detrimental impacts of cyberbullying and online harassment. Conversely, protective factors can help adolescents mitigate these negative consequences. Adolescents who use active coping strategies, such as seeking support from trusted adults or blocking harassers, and have well-developed online social relationships often fare better than those who adopt passive or avoidant strategies (Gabrielle, Sonne and Indolo, 2024[128]; De Coninck, Waechter and d’Haenens, 2023[130]).
Understanding how motivations for using social media shape perceptions of its outcomes is crucial, as these effects may not always align with expectations. For instance, adolescents who use social media to make new friends or feel connected to others may experience higher levels of depression and anxiety compared to those who have different motivations (Gingras et al., 2023[131]). This could be because their expectations for social media to alleviate feelings of isolation are higher than when it is primarily used for accessing information or entertainment.
It is important to recognise that the need to strengthen policies does not hinge on digital media being the sole or primary cause of mental health deterioration to warrant concern. Similarly, digital media does not have to directly improve mental health to be considered beneficial. Even if digital media use is one of many contributing factors, it may still justify policy interventions to regulate usage. Moreover, as highlighted in the detailed review of evidence below, the effects of digital media vary depending on the nature of its use, including the motivations behind it and the types of interactions and engagement occurring on platforms and apps. These dynamics can be difficult to measure accurately with current assessment tools. In particular, extreme cases are especially challenging to capture, such as when a young person experiencing suicidal thoughts gains rapid access to content about suicidality that may encourage harmful actions.
Emphasising the interaction between digital behaviour and pre-existing vulnerabilities is crucial for understanding how digital practices, including problematic Internet and media use, evolve and affect well-being (Gabrielle, Sonne and Indolo, 2024[128]). Additionally, it is essential to integrate insights from professionals working with young people, parents, and, importantly, young people themselves, especially those involved in the most serious cases. These perspectives can help identify vulnerability factors and uncover the underlying dynamics at play.
In their meta-analysis of studies on the link between digital technologies and adolescent mental health, Odgers and Jensen (2020[122]) found that the evidence in this area is mainly correlational, with a range of small, often conflicting positive, negative, and null associations. Recent large-scale, preregistered studies – among the most rigorous to date – report small links between time online and adolescents’ well-being. Moreover, these associations do not clarify whether digital use causes changes in well-being or vice versa, and the authors considered that, due to their limited size, the estimated associations are unlikely to have meaningful clinical significance. In addition, they point out that most of the evidence has focused on the negative effects, and that it is necessary to investigate further whether digital technologies are a valuable source of social support or are required to build digital and interpersonal (digitally mediated) skills for the economies of the future.
The meta-analysis by (Ferguson et al., 2021[127]) explores what substance lies behind claims that screen media is driving the decline in mental health, in particular the rise in suicide among teen girls in the United States and other countries. It finds that concerns about screen time and mental health are not based in reliable data, concluding that no robust data exist to suggest that screen time is associated with, let alone a cause of mental health problems. Screen media, both smartphones and social media considered together and individually, are found to play little role in mental health concerns and statistically significant effects are likely to be explained by systematic methodological flaws rather than true effects. The authors warn that misplaced attention on managing screen media as a primary strategy could distract attention from addressing well-established causes of mental health decline, such as economic issues, family stress and bullying, and lead to the positive aspects of technology being overlooked or negatively impacted.
Similar conclusions are drawn by Hancock et al. (2022[126]) in a meta-analysis of studies on the link between social media use and psychological well-being. The authors found no overall association with subjective well-being, but identified small yet significant associations on specific aspects, such as slight increases in anxiety, depression, and social well-being. These effects varied based on factors like population cohort, geographic region, study methods, and the type of social media use. Overall, their findings align with large-scale studies, highlighting small links between social media use and well-being, with a trade-off between higher depression and anxiety and enhanced social well-being.
Gabrielle et al. (2024[128]) conducted a review of 45 studies covering 153 285 adolescents (from age 10 to 19), suggesting that increased social media use (measured by frequency and duration per day or week), is associated with a range of negative mental health outcomes in adolescents. However, the effects are small, and several moderating factors highlight the importance of adopting a nuanced, context-specific approach to understanding the impact of social media on adolescent mental health. Specifically, the meta-analysis revealed small but statistically significant associations between increased social media use and heightened depressive symptoms (r = 0.12), anxiety (r = 0.10), and loneliness (r = 0.15). Additionally, a significant negative association was found between social media use and self-esteem (r = -0.08).
The analysis also identified several moderators of these effects, including gender, age, and type of social media platform. Older adolescents (age 16 to 19) and girls appear more vulnerable to the negative effects, particularly when combined with pre-existing vulnerabilities such as low-quality offline relationships or unsupportive family environments. The authors further concluded that how adolescents cope with online harassment or cyberbullying significantly influences its impact. Those who engage in active coping strategies, such as seeking help from trusted adults or blocking the perpetrator, may fare better than those who resort to passive or avoidant coping strategies. Adolescents with pre-existing mental health conditions, such as anxiety or depression, may be particularly vulnerable to the negative effects of cyberbullying and online harassment.
In their review of evidence on digital media and brain development in adolescence, Marciano et al. (2025[93]) underline that the pervasive nature of negative online experiences, coupled with their still-developing affective cognitive control system, leaves adolescents less equipped to manage strong negative emotions, especially if they have mental health disorders. While screen time may correlate with negative outcomes, it is often part of broader underlying issues, such as mental health challenges. Additionally, adolescents’ heightened sensitivity to peer influence and group norms amplifies their emotional responses and activates socio-affective brain regions when processing social information.
Digital technologies as a driver of social connectedness?
Children’s social and emotional well-being depends to a great extent on the quality of their relationships with friends and families (OECD, 2021[132]). Digital technologies, in particular social media, offer children opportunities to stay in contact with friends and families and to establish new social connections. Children can find support online that may be unavailable in the physical world, through specialised help sites or connections made on social networks. Social media also provides opportunities to connect with peers, share ideas, seek advice and social support, reduce loneliness and engage in quality friendship relationships (Burns and Gottschalk, 2019[4]; Scott et al., 2024[133]; Jones et al., 2023[134]; Angelini, Marino and Gini, 2023[135]; Odgers and Jensen, 2020[122]). Some of these friendships are “only online”. Across the OECD, 40% of 11- to 15-year-olds have friends they met online and communicate with at least once a week or more (Figure 4.4).
