Heliyon 8 (2022) e12489

Contents lists available at ScienceDirect

Heliyon
journal homepage: www.cell.com/heliyon

Review article

The impact of media on children during the COVID-19 pandemic: A

narrative review☆
M. Mesce a, A. Ragona a, S. Cimino a, L. Cerniglia b, *
a
Sapienza, University of Rome, Department of Dynamic Clinical and Health Psychology, Via degli Apuli, 1, 00186, Rome, Italy
b
International Telematic University Uninettuno, Faculty of Psychology, Corso Vittorio Emanuele II, 39, 00186, Rome, Italy

A R T I C L E I N F O A B S T R A C T

Keywords: Although mobile technologies are a fundamental part of daily life, several studies have shown increased use of
Media electronic devices, TV, and gaming during childhood in conjunction with the COVID-19 pandemic. The virus
Children affected almost every country, causing uncertainty about the future, social isolation, and distress. This narrative
COVID-19
review has searched the scientific literature in the field focusing on children. A non-systematic literature review
Narrative review
was conducted in May 2022. Various databases were employed to conduct the document research for this paper,
such as “Google Scholar”, “PubMed”, “Web of Science”. Keywords for the search included “screen time”, “media”,
“digital use”, “social media”, “COVID-19”, “pandemic”, “lockdown”, “children”, “effect of media on children
during COVID”. It was found that both children and adolescents seem to have used technologies to confront
struggles provoked by COVID-19, such as the onset or exacerbation of symptoms of anxiety, depression, and
attention-deficit/hyperactivity disorder. However, moreover, other studies have suggested that increased media
use can have positive effects on children depending on usage and monitoring by the parents.

1. Introduction possible harm caused by the excessive use of digital technology (Huber
et al., 2018; Przybylski et al., 2020) that could even result in a full-blown
1.1. Background: children and media Internet addiction (Mak et al., 2014).
There is significant literature highlighting the various problems that
Earlier literature has pointed out that media, particularly the Internet, may result from excessive exposure to digital media, and the concerns are
affect individuals' health, interpersonal relationships, concerns and specific to each age group, from infants to adolescents (Chonchaiya et al.,
opinions, and sleep (Do et al., 2020; Tran et al., 2017, 2020; Zhang et al., 2011; Heffler et al., 2020; Srisinghasongkram et al., 2021).
2017). Particularly for children, media contribute to daily life throughout Previous studies suggest that children's cognitive, behavioral, and
development (Calvert and Valkenburg, 2013): today's children are born emotional development might be impaired by exposure to digital media
and grow involved in media, as brilliantly described by the expression early in life, as it narrows their interests and limits areas of exploration
"digital natives" (Prensky, 2001). Mobile technologies are a gateway to a and learning. This makes it difficult for kids to involve themselves in non-
wide range of information: their continued modernization, such as electronic tasks, decreases play time with other children, and thus im-
electronic tablets and smartphones, allows children and adolescents to be pairs the development of imaginative skills, creativity, and social skills.
connected to media and move between them 24/7: youths can use their Digital media also impairs children's maturation of language, attention,
mobile phones to text or call one another, watch online television pro- reading, and reasoning (Chonchaiya et al., 2011; Heffler et al., 2020), the
grams or movies, play online games, or use mobile apps (Calvert, 2015). latter of which is also hindered by the many behavioral problems that can
Digital progress has supplied more innovative educational opportu- develop, like hyperactivity and inattention, aggression and conduct
nities and easier access to information and communication (Chauhan problems (Srisinghasongkram et al., 2021). All of this has a huge negative
et al., 2021). Therefore, the digital age has fundamentally changed the effect and involves several areas of the individual: cognitive (intellectual)
lives of children, affecting their learning, social relationships, play, and disorders, lack of attention, poor school performance, impulsivity, and
overall development. At the same time, there are concerns about the poorer logical reasoning (Srisinghasongkram et al., 2021).

☆
This article is a part of the "The effects of media on children during the COVID-1900 Special issue.
* Corresponding author.
E-mail address: [email protected] (L. Cerniglia).

https://doi.org/10.1016/j.heliyon.2022.e12489
Received 31 May 2022; Received in revised form 9 August 2022; Accepted 10 December 2022
2405-8440/© 2022 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
M. Mesce et al. Heliyon 8 (2022) e12489

