by Susan Rvachew, Ph.D., S-LP(C), Associate Professor, School of Communication Sciences and Disorders, McGill University
The Atlantic (Holly Korby, September 12, 2013) has a story about a horrified parent discovering that her toddler is being exposed daily to iPads at daycare. Incensed, the parent withdraws her son from what is described as a “pricey” preschool. Here at the Digital Media Project we have been keeping a database of articles in the popular media about digital media and young children and this one follows the usual script: first, the article attests to the ubiquity of these devices in children’s environments; second, the article amplifies parental anxiety about the potential harm that digital media may pose to their children’s brains. The notion that these technologies are harmful has been propagated effectively by the American Academy of Pediatrics, specifically through their policy statement that states clearly that “under twos” should not be exposed to any “screen time”. The empirical basis for this recommendation rests in part on three studies that are cited to support the statement “In the short-term, children younger than 2 years who watch more television or videos have expressive language delays. (p. 4)” It is quite a shock to examine those three papers (which have been repeatedly cited in subsequent papers to support similar statements without further examination).
Perhaps the most influential, given its high profile in the popular media due the controversy over the Baby Einstein videos, is the paper by Zimmerman, Christakis and Meltzoff (2007). In this study parents were interviewed by phone about their infants’ television and video viewing and responses to the short version of the Communication Development Inventory were obtained. Linear regression analyses involving a great many control variables led to a negative relationship between viewing of baby DVDs/videos and receptive language development for the youngest infants. No relationship between any kind of screen time and expressive language development was observed for the older infants and no effect of other kinds of television or video viewing was observed for any age group. But, more recently, Ferguson and Donellan (2013) obtained their raw data and have shown in a re-analysis that in fact there is no evidence in this study of a harmful effect of baby videos on language outcomes. They argue convincingly that the selection of control variables in the original paper was not theoretically motivated; in fact, the zero-order correlations (not included in the Journal of Pediatrics report) are not statistically significant. Ferguson and Donellan substituted raw scores (number of known words) for percentile scores as the outcome measure and included only those covariates that could be theoretically motivated and found that there were no conditions under which media exposure was negatively correlated with language development although there were some positive associations.
The second study cited by the APA position paper is a prospective diary study of children followed from 6 to 30 months of age, conducted by Linebarger and Walker (2005). In this case, paradoxically given its reputation, the authors found a strong positive relationship between the viewing of several children’s television programs and language development. There were some negative findings that won’t surprise those of us who remember the Teletubbies! The overall conclusion is that the impact of television on toddlers is directly related to the specifics of the content and the presentation of that content. Programs that employed well known language teaching devices such as speaking directly to the child and eliciting active participation by the child while explicitly teaching language content were effective. Citing this paper in support of the opinion that watching tv by toddlers causes language delay is intellectually dishonest.
The third paper is a case control study conducted in Thailand in which children with diagnosed language delay were compared on a large number of variables to children with normally developing language skills. Earlier and longer exposure to television was associated with a significant odds ratio for language delay but in this study the two groups were not matched on even the most basic variables such as gender or parental education. The most rational conclusion to be drawn from this study is that boys with delayed language skills prefer solitary television watching to verbal interactions with their mothers in comparison to boys and girls with typical language skills. Certainly a causal relationship between early television exposure and language impairment cannot be inferred.
Given that, in my opinion, the APA statement is not reliable on the subject of language delay, how are parents to decide if “screen time” is to be verboten for their infants? As in all parenting decisions, common sense will have to prevail. What are the potential harms and benefits of exposing an infant to stimuli such as baby videos, children’s television programming, educational apps and electronic books? Let’s consider the potential harms first, which all fall under the category of “opportunity costs” – what else might the parent and the infant be doing?
Potential Harm from “Screen Time”
• Loss of opportunity for exercise: watching videos or television and playing with tablets or computers are sedentary activities and thus concern about poor physical fitness and childhood obesity as children become used to low levels of physical activity, especially as they follow their parents’ model, are an obvious concern.
• Loss of opportunity for other kinds of sensory learning and stimulation: the toddler can watch the television personality bake a cake or sit on the kitchen counter and “help” mum bake the cake; the latter learning experience is enriched by multiple kinds of sensory experience that cannot be obtained while watching another person perform the same activity on television.
• Loss of opportunity for high quality language input in interaction with adults and other children: it has been shown that the quality of interactions between mothers and toddlers declines while watching video. It is not known that this is true when parents and children share digital tablets but none-the-less there is no reason to substitute coviewing of media via television or tablets for authentic conversation around shared activities in the kitchen or at the playground.
At the same time, are there any potential benefits to allowing your child to watch television or videos, read ebooks or play games or your phone? Let us consider some possibilities:
Potential Benefits from Screen Time
• Cuddling: coviewing digital media often requires closes proximity of the child to the parent in a relaxed context. If dad and child have spent the morning raking leaves and then come in to curl up on the couch to watch “Arthur”, who would deny them the much needed rest or disavow the value of this physical closeness. My daughter is 24 years old now and we still cuddle while watching tv! The transitions from Mr. Dressup to Degrassi Junior High through Greys Anatomy and now Big Bang Theory happened seamlessly but tv watching as an excuse to sit down close to one another remains a constant.
• Direct and indirect educational impacts: although the research on direct effects of digital media on learning has been mixed due to the specificities of content and context as mediators of those effects, there is some evidence for indirect effects. Pempek et al. found that parents learn about how to stimulate learning by their children from cowatching of certain videos (specifically, Sesame Beginnings) and apply that knowledge after the tv is turned off.
• Independence: a lot of early learning by infants and children is mediated by adults and modern society places a lot of pressure on parents to acquire excellent skills as facilitators of their child’s learning. At the same time, the popular media criticizes the “helicopter parent”, emphasizing the fact that children must also learn to be independent of their parents. One reason for the “complex ambiguity” expressed by parents in the popular media on the topic of digital tools is that they are used as distraction devices when the parent is otherwise engaged, on the phone or with a guest for example. I don’t see any reason for parents to feel guilty about this particular use however, within reason. Learning to leave the adult alone and entertain themselves is an important skill for a growing child, even at the toddler age.
• Fun: It is often pointed out that children, when bought an extravagant toy will play with the box for hours. We admire the child’s creativity in finding multiple uses for the box. Similarly, my graduate students will sometimes bring their infants to meetings with loaded up with bags full of toys. The infants usually run through the toys intended to keep them quiet and distracted for an hour inside of 3 minutes! Inevitably the parent will resort to handing the infant her phone! I have been enthralled watching these infants, over the course of the first year or so, learn remarkable skills such as how to find their favourite Elmo video on the iPhone! I see no reason to be less impressed by the child’s creativity with complex objects as simple ones. Sometimes we let the child play with things because the child finds them to be interesting, not because they are supposed to be “educational”.
My conclusion after this day of hunting down the “evidence” for the popular opinion that digital media is bad for toddlers is that an awful lot of what has been written on this topic, in the scientific and popular media, has been driven by ideology rather than data. Zimmerman, Christakis and Meltzoff (2007) called for randomized control trials and it is true, we desperately need well controlled studies in this domain. However, these studies will not be meaningful if the question continues to be something along the lines of ‘is digital media bad for children’? All the research to date suggests that the details are very important. We need to unpack the question into many layers so that each randomized control trial can examine very precise aspects of the digital media in question, vary contextual variables in a principled fashion, and target very specific harms or benefits. And then we need to communicate the results of those studies in a way that treats parents with respect, providing useful information without unnecessarily amplifying a natural tendency for guilt and anxiety.