11-, 13- and 15-year-old school children who report on the frequency of their online contact with friends that they got to know through the Internet but didn’t know before
Note: **The OECD average includes all countries depicted in the figure except Belgium and the United Kingdom.
Children were asked "The next question is about ‘online contact’ and ‘online communication’. When we use these terms, we mean ‘sending and receiving text messages, emoticons, and photo, video or audio messages through instant messaging (e.g. WhatsApp, Snapchat), social networking sites (e.g. Instagram, TikTok) or video calling (e.g. Zoom). How often do you have ONLINE contact with ... Friends that you got to know through the Internet but didn’t know before?" and presented with the response options displayed in the graph.
Source: OECD Secretariat calculations based on WHO (n.d.[136]), Health Behaviour in School-aged Children (HBSC) World Health Organization Collaborative Cross-National Survey 2021-22, https://hbsc.org/about/.
Online friendships can enhance adolescents’ sense of companionship, especially for socially isolated teens, and may partially compensate for difficulties with offline peer interactions. Some evidence also suggests that social media features are primed for enhancing friendship quality. First, adolescents who see social media as a way to frequently and quickly connect with many people, especially peers, report higher satisfaction with the support they receive from friends and a greater sense of companionship (Angelini, Marino and Gini, 2023[135]; Nesi, Choukas-Bradley and Prinstein, 2018[137]). This could be because the wide visibility and accessibility of online interactions increase opportunities for both giving and receiving support. Additionally, social media helps maintain communication with distant friends and fosters online-exclusive friendships, enhancing feelings of companionship. Second, social media communication is asynchronous, allowing individuals to respond at their own convenience rather than in real-time. This may provide adolescents with greater flexibility to manage conflicts effectively compared to real-world interactions, by allowing for thoughtful responses and reducing the immediacy of face-to-face interactions. (Yau and Reich, 2019[138]).
A review by Charmaraman et al. (2025[139]) notes that while large-scale studies suggest a small negative relationship between social media use and social connection, methodological issues – such as inconsistent definitions and reliance on cross-sectional data – limit conclusions. Emerging research shifts focus from overall "screen time" to specific social experiences like self-presentation, social comparison, and peer feedback, highlighting their varied impacts on different adolescents. Recent experimental studies have shown that adolescents receiving negative peer feedback on social media, such as receiving fewer “likes,” experience increased negative emotions and feelings of rejection. Additionally, youth with prior experiences of offline peer victimization may be particularly vulnerable to the impact of such negative feedback (Lee et al., 2020[140]).
At the same time, social media platforms can offer valuable opportunities for young people to connect with peers, receive social support on challenging topics, and help foster a sense of community around marginalised interests and identities (Ito et al., 2020[141]; Charmaraman et al., 2025[139]). A strength of the Internet and digital devices is to facilitate connections with friends and other peers, providing opportunities for communication, collaboration, and shared interests. For instance, a survey conducted in 2018 in the United States, reported that 81% of teens say social media makes them feel more connected to what’s going on in their friends’ lives, with 37% saying it makes them feel “a lot” more connected (Anderson and Jingjing, 2018[118]). Similarly, about seven in ten teens say these sites make them feel more in touch with their friends’ feelings (69%), that they have people who will support them through tough times (68%), or that they have a place to show their creative side (71%).
Recent research suggest also that social media and digital communication may help to overcome loneliness, including for an important number of children who find it easier to be themselves online than face-to-face (Siva, 2020[142]). However, the extent to which the Internet and related media can help people have better interpersonal interactions and reduce loneliness depends on how digital services are used; when they are used to enhance existing social relationships and develop new social connections, they are a valuable tool for reducing loneliness (the “stimulation hypothesis”), but when they are used to escape from the social world and withdraw from social interactions, they will increase feelings of loneliness (the “displacement hypothesis”) (Nowland, Necka and Cacioppo, 2018[143]; Masur, 2021[144]). Moreover, whether digital connections can reduce feelings of loneliness and other negative emotions is an open question. Some evidence suggests that the use of digital technologies can help temper negative feelings in a day. However, this recovery may be short-lived, as digital emotional regulation can also be associated with increased negative emotions, loneliness, and greater use of digital technologies by the following day (Scott et al., 2024[133]).
The Internet and social media can provide minority groups, whether due to their origin or sexual orientation, with ways to find information and connect with others in similar situations. A review of evidence suggests that social media may support the mental health and well-being of LGBTQIA+ youths through peer connection, identity management, and social support (Berger et al., 2022[145]). LGBTQIA+ youth frequently use social media to connect with LGBTQIA+ communities. Qualitative studies suggest that these youths explore their identities and seek support from peers on social media platforms, which offer ease of anonymity. Key strategies for managing identities include maintaining anonymity, censoring locations or content, restricting audiences, and using multiple accounts. A systematic review suggests that social media may support the mental health and well-being of LGBTQIA+ youths (from age 13 to 29) through peer connection, identity management, and social support, but findings are limited by weaknesses in the evidence (Berger et al., 2022[145]). The association between social media use and well-being of LGBTQIA+ individuals can be complex, however. Chan (2023[146]) found that LGBTQIA+ social media use can have both positive and negative association with well-being. On the positive side, integrating LGBTQIA+ social media into social routines was found to be associated with lower levels of internalized stigma and higher levels of community connectedness in Hong Kong LGBTQIA+ community, both of which being linked to improved well-being. On the negative side, emotional investment in LGBTQIA+ social media was found to have a negative impact on well-being, with this relationship being mediated by internalized stigma and loneliness (Chan, 2023[146]). Some evidence also suggests that people with mental health needs can peer support via social media and other online communities (Rayland and Andrews, 2023[147]; Naslund et al., 2016[148])
Intensive and problematic digital habits
The frequency and duration of adolescents’ use digital technologies impact their social and emotional well-being in various ways. Some evidence suggests that moderate use of digital devices appears to be associated with positive feelings and greater life satisfaction for many children, while excessive use is associated with negative mental well-being (OECD, 2018[3]; Internet Matters, 2022[149]). Just as Goldilocks in the fairytale Goldilocks and the Three Bears finds that moderation (in porridge (not too hot, not too cold), and beds (not too hard, not too soft)) is “just right”, so too would it seem to be for screen time (Przybylski and Weinstein, 2017[9]). A survey conducted in 2022 on 1 000 UK children (aged 9-15) confirms the inverted U-shaped association between the time spent on digital devices and subjective well-being outcomes: children using digital devices the least report lower scores on positive emotional and social dimensions, while those using them the most report higher scores on all negative dimensions (Internet Matters, 2022[149]). It is suggested that children who spend less time online have fewer opportunities for both positive and negative impacts, while those who spend the most time appear to have the greatest exposure to negative effects. Moreover, the findings suggest that the impact of digital time on children’s well-being is less about the quantity of time spent and more about the nature of the activities performed online. For instance, greater social media use was associated with lower on social well-being,14 particularly for girls, while increased time spent gaming was linked to higher feelings of a lack of control and missing out on physical activity due to digital technology use, especially among boys (Internet Matters, 2022[149]).