A recent publication (Stiglic and Viner, 2019) showed moderately 50 percent of the world's infants were frightened by reports of COVID-19
convincing support for a correlation betwixt display time and depressive (G€otz et al., 2020). Since pandemic-related news on social media chan-
symptomatology and weak evidence for an association betwixt screen nels was frequently misinformative, getting exposed to this could have
time and behavior problems, anxiety, hyperactivity, inattention, adverse emotional implications (Gabarron et al., 2021).
decreased self-esteem, and decreased psychosocial well-being in young In addition, children can be exposed to inappropriate content and
children. cyberbullying: according to a study conducted by Hunduja and Patchin
Another serious consequence is cyberbullying: children may be (2020), even in the pre-COVID-19 period, the Internet was seen to expose
bullied and exposed to traumatic and pornographic/sexually explicit children to increased cyberbullying, which can result in low self-esteem
images. All of these may develop further adverse psychological impli- and even suicide attempts.
cations (American Academy of Pediatrics, 2016). Indeed, the increase in media use is one of the most insidious threats
of our time, as it has lowered the age of Internet use and awareness,
1.2. The impact of the COVID-19 pandemic consequently increasing the related risks and dangers. Therefore, the
pandemic fueling this condition has left its mark on further development
At the end of 2019, Coronavirus Disease 2019 (COVID-19) was first (Kamaşak et al., 2021).
reported in China; it is a severe infectious disease with high conta- Earlier literature has focused mainly on adulthood (e.g., Wang et al.,
giousness and rapid transmission rate, affecting the entire world popu- 2021a; Wang et al., 2021b) or adolescents (Ren et al., 2021), paying less
lation and causing various inconveniences in daily life (Phelan et al., attention to the impact that media has on children, particularly during
2020). Several studies have shown that the policy of social isolation to COVID-19. Therefore, this paper is designed to recapitulate the impact of
control the circulation of COVID-19 did carry a complex influence on media on infancy during COVID-19 and its implication on welfare.
psychological well-being (Chen et al., 2020; Duan et al., 2020; Lee et al.,
2021; Xie et al., 2020). 2. Method
COVID-19 took place when digitization was now global, in a society
where anyone can be connected in any part of the globe (Serra et al., The methodological approach of the present paper consists of a
2021). Millions of children have been adversely affected by it: due to narrative review (Green et al., 2006; Pan, 2008) and it is a type of
school closures, many youths have been forced to continue their educa- interpretive-qualitative publication that does not answer a specific
tion online and rely on digital media to stay connected with their peers question but aims to discuss the state of the literature on a given issue and
(Gupta and Jawanda, 2020). Consequently, social network use has increase the scientific community's debate on it (Grant and Booth, 2009).
increased: children spent more time with smartphones, tablets, and A non-systematic literature review was conducted in May 2022. Since
computers (e.g., Chen et al., 2021; Dong et al., 2020; Eales et al., 2021; this was a narrative review, we did not use a risk of bias instrument, as
Kamaşak et al., 2022; Serra et al., 2021; Susilowati et al., 2021; Teng some authors believe that this type of review may or may not include a
et al., 2021). quality assessment (Grant & Booth, 2009; Pautasso, 2013).
Internet and social media provided kids and teenagers to remain Various databases were consulted in the search for papers, such as
connected with peers and relatives but also an avenue to confront un- “Google Scholar”, “PubMed”, “Web of Science”. Keywords for the search
availability of human interactions during COVID-19 and thus adverse included “screen time”, “media”, “digital use”, “social media”, “COVID-
emotions (Cauberghe et al., 2021; G€ otz et al., 2020; Marciano et al., 19”, “pandemic”, “lockdown”, “children”, “effect of media on children
2021). In compliance with these studies, the Compensatory Internet Use during COVID”. These keywords were combined with Boolean operators
Theory (Kardefelt-Winther, 2014) argues that adverse life events and to restrict the results. The studies were filtered by two of the authors
stressors can provide motivation for anyone to turn to the Internet to (A.R. and M.M.) and the relevant ones were included in this review,
mitigate adverse feelings related to these factors. while the unrelevant ones were excluded, as shown in Figure 1. Conse-
Nevertheless, it is crucial to consider that during the pandemic quent information is summarized in Table 1.
internet access was justified by online classes and peer communication, As for the eligibility criteria, we considered the age group 2–13 years,
causing possible misuse (Li et al., 2021a). and papers that did not treat the main theme of the age group were
Because chronic stress during the pandemic can result in adverse discarded. Only studies published between 2020 and 2022 were
emotional disorders, such as depression and anxiety (e.g., Pfefferbaum considered. Since limiting the inclusion of studies by the language of
and North, 2020; Qiu et al., 2020), it has been observed that during the publication is a widespread practice in reviews (Stern and Kleijnen,
COVID-19 emergency, some people relied on dangerous coping strate- 2020), we chose to follow this line: articles published not in English were
gies, such as using smartphones more frequently to consult the Internet not considered in the present paper. Also, some thesis dissertations (n ¼
and social media in order to alleviate pandemic-related anxiety and 2) were included. We examined each publication's title and abstract using
follow the news (Kir aly et al., 2020). our focus as a guide.
Indeed, using the Internet as entertainment can be a regular way for
infants to discharge emotions and stress and cope with reality (Kwon, 3. Results
2011); however, excessive media use can lead users, especially children,
to be less interested in real life and focus only on what is happening on This manuscript aimed to summarize the evidence on the influence of
the Internet (King and Delfabbro, 2014). The World Health Organization media on children during COVID-19 and its impact on well-being.
(WHO) indicates a limit of 1 h of display time for 5-year-olds as a Table 2 provides a brief description of the selected studies.
guideline (WHO, 2019). Nevertheless, parents experienced many pres- Several papers selected in this review proved that the pandemic
sures related to screens and technologies since before the onset of the influenced children's habits toward electronic media, such as gaming and
pandemic (Radesky et al., 2016). Considering COVID-19, the inability of time spent on social media or smartphones (Adachi et al., 2022; Camerini
the majority of families to comply with the instructions on screens has & Albanese, 2021; Chen et al., 2021; Chen et al., 2022; Hmidan, 2022;
been recognized. Kim et al., 2021; Marfua, 2021; Sciberras et al., 2022; Serra et al., 2021;
During the pandemic, the news trended mostly negatively (Ogbodo Werling et al., 2021a,b).
et al., 2020; Robertson et al., 2021; Priest, Sehgal, & Cook, 2020). It is possible to summarize the various contributions in this article by
Exposure to this kind of news, such as increased infections and deaths or following a few main themes: the psychological and physical outcomes of
the resulting economic crisis, causes stress and anxiety, and even panic using and owning technological gadgets during COVID-19 (Adachi et al.,
attacks, especially among susceptible groups (Scheufele, 1999). In fact, 2022; Camerini et al., 2022; Chen et al., 2021; Chen et al., 2022; Cowan
cross-cultural research centered on the moment of isolation found almost et al., 2021; Guo et al., 2021; Hmidan, 2022; Limone and Toto, 2021;

