Toddlers Who Had Screen Time as Infants Experienced Developmental Delays, Study Shows

New research sheds light on screen time harms.

Fact checked by Sarah Scott

It’s challenging to escape screens in today’s world. Some employers expect working parents to stay constantly plugged into email or messaging apps like Slack or Microsoft Teams. Giving infants access to a tablet may temporarily distract them in the short term. However, a new study of more than 7,000 infants sheds light on the potential for long-term harm.

The study, published in JAMA Pediatrics, found babies who spent one to four hours with screens daily were more likely to have developmental delays, especially in problem-solving and communication skills, by age 2.

“It gives some meat to our understanding of problematic screen time for babies,” says Scott A. Roth, PsyD, a New Jersey-based child psychologist. “Experts have been saying for years that parents should be limiting screen time exposure, and now we are starting to see specific data coming in about the possible effect of too much exposure.”

The American Academy of Pediatrics (AAP) does not recommend screen time for children younger than 2 years old.

The Impact of Screen Time on Infants

The study involved 7,097 children and their mothers who were part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study based in Japan from July 2013 through March 2017.

Researchers looked at children’s screen time duration by age 1. They assessed their performance in developmental categories, such as communication, fine motor, personal and social, and problem-solving skills at ages 2 and 4, through self-reported information from participating mothers. Children with up to four hours of daily screen time had a three-fold higher risk of communication and problem-solving skill delays.

Children with four or more hours of screen time per day were nearly five times more likely to be experiencing communication skill delays and twice as likely to be behind on personal and social milestones at age 2. Moreover, these children were 1.74 times more likely to have underdeveloped fine motor skills.

The risks of developmental delays based on daily screen time were only significant in communication and problem-solving by the time the participating children reached their fourth birthdays.

The study has some limitations. For example, researchers relied on self-reported data, and parents may not have given accurate numbers on a child’s screen time because they wanted to do the “right” thing (and not provide long hours of screen time). Parents may have overstated a child’s developmental skills for the same reason. Experts did not look at the type of screen time, including different types of shows or FaceTime versus TV.

Overall, Zishan Khan, MD, a board-certified psychiatrist with Mindpath Health, says the sample size and focus on specific developmental areas impacted by an infant’s exposure to electronic devices is impressive.

“This study clearly shows that the more screen time a baby receives, the greater risk a parent places them of struggling in some developmental regions,” Dr. Khan says.

The Issue with Screen Time

Parenting is challenging, and some caregivers may be doing it separated from the family and friends that would have once formed the all-important “village” it takes to raise a child.

Screen time is distracting and can allow parents to get other tasks done, such as work when an infant is home sick from daycare but they cannot take off. It may also help while an adult is cooking, cleaning, and showering. However, experts say it’s true there are potential harms in screen time.

“Children develop their language skills and ability to communicate by interacting with others, including their parents and siblings,” Dr. Khan says. “By engaging with a parent, for instance, they observe facial expressions and learn to decipher emotions and responses to various motions and communication methods.”

The nature of face-to-face encounters is also why social skills are affected by passively consuming on-screen content.

“A human being thrives on back-and-forth interaction, and our brains must be exposed to stimuli that can guide our behavior and allow us to learn how to appropriately interact with the people and things in our environment,” Dr. Khan says.

Face-to-face interaction is crucial, as is play—even independent.

“If watching a show on YouTube is replacing playing [with] blocks or a puzzle, there is no creativity, understanding of if-then contingencies or other types of problem-solving,” Dr. Roth says. “This is when screen time can become problematic.”

Screen time may also make a child less interested in these types of play.

“The rapid scene changes, bright colors, and constant noise from screens can be overstimulating, potentially reducing a child's ability to tolerate slower-paced activities that are important for learning,” says Sogand Ghassemi, MD, a child, adolescent, and adult psychiatrist and the chief of medical staff for PrairieCare.

Is There Such a Thing as Quality Screen Time?

In 2016, the AAP updated its policy statement to say video-conferencing (think Zoom and FaceTime) was an exception. However, the organization stressed parental support is needed for infants and toddlers to “understand what they are seeing.”

“The question arises, ‘What is the screen time taking the place of?’” Dr. Roth notes. “With FaceTiming Grandma, it might be taking the place of not having frequent communication with Grandma.”

In these instances, isolation could be hard on families, including toddlers forming relationships with extended relatives.

How to Keep a Baby Entertained Sans Screens

Can we be real for a second? Face-to-face interactions are critical, but so are cooking dinner and showering. Dr. Roth gets it.

“Yes, face-to-face interactions with loved ones are essential, but it is also unrealistic to assume that it could happen all of the time,” Dr. Roth says.

Screen time doesn’t necessarily have to fill the gap.

Dr. Ghassemi says high-contrast toys and books can engage children and aid visual development. Soft, cloth books with texture, rattles, and sensor bottles with colorful contents engage numerous senses and help with motor skills like grip and strength.

Need another idea? How about sending your baby to the gym? (Not literally, of course.)

“Having playmats and baby gym mats accessible with interactive touches and sounds can help occupy your child when cooking [and] cleaning,” Dr. Roth says.

Cooking is also ripe with opportunities to spark conversations and develop communication skills—yes, even with an infant who isn’t talking.

“A parent may wish to narrate what they are doing while cooking dinner,” Dr. Roth says. “Anything that can engage your babies’ senses can be helpful, and remember, the more interactive, the better.”

That said, screens are a part of our everyday lives, and some parents may be concerned that the damage is already done. So, one last thing:

“This study is not meant to shame a parent who decides to let their child spend a short while in front of the television or on a tablet while they take a moment to quickly shower or prepare a meal for the family,” Dr. Khan says. “Parents should not fear they have ruined their baby if they have allowed them to enjoy an educational show on the TV or tablet, and they absolutely should not avoid letting distant family members interact with their child over FaceTime. They should try their best to positively interact with their child and spend as much quality time with them as possible.”

Related: 11 Simple Activities for Babies 0 to 6 Months Old

For more Parents news, make sure to sign up for our newsletter!

Read the original article on Parents.