How pervasive are adolescents' online lives?
The widespread diffusion of digital devices and services targeting teenagers can lead to intensive use, with many adolescents being constantly connected (Kuss and Griffiths, 2017[150]). Across the OECD, about 35% of teenagers aged 11 to 15 report being in contact with their friends almost constantly throughout the day. This risk increases with age (Figure 4.5, Panel A) and is significantly higher on average for girls (38%) than for boys (31%) (Panel B).
11-, 13- and 15-year-old school children who report intensive online communication
Note: *The difference between 11- and 15-year-olds, and between boys and girls is statistically significant at the 5% level.
**The OECD average includes all countries depicted in the figure except Belgium and the United Kingdom.
Children were asked how often they had online contact with four different friendship categories (Close friend(s); Friends from a larger friend group; Friends that you got to know through the Internet but didn’t know before; People other than friends (e.g., parents, brothers/sisters, classmates, teachers)), and presented with the response options "Don't know/doesn't apply", "Never or almost never", "At least every week", "Daily or almost daily", "Several times each day" and "Almost all the time throughout the day". Data refer to the percent of children who respond "Almost all the time throughout the day" for at least one of the four friendship categories.
Source: OECD Secretariat calculations based on WHO (n.d.[136]), Health Behaviour in School-aged Children (HBSC) World Health Organization Collaborative Cross-National Survey 2021-22, https://hbsc.org/about/.
The availability of Internet-enabled mobile phones and tablets may contribute to raising the risk of intensive digital device use, as they typically offer a wide array of applications (e.g., texting, apps, video chat) that facilitate constant connectivity (Haug et al., 2015[151]). A lack of access to digital tools can indeed lead to feelings of frustration, nervousness, and anxiety among a significant minority of 15-year-olds. According to OECD data, about 17% of 15-year-old teenagers report feeling anxious over half the time when they are without their digital devices. In nearly every country, girls (21%) are notably more likely than boys (13%) to experience such anxiety (Figure 4.6).
15-year-old students who report feeling nervous or anxious more than half of the time when they don't have their digital device near them
Note: *The difference between boys and girls is statistically significant at the 5% level.
15-year-old students were asked "Think about your use of digital devices. How often do you feel or act the following ways? ... I feel nervous/anxious when I don't have my digital device near me." and presented with the response options "Never or almost never", "Less than half of the time", "About half of the time", "More than half of the time", "All or almost all of the time" and "Not applicable". Data refer to the percent responding: "More than half of the time" and "All or almost all of the time". Students responding "Not applicable" are excluded from the calculations.
Source: OECD Secretariat calculations based on OECD (2022[102]), PISA 2022 Database, https://www.oecd.org/en/data/datasets/pisa-2022-database.html.
Teenagers often experience a pervasive presence of digital devices. For instance, in 2018, 95% of US adolescents aged 13 to 17 reported having access to a smartphone, and 45% stating they were online “almost constantly” (Anderson and Jingjing, 2018[118]). A Common Sense Media survey carried out in 2016 suggested that half of teenagers from ages 13 to 18 in the United States said they felt addicted to their mobile devices, while three quarters said they felt compelled to immediately respond to texts, social media posts, and other notifications (Felt and & Robb, 2016[152]). Based on data collected via an app installed on adolescent smartphones, a study carried out in 2022 showed that teens in the United States picked up and checked their smartphones an average of 51 times per day, ranging from two to 498 times per day (Radesky et al., 2023[153]). While younger participants (11- to 12-year-olds) tended to pick up their phones less frequently each day, adolescents (age 13 and older) were more likely to check their phone over 100 times per day. Notifications are plentiful, with half of our participants receiving 237 or more per day. Over two-thirds of 11- to 17-year-olds reported that they "sometimes" or "often" find it difficult to stop using technology, use technology to escape from sorrow or get relief from negative feelings, and miss sleep due to being on their phone or online late at night.
Challenges and consequences of “Problematic Internet Use”
When children are online, they can engage in multiple activities either simultaneously or consecutively, making it difficult to accurately determine the time spent on each activity. Consequently, some research focuses on children's overall Internet use and its impact on well-being, without necessarily differentiating between specific activities. A few reviews focus especially on the relationships between Problematic Internet Use15 (PIU) and children’s well-being outcomes. These studies emphasise the links between excessive or compulsive Internet use and various negative well-being outcomes, such as challenges in daily functioning, strained interpersonal relationships, depressive symptoms, anxiety, loneliness, reduced subjective well-being, lower life satisfaction, and other mental health issues (Aboujaoude and Starcevic, 2015[154]; Cai et al., 2023[155]; Chen and Fan, 2024[156]; Ortuño-Sierra et al., 2022[157]).
A recent meta-analysis found that higher levels of problematic Internet use are associated with increased negative mental health problems and lower levels of subjective well-being (Cai et al., 2023[155]). These findings align with previous studies in the field and support the Internet use displacement hypothesis suggesting that the time spent on the Internet displaces or replaces time that could be spent on other activities, such as face-to-face social interactions, physical activities, or other offline pursuits. Concurrently, some studies suggest that negative mental health issues may be potential risk factors for problematic Internet use (Çikrikçi, 2019[158]; Liu et al., 2022[159]). Longitudinal evidence suggests that adolescents developing problematic Internet use tend to experience poorer mental health, including symptoms of depression, anxiety, and low self-esteem. They also face challenges in interpersonal relationships, such as strained parent-child, peer, and teacher-student dynamics, alongside diminished academic performance and school functioning (low behavioural, emotional and cognitive engagement) (Geng et al., 2023[160]; Coyne et al., 2020[161]; Zhou et al., 2022[162]).