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M. Mesce et al. Heliyon 8 (2022) e12489

playtime during school hiatus. In a longitudinal study (Chen et al., 2022)

repeated-measures analyses of variance noted a significant difference in
mean psychological distress, problematic smartphone use, and prob-
lematic gaming. Moreover, other researchers not only gave attention to
the emotional state of children but also of mothers, showing that
maternal anxiety/depression was related to an overuse of handheld
Internet devices, especially smartphones, among infants and children
(Guo et al., 2021).
In line with these results, very interesting is Hmidan's (2022) study
that explored and demonstrated a significant association between screen
time and internalizing behaviors: time spent on the screen was a positive
predictor of internalizing behaviors (p < .05). In contrast, no association
was noted between screen time and externalizing behaviors.
In the second place, on behavioral problems, two studies (Li et al.,
2021b; Marfua, 2021) found a worsening in children's conduct during
COVID-19 concerning media usage. The study by Li and colleagues
(2021) showed that in younger children, higher time spent using TV or
digital media was associated with higher levels of behavior problems and
hyperactivity/disattention (Li et al., 2021b). In the same paper (Li et al.,
2021b), was found that in older children (M ¼ 11.3 þ/- 3.3 years) more
time spent using digital media or watching TV was connected with higher
levels of depression, irritability, inattention, and hyperactivity; more
time spent in online learning was linked with higher levels of depression
and anxiety; higher levels of video-chatting time were associated with
higher levels of depressive symptoms (Li et al., 2021b). Marfua (2021)
noted that 55% of mothers reported a change in their children's behavior
because of the long time spent on screens during the spread of COVID-19:
children shower overactivity, attention problems, reduced interest in
learning, showed aggressive attitude, were unable to control emotion and
began to hide information (ibidem). In addition, a significant correlation
was also found: the prosocial behavior of children decreases in relation to
Figure 1. Flowchart. higher screen time (ibidem). The correlation between conduct, hyper-
activity, peer relationship, and screen time was non-statistically
significant.
Other studies have given importance to the adverse effects of screen
Table 1. Search strategy.
time on physical health during the COVID-19 pandemic, such as eating
Database Keywords Population habits, physical activities, and sleep. In particular, some studies focused
Google Screen time, media, digital use, social media, Children between on unhealthy eating habits. One study (Kamaleddine et al., 2022) con-
Scholar, COVID-19, pandemic, lockdown, children, child, 2-13 years ducted a logistic regression analysis using food consumption while using
PubMed, effect of media on children during COVID. media devices as a dependent variable. The significant independent
Web of
Science
variables that predicted children's habit of eating foods while using
electronic devices were total time spent on screen 2 h, time spent on
smartphone screen 2 h, sleep problems, the ownership of technological
Werling et al., 2021a; Serra et al., 2021); behavioral problems related to device, and not eating unhealthy foods (ibidem). Another study (Kim
overuse of media during COVID-19 (Li et al., 2021b; Marfua, 2021); the et al., 2022) that seems to confirm this result states that during the
relationship between eating and sleeping disorders and the use of media closure of school children gained weight, have done less sport, and have
during the pandemic (Kamaleddine et al., 2022; Kim et al., 2022; Kotrla suffered increased exposure to screens. This study also observed that
Topic et al., 2021); the effect of media in groups of clinical and ADHD children's sleep problems were associated with time spent on tablets and
children (Sciberras et al., 2022; Shuai et al., 2021). smartphones, but not their frequency. In line with these results the study
First, several focused on the outcomes of media on psychological and of Camerini et al. (2022) emphasized a reduction in the time that chil-
physical well-being, showing that some aversive outcomes due to the use dren have spent outdoors (green time) and an increase in media time
of smartphones were noticed significantly more often in the study pop- with an overall reduction in children's health.
ulation during COVID-19, compared to the pre-pandemic time. In The work of Kotrla Topic et al. (2021) concerns sleep. In this study,
particular, the study by Serra et al. (2021) revealed a considerable risk of sleep quality was investigated independently for three age groups of
smartphone addiction in the pandemic (31.5 % before vs during the children (attending kindergarten, lower, or upper elementary school
emergency 46.7% were outlined and 27.2% were high risk). Moreover, a grades); in all three age groups, parents reported that their children had a
study (Adachi et al., 2022) instead focused on smartphone ownership and good or very good sleep quality. The findings showed a significant
revealed a dissimilar result on depressive symptoms depending on negative association between sleep quality and age (partial r ¼ -0.213, p
whether children owned a smartphone or not: those who owned a cell < 0.001). For children, partial correlations were calculated between
phone had significantly higher and lower rates at the cutoff than ex- parents' ratings of sleep quality and digital technology usage, and the
pected. Consistent with these results on the effects of media overuse in effect of age was controlled for. Researchers found a significant negative
children during COVID-19, the work of Chen et al. (2021) showed that correlation between sleep quality and smartphone use in leisure time,
IGDS, BSMAS, SABAS, depression, anxiety, and stress scores were posi- implying that those who most frequently used smartphones for leisure
tively and significantly related. In this study, mediation analyses indi- time had poorer sleep quality.
cated that social media and smartphone activities were mediators in the An interesting study by Werling et al. (2021a) focused on a clinically
association between depression, anxiety, and stress, and increased referred sample and conducted a repeated-measures analysis of gaming

