Problematic smartphone and social media use associated mental health outcomes in children and young people with ADHD or ASD: A systematic Review, Meta-analysis and GRADE

Aim: What is the prevalence of problematic smartphone use and problematic social media use in children and young people aged 6-24 years with Attention-Deficit/Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD), and is there an association with depression, anxiety, poor sleep quality, and self-harm? Methods: Five databases (MEDLINE, PubMed, Embase, PsycINFO, and Scopus) were searched to April 2026. Results: 24 studies were included and few examined clinical ADHD samples; most used self-reported ADHD or ASD symptom measures in general population samples. Evidence for ASD was sparse, and no study reported problematic smartphone use or problematic social media use prevalence. One study reported problematic smartphone use of 42.7% in a clinical ADHD sample. Among clinical ADHD samples, problematic smartphone use was associated with depression (OR 3.06) and anxiety (OR 4.77). In general population samples using ADHD symptom screening tools, problematic smartphone use was associated with poor sleep quality (OR 3.07) and ADHD symptoms (OR 2.94). Conclusion: Problematic smartphone use was common in children and young people with ADHD and associated with poorer mental health outcomes, but evidence remains limited by reliance on self-report measures without clinical evaluation. Whilst longitudinal studies show a consistent directional effect, more are needed to guide intervention.