Gender does not consistently alter the association between problematic Internet use and adverse well-being outcomes in adolescents, either positively or negatively (Cai et al., 2023[155]). On one hand, the relationship between problematic Internet use and loneliness seems to be stronger for boys than for girls. One possible explanation for this finding could be related to gender difference in Internet usage: more girls tend to use the Internet for social communication, which can lead to lower levels of loneliness, whereas more boys spend time on online gaming or use the Internet as an escape from real life, further increasing their loneliness (Dufour et al., 2016[163]; Cai et al., 2023[155]; Svendsen, 2024[164]). Regarding the relationships between problematic Internet use and the other adverse mental health outcomes (e.g. depressive symptoms, anxiety, subjective well-being), gender did not show up as having a consistent role. However, some studies have reported that gender does play a role in the relationships between problematic Internet use and depressive symptoms, as well as subjective well-being, indicating that further research on this issue may be warranted (Lei, Chiu and Li, 2019[165]; Lozano-Blasco and Cortés-Pascual, 2020[166]).
Family-based adversity factors, such as child maltreatment and parental conflicts, are also found to significantly increase the risk of developing problematic Internet use over time (Geng et al., 2023[160]). In particular, adolescents may turn to highest levels of problematic Internet use as a consequence of inter-parental conflicts, maltreatment or poor child-parents’ relationships. Turning to virtual environments can provide an escape from childhood psychological maltreatment and a toxic family atmosphere. However, this behaviour has been found to be associated with an increased risk of depression and the adoption of maladaptive coping mechanisms (e.g., self-blame, blaming others, rumination, or catastrophising), as well as a heightened vulnerability to Internet gaming addiction (Wu et al., 2022[167]).
Recent evidence also suggests that parental mediation practices regarding Internet use can mitigate the risk of developing problematic Internet use only to a small extent. A meta-analysis suggests that parental warmth and control showed a small negative association with problematic Internet use, while overall parental efforts to regulate their children’s and adolescents’ media use do not seem to protect adolescents against problematic Internet use (Lukavská et al., 2022[168]). However, recent evidence suggest that rules established by parents on the content of authorised sites and applications seem more likely to attenuate adolescents’ problematic use of Internet than strict rules on screen time (Chen and Fan, 2024[156]). Stringent time restrictions may lead to rebellious behaviours as adolescents seek independence from parental control, or withdrawal symptoms if Internet use is abruptly discontinued. Conversely, restrictions on the content accessed online are perceived as less arbitrary and seem more effective to reduce adolescent problematic Internet use across various mental health profiles (Chen and Fan, 2024[156]).
Challenges and consequences of video-gaming
Video games, like social media, are intentionally designed to maximise user engagement, with these strategies becoming increasingly sophisticated over time (Schwarz et al., 2020[169]; Rapp, 2022[170]; Ruiz, León and Heuer, 2024[171]). Children are particularly vulnerable to persuasive design elements in digital devices and games that encourage prolonged engagement (Alsheail, Alexandrovskz and Gerling, 2023[172]). However, problematic video gaming involves more than just excessive online activity; it also involves negative effects on various aspects of functioning, including personal, social, occupational, and familial domains (Gros et al., 2020[173]).
A study on the problematic screen use16 (specifically, video gaming, social media use and mobile phone involvement) based on the Adolescent Brain Cognitive Development (ABCD) Study, covering 8 753 children aged 10 to 14 between 2018 and 2020 in the United States, shows that problematic use concerns a significant minority of young adolescents, with slightly higher numbers for video gaming than for social media use (Nagata et al., 2022[174]). A bit more than 20% of young adolescents report that they occasionally or frequently feel the need to play video games more and more, and slightly more than 11% feel the same about the use of social media apps. Around 17% of young adolescents report that they have tried to play video games less but can't (15% for social media use) or become stressed or upset if they are not allowed to play video games (12% for social media use). Slightly more than 6% think that they play video games or use social media so much that it has had a negative effect on their schoolwork. Video gaming serves as a means to forget about problems for around a quarter of young teenagers, and social media use has the same function for around 18% of teenagers.
In the OECD, the majority of 15-year-olds (73%) spend no more than three hours playing video games on a typical weekday (Figure 4.7, Panel A). However, a minority of 15-year-olds (27%) spend 3 hours or more, and around 5% spend more than seven hours a day playing video games. On weekends, this proportion rises to 8.5%. In all countries, boys (7% on average, Figure 4.7, Panel B) and teenagers with a low socio-economic status (7%, Figure 4.7, Panel C) are more likely than others of spending extended amounts of time playing video games during the week. On weekends, almost 12% of boys and 11% of 15-year-olds with a low socio-economic status play video games for seven hours or more each day (data not shown). Whether excessive video game and screens usage should be considered a clinical addiction remains open to date (Box 4.6).
Note: *The difference between boys and girls, and students with high and low socio-economic status is statistically significant at the 5% level. 15-year-old students were asked "During a typical weekday, how much time do you spend doing the following leisure activities? ... Play video games (using my smartphone, a gaming console or an online platform or Apps)" and presented with the response options listed in Panel A.
Source: OECD Secretariat calculations based on OECD (2022[102]), PISA 2022 Database, https://www.oecd.org/en/data/datasets/pisa-2022-database.html.
There is currently a lack of consensus on whether screen or Internet addiction should be classified as an addictive disorder. Some authors argue that digital access can lead to adverse consequences similar to those caused by substance addictions (Luker, 2022[175]; Aragay et al., 2023[176]; Kuss and Lopez-Fernandez, 2016[177]). Moreover, there is debate over whether the addiction is to the device itself (e.g., mobile phone, computer, tablet) or to the content consumed (e.g., video games, social networks) (Kardefelt-Winther, 2017[178]). Some suggest that “pathological use of the Internet” constitutes a behavioural addiction, characterised by a loss of control over technology use and connection-seeking behaviour, leading to negative consequences and an inability to curb the impulse or desire to stay connected (Sussman et al., 2018[179]). However, these studies often lump together various uses (video games, social networks, different devices) and symptoms under the same concept of addictive digital behaviours.
Symptomatic “addictive” behaviours include (Luker, 2022[175]): (i) having intense urges for screen time or to play video games, and these urges block out other thoughts; (ii) spending money on video games or screens, even though you can't afford it; (iii) cutting back on social or recreational activities because of preference for screen time or video games; (iv) Continuing to play video games or participate in screen time, even though you know it's causing problems in your life, such as poor performance at school or work, or letting household responsibilities go; (v) Displaying signs of irritability, anxiety or anger when forced to stop playing, even for brief periods of time; (vi) Lying to others about the extent of your use; (vii) Needing more screen time over time to get the same level of enjoyment; (viii) Neglecting your appearance, including lack of interest in grooming or clothing.