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M. Mesce et al. Heliyon 8 (2022) e12489

Table 2. List of selected publications: Author/Year; Title; Main Issues and Measures.

Author/Year Title Highlighted issues Measures

Adachi, M., Takahashi, M., Longitudinal association between smartphone Smartphone, COVID-19, Depression, An ad hoc questionnaire was developed for the
Shinkawa, H., Mori, H., ownership and depression among Schoolchildren, Screen time present study; Patient Health Questionnaire for
Nishimura, T., & Nakamura, K. schoolchildren under COVID-19 pandemic Adolescents (PHQ-A; Johnson et al., 2002).
(2022)
Camerini, A. L., Albanese, E., The impact of screen time and green time on Screen time, green time, mental health, An ad hoc questionnaire was developed for the
Marciano, L., & Corona mental health in children and adolescents child, COVID-19 present study; Corona Immunitas Ticino (CIT;
Immunitas Research Group. during the COVID-19 pandemic West et al., 2020).
(2022)
Chen, C. Y., Chen, I. H., Pakpour, Internet-related behaviors and psychological COVID-19; problematic gaming; problematic An ad hoc questionnaire was developed for the
A. H., Lin, C. Y., & Griffiths, M. D. distress among schoolchildren during the social media use; problematic smartphone present study; Internet Gaming Disorder Scale-
(2021). COVID-19 school hiatus. use; psychological distress; school hiatus Short Form (IGDS-SF9; Yam et al., 2019); Bergen
Social Media Addiction Scale (BSMAS; Ibidem);
Smartphone Application-Based Addiction Scale
(SABAS; Ibidem); Depression, Anxiety, Stress
Scale-21 (DASS-21; Wang et al., 2016).
Chen, C. Y., Chen, I. H., Hou, W. The Relationship Between Children's addictive behaviors, COVID-19, Internet, Depression, Anxiety, Stress Scale-21 (DASS-21;
L., Potenza, M. N., O'Brien, K. S., Problematic Internet-related Behaviors and pandemic, psychological distress, social Wang et al., 2016); Smartphone
Lin, C. Y., & Latner, J. D. (2022) Psychological Distress During the Onset of the media, video games Application-Based Addiction Scale (SABAS; Yam
COVID-19 Pandemic: A Longitudinal Study et al., 2019); Internet Gaming Disorder
Scale-Short Form (IGDS9-SF; Ibidem).
Cowan, K., Potter, J., Olusoga, Y., Children's Digital Play during the COVID-19 Digital Play, COVID-19, Childhood, Digital An ad hoc questionnaire was developed for the
Bannister, C., Bishop, J. C., Pandemic: insights from the Play Observatory Media present study for both parents and children.
Cannon, M., & Signorelli, V.
(2021)
Eales, L., Gillespie, S., Alstat, R. Children's screen and problematic media use in Screen media use; problematic media use, An ad hoc questionnaire was developed for the
A., Ferguson, G. M., & Carlson, S. the United States before and during the COVID- COVID-19, children present study; adapted versions of the Common
M. (2021) 19 pandemic Sense Census (CSC; Rideout and Robb, 2017);
Measure of Problematic Media Use - Short Form
(Domoff et al., 2019).
Guo, X., Zhou, Y., Xu, J., Hu, Y., The Association of Maternal COVID-19 pandemic, maternal depression, An ad hoc questionnaire was developed for the
& Liu, Z. (2021) Emotional Status With Child maternal anxiety, child electronic devices present study; Self-rating Depression Scale (SDS;
Over-Use of Electronic Devices During the over-use, media, family environment Zung, 1965); Self-rating Anxiety Scale (SAS; Zung,
