Parental Technoference and Behavioral-Emotional Development in Early Childhood: A 6-Month Prospective Study

This is a single-center, prospective observational study conducted among parents of children aged 24 to 60 months attending a pediatric outpatient clinic at a tertiary training and research hospital.

Parental technoference is defined as interruptions in parent-child interactions due to parental use of smartphones or other digital devices. At baseline, participating parents will complete an online questionnaire that includes sociodemographic characteristics, self-reported average daily smartphone screen time over the previous seven days (recorded from the device's built-in screen time or digital wellbeing function), and information about the child's daily screen exposure.

Parental technoference will be assessed using a validated parental technoference scale, and children's behavioral and emotional characteristics will be evaluated using the parent-report version of the Strengths and Difficulties Questionnaire (SDQ) for preschool-aged children. Both instruments have established validity and reliability in the Turkish population.

At the end of the baseline assessment, parents will be provided with a brief informational message aimed at increasing awareness of digital distractions during parent-child interactions. No behavioral intervention will be enforced as part of the study.

Six months after the initial assessment, parents will be re-contacted via phone or email and invited to complete a follow-up questionnaire, including the SDQ and updated information on parental and child screen exposure. The primary outcome is the association between parental technoference levels and children's behavioral and emotional outcomes. Secondary outcomes include changes in SDQ scores over the six-month follow-up period.

All data will be collected anonymously and analyzed using appropriate statistical methods, including correlation analyses and multivariable regression models. This study involves no medical intervention and poses minimal risk to participants.

Inclusion criteria

• Children aged 24 to 60 months.
• Parent or primary caregiver able to read and understand Turkish.
• Parent uses a smartphone and can access device-based screen time information.
• Ability to complete an online questionnaire.
• Provision of written informed consent by the parent or legal guardian.
• Availability for a 6-month follow-up assessment.

Exclusion criteria

• Children with severe neurodevelopmental disorders (e.g., autism spectrum disorder, severe intellectual disability, neurometabolic diseases).
• Parents unable to reliably complete questionnaires due to cognitive, psychiatric, or language-related limitations.
• Parents who do not use a smartphone or cannot access screen time data.
• Refusal or inability to provide informed consent.
• Inability to be contacted for follow-up assessment.