Some authors question the adoption of clinical addiction concepts that may stigmatise children for whom clinical impairment may be very low (Bean et al., 2017[180]). Nevertheless, although both Internet/social networks and video games have addictive qualities, video games can cause more significant disruptions in daily life due to their requirement for isolation in a room to hear and talk to other players and extended play sessions, which can interfere with responsibilities like school and social activities (Aragay et al., 2023[176]). According to Aragay et al. (2023[176]), the higher level of interference may contribute to increased video game addiction compared to Internet/social networking practices. Conversely, social networks, accessible via mobile phones, are less disruptive to daily activities but can still lead to behavioural addictions and contribute to problems such as low self-esteem, body image disorders, anxiety, depression, and obsessive-compulsive disorders.
Several systematic reviews examining the link between Internet Gaming Disorder (IGD)17 and psychiatric comorbidities in children and adolescents suggest that both IGD and SMU are key contributors to the growing mental health challenges faced by children and adolescents (Ghali et al., 2023[181]; Gao, Wang and Dong, 2022[182]; Paulus et al., 2018[183]). These reviews indicate that problematic engagement with online gaming is significantly associated with issues such as anxiety, depression, and other emotional disturbances among these population groups.18 However, the exact causes of these difficulties are still debated, with factors like internal psychological factors,19 time spent online, the types of media consumed, and gender differences being explored (Griffiths et al., 2025[184]). Some studies suggest that family dynamics, including poor parenting styles – neglectful, authoritarian, permissive –, contribute to exacerbate problematic Internet use, including problematic video-gaming (Nielsen, Favez and Rigter, 2020[185]). Moreover, certain game genres, particularly immersive ones like Massively Multiplayer Online Role-Playing Games, Multiplayer Online Battle Arenas, Real-Time Strategy Games, are strongly associated with GD (Griffiths et al., 2025[184]). Additionally, structural features of games, such as in-game rewards that trigger dopamine release and the unpredictability of these rewards, play a key role in reinforcing prolonged gaming sessions and maintaining gaming disorders.
The use of mobile phones is also highlighted in the Adolescent Brain Cognitive Development (ABCD) Study as a source of problematic behaviour (Nagata et al., 2022[174]). For example, around 30% of teenagers aged 10 to 14 say that they interrupt whatever they are doing when they are contacted on their phone, and 45% say that they frequently use their mobile for no particular reason. Around 17% say they are unable to reduce their phone use, and over 11% report stress at the thought of being without their phone. There are also gender differences: girls report higher scores for problematic social media and mobile phone use.
Challenges and consequences of social media
With respect to social media, more and more children report a negative impact. While research indicates a relatively low overall impact on well-being outcomes at the population level, nearly 10% of teenagers across the OECD reported in 2021-22 that their use of social media has had a negative impact on their attitudes and mindset that can be classified as problematic, up from less than 7% in 2017-18 (OECD, 2024[2]). Reporting varies across age groups (Figure 4.8). Once again, girls (12%) are generally more often exposed to this type of problem than boys (7%),20 and children with a migrant background (14%) are more exposed than natives (10%). These findings are consistent with US-based studies that find that girls report higher problematic social media and mobile phone use while boys report higher problematic video game use (Nagata et al., 2022[174]).
11-, 13- and 15-year-old school children who report having problematic social media use
Note: *The difference between 11- and 15-year-olds, boys and girls, and students with and without migrant background is statistically significant at the 5% level. **The OECD average includes all countries depicted in the figure except Belgium and the United Kingdom.
Children were asked a series of nine questions about whether, over the past year, social media use has had a negative impact on various aspects of their lives, including: whether they (i) can’t think of anything else but the moment that they will be able to use social media again, (ii) regularly felt dissatisfied because they wanted to spend more time on social media, (iii) often felt bad when they could not use social media, (iv) tried to spend less time on social media, but failed, (v) regularly neglected other activities (e.g. hobbies, sport) because you wanted to use social media, (vi) regularly had arguments with others because of their social media use, (vii) regularly lied to their parents or friends about the amount of time they spend on social media, (viii) often used social media to escape from negative feelings, (ix) had serious conflict with their parents, brother(s) or sister(s) because of their social media use. Response options for each question were "No" or "Yes". Data refer to the percent of children who respond "Yes" to at least six of the nine questions. "Social media", in this instance, is defined as referring to social network sites and instant messengers.
Source: OECD Secretariat calculations based on WHO (n.d.[136]), Health Behaviour in School-aged Children (HBSC) World Health Organization Collaborative Cross-National Survey 2021-22, https://hbsc.org/about/.
Several literature reviews focus on the impact of problematic social media use21 on children and/or adolescents mental health and well-being (Sala, Porcaro and Gómez, 2024[186]; Bozzola et al., 2022[187]; Bottaro and Faraci, 2022[188]; Cataldo et al., 2021[189]; Hussain and Griffiths, 2018[190]; Ghali et al., 2023[181]; Coyne et al., 2025[191]). These studies point to children and adolescents who use social media for many hours a day showing higher risk for being exposed to contact and conduct risks depicted in the previous section, such as cyberbullying, online grooming. According to Sala (2024[186]), there is a robust corpus of evidence pointing that “high social media use” (above two hours per day) correlates with negative social and mental health outcomes, including reduced social well-being, happiness, and self-esteem, and increased vulnerability to harassment (Bozzola et al., 2022[187]; Senekal et al., 2023[192]). A dose-response meta-analysis by Liu et al. (2022[159]) revealed that each additional hour of social media use increased the risk of depression by 13%, with stronger effects observed in girls, though boys were also significantly affected. Greater time spent on social media is linked to poor sleep, negative body image (above 3 hours in Kelly (2018[193]), psychological distress, self-rated poor mental health, and suicidal ideation (Vidal et al., 2020[194]).
Several factors could explain a negative link between social media use and depression (Twenge et al., 2025[195]). Social media can displace time spent on activities beneficial to mental health, such as in-person social interactions, especially as norms shift away from face-to-face gatherings. It can amplify social comparison, body image concerns, and appearance dissatisfaction, which may lead to depressive symptoms. The risk of cyberbullying, strongly associated with depression, is also heightened. Social media can reinforce negative thinking patterns as users seek content aligning with their emotions, creating "rabbit holes".22 Additionally, screen time, including social media use, disrupts sleep by delaying bedtimes, reducing sleep quality, and suppressing melatonin, all of which are linked to depressive symptoms in children and adolescents.