COVID-19 Pandemic 1971); Family Environment Scale (FES-CV;
Phillips, 1999).
Hmidan, A. (2022) Screen time use and Children's Mental Health Parent stress, parenting styles, screen time, An ad hoc questionnaire was developed for the
During the COVID-19 Pandemic behavioral outcomes, education, COVID-19 present study; Alabama Parenting Questionnaire
(APQ; Frick, 1991); Parent Stress Index -Fourth
Edition Short Form (PSI-4; Cohen et al., 1983);
Strengths and Difficulties Questionnaire (SDQ;
Goodman, 1997).
Kamaleddine, A. N., Antar, H. A., Effect of Screen Time on Physical and Mental COVID-19; Screen time; Eating; Sleep; An ad hoc questionnaire was developed for the
Abou Ali, B. T., Hammoudi, S. F., Health and Eating Habits During COVID-19 Depression. present study; Children Sleep Habit
Lee, J., Lee, T., ... & Salameh, P. Lockdown in Lebanon Questionnaire-Abbreviated (CSHQ-A; Owens
(2022) et al., 2000); Preschool Feelings Checklist (PFC;
Luby et al., 2004).
Kim, S. J., Lee, S., Han, H., Jung, Parental Mental Health and Children's COVID-19; School Closure; Parental Mental An ad hoc questionnaire was developed for the
J., Yang, S. J., & Shin, Y. (2021) Behaviors and Media Usage during COVID-19- Health, Children's Behaviors; Media Usage present study; Children's Sleep Habits
Related School Closures Questionnaire (CSHQ; Owens et al., 2000);
Behavior Problem Index (BPI; Zill and Peterson,
1986); Patient Health Questionnaire-9 (PHQ-9;
Kroenke et al., 2001).
Kotrla Topic, M., Varga, V., & Digital technology use during the covid-19 digital technology, life satisfaction, An ad hoc questionnaire was developed for the
Jelovcic, S. (2021) pandemic and its relations to sleep quality and lockdown, sleep quality present study.
life satisfaction in children and parents
Li, X., Vanderloo, L. M., Keown- Screen Use and Mental Health Symptoms in specific forms of screen use, depression, Multiple ad hoc questionnaires were developed
Stoneman, C. D., Cost, K. T., Canadian Children and Youth During the anxiety, conduct problems, irritability, for the present study.
Charach, A., Maguire, J. L., ... & COVID-19 Pandemic hyperactivity, and inattention in children
Birken, C. S. (2021b) and youth during COVID-19.
Limone, P., & Toto, G. A. (2021) Psychological and Emotional Effects of Digital digital technology; brain condition; *
Technology on Children in COVID-19 neuropsychological effects; COVID-19
Pandemic
Marfua (2021) Exploring the Influences of Prolonged Screen Prolonged screen time; Pandemic; COVID- An ad hoc questionnaire was developed for the
Time on the Behavior of Children aging 3–6 19; Child's behavior; Digital device present study; Strength and Difficulties
years During COVID-19 Crisis Questionnaire (SDQ; Goodman, 1997);
Socioeconomic Status Questionnaire (SES).
Sciberras, E., Patel, P., Stokes, M. Physical Health, Media Use, and Mental ADHD, COVID-19, psychological well-being An ad hoc questionnaire was developed for the
A., Coghill, D., Middeldorp, C. Health in Children and Adolescents With ADHD present study; CoRonavIruS Health Impact Survey
M., Bellgrove, M. A., ... & During the COVID-19 Pandemic in Australia (CRISIS; Nikolaidis et al., 2021); An adapted
Westrupp, E. (2020) version of the COVID-19 Pandemic Adjustment
Survey (CPAS; Westrupp et al., 2020).

