Study supports AAP guidelines on screen exposure
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A recent study published in JAMA Pediatrics concurred with AAP guidelines that children aged younger than 18 months should not be exposed to screens, whereas screen time should be limited to an hour for those aged between 2 and 5 years.
The study further determined that children with a higher rate of screen time exposure had lower language skills.
The researchers conducted a systematic review and meta-analysis using research sourced from MEDLINE, Embase and PsycINFO in March 2019. Studies were excluded if they were qualitive; they included children aged older than 12 years; the language measure was preverbal; the study included children with autism spectrum disorder; and the study was experimental.
The initial search identified 26,751 records. Only 42 studies met the criteria to be examined.
The publication years examined were between 1973 and 2019. Children observed were aged between 35.7 and 44.4 months. Overall, 70.7% of the studies used television exclusively to assess screen time, whereas 24.4% used a composite of video games, mobile use and television or computers, and 4.8% examined mobile use only.
The data suggested multiple conclusions. According to the researchers, a greater quantity of screen use was associated with lower child language based on 38 studies that produced a significant and negative combined effect size (r = –0.14; CI, 95% –0.18 to –0.10). Background television also was associated with decreased language skills according to five studies that produced a pooled effect size of r = –0.19 (CI, 95% –0.33 to 0.05).
Viewing educational content was associated with increased language skills in 13 studies that produced a significant and positive combined effect size (r = 0.13; CI, 95% 0.02-0.24). Coviewing educational programs also produced a significant and positive combined effect size in 12 studies (r = 0.16; CI, 95% 0.07-0.24).
Four studies suggested that as the age at onset of screen use increased, stronger language skills were observed. The studies produced a significant pooled effect size of r = 0.17 (CI, 95% 0.07-0.27). – by Ken Downey Jr.
Disclosures: The authors report no relevant financial disclosures.
Perspective
Back to TopCori Cross, MD
This study reinforces the AAP’s guidelines and current policy. The AAP’s policy states that it is better to put off the early introduction of device use until a child is at least 2 years of age. There are no benefits to earlier introduction. The most beneficial use of time for a very young child is interacting with their parents and with the world around them. There really is no need to have children younger than the age of 18 months on a device, except to communicate with FaceTime with relatives. Parents may think they are getting an educational edge, but that simply isn’t true. The best way for young children to learn is through real life experiences and interactions. Other families turn to devices as a way to distract their child. However, I would caution that with the very young child, this may not be the best idea.
That being said, if parents choose to allow a young child to use a device or watch TV, then ensuring that the programming is of quality content and co-viewing as often as possible is extremely important. Parents should realize that just because a show is animated or geared toward children does not mean it is a good use of time or will mimic values that family holds. Only by co-viewing can a parent decide if the content is appropriate for their child.
It may be difficult for parents to discern what is quality content. There are a lot of programs out there that label and promote themselves as educational but in reality have no basis for that claim. Going with trusted stations such as PBS kids allows parents to know that these programs are actually meeting the educational requirements and standards. These shows will have a small E/I logo in the lower corner of the screen indicating that they are specifically designed to meet the educational and informational needs of children aged younger than 16 years.
For apps, no standard has been developed, which makes it even more difficult for parents. Any app can claim to be educational. My advice would be, after a parent has downloaded an “educational” app, look at it first and use it before exposing your child to it. See if it makes sense — is it truly teaching the skill you were hoping, or is it a waste of time? If it's not worth your child’s time, delete it.
Of course, parents sometimes get to the point where they just need that mental break. I always tell parents that it is fine to use TV or a device when they are at that breaking point, but make a good choice in what you put on at that moment.
Parents should remember TV and app use isn’t all bad, especially for older children and toddlers. If we use a device to augment what we're teaching, that's great, but when we use a device to replace us as a parent or a caregiver, that's where we run into problems. Parents should not be fooled into thinking early device use is going to give their child some sort of educational head start, parental interaction is probably more beneficial. If you want to give your child a leg up, read to them nightly.
Disclosure: Cross reports no relevant financial disclosures. She co-authored the AAP’s guidelines on proper screen time in children.
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