Social media are also found to significantly influence body dissatisfaction and disordered eating through mechanisms like social comparison and internalisation of beauty ideals (Choukas-Bradley et al., 2025[196]). Adolescents and young adults, particularly girls and women, engage in upward comparisons with peers, celebrities, and influencers, reinforcing specific and often sexualised beauty ideals, such as the "slim-thick" ideal. Experimental studies reveal that exposure to edited, idealised images on social media exacerbates body image concerns, especially among individuals prone to social comparison (Fioravanti et al., 2022[197]). Choukas-Bradley et al. (2025[196]) highlight that nonexperimental research confirms social media appearance pressures uniquely contribute to body dissatisfaction and disordered eating, surpassing the influences of family, peers, and traditional media. Additionally, appearance-focused social media use has been linked to heightened self-objectification and body surveillance, emphasising the pervasive and enduring effects of idealised content on mental health.
Meta-analyses indicate a small but significant effect of social media use on mental health, though interpretations of these effect sizes vary widely (Valkenburg, Meier and Beyens, 2022[198]). The majority of studies included in these analyses rely on cross-sectional, self-reported data, limiting the strength of their conclusions. Additionally, the relationship between social media use and mental health differs among individuals. For instance, a recent study on individual susceptibility found that 92% of adolescents reported neutral or positive effects of social media use on their self-esteem, a factor linked to mental health, while 8% reported consistent negative effects (Valkenburg et al., 2021[18]).
Some individuals are more susceptible to media effects due to factors such as personality, developmental stage, and social context, with their responses shaped by cognitive, emotional, and physiological states (Hamilton et al., 2025[199]). Girls are often found to face higher risks of depression and suicidality during adolescence, with some studies indicating "windows of vulnerability" to social media exposure that vary by sex. These periods of increased risk appear to be more pronounced for girls between the ages of 11 and 13, as well as at age 19, while boys are most vulnerable between the ages of 14 and 15 and again at 19 (Orben et al., 2022[8]). Offline vulnerabilities, like social comparison and stress, may amplify online risks. Youths with minoritised identities, such as LGBTQIA+ individuals and youths of colour, are more likely to experience identity-based online victimization, including by being directly and indirectly targeted by verbal and sexual harassment and threats of physical harm and experiencing vicarious exposure to discrimination based on race, leading to negative mental health outcomes like depression and suicidal ideation (Kruzan et al., 2025[200]; Tao and Fisher, 2022[201]; Nesi et al., 2021[202]). Economically disadvantaged adolescents, who spend more unsupervised time online, also face heightened risks, with stronger links between social media use, conduct problems, and psychological distress (Odgers and Jensen, 2020[122]; George et al., 2020[203]).
The impact of social media use depends not only on the quantity of time spent on social media but also on the type of usage (Coyne et al., 2025[191]). Many studies also report different mental health outcomes deriving from active (i.e., posting, commenting, messaging, or liking) and passive (i.e., browsing other users' photos or scrolling through comments or feeds) use of social media (Sala, Porcaro and Gómez, 2024[186]). Passive use is linked to higher social comparison, lower perceived social support, envy, depressive moods, and anxiety, particularly in individuals with loneliness, stress, or depressive symptoms. In contrast, active use is associated with improved well-being, life satisfaction, and perceived social support, especially among girls. Active use generally shows no strong association with later depressive symptoms (Sala, Porcaro and Gómez, 2024[186]).
In addition, some adolescents report feeling pressured to share, stay connected, and respond immediately to messages, which acts as a barrier to disconnecting from social media (Shankleman, Hammond and Jones, 2021[108]). Moreover, prolonged and unsupervised use of social media appears to increase the risk for children of being exposed to sexting, pornography, grooming, and unwanted sexual content online (Bozzola et al., 2022[187]). Consequently, measures of problematic social media use aim to capture not only excessive time but also compulsive engagement that disrupts daily life, emotional well-being, or interpersonal relationships. The general findings of studies using PSMU measures suggest that PSMU co-occurs with higher levels of depression, anxiety, and stress, as well as with higher prevalence of Attention-deficit/hyperactivity disorder (Hussain and Griffiths, 2018[190]; Ghali et al., 2023[181]; Sala, Porcaro and Gómez, 2024[186]). For instance, Boer et al. (2020[5]) found from cross-national data from over 150 000 adolescents across 29 countries that problematic social media use is associated with lower subjective well-being outcomes, in areas such as life satisfaction, psychological complaints, school satisfaction, perceived school pressure, family support, and friend support.
In addition to the amount of time spent and problematic use, an individual’s experience with social media is likely influenced by the type of content and the context of their interactions (Coyne et al., 2025[191]). For instance, exposure to "positive" content is linked to lower levels of depression, while "negative" content is associated with higher levels of depression. However, negative content tends to have a stronger impact and is more closely connected to depression than positive content (Primack et al., 2018[204]; Skogen et al., 2023[205]). Personal psycho-social characteristics are also key factors affecting how social media are used and its association with well-being outcomes (Sala, Porcaro and Gómez, 2024[186]). For instance, the quality of offline social networks, feelings of loneliness, and personality traits like introversion and extroversion are important factors in online social media use. Extroverted adolescents with high self-esteem and strong offline friendships tend to use social media to reinforce existing relationships, while introverted adolescents with low self-esteem and weaker social networks are more likely to connect with strangers, increasing the risk of unwanted interactions (Pellicane, Cooks and Ciesla, 2021[206]). A longitudinal study also revealed that experiences of acceptance on social media were linked to fewer symptoms of depression and anxiety in LGBTQIA+ participants, but not in their heterosexual counterparts. Similarly, a recent study of early adolescents found that LGBTQIA+ youth were significantly more likely to participate in online support groups to alleviate feelings of isolation (Charmaraman et al., 2024[207]).