(continued on next page)

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M. Mesce et al. Heliyon 8 (2022) e12489

Table 2 (continued )
Author/Year Title Highlighted issues Measures
Serra, G., Scalzo, L. L., Giuffr
e, Smartphone use and addiction during the Smartphone, Addiction, COVID-19, School- An ad hoc questionnaire was developed for the
M., Ferrara, P., & Corsello, G. coronavirus disease 2019 (COVID-19) age children present study; Italian Smartphone Addiction Scale
(2021) pandemic: cohort study on 184 Italian children Short Version (SAS-SV; De Pasquale et al., 2017).
and adolescents
Shuai, L., He, S., Zheng, H., Influences of digital media use on children and ADHD, COVID-19, Digital media, Mental Self-rating Questionnaire for Problematic Mobile
Wang, Z., Qiu, M., Xia, W., ... & adolescents with ADHD during COVID-19 health Phone Use (SQPMPU; Tao et al., 2013); Internet
Zhang, J. (2021). pandemic Addiction Test (IAT; Young, 2004).
Swanson, Nolan, and Pelham Rating Scale (SNAP;
Zhou et al., 2013); Behavior Rating Inventory of
Executive Function (BRIEF; Gioia et al., 2000);
Adolescent Self-rating Life Events Checklist
(ASLEC; Xin and Yao, 2015); the Chinese version
of the Family Environment Scale (FES-CV; Tao
et al., 2015); Students learning motivation scale
(SLMS; Chen and Xu, 2020); Depression
self-rating scale for children (DSRSC; Su, 2003);
Screening child anxiety-related emotional
disorders (SCARED; Wang, 2002); the study also
designed the Home Quarantine Investigation of
the Pandemic (HQIP).
Werling, A. M., Walitza, S., Media use before, during, and after COVID-19 Screen media use, problematic use of the An ad hoc questionnaire was developed for the
Grünblatt, E., & Drechsler, R. lockdown according to parents in a clinically internet, COVID-19 pandemic, Lockdown, present study; PUI-Screening Questionnaire for
(2021a) referred sample in child and adolescent Child and adolescent psychiatry Children and Adolescents (PUI-SQ; Werling et al.,
psychiatry: Results of an online survey in 2021b).
Switzerland
*
This paper is a Review.

time, finding that the primary outcome of gaming over time and the game digital media use presented significantly more impaired executive func-
interaction divided by gender were significant. A pairwise comparison tion on shift, emotional control, initiation, working memory, plan, and
showed that after the lockdown, female patients reported a play time behavior regulation index, metacognition than the group without this
similar to the pre-pandemic, but this did not occur in male patients. condition. The total score on the depression self-rating scale for children
Planned contrasts disclosed significant differences in time spent on social and the screening child anxiety-related emotional disorders was signifi-
media from T1 to T2 and T1 to T3. The pairwise comparisons revealed cantly worse in ADHD with problematic digital media use group
significant differences between time spent on social media from T1 to T3 compared the other group. The ADHD children in the PDMU group spent
in girls but not in boys. According to the results of this study, during the more time on screens independently for playing video games than for
lockdown, the negative effects of using devices on family quality of life using social media.
have intensified. In the last two weeks, these negative outcomes seem to
have returned to normal levels for most parents. Taken together, how- 4. Discussion
ever, according to parents' perceptions, the lockdown appears to have
had very little effect on problem behaviors and specific risks related to The present study aims to highlight the implication of media use on
the media usage. Parents were requested to indicate if the intensity of the children during COVID-19. The emergency that the world has faced over
main psychopathological problem had varied since January 2020 and the past two years has had serious repercussions in every sphere of
during the lockdown. Most replied that there had been no significant human life, affecting the psychological and non-psychological habits and
change, meanwhile an increase in problems was referred by an average welfare of everyone, regardless of age, putting family relationships and
percentage of parents (37.7%) and a worsening by 21.2%. Statistical children's social-emotional maturation at risk (Witt et al., 2020). Espe-
comparison between groups concerning estimated screen time in patients cially for children and adolescents the crisis has favored increased vul-
with worsened, unaltered, and improved symptoms during the lockdown nerabilities and affected the stability of family members (Douglas et al.,
found noticeable and significant effects. In children between 10 and 13 2020; Garcia and Duarte, 2020; Wang et al., 2020a; Lee, 2020; Viner
years with worsening symptomatology, the total time expended on media et al., 2020).
was significantly higher compared to other groups with no change or Considering the 18 selected articles in our review, we can highlight
improvement in symptoms of the psychopathological disorder. It was that the issues the authors focused on most are the problematic use of
also explored if overall time spent on media was correlated with the devices in early childhood and the psychological and physical impact
number of psychopathological disorders reported by parents, the fre- that technology can have on children and their mental health. There is no
quency of online school during the lockdown and the frequency of doubt that COVID-19 there was an increase in the time spent at home
allowed activities outside the home during the lockdown. Neither of compared to before the lockdown and so on screens, even for younger
these factors had a significant effect on the total time dedicated to media. children (Kotrla, Varga & Jelovcic., 2021; Andrew et al., 2020; Moore
Finally, two studies have considered children with ADHD. In the first et al., 2020). In fact, the prevalence of technology device use increased
one (Sciberras et al., 2022), children's stress about COVID-19 was significantly during the pandemic due to the lack of outdoor activity and
significantly associated with a higher use of social media; the hypothesis indoor confinement. The increase of technology device employment
of an association between COVID-19 worries and increased gaming has during COVID-19 has been brought to 15 percent (Ammar et al., 2021)
not been confirmed by statistical analysis. Shuai et al. (2021) also focused and this has led to dysfunction in normal functioning (Lau et al., 2022). In
on children with ADHD: subjects were distinct in ADHD with and without fact, increased use of technological devices is a prodrome for the eventual
PDMU (problematic digital media use). The ADHD group with PDMU had onset of sleep disorders, irritability but also Internet addiction, and
significantly worse symptoms in attention scores, in oppositional defiant gaming problems (Mohan et al., 2021). Earlier studies have observed that
scores, behavioral problems, and emotional difficulties when compared Internet addiction is significantly correlated with the onset of psychiatric
with the ADHD group without PDMU. The children with problematic symptoms such as ADHD, depression, and anxiety (Ho et al., 2014).

