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Abstract
The world of digital screens was once a random activity for children, but it has now become almost everywhere, with the potential to have a significant impact on sleep, physical activity, child-caregiver interaction, and the process of self-regulation in everyday life. Evidence from metropolitan settings in South Asia is sparse in terms of multi-domain precision, particularly on the lives of Generation (Gen) Alpha, who have grown up in a "always on" digital ecology. To analyze and quantify screen-time exposure and caregiver-reported emotional, language, cognitive, physical, and social outcomes in children in Lahore, Pakistan, and to contextualize these findings by directly referencing existing worldwide screen-time research. A cross-sectional study was conducted with urban caregivers of 295 children aged 3 to 14 years, who completed a standardized and pre-tested questionnaire on multidomain outcomes, daily screen time, and parental-control effectiveness. For all potential inferential comparisons, the strength of the link was measured using chi-square tests stratified by age, with proportions computed using Wilson 95% confidence intervals. Of 288 classifiable replies data set, 130 youngsters (45.1%, 95% CI 39.4-50.9) utilized screens for at least 3 hours per day. The most common emotional-regulation indicators in the risk profile were feeling frustrated/upset on restriction (52.5% of children) and feeling irritable after taking it for a long time, often or every day (44.7% of children), even though no other physical indicators were measured to outweigh these indicators. Cognitive engagement was content-dependent and not uniformly positive or negative: whereas 167 children (56.6%) played memory-based games without assistance, 197 (66.8%) never or rarely chose logic-based games over entertainment games. Age had a slight but significant association with independent memory-game completion (χ² = 18.19, p = 0.006, V = 0.176), perceived memory advantage (χ² = 17.26, p = 0.008, V = 0.171), and weekly cognitive screen engagement. A large proportion of this urban Pakistani population engaged in unusually high amounts of daily screen time, which was accompanied primarily by emotional-regulation difficulties rather than cognitive or physical impairments, implying that more than just time limits are required, as routine and content are equally important. Thus, longitudinal, multivariable-adjusted designs with objective screen-time measurement are the next step toward causal evidence to support its claims.