Adolescents' motivations for using social media affect their mental health and well-being (Sala, Porcaro and Gómez, 2024[186]; Ariefdjohan et al., 2025[208]). Social media can be used for entertainment, to get updated information, to get inspired or to nurture an interest or passion, or to learn about a new topic that positively affects mood (Shankleman, Hammond and Jones, 2021[108]). Social media can also be used for self-expression and online disclosure, to engage with relatives and friends, to strengthen friendships, or to expand one's social network, finding like-minded individuals, therefore creating online communities, and boosting a sense of belonging (Bottaro and Faraci, 2022[188]). In such cases, mobile devices are suggested to have increased the use of social networking sites (SNSs), providing online social support that complements in-person interactions. Adolescents benefit from a larger network of online friends and feedback (e.g., likes and comments). Sharing emotions on SNSs has been linked to improved cognitive and affective empathy, while participation in online communities fosters social skills and positive emotional contagion. However, SNSs also pose risks, such as negative emotional experiences when expected feedback (e.g., likes) is lacking, potentially harming self-acceptance and self-worth (Bottaro and Faraci, 2022[188]). Moreover, social media can also be used for social comparison, a mechanism highly involved in identity development and be associated with lower self-esteem and heightened negative emotions, especially when adolescents compare themselves to idealised portrayals of others. Additionally, using SNSs to escape real-world interactions can increase the risk of developing problematic social media use. Across the OECD, according to data from the Health Behaviour of School-aged Children, approximately 46% of adolescents aged 11, 13, and 15 (respectively 36% of boys and 55% of girls) using social media reported in 2022 that they often used social media to escape from negative feelings.
Social media's affordances, such as visual content and platform design, are key factors in understanding the impact of social media use on mental health and well-being (Sala, Porcaro and Gómez, 2024[186]). First, the content that users search for or are recommended on social media can have both positive and negative effects on their well-being and mental health. Positive content can inspire users and promote learning about widely different topic, while social media can serve as a platform for discussing and reducing the stigma around mental health issues, creating support networks for those with similar experiences (Popat and Tarrant, 2023[209]; Zhou and Cheng, 2022[210]). Conversely, negative content, such as harmful health advice and distressing news, can negatively affect harm mental health, while disturbing content like pro-eating disorder or self-harm material can negatively influence mood and behaviour with the risk of social contagion (Sala, Porcaro and Gómez, 2024[186]). Additionally, platform features like the "like mechanism" may trigger social comparison and rumination, affecting self-worth and increasing anxiety (Cataldo et al., 2021[189]). Design elements can also promote increased user engagement, to which children are particularly vulnerable, contributing to mental health challenges.
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← 1. The potential negative impacts of the digital environment on children’s health and well-being are categorized as cross-cutting risks within the typology of risks in the digital environment, and are particularly concerning, as they can significantly affect children’s lives in multiple ways (OECD, 2021[1]).
← 2. Screen time is typically defined as the amount of time a person spends using screen-based devices – such as smartphones, tablets, computers, televisions, or gaming consoles – for activities like entertainment (watching videos, gaming, or social media), educational or work-related tasks (studying, working, or attending online classes), and communication (video calls, texting, or emailing).
← 3. While there are indications of rising mental distress among adolescents in several countries, this trend is not uniform across nations or population groups. Additionally, it remains unclear whether this reflects a genuine increase in mental distress or is a result of greater disclosure and diagnosis, driven by reduced stigma and increased awareness of mental health issues.
← 4. A systematic review is a comprehensive and rigorous synthesis of research evidence on a particular topic or question. It follows a structured and transparent process to identify, select, critically appraise, and analyse relevant studies from existing literature. The advantage of these reviews is that they enable a rigorous selection of findings from studies of varying designs and qualities and highlight associations that do not always reflect causal effects.
← 5. Digital marketing, encompassing online promotions on platforms such as social media, websites, and gaming platforms, has been a key strategy for food brands targeting youth since the 1990s (Harris et al., 2025[54]). These brands use advertisements, branded games, company apps, and social media accounts to engage young audiences. Their strategies include celebrity endorsements, user-generated content, and viral marketing through peer networks. Recent innovations include influencer promotions, product placements in online entertainment, and immersive experiences in gaming and the metaverse, such as Roblox. Studies show that digital food marketing predominantly promotes unhealthy products like fast food, sugary drinks, and snacks, significantly influencing children’s and adolescents’ food preferences, purchase requests, and consumption (Harris et al., 2025[54]). Exposure to these digital campaigns has been found to have similar effects on youth diets as traditional TV advertising, driving positive attitudes toward unhealthy foods and increasing their consumption.
← 6. There are no clear cut-off points for defining excessive screen time, as studies use different time categories, and what is considered excessive varies depending on the outcomes and the child's age. For instance, Massaroni’s review report that prolonged screen time of more than 4 hours per day in children aged 2 to 4 years has been linked to deficient expressive vocabulary. Additionally, children aged 12 to 35 months exposed to 2 hours of television daily have a significantly higher risk of cognitive and motor developmental delays. Preschoolers around 5 years old with more than 1 hour of screen time daily showed greater vulnerability in areas such as cognitive, communicative, social, physical, and emotional development compared to those with less than 1 hour of screen time (Massaroni et al., 2023[72]).
← 7. Research reviewed in Santos et al. (2022[88]) indicates that most studies found that exceeding daily screen time recommendation to limit school-age children to no more than two hours of daily television and video game use combined is linked to higher rates of attention problems in children. Early grade children were particularly susceptible, with video games showing a stronger association with attention issues than television. For instance, Rosen et al. (2014[211]) found that for children aged 4-8, daily technology use was broadly associated with attention problems, while for pre-adolescents (9-12), only video games and technological toys were linked to such issues. Hetherington et al. (2020[212]) observed that even one hour of screen time daily was excessive for 5-year-olds, with inattention increasing with additional exposure, regardless of the type of media. These findings, based on parent and teacher reports, highlight difficulties in maintaining focus and staying on task associated with excessive screen use.
← 8. Nevertheless, a recent study points to an association between the decline in mean PISA scores over time and the use of digital devices (Andrews, Égert and de la Maisonneuve, 2024[213]). This study suggests that the decline in PISA test scores since 2009 can be primarily attributed to two factors: digital device use and the COVID-19 pandemic. Non-class-related digital device use in schools contributes to an almost 8-point drop in PISA scores, including a 5-point decline from 2009 to 2018 and nearly a 3-point decrease from 2018 to 2022. At the same time, school policies aimed at promoting responsible internet use have partially mitigated this trend, reducing the negative effects of digital device use by 1 PISA point between 2009 and 2022. Lastly, the impact of the COVID-19 pandemic accounts for nearly a 4-point decrease in overall PISA scores after 2018. However, this study highlights a correlation without providing certainty about the existence of causal relationships. The paper does not rule out the possibility that trends in the use of digital devices and PISA test scores could be driven by unobserved factors.