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There is ample evidence that screen overexposure (4 h per day) can particular, are often left alone with technological devices as they are
be a prodrome for major depressive disorder and social phobia in chil- considered more independent.
dren (Kim et al., 2020), emphasizing the need to restrict children's Regarding mental health during COVID-19, some studies have found
exposure to screens, regardless of their age (Hmidan, 2022). According to a correlation not only between device ownership and depression in
research by Kim et al. (2021), children gained weight during the school-aged children (Adachi et al., 2022), but also between maternal
blockade and engaged in less physical activity and more media use; the symptomatology and excessive use of handheld Internet devices,
most used media was online educational content (97.2%); however, particularly smartphones, among children (Guo et al., 2021), and this
YouTube was found to be one of the most used contents (87.6%) association varies according to the age of the children. This is a crucial
immediately followed by online games (78.3%). This increased use of point because we need to consider that children's social isolation and the
media and the Internet could lead not only to physical problems but also activities, they engage in during the shutdown also affect parents' mental
to internalizing and externalizing symptoms (Hmidan, 2022). In this health. Maternal mental state can affect the child in several ways: for
study, the author noticed a positive correlation between screen time and example, mothers with internalizing disorders might make excessive use
internalizing behaviors and hypothesized that age-related factors may of electronic devices, act as role models for children, or use screen time to
moderate the strength of the correlation (ibidem). replace insufficient maternal companionship (Bjelland et al., 2015;
Another crucial point is that the school hiatus, and consequently the Faltýnkova et al., 2020; Wu, 2016) or children may take relief from
lockdown related to the pandemic, could have caused psychological portable internet devices when the mother is unable to provide emotional
distress in elementary school children (Chen et al., 2021), and the support.
negative impact can be extended to the problematic use of social media However, it is worth noting that the media can further have a bene-
and smartphones. Longitudinal research conducted by Chen et al. (2022) ficial impact: it has been shown that children and adolescents can benefit
shows that the pandemic has worsened psychological health and because social media helps increase communication skills and develop
increased problematic Internet use in a large sample of schoolchildren technical skills (Tartari, 2015). During the lockdown, social media shares
increasing digital media-related distress. allowed for similar feelings to be shared: in fact, it was observed that
In addition, in research conducted by Atia Marfua (2021), mothers those who perceived they had more support on social media had a better
noted various behavioral and health concerns in their sons and daughters level of mental health (Kaya, 2020; Canale et al., 2022).
during COVID-19 related to the prolonged use of screens and techno- Further, COVID-19 allowed new intervention methods for chronic
logical devices. Other researchers (Li et al., 2021b) found that increased disease management that proved to be extremely useful in that they
screen use was related to greater rates of psychological health symptoms allowed essential services needed during isolation not to be interrupted
in children and adolescents during COVID-19, consistent with findings in (Shamsabadi et al., 2022).
the pre-pandemic literature (Stiglic and Viner, 2019; Hoare et al., 2016; Psychotherapy has also had to adapt to the period of isolation,
Suchert, Hanewinkel & Isensee, 2015). In particular, in young children, resorting to the use of virtual platforms. Regarding the treatment of
increased time spent on TV or digital media has proven to be related to symptoms due to the pandemic, it has been found that cognitive-
conduct issues and hyperactivity/disattention (Cost et al., 2022.; Pat- behavioral therapy via the Internet is the most effective therapy (Ho
terson et al., 2002). Television has had a significant impact during this et al., 2020; Zhang and Ho, 2017).
period of isolation because everyone has it in the home: greater and more Overall, therefore, digital technologies can be useful resources in
constant access to information regarding the pandemic has been posi- addressing issues posed by COVID-19.
tively related to symptoms of anxiety and depression as well as PTSD Ultimately, the increased reliance on technology during COVID-19
(Wang et al., 2020b; Xiong et al., 2020). Such negative consequences can has a complex impact. Technological devices have indeed provided an
strike especially hard with children: in fact, it has been shown that escape from loneliness but, at the same time, maybe a prodrome for the
watching television before age 3 can negatively affect children's cogni- development of depression, anxiety, irritability, and sleep problems. This
tive functions (Zimmerman and Christakis, 2005). review has some limitations explained below. First, we only included
Gaming has also played a significant role in entertaining children papers published in English; we chose to follow this line due to lack of
during isolation, even bringing in some cases positive, and non-negative, time and unavailability of language resources, which, as suggested by
effects such as improving mental health and helping combat isolation Neimann Rasmussen and Montgomery (2018), are among the most
(Barr and Copeland-Stewart, 2022). In fact, video games are functional common reasons for not including languages other than English. Another
stress-relieving tools for both children and adults: they are believed to limitation may be related to the survey methods of the articles included
reduce both anxiety and depression and increase other abilities (Bowman in this manuscript; in fact, in most cases, they are based on parental
et al., 2022; Limone, 2021; Yee and Sng, 2022). observation. Since the results of the studies considered refer to a poten-
However, Werling et al. (2021) found that although most of the ef- tially frightening and depressing period for the children, likely, the time
fects due to dysfunctional media use seemed reversible, this was not the spent with the parents, which was greatly increased due to the closure,
case in a clinical champion of young males with psychiatric disorders. It and the quality of the relationship may also have been affected; this
is, therefore, possible to conclude, based on the earlier research cited situation could therefore have influenced the parents' ability to observe
above, that excessive media use was only temporary in most individuals, and, consequently, the results obtained. A controlled type of data
however, for those who were already at risk for technological depen- collection would be useful to try to isolate possible causal agents.
dence, the lockdown may have exacerbated the problem.
In addition, our investigation shows that children who engaged more 5. Conclusions
in activities involving screens during the pandemic are more likely to
develop higher levels of anxiety and psychosomatic symptoms (Camerini We are aware that COVID-19 sets a unique issue and raises the need to
et al., 2022), thus confirming previously observed findings (Ho et al., find innovative solutions to the latest problems. We suggest that
2014; Mohan et al., 2021). emphasis and attention be placed on children's psychological health
A very interesting point to consider is that during COVID-19 infants during the pandemic because it is important to limit the negative impact
experienced different age-related challenges (Eales et al., 2021): in of restrictions on their health to avoid long-term consequences. The
particular, while younger children may not need media to stay in virtual family atmosphere plays a key role in promoting dialogue and a pro-
contact with peers, older children may have contacts outside the family tective environment, especially in this period. Parents have a key role in
to maintain (Masten and Motti-Stefanidi, 2020). These researchers, in this context and should check their children for negative outcomes of
line with others, cited so far, have also found that in general an improve increased technology and media use. An effective strategy might be to
in children's media use was observed and that older children, in limit screen time in favor of more interactive, creative, and in-person

