RESEARCH REVIEW: Is handheld screen time use associated with language delay in infants? 1

Every now and then, the news cycle has a story about screen time and children that makes me shake my head. While these stories are meant to showcase the latest research, they instead almost always feature fear-inducing headlines that make parents feel guilty for allowing their children to interact with any kind of screen. Even worse, the reports of these kinds of studies do not use a critical eye. For me, the shallowness of the reporting makes me downright angry. Last week’s big story about screen time and language delays is the perfect example of this. I’d like to pull it apart here.

The study in question was presented last week at the 2017 Pediatric Academic Societies Meeting. The study, titled  “Is handheld screen time use associated with language delay in infants?” was conducted in Toronto, Canada. Almost 900 children participated in this study. Parents reported the number of hours a child used a handheld screens per day, and children were later assessed with the Infant Toddler Checklist (ITC) – a validated questionnaire for detecting expressive speech delay and other communication disorders. The researchers found that at the 18-month check ups, 20% of the children in the study were using handheld devices for an average of 28 minutes per day. Results also show that the more time a child spent with a handheld device, the more likely the child was to have a speech delay. Each 30-minute increase in exposure to handheld devices resulted in a 49% increased risk in speech delay.

So that’s the main story here… or at least, what is usually reported. And I have to admit, those results are pretty impressive. And since this is the FIRST study to ever suggest a connection between speech delay and screen time, that’s something to say. However, I am not without my reservations.

First of all, news reports neglect to emphasize that these results come from parental reports of screen time. Parental reporting is always going to be a little off. Many parents might feel embarrassed about the amount of screen time they share with their child. But even if these reports are uniformly “off” – let’s say the liars are equally distributed – then we have another thing to contend with: There is no mention of what content is being used on these handheld devices. Is it YouTube clips? A learning game? FaceTime with Grandpa? Watching a live cat cam? Not all screen interactions are the same. Content does matter.

Not only does content matter, but so does situational context. If a child is co-viewing or co-playing with a parent, then there is a whole new level of screen time use. Both of my twins used to love taking selfies with me… this was something we did while waiting for food at a restaurant to arrive. We’d practice making funny faces together. Is this harmful “handheld screen time” or is this simply play-time with mom? The lack of context is a big issue, and one that has been minimized by this study.

Finally, this study does not take into account the individual differences of each child. Perhaps these babies were fussy and hard to engage. Perhaps they calmed down with a screen. As a parent of a child with autism, I am aware that my child interacts differently with screens. While touch screen devises were not around when Quentin was a baby, I do wonder if I would have exposed him to one if they were. I was careful to keep my kids interacting and away from televisions for the most part until they were about two years old, but if I saw that Quentin made more verbalizations with a screen than a human, then by all means I would have exposed him to more. This study does not take into account that some of those children might already be autistic, and language development might be delayed and therefore, parents see their child interacting with the screen more, so they give them more time with their handheld devise.

In many ways, this study is great news for the American Academy of Pediatrics, which back in 2001, issued a statement that declared that there should be absolutely no screen time for children under the age of two. When that policy was first introduced, many media producers and  curriculum developers or researchers (like myself) were frustrated that there was little to no research to back up this statement. At least now, the AAP has a solid argument to stand behind. (Note: The AAP also modified their policy a year ago, lowering the age of “no screen media” to younger than 18 months and made exceptions for some screen use, such as video-chatting with friends and family.)

Let me be clear: I am not disagreeing that it is important for infants to be interacting with people more than screens. Most children will, indeed, learn language best from actual people and not from screens. Human interaction is very important, and parents should limit screen time if they can. However, I am very much a firm believer of the the theory of the “three C’s” that Lisa Guernsey proposes when we discuss children and screen time: Context, content, and the individual child. Studies like this, which don’t take those concepts into account, are simply shaming parents for giving their child any kind of screen time. As a parent, I am sick and tired of needing to defend myself when it comes to screens.


Photo by essie is licensed under CC BY 2.0


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