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Screen Time Linked With Developmental Delays in Children Under 4, Study Says

Putting toddlers in front of a screen may delay their development in communication and problem-solving skills, a new study involving more than 7,000 children suggests.

Spending anywhere between one and four hours of screen time per for children under one year old is linked to higher risks of delays in crucial skills, ranging from controlling their body movement to interacting with their surroundings to socializing with other children, researchers at Japan’s Tohoku University and Hamamatsu University School of Medicine found.

For their study, published on Monday in the JAMA Pediatrics, the researchers followed 7,097 pairs of mothers and children between 2013 and 2017.

To examine the association between screen time exposure and child development outcomes, the researchers first asked the mothers how many hours they would allow their younger-than-one-year-old child to watch television, play video games, and use mobile phones, tablets, and other electronic devices on a typical day.

When the children reached between two and four years of age, the mothers were asked to rate their child’s development in five aspects: communication, which includes babbling, vocalizing, and understanding of sounds; gross motor, which involves arm, body, and leg movement; fine motor, which refers to more sophisticated hand and finger movement; problem-solving skills such as learning and playing with toys; and social skills like playing with other children.

According to the result, those who had more than four hours of screen time per day were the most likely to have developmental delays in all four criteria by age two. They were also found to be more likely to have continued delays in both communication and problem-solving skills by age 4.

What also emerges in this analysis is a portrait of Japanese women who would let their children stare at a screen for longer hours.

“Mothers of children with high levels of screen time were characterized as being younger, having never given birth, and having a lower household income, lower maternal education level, and having postpartum depression,” the paper stated.

The researchers did recognize the difficulty for today’s parents to cut down screen usage. If exposure seems unavoidable, they said, it might be better for parents to watch some high-quality educational programs with their children together.

“Although screen time has been associated with developmental delay, it may have an educational aspect depending on the programs watched on electronic devices,” the researchers suggested, pointing to a meta-analysis study published by JAMA in 2020, which reported that screen time spent on educational programs was actually associated with increased language skills among young children, especially when watched with a parent.

“Because it is difficult to limit screen time in general in today’s world of electronic devices, it may be beneficial to identify and limit the screen time aspects that are associated with developmental delays while taking advantage of the educational aspects.”

The author admitted that the information they collected for the study didn’t allow them to separate educational screen time from other types of screen time. “Doing so may have helped us in examining the association between screen time and child development while considering both positive and negative aspects of screen time,” they wrote.

Screen Time Recommendations

The American Academy of Pediatrics (AAP) used to recommend that children younger than two get no screen time at all, except when it is a live video chat with family members or friends, which is considered quality interaction with other people.

In 2016, the AAP revised the guidelines, saying that children can have screen time starting at 18 months, but still recommending that parents watch a program with their child and guide the child through the experience.

“For children ages 18 to 24 months of age, if you want to introduce digital media, choose high-quality programming and use media together with your child. Avoid solo media use in this age group,” the professional organization said.

“For children two to five years of age, limit screen use to one hour per day of high-quality programming, co-view with your children,” it added. “Help children understand what they are seeing, and help them apply what they learn to the world around them.”

Meanwhile, The American Academy of Child and Adolescent Psychiatry (AACAP) in 2020 updated recommendations on screen time, telling parents to avoid non-educational usage as much as possible for all children under the age of 2.

For children under 18 months, the pediatric psychiatrist recommends limiting screen time to video calls monitored by a caregiver. They also specifically advise against using screens as pacifiers, babysitters, or to stop tantrums.

For children between 2 and 5, the AACAP recommends to “limit non-educational screen time to about 1 hour per weekday and 3 hours on the weekend days.”

“Talk to your child about what they are seeing. Point out good behavior, such as cooperation, friendship, and concern for others,” it noted. “Encourage your child to learn other activities such as sports, music, art, and hobbies that do not involve screens. Set a good example with your own safe and healthy screen habits.”

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