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games; in addition, it would be helpful to promote time spent outdoors as Cauberghe, V., Van Wesenbeeck, I., De Jans, S., Hudders, L., Ponnet, K., 2021. How
adolescents use social media to cope with feelings of loneliness and anxiety during
much as possible, as access to green spaces has been combined with
COVID-19 lockdown. Cyberpsychol., Behav. Soc. Netw. 24 (4), 250–257.
improved psychological health and maturation in infants (Becker et al., Chauhan, N., Patra, S., Bhargava, R., Srivastava, C., Gujar, K.V., Gupta, N., Seshadri, S.,
2017; McCormick, 2017; Tremblay et al., 2015). We hope that more 2021. Exposure to smartphone and screen media in children and adolescents
in-depth research can be conducted in the future on how the media and COVID-19 pandemic. J. Indian Assoc. Child Adolesc. Ment. Health 17 (2),
219–229.
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2022. The relationship between children’s problematic Internet-related behaviors
and psychological distress during the onset of the COVID-19 pandemic: a longitudinal
Author contribution statement study: a longitudinal study. J. Addiction Med. 16 (2), e73–e80.
Chen, I.-H., Chen, C.-Y., Liu, C.-H., Ahorsu, D.K., Griffiths, M.D., Chen, Y.-P., Kuo, Y.-J.,
Lin, C.-Y., Pakpour, A.H., Wang, S.-M., 2021. Internet addiction and psychological
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and the writing of this article. latent class analysis. J. Behavioral Addict. 10 (3), 731–746.
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