Most young children are exposed to screens. At home, daycare, preschool, and school. Large studies have found that kids under the age of five get an average of 1.5 to 3 hours per day (and that’s just average). All while the AAP recommends no more than one hour per day for this age group.

Screen time and early childhood development has been a really hot topic in 2019 in general, but this last month in particular. Popular news outlets have been covering research on it (e.g. here and here).  

But have the news outlets gotten it right?

Upon closer examination, the research isn’t as straightforward as one might hope. And the implications of telling parents, “Don’t allow screens” are huge. So let’s look at the data—

The paper that’s been getting all the press lately is this one—a pretty cool publication that’s a DTI study (brain imaging, where they look at the brain’s connective pathways) of preschoolers. Which—completing DTI in a bunch of preschoolers is a feat in and of itself! They found that screen time is associated with less well-developed “… white matter tracts that support language, executive functions, and emergent literacy skills…” as well as lower scores on tests of these skills. WOW. Now that’s relevant to SLPs!  

But not so fast. The tough thing about most research on screen time is that pretty much none of it has determined causation. Only correlation, or association. Meaning, we’re not confident that screen time causes lower language or executive function skills; instead just that kids who have higher rates of screen time tend to be kids with lower skills. And that issue—the inability to determine causation—is true of that highly-hyped DTI study, as well as this study, this one, and almost all the studies in this recent meta-analysis. And, of the few papers that are closer to measuring the direction of the relationship, like this one, effects are significant, but not strong. Experts in this editorial state, “… the association between screen time and different indicators of well-being and/or functioning is often inconsistent and, at best, small.” And another states that, “…the moral panic of screens is not justified.”

“. . .the moral panic of screens is not justified.”

 

– Ophir et al., 2019

OK… so is screen time no big deal, then?

We don’t want to swing too far in either direction with this. Though the research isn’t conclusive, we also can’t wait on better research to act, when the literature is definitely giving us warning signs about the relationship between screen time and child development. And, you know what? Scientists wish we had stronger data, too! But that’s often impossible (for example, think for a moment what it would take to completely control a household’s screen time, regardless of what the parents wanted… providing some kids lots of it, on purpose, and other kids none, on purpose… to measure what happens. Eeeek!).

And this is where we, as professionals, need to consider what we know about child development, and use that to make sense of things. 

We know that speech and language exposure matter—a lot. And that communicative interactions matter. And that screens could easily interfere with this. But are screens worse than other activities that disrupt communication? (We don’t know.)

And I bet all of us can think of a myriad of reasons why children with lower language, lower executive functioning, or lower cognitive skills in general may simply be more likely to be given screens, as well.

Finally, it’s important that we consider the families’ perspective in this, and the implications of telling a family not to do something. Making a parent feel bad for using screens with their kids—whether TV time, passing their kid the phone while they wait at the doctor’s office, or allowing tablets to be part of their evening routine—is not going to be healthy for the therapeutic relationship. Yet, we do have a responsibility to educate parents about concerns regarding screens, and what the AAP recommends. It’s complex! See this TISLP staff member’s thought-provoking thread on Twitter recently about other factors to consider, too, while helping families make sense of screen time.

Adelanto-Renau, M., Moliner-Urdiales, D., Cavero-Redondo, I., Beltran-Valls, M.R., Martinez-Vizcaino, V., Alvarez-Bueno, C. (2019). Association between screen media use and academic performance among children and adolescents: a systematic review and meta-analysis. JAMA Pediatrics. http://doi.org/10.1001/jamapediatrics.2019.3176. 

Hutton, J.S., Dudley, J., Horowitz-Kraus, T., DeWitt, T., Holland, S. (2019). Associations between screen-based media use and brain white matter integrity in preschool-aged children. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2019.3869.