How Are Digital Media Use and ADHD Symptoms Related in Children and Teens?

What you need to know

• There is evidence for bi-directional relationships between digital media use and ADHD symptoms in children and adolescents
• Problematic or addictive digital media use shows stronger associations with ADHD symptoms compared to screen time alone
• Factors like sleep, physical activity, and social relationships may play a role in the link between digital media and ADHD
• More research is needed on potential moderators and mediators to better understand these complex associations

Digital media use and ADHD: A complex relationship

In recent years, children’s access to and use of digital media has increased dramatically. At the same time, there has been a rise in the number of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). This has led researchers to investigate whether there may be a connection between digital media use and ADHD symptoms in young people.

A new systematic review published in European Child & Adolescent Psychiatry examined the evidence from longitudinal studies on this topic. The researchers looked at studies published in the last 10 years that followed children and adolescents over time to see how digital media use and ADHD symptoms might influence each other.

What did the review find?

The review included 28 studies with over 66,000 total participants ranging from preschool age to late adolescence. Overall, the findings suggest there are likely bi-directional relationships between digital media use and ADHD symptoms. This means that digital media use may contribute to increases in ADHD symptoms over time, but also that children with more ADHD symptoms may be prone to increased digital media use.

Some key findings from the review:

• About 63% of studies found significant associations between digital media use and later ADHD symptoms
• About 53% found associations between ADHD symptoms and later digital media use
• Associations were generally small to moderate in size
• Problematic or addictive digital media use showed stronger links to ADHD compared to screen time alone
• Few studies looked at potential moderating or mediating factors that might explain the connections

The review highlights that this is a complex topic, with many factors likely involved in the relationships between digital media and ADHD symptoms in youth.

How might digital media affect ADHD symptoms?

The review discussed several theories for how digital media use could potentially contribute to increases in ADHD symptoms over time:

Scan and shift hypothesis: The fast pace of digital media may train the brain to quickly scan and shift attention, making it harder to sustain focus on less stimulating tasks.

Arousal and habituation: Highly arousing digital media content may lead to habituation, causing difficulties with lower-arousal activities.

Multitasking effects: Frequent media multitasking may make it harder to focus on single tasks.

Displacement of other activities: Time spent on digital media may displace other important activities like sleep, physical activity, and in-person social interaction.

However, it’s important to note that these are theories, and more research is needed to determine if and how these mechanisms may actually be operating.

Why might children with ADHD use more digital media?

The review also explored reasons why children with ADHD symptoms may be prone to higher levels of digital media use:

Attraction to stimulating content: Children with ADHD may be especially drawn to the fast-paced, arousing nature of many digital media activities.

Escape and coping: Digital media may be used as an escape from difficulties with peers or academics that are common for children with ADHD.

Social compensation: Online interactions may be used to compensate for challenges with in-person social relationships.

Again, more research is needed to confirm these potential explanations. It’s likely that multiple factors contribute to digital media use patterns in children with ADHD.

Problematic use vs. screen time

An important finding from the review was that problematic or addictive patterns of digital media use showed stronger associations with ADHD symptoms compared to screen time alone.

Problematic use refers to digital media habits that interfere with daily life or cause distress. This could include things like:

• Preoccupation with gaming or social media
• Difficulty controlling or cutting back on use
• Neglecting other activities because of digital media use
• Using digital media to escape negative moods
• Conflicts with family over digital media use

The review found that 8 out of 9 studies looking at digital media addiction found significant associations with ADHD symptoms. In contrast, studies just measuring screen time showed more mixed results.

This suggests it may be the pattern of use, rather than just time spent, that is most relevant when it comes to connections with ADHD symptoms. Helping children develop healthy digital media habits may be more important than focusing only on reducing screen time.

Other factors that may play a role

The review highlighted that other lifestyle and environmental factors likely play a role in the connections between digital media use and ADHD symptoms. Some factors that may be involved include:

Sleep: Digital media use, especially close to bedtime, can interfere with sleep. Poor sleep is also associated with increased ADHD symptoms.

Physical activity: Time spent on digital media may displace physical activity, which is important for attention and overall health.

Social relationships: Excessive digital media use may impact in-person social skills and relationships. Social difficulties are also common in ADHD.

Parenting practices: How parents manage and monitor children’s digital media use may influence its impacts.

However, few of the reviewed studies examined these types of mediating or moderating factors in depth. This is an important area for future research to better understand the complex connections between digital media and ADHD.

Limitations and future directions

While this review provides valuable insights, the authors note several limitations in the current research:

• Most studies relied on self-report or parent-report measures rather than objective assessments
• Few studies looked at potential moderators or mediators of the associations
• Most studies used linear models rather than examining potential non-linear relationships
• Time lags between assessments varied, which could impact results
• Relatively few studies examined social media use specifically

The authors call for more research addressing these limitations to gain a clearer picture of how digital media use and ADHD symptoms influence each other over time in children and adolescents.

In particular, they emphasize the need to identify subgroups that may be more vulnerable to developing problematic digital media use patterns. Understanding risk factors could help target prevention and intervention efforts.

Conclusions

Overall, this systematic review suggests there are likely bi-directional relationships between digital media use and ADHD symptoms in children and teens. While associations were generally small, even small effects may be meaningful given how prevalent digital media use is among youth today.

The findings highlight the importance of helping children and adolescents develop healthy digital media habits. This is especially crucial for youth with ADHD who may be more prone to problematic use patterns.

Parents and health professionals should be aware of signs of problematic digital media use, not just high screen time. Teaching children skills to regulate their own media use and ensuring it doesn’t interfere with sleep, physical activity, and in-person relationships is key.

More research is still needed to understand the complex connections between digital media and ADHD. But this review provides an important synthesis of the current evidence to inform both clinical practice and future studies on this critical topic for child and adolescent mental health.