Clayton Li, Maria Mendoza and Ruth Milanaik
Background: The 2011 AAP policy (which predated the rising use of “new media” such as smart phones and tablets) discouraged the use of electronic media by children younger than age 2 citing potential adverse developmental effects and lack of evidence of educational benefit. The new 2013 AAP policy recognizes “important positive and pro-social effects of media use” but does not address children ages 0-3. The relationship between touchscreen device usage (TDU) and cognitive development of children younger than 3 years has yet to be studied.
Objectives: 1) To assess touchscreen device usage in infants and toddlers. 2) To identify association between TDU and cognitive development.
Design/methods: A questionnaire was given to parents of high-risk infants and toddlers to assess touchscreen device usage. Results were paired to the child's Cognitive Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) development quotient (DQ) scores. Bivariate associations were examined using a two-sample t-test.
Results: Of 65 families, 63 (97%) reported owning a touchscreen device (TSD). Of these, 44 (70%) reported TDU by a child of age <3 years. The mean chronological age of children who did and did not use a TSD was significantly different (17.4 ± 9.2 months vs. 9.4 ± 5.9 months, p<0.001). Mean age at initial TDU was 11.2 ± 7.6 months, and daily TDU ranged from 1-240 minutes with a median of 17.5 minutes. The most common forms of TDU reported were: watching children's “educational shows" (30%), using educational applications (26%), and pressing buttons on the screen aimlessly (28%). 60% of parents selected “educational benefits” of TDU as a reason for child TDU. 57% believed “other children” have higher TDU. There was no significant difference in CAT/CLAMS DQs between children with and without TDU (CAT 99.6 ± 19.5 vs. 103.4 ± 19.8; CLAMS 104.0 ± 24.0 vs. 113.5 ± 26.2). Children who played “non-educational games” during TDU had lower CLAMS DQs than those who did not (86.5 ± 34.2 vs. 106.7 ± 21.4; p=0.054).
Conclusion: The majority of the families in this study allowed their children to use touch screen devices with a mean age of initial play below a year of age. Although the majority of surveyed parents reported they believed TDU had educational benefits, developmental scores showed no significant difference between children with and without TDU. Children who played non-educational games had lower receptive and expressive language scores compared to children who engaged in other types of TDU. Although our results do not imply a causal relationship, parents should be encouraged to restrict TDU for children under the age of three as no educational benefits were noted.