For years now, we’ve been hearing about the dangers of tablet use kids having too much screen time. And anyone who’s spent any time with young kids knows that a tantrum or angry outburst once in a while is pretty much unavoidable when they’re a certain age. But new research shows a potential link between young children who use tablets and difficulty managing emotions — particularly when it comes to anger and outbursts.

The study, published in JAMA Pediatrics, shows that using a tablet at 3.5 years old was associated with a higher number of expressions of anger or frustration a year later. And kids who were more prone to anger and frustration when they were 4.5 years old were more likely to have higher tablet use a year later than that. Because of this, researchers aren’t sure if tablet use is contributing to poorer emotional regulation, or if poorer emotional regulation is contributing to more tablet use — or both. They wrote that early childhood tablet use “may contribute to a cycle” of problems with emotional regulation.

The study was conducted in Nova Scotia, Canada, where researchers surveyed 315 parents of preschool aged children. The parents filled out surveys when their kids were 3.5, 4.5, and 5.5 years old, reporting on their tablet use and how their kids expressed emotions like anger and frustration.

The researchers found an association between higher levels of tablet use at age 3.5 and an increase in anger and frustration at age 4.5, but noted that the association was “bidirectional,” which means the results could go both ways.

CNN wellness expert Dr. Leana Wen, an emergency physician and adjunct associate professor at George Washington University who is also a mom of two, said she was “not at all” surprised by the results of the study.

“There have been other studies that have come up with similar results,” she said. “One paper published just this year sheds some light as to why tablet use could be related to anger outbursts. Researchers found that among kids 2- to 5-years old, those whose parents often used technology to manage their negative emotions were more likely to show poor anger and frustration management a year later. These kids were also less capable of deciding on a deliberate response over an automatic reaction.”

Wen added, “One reason is that children need to learn to deal with their own negative emotions themselves. They need to go through the process as part of their childhood development, aided by their parents, caregivers and teachers. If, instead, they are given a tablet, computer or smartphone in an effort to soothe them, they won’t learn to manage these emotions themselves. This could result in problems later in childhood and adulthood, including with anger management.”

How parents can adjust tablet time

So does this mean parents should avoid screen time altogether? Not necessarily, Wen said, but they should be aware of its potential negative effects and try to limit it to reasonable amounts.

“There are some apps that can aid in learning, and many schools use tablets in their teaching curriculum. I think the new JAMA Pediatrics study, as well as other research, illustrates that tablets, smartphones and other electronics shouldn’t be used as pacifiers. They shouldn’t be given to kids when they are crying and upset to try to calm them down,” Wen said.

She recommends four things: delay smartphone and social media use for kids as long as possible; don’t resort to screens to solve tantrums; once kids are old enough for social media, speak to them about its potential impact, from addiction to mental health effects; and set reasonable limits, like no phones at school or in the bedroom overnight.