Abstract
BACKGROUND: This systematic review investigated the association between smartphone/tablet exposure and motor development in children aged 0-6 years. METHODS: Observational studies in Portuguese, English or Spanish were included following the Participants, Exposure, Comparison, Outcomes and Study Design. A search conducted in November 2024 across seven databases identified 3228 records. After screening titles, abstracts and full texts, seven studies met the eligibility criteria, comprising sample sizes that ranged from 25 to 715 participants, for a combined total of 1339. Exposure was assessed via parental report, considering variables such as average daily time of use, frequency and age at first exposure, although definitions varied across studies. Methodological quality was assessed using the AXIS tool, and findings were synthesised qualitatively. RESULTS: Findings were heterogeneous; one study reported negative associations with gross motor skills, two with fine motor skills and one with overall motor performance. Conversely, three studies indicated potential benefits for fine motor skills, and one found no significant associations. The relationship appears complex and may depend on the context, frequency and duration of use. CONCLUSIONS: The findings underscore the importance of guiding parents, educators and healthcare providers to balance smartphone/tablet exposure with motor-enriching activities. Future longitudinal studies are needed to clarify causal pathways and the long-term effects of these exposures (PROSPERO: CRD420251008664).