The relationship between executive functions and naturalistic use of screen-based activities in children.

Engagement in interactive game-playing and passive TV watching has become an integral part of young children's routines. While there is a consensus regarding the harmful effect of long passive TV viewing on child development, the influence of interactive game playing is much less clear. This study seeks to specifically explore the association between passive TV watching and interactive-game playing, to executive functions (EF) in typically developing children in their natural environment. A convenience sample of 194 Israeli children (aged 5-7 years) was recruited for our cross-sectional study. Parents provided information on the average daily time their children spent watching TV and playing interactive games. In addition, parents fulfilled the Behavior Rating Inventory of Executive Function (BRIEF) to assess everyday executive skills in natural settings. Our findings revealed significant correlations between TV viewing and poor EF in five out of eight subscales of BRIEF, in addition to the indexes and the global executive composite ( p  < 0.05). However, the time spent on playing interactive games was not correlated with any of the BRIEF's subscales except one. Moreover, longer time spent watching TV was found to be a significant predictor of low EF among children (F(1,189) = 8.37; p  = .004, R 2  = 3.7%). The current study results show that passive viewing led to worse EF performance than active digital gaming. As a consequence, our study supports previous professional recommendations to limit passive TV viewing.