The Impact of Screen Time on ADHD Symptoms in Children and Adolescents: A Narrative Review of Treatment Approaches

Abstract

The increasing prevalence of digital media use among children and adolescents has raised concerns about its potential impact on attention deficit hyperactivity disorder (ADHD) symptoms. This narrative review explores the relationship between screen time and ADHD in young people, with a particular focus on the impact of different treatment approaches in the context of digital engagement. A structured search identified 147 studies published between January 2018 and December 2024, of which 14 met the inclusion criteria for detailed review.

The findings indicate that excessive and unstructured screen time is consistently associated with the worsening of ADHD symptoms, particularly inattention and hyperactivity. Sleep disruption and neurobiological vulnerabilities, including altered reward processing and white matter changes, appear to mediate these associations. At the same time, certain forms of digital activity, particularly interactive or cognitively engaging tasks, may provide benefits, highlighting the complexity of this relationship.

Treatment approaches reflected a similar complexity. Pharmacological interventions remain central but are most effective when complemented by behavioural therapies and lifestyle modifications, such as structured screen time reduction, improved sleep routines, and increased physical activity. This review suggests that the management of ADHD in the digital era requires a holistic approach that recognises both the risks and potential benefits of screen use. Further longitudinal research is needed to clarify long-term effects and identify which forms of digital media can be harnessed constructively in clinical care.

Plain Language Summary

Children and teenagers are spending more time than ever on screens, whether that is phones, tablets, computers, or video games. For those with ADHD, this can be especially challenging. This review looks at how screen use may affect the main signs of ADHD, such as difficulty paying attention, being overly active, or acting without thinking. The findings show that too much screen time is often linked with worse symptoms. In some cases, it also leads to poor sleep, which can make things even harder for children already struggling with focus and behaviour. Not all screen time is harmful, however. Some types of digital activities that require problem-solving or thinking can support certain skills. But overall, managing screen use remains important. The review also considers common treatments for ADHD: such as medication and therapy and how these work when screen time is taken into account. It suggests that combining treatment with lifestyle changes, such as reducing screen use and encouraging physical activity, may give better results. The review concludes by encouraging parents, carers, and professionals to be thoughtful about screen use, especially for children who already have attention difficulties. A balanced approach that combines medical and behavioural support with everyday strategies at home is recommended. While more research is needed, these ideas can already guide families and clinicians in managing ADHD in a world full of digital distractions.