Background: Screen use among children has increased significantly in recent years, becoming a central part of their daily lives. While it may have some beneficial effects when guided by clear recommendations, excessive and inappropriate use can negatively affect psychomotor development. Despite growing scientific interest, there is still a lack of studies directly comparing children with and without neurodevelopmental disorders in terms of the amount, content, and context of screen use. This study aims to address this gap by comparing screen exposure in children aged 3 to 10 years with and without neurodevelopmental disorders, focusing on differences in time, content, and context of screen use.Method: In this prospective study, the Portuguese version of the ScreenQ questionnaire (validated for the Portuguese population) was administered between June 2024 and June 2025 to parents of children aged 3–10 years: healthy children attending a primary healthcare Child and Adolescent Health Consultation (CAHC) and children with neurodevelopmental disorders attending the Neurodevelopment Consultation (NDC) of a Level II hospital in the same region. Data were analyzed using SPSS.Results: ScreenQ responses were analyzed for 119 children from the Neurodevelopment Consultation (NDC; 68.1% male; median age 7 years) and 107 from the Child and Adolescent Health Consultation (CAHC; 66.4% male; median age 6 years). In the NDC group, Autism Spectrum Disorder (40.3%) and ADHD (47.9%) were the most frequent diagnoses. Median age at first screen exposure was 24 months in both groups. Ownership of a personal device was more common in the NDC group (53.8% vs. 39.3%; p=0.029).Children with neurodevelopmental disorders exhibited higher ScreenQ scores (median 11 vs. 8; p < 0.001) and longer daily screen time (2 hours vs. 1 hour; p < 0.001). The use of TV/videos to fall asleep was reported significantly more often (frequently: 19.3% vs. 3.7%, p=0,001). In addition, the NDC group more often engaged with fast-paced content (31.1% vs. 22.4%; p=0,001), entertainment media (79.0% vs. 64.5%; p<0.001), unsupervised use (51.3% vs. 35.5%; p=0,022), and screen use for self-soothing (15.1% vs. 1.9%; p=0,002)Conclusion: Children with neurodevelopmental disorders spent significantly more time on screens than their neurotypical peers and were more frequently exposed to fast-paced, entertainment-oriented content, often without adult supervision. They also showed a greater tendency to use screens for self-soothing. These differences extended beyond duration, encompassing the type, context, and purpose of screen use. Our findings indicate that children with neurodevelopmental disorders display distinct patterns of screen use that warrant closer monitoring and targeted guidance.While this study does not establish causality, existing literature suggests a potentially bidirectional relationship: underlying vulnerabilities may increase susceptibility to problematic screen use, while excessive exposure may further exacerbate existing difficulties. Further research is needed to clarify the long-term cognitive, behavioral, and emotional consequences of these patterns.
