[
  {
    "topic": "MRI / white matter",
    "citation": "Hutton JS et al. Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children. JAMA Pediatrics. 2020;174(1):e193869.",
    "pmid": "31682712",
    "pmcid": "PMC6830442",
    "doi": "10.1001/jamapediatrics.2019.3869",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6830442/",
    "takeaway": "Real core paper behind the Reel. In 47 healthy preschool children, higher ScreenQ scores were associated with lower white-matter microstructural integrity in language/literacy tracts and lower language/literacy scores. Cross-sectional association, not proof of causation or brain damage."
  },
  {
    "topic": "Developmental milestones",
    "citation": "Madigan S et al. Association Between Screen Time and Children\u2019s Performance on a Developmental Screening Test. JAMA Pediatrics. 2019;173(3):244\u2013250.",
    "pmid": "30688984",
    "pmcid": "PMC6439882",
    "doi": "10.1001/jamapediatrics.2018.5056",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6439882/",
    "takeaway": "Longitudinal cohort: higher screen time at 24 and 36 months was associated with poorer performance on developmental screening at later waves. Supports caution; does not say every tablet causes damage."
  },
  {
    "topic": "Mobile devices for calming / emotion regulation",
    "citation": "Radesky JS et al. Longitudinal Associations Between Use of Mobile Devices for Calming and Emotional Reactivity and Executive Functioning in Children Aged 3 to 5 Years. JAMA Pediatrics. 2023.",
    "pmid": "36508199",
    "pmcid": "PMC9857453",
    "doi": "10.1001/jamapediatrics.2022.4793",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9857453/",
    "takeaway": "Using devices to calm 3\u20135-year-olds was associated with later emotional reactivity/executive-functioning problems, especially in boys and children with higher surgency. Supports the self-regulation concern."
  },
  {
    "topic": "Tablet use and anger",
    "citation": "Fitzpatrick C et al. Early-Childhood Tablet Use and Outbursts of Anger. JAMA Pediatrics. 2024.",
    "pmid": "39133514",
    "pmcid": "PMC11320330",
    "doi": "10.1001/jamapediatrics.2024.2511",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11320330/",
    "takeaway": "Longitudinal findings link tablet use in early childhood with more anger/frustration outbursts, and child anger with later tablet use \u2014 likely bidirectional."
  },
  {
    "topic": "Attention / inattention",
    "citation": "Tamana SK et al. Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study. PLOS ONE. 2019.",
    "pmid": "30995220",
    "pmcid": "PMC6469768",
    "doi": "10.1371/journal.pone.0213995",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6469768/",
    "takeaway": "Preschool screen time above guidelines associated with clinically significant externalizing problems and inattention. Association remains after adjustment for several factors."
  },
  {
    "topic": "Mental health meta-analysis",
    "citation": "Eirich R et al. Association of Screen Time With Internalizing and Externalizing Behavior Problems in Children 12 Years or Younger: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2022.",
    "pmid": "35293954",
    "pmcid": "PMC8928099",
    "doi": "10.1001/jamapsychiatry.2022.0155",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8928099/",
    "takeaway": "Meta-analysis found small but significant associations between screen time and internalizing/externalizing problems; effect sizes vary and causality remains complex."
  },
  {
    "topic": "Executive function",
    "citation": "Screen time exposure and executive functions in preschool children. Scientific Reports. 2025.",
    "pmid": "39805846",
    "pmcid": "PMC11731003",
    "doi": "10.1038/s41598-024-79290-6",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11731003/",
    "takeaway": "Preschool executive function evidence is mixed and moderated by type/content/context. Supports careful media habits rather than panic."
  },
  {
    "topic": "Sleep",
    "citation": "Within-Person Association Between Daily Screen Use and Sleep in Youth: A Systematic Review and Meta-Analysis. JAMA Pediatrics. 2026.",
    "pmid": "41770550",
    "pmcid": "PMC12954599",
    "doi": "10.1001/jamapediatrics.2025.6490",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12954599/",
    "takeaway": "Sleep evidence is strong enough for practical guidance: screen use, especially near bedtime, is associated with worse sleep outcomes; mechanisms include displacement, arousal, notifications and light exposure."
  },
  {
    "topic": "Guideline \u2014 Canada",
    "citation": "Canadian Paediatric Society. Screen time and preschool children: Promoting health and development in a digital world. Updated position statement.",
    "url": "https://cps.ca/en/documents/position/screen-time-and-preschool-children",
    "takeaway": "CPS recommends minimizing screen time under age 2 and limiting routine/sedentary screen time for ages 2\u20135; emphasizes co-viewing, quality content, and replacing screens with sleep, movement and interaction."
  },
  {
    "topic": "Guideline \u2014 WHO",
    "citation": "World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age / news release: To grow up healthy, children need to sit less and play more. 2019.",
    "url": "https://www.who.int/news/item/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-more",
    "takeaway": "WHO frames the issue as a 24-hour movement pattern: less sedentary screen time, more active play, and enough sleep."
  }
]