Screen Time and Autism Spectrum Disorder: A Comprehensive Systematic Review of Risk, Usage, and Addiction

The relationship between autism spectrum disorder (ASD) and screen time (ST) has been extensively studied; but the evidence remains inconsistent, and a comprehensive quantitative synthesis of this association is lacking. This study aims to provide a robust quantitative assessment of the relationship between ASD and ST by consolidating and analyzing available evidence to offer a more precise understanding of this complex association. This systematic review followed PRISMA 2020 statement, and applied a quality assessment tool for quantitative studies to identity best available evidence. A comprehensive search was conducted in PubMed, Web of Science, Embase, and Scopus, covering literature published from January 1, 2006 to June 12, 2024. In total, 30 studies involving 356,666 participants met the inclusion criteria. The findings revealed a significant association between screen exposure in preschool children and the development of ASD, with a longer duration of screen exposure correlating with an increased likelihood of being diagnosed with autism. Furthermore, autistic people tend to have longer daily screen use and are at a higher risk of screen addiction compared to non-autistic individuals. These findings emphasize the importance of limiting ST for preschoolers and autistic people. However, the level of evidence supporting these conclusions is very low. Future studies should focus on controlling for confounding factors, using more objective measures, and further investigate the relationship between screen engagement styles (active or passive), screen use patterns (screen devices and content), and ASD.