← 9. "Soft skills" refer to a set of personal attributes and interpersonal abilities that enable individuals to interact effectively and harmoniously with others in various contexts. Unlike "hard skills," which are specific technical skills or knowledge related to a particular job or task, soft skills are more about how people behave, communicate, and work with others. Examples of soft skills include communication skills, teamwork, adaptability, problem-solving, time management, leadership, emotional intelligence, and interpersonal skills. These skills are often considered essential for success in the workplace and in personal relationships (OECD, 2021[132]).
← 10. Creativity consists of imaginative thinking or behaviour which is purposeful and leads to an original outcome which is of value in relation to the original objective.
← 11. Migrant children may use digital storytelling to express their cultural heritage and navigate their identities. The European research project Children in Communication about Migration highlighted how refugee youth utilised media production for personal expression and identity formation (de Leeuw and Rydin, 2007[214]). their children's cultural identity and engagement by providing access to digital content in their primary language(s) and cultural background(s). They also help their children use digital tools to communicate with family members across different languages, fostering both linguistic development and cultural connections (Notley and Aziz, 2024[215]).
← 12. Migrants use tools like WhatsApp, Facebook, and Skype to stay connected with family and communities back home while building networks in their host countries. Social media also helps in real-time decision-making, such as adjusting travel routes based on shared experiences from other migrants. Platforms like YouTube assist in learning new languages and acquiring professional skills to adapt to their new environments (Diminescu, 2018[116]; McAuliffe, Blower and Beduschi, 2021[117]).
← 13. Moderate video game play (1-3 hours per day) showed no significant differences compared to non-players, while heavy play (over 3 hours daily) was linked to more negative psychosocial outcomes, suggesting a potential dosage effect. The results suggest that responsible video game use can offer benefits for child well-being, akin to traditional forms of play. Nevertheless, the effects are minor, accounting for at most 2% of the observed variability in well-being outcomes. This suggests that 98% of the variability is attributable to factors unrelated to video gaming and its intensity.
← 14. Social well-being is defined as the ability to participate in broader communities, such as schools, clubs, or societies; being an active citizen; collaborating effectively with others; engaging in healthy interactions within online communities; maintaining positive and sustainable online identities; managing risks such as grooming and exploitation; fostering and sustaining good relationships with significant individuals both online and offline; and communicating effectively with persons children know.
← 15. Problematic Internet use (PIU) is generally defined as excessive or compulsive Internet engagement that leads to negative consequences, such as interference with daily life or mental health issues. Measurement of PIU varies, but it often involves self-reported surveys or scales assessing the frequency and impact of Internet use, such as the time spent online, emotional dependence, and the extent to which online activities disrupt personal, academic, or social life. These assessments are typically based on established diagnostic criteria or standardised questionnaires, such as the Young’s Internet Addiction Test, Caplan’s Generalized Problematic Internet Use Scale, Internet Addiction Test, and the Chen Internet Addiction Scale.
← 16. In this study, problematic screen use is analysed through three categories: video gaming, social media, and mobile phone use. Each category is assessed using specific diagnostic tools, such as the Video Game Addiction Questionnaire, the Social Media Addiction Questionnaire, and the Mobile Phone Involvement Questionnaire. The research identifies problematic screen use as patterns of behaviour that include excessive or compulsive engagement, interference with daily functioning, and the experience of associated negative consequences like reduced physical activity or social detachment (Nagata et al., 2022[174]).
← 17. Internet Gaming Disorder (IGD) is defined in both the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) and ICD-11 (International Classification of Diseases, 11th Revision) with criteria that focus on problematic gaming behaviour and its negative impact on an individual’s daily life. in the DSM-5 as a condition for further research, with diagnostic criteria focusing on symptoms such as preoccupation with gaming, withdrawal symptoms, tolerance, unsuccessful attempts to cut back, and continued gaming despite negative consequences. The disorder is suspected when at least five of these criteria are met over a 12-month period, causing significant impairment in personal, social, or academic functioning. ICD-11, in contrast, officially classifies Gaming Disorder as a mental health condition, with criteria that include impaired control over gaming, prioritisation of gaming over other activities, and continuation despite harmful effects. To be diagnosed, the symptoms must persist for at least 12 months and significantly impact daily life.
← 18. Ghali et al. review (2023[181]) covers children aged 6-12 years and adolescents aged 13-18 years across 20 selected studies on the subject. These studies used a substantial sample size of 48 652 participants, encompassing both online and in-person questionnaires administered to children, teenagers, and their parents in educational institutions, healthcare facilities, and online platforms. The other two reviews include children and adolescents aged 8 to 18.
← 19. Paulus et al. (2018[183]) highlighted that deficient self-regulatory and decision-making abilities as a consequence of dysexecutive problems, mood and reward system dysregulation, and avoidant behaviour (escapism, deficient coping with negative emotions), low self-esteem, poor self-efficacy, and neurobiological factors may contribute to explain Internet gaming behaviours and its consequences on individuals well-being and mental health outcomes. Griffiths et al. (2025[184]) also highlight that gaming disorders appear to be positively associated with neuroticism, as individuals prone to depression, stress, and anxiety may use gaming as a perceived safe escape from real-life challenges. Low conscientiousness, characterised by impulsivity and disorganisation, is negatively linked to gaming disorders, while impulsivity itself shows a consistent positive relationship.
← 20. Additional data suggests that adolescents from one-parent families (12%) are more likely to report problematic use compared to those from two-parent families (9%) (OECD, n.d.[216]).
← 21. Problematic social media use (PSMU) is commonly defined as excessive or compulsive engagement with social media platforms that disrupts daily functioning, emotional well-being, or interpersonal relationships. It is typically measured using self-reported scales or questionnaires, such as the Bergen Social Media Addiction Scale or the Social Media Disorder Scale, which assess factors like time spent on social media, inability to reduce usage, negative emotional responses when unable to use, and the impact on work, studies, or relationships.
← 22. The term "rabbit holes" originates from Alice's Adventures in Wonderland by Lewis Carroll, where Alice follows a rabbit into a hole and ends up in a fantastical and confusing world. In modern usage, "rabbit holes" refers to deep, often unexpected, explorations or distractions that consume time and focus. Online, rabbit holes frequently occur when you click on one link, then another, and another, exploring an endless stream of information. Social media algorithms, search engines, and video platforms can facilitate this behaviour, drawing users into extended engagement cycles.