A new study published in the journal JAMA Pediatrics reveals that babies and toddlers who watching television or videos may be more susceptible to atypical sensory processing behaviors. These behaviors include a lack of engagement and interest in activities, seeking more intense stimulation in an environment, or being overwhelmed by sensations such as loud noises or bright light, according to data from researchers at Drexel’s College of Medicine.
The study suggests that children who watched television or DVDs more frequently before their second birthday were more likely to develop atypical sensory processing behaviors such as „seeking sensations“ and „avoiding sensations“ as well as „low registration“ by the age of 33 months. This means they were less sensitive to or had slower reactions to stimuli, such as answering to their name.
Sensory processing abilities reflect the body’s ability to respond efficiently and appropriately to information and stimuli received by its sensory systems, such as what the toddler hears, sees, touches, and tastes.
The researchers drew data on television or DVD viewing from babies and toddlers at 12, 18, and 24 months from the years 2011 to 2014 from the National Children’s Study involving 1,471 children (50% male) nationwide.
The results of sensory processing were assessed after 33 months using the Infant/Toddler Sensory Profile (ITSP), a questionnaire filled out by parents/caregivers aimed at providing insights into how children process what they see, hear, smell, and more.
ITSP subscales examine children’s patterns of behavior related to low registration and seeking sensation, such as excessive touching or smelling of objects; sensory sensitivity, such as over-excitement or irritation to light and noise; and sensory avoidance – actively trying to control their environment to avoid things like brushing their teeth. Children are categorized into „typical,“ „high,“ or „low“ groups based on how often they exhibit various sensory behaviors. Values were considered „typical“ if they fell within one standard deviation of the ITSP norm’s average.
Screen exposure measurements at 12 months were based on caregivers‘ responses to the question: „Does your child watch TV and/or DVDs? (Yes/No)“ and at 18 and 24 months based on the question: „About how many hours per day has your child watched TV and/or DVDs on average in the past 30 days?“
The results suggest:
- At 12 months, any screen exposure compared to no screen viewing was associated with a 105% increased likelihood of exhibiting „strong“ sensory behaviors instead of „typical“ sensory behaviors associated with low registration after 33 months.
- At 18 months, each additional hour of daily screen time was associated with a 23% increased likelihood of exhibiting „strong“ sensory behaviors associated with later sensory avoidance and low registration.
- At 24 months, each additional hour of daily screen time was associated with a 20% increased likelihood of developing „high“ sensation seeking, sensory sensitivity, and sensory avoidance after 33 months.
The researchers took into account the child’s age, whether the child was born prematurely, the caregiver’s education, race/ethnicity, and other factors such as how often the child plays or goes for walks with the caregiver.
The findings add to a growing list of concerning health and developmental outcomes associated with screen time among infants and toddlers, including language delay, autism spectrum disorder, behavioral problems, sleep disturbances, attention problems, and delays in problem-solving.
This association could have important implications for attention-deficit/hyperactivity disorder and autism, as atypical sensory processing is far more prevalent in these populations. Repeated behaviors, such as those seen in autism spectrum disorder, strongly correlate with atypical sensory processing. Future work could elucidate whether early screen time could fuel the sensory hyperconnectivity of the brain observed in autism spectrum disorder, such as increased brain responses to sensory stimulation.
Karen Heffler, MD, Lead author, Associate Professor of Psychiatry at Drexel College of Medicine
Atypical sensory processing in children with autism spectrum disorder (ASD) and ADHD manifests in a range of deleterious behaviors. In children with ASD, stronger sensory seeking or avoidance, heightened sensory sensitivity, and diminished registration have been linked with irritability, hyperactivity, eating and sleep problems, and social issues. In children with ADHD, atypical sensory processing is associated with executive function problems, anxiety, and reduced quality of life.
„Considering this link between high screen time and a growing list of developmental and behavioral problems, it may be beneficial for toddlers showing these symptoms to undergo a reduction in screen time, along with sensory processing practices by occupational therapists,“ said Heffler.
The American Academy of Pediatrics (AAP) advises against screen time for babies under 18-24 months. Live video chatting is considered fine by the AAP as the interaction taking place may bring benefits. The AAP recommends limiting the use of digital media for children aged 2 to 5 to typically no more than 1 hour per day.
„Education and awareness for parents are key to minimizing or hopefully even avoiding screen time for children under two years of age,“ said lead author David Bennett, PhD, Professor of Psychiatry at Drexel College of Medicine.
Despite all the evidence, many toddlers are still spending increasing amounts of time in front of screens. According to a research brief from 2019, children aged 2 and under in the United States spent an average of 3 hours and 3 minutes per day in front of a screen in 2014, compared to 1 hour and 19 minutes per day in 1997 JAMA Pediatrics. According to a study in July 2015, some parents cite exhaustion and inability to find affordable alternatives as reasons for screen time Journal of Nutrition and Behavior.
While the current paper focused solely on watching television or DVDs and not media viewed on smartphones or tablets, it provides some of the earliest data linking early-life digital media exposure with later atypical sensory processing across various behaviors. The authors said that future research was needed to better understand the mechanisms determining the connection between early screen time and atypical sensory processing.
Heffler, KF, et al. (2024). Digital media experience in early life and development of atypical sensory processing. JAMA Pediatrics. doi.org/10.1001/jamapediatrics.2023.5923.