Abstract
BACKGROUND/OBJECTIVES: The increasing prevalence of digital media use among children and adolescents has raised concerns regarding its potential impact on cognitive and communication development. Previous research has linked higher screen exposure to poorer language outcomes; however, the mechanisms underlying these associations remain insufficiently understood, particularly with respect to pragmatic communication. The present study aimed to examine the relationships between daily screen time, executive functioning (EF), and communication-related outcomes, and to test whether EF mediates the association between digital media exposure and pragmatic communication and language performance. METHODS: A cross-sectional observational study was conducted with 240 children and adolescents aged 6-15 years. Caregivers reported children's daily screen time, digital consumption and communication skills. EF was assessed using performance-based tasks measuring inhibitory control, working memory, and cognitive flexibility. Language performance was evaluated using a standardized composite measure. Pearson correlations, mediation analyses with bootstrapped confidence intervals, and factorial analyses of variance were performed, controlling for age, sex, parental mediation, and educational content exposure. RESULTS: Higher daily screen time was significantly associated with lower EF, weaker pragmatic communication, and poorer language performance. EF was positively related to both pragmatic and language outcomes and partially mediated the relationship between screen time and communication measures. Educational digital content and parental mediation showed positive associations with EF and communication outcomes, whereas recreational content exhibited negative associations. Group comparisons indicated that negative associations between screen exposure and developmental outcomes were more pronounced in younger children. CONCLUSIONS: These findings suggest that EF may represent a key intermediary mechanism underlying the association between digital media exposure and communication-related development. The results highlight the importance of considering not only the quantity but also the quality and context of children's digital media use, particularly during early developmental stages.