Media Use by Children Younger Than 2 Years

LOST IN TRANSLATION: CAN CHILDREN LEARN FROM MEDIA?

Research has found that certain high-quality programs have educational benefits for children older than 2 years. Children who watch these programs have improved social skills, language skills, and even school readiness.⁹ However, the educational merit of media for children younger than 2 years remains unproven despite the fact that three-quarters of the top-selling infant videos make explicit or implicit educational claims.⁵ To be beneficial, children need to understand the content of programs and pay attention to it. Children older than 2 years and those younger than 2 years are at different levels of cognitive development and process information differently.¹⁰ In fact, 2 studies have found that watching a program such as “Sesame Street” has a negative effect on language for children younger than 2 years,^11,12 and 2 studies have found no evidence of benefit.^13,14 There is a paucity of research on this topic, but the existing literature suggests that media use does not promote language skills in this age group.

Young children have difficulty discriminating between events on a video and the same information presented by a live person, which is referred to as “video deficit.”^15,–,17 Children 12 to 18 months of age are more likely to learn from a live presentation than from a televised one and are also more likely to remember the information from a live presentation afterward.¹⁸ These studies have only been performed on noncommercial videos. Some studies have found that children 1 to 2 years of age can remember an event on video if the screen demonstration repeats several times.¹⁹ Two studies have shown that infants as young as 12 months learn emotional responses after media viewing.^20,21 One longitudinal study performed has thus far found that children younger than 2 years who watch television have no statistical improvement in their cognitive development compared with their nonviewing peers by 3 years of age.²²

Children aged 12 months and younger do not follow sequential screen shots or a program's dialogue.^23,24 Other research has found that children younger than 18 months do not pay much attention to televised programs.²⁵ However, there are significant individual differences in attention to and interest in television in this age group that depend on content, setting, and whether a parent is watching with the child.²⁶ A developmental shift in attention to televised programs occurs between 1.5 and 2.5 years of age.^24,25

Children progress through developmental milestones on a continuum. Where each individual child is on that continuum determines what that child is capable of learning from a televised program. Some 18- to 24-month-olds might be capable of learning from media, but others might not. Other variables that influence a child's ability to learn are the content of the program, the amount of television watched, and whether a parent is watching with the child.^13,27

Despite the explicit or implicit marketing claims of educational programs for infants, whether they are actually learning something from these programs is questionable. More research is needed to determine if early television exposure has any long-term effects on learning.

SECONDHAND TELEVISION: FOREGROUND VERSUS BACKGROUND MEDIA

Many families have reported that they have a television on at least 6 hours/day or that a television is “always on” as background noise.²⁸ Thirty-nine percent of families with infants and young children have a television on constantly.²⁹ When a parent has an adult television program on, children are often in the room; 61% are there at least some of the time, including 29% who are there all or most of the time.³

Young children may not be paying close attention to a televised program that they cannot understand, but their parents are watching. It might be background media to the child, but it is foreground media to the parent. It distracts the parent and decreases parent-child interaction.^30,31 Infant vocabulary growth is directly related to the amount of “talk time” or the amount of time parents spend speaking to them.³² Heavy television use in a household can interfere with a child's language development simply because parents likely spend less time talking to the child.³³

Even if the program is not intended for the child to watch, research has found that children play and interact less with adults when a television is on, perhaps because the adult's attention is focused on the television program. A study that examined 12-, 24-, and 36-month-olds found that background television not only reduced the length of time that a child played but also that it reduced the child's focused attention during play.³⁴ Children stop to look at a televised program, halt their ongoing play, and move on to a different activity after the interruption.³⁴ Although most research has been performed on adolescents, study results suggest that background media might interfere with cognitive processing, memory, and reading comprehension.^4,34,–,36 Only 1 research study, conducted in 1996, resulted in evidence to the contrary. In that study, 10-month-old infants tuned out surrounding noise and concentrated more during play.³⁷

Background television has the direct effect of distracting a child and the indirect effect of taking a parent's attention away from the child. In addition, parents' media diet influences the media habits of their children.³

A GOOD USE OF TIME?

Children younger than 5 years who watch television spend less time in creative play and less time interacting with parents or siblings.³⁸ For every hour of television that a child younger than 2 years watches alone, he or she spends an additional 52 minutes less time per day interacting with a parent or sibling. For every hour of television, there is 9% less time on weekdays and 11% less time on weekends spent in creative play for a child younger than 2 years.

Does television displace more developmentally valuable playtime? No research exists at this point to know whether a child would find better things to do with his or her time if all screens were turned off, although evidence suggests that the child would hear more adult speech and talk more.⁶ Heavy media use is defined as the television being on always or most of the time. Heavy media use may be a sign of parenting style, so one cannot assume that parents will spend developmentally nurturing time with their child with the television off.³⁸

Heavy media use in a household does not seem to affect the amount of time a child of any age plays outside.⁴ However, children who live in households with heavy media use spend between 25% (for 3- to 4-year-olds) and 38% (for 5- to 6-year-olds) less time being read to or reading.^3,4 These children have a lower likelihood of being able to read compared with their peers from households with low media use.⁴ What is known is that unstructured playtime is critical to learning problem-solving skills and fostering creativity.³⁹

HEALTH CONSEQUENCES

Media use has been associated with obesity, sleep issues, aggressive behaviors, and attention issues in preschool- and school-aged children.^1,40 Studies are lacking on the health effects in children younger than 2 years. One area of concern, however, is media's effect on sleep. Television is part of the bedtime routine for many children. In 1 survey, 19% of parents of children younger than 1 year reported that their children have a television in their bedrooms. Twenty-nine percent of children 2 to 3 years of age have a television in their bedroom, and 30% of parents have reported that watching a television program enabled their children to fall asleep.³ Although parents perceive a televised program to be a calming sleep aid, some programs actually increase bedtime resistance, delay the onset of sleep, cause anxiety about falling asleep, and shorten sleep duration.⁴¹ Specifically, in children younger than 3 years, television viewing is associated with irregular sleep schedules.⁴² Poor sleep habits have adverse effects on mood, behavior, and learning. Although the effects of media on infants' cognitive and emotional development are still being explored, there are ample reasons to be concerned.

DEVELOPMENTAL CONSEQUENCES

Since 1999, 3 studies have evaluated the effects of heavy television use on language development in children 8 to 16 months of age. In the short-term, children younger than 2 years who watch more television or videos have expressive language delays,^12,43,44 and children younger than 1 year with heavy television viewing who are watching alone have a significantly higher chance of having a language delay.⁴⁴ Although the long-term effects on language skills remain unknown, the evidence of short-term effects is concerning.

Two studies have examined infant media use and subsequent attention problems in school-aged children.^45,46 One of these studies found that the effects of television watching on infants' attention span varied with the content of the programming.

Research findings to date might suggest a correlation between television viewing and developmental problems, but they cannot show causality. Are infants with poor language skills placed in front of the television more? Are infants with shorter attention spans more attracted to screens? Does media exposure contribute to a delay in social or communication skills and diminished attentional capacity? Because these questions remain unanswered, more research is needed.

CONCLUSIONS AND RECOMMENDATIONS

This updated policy statement provides further evidence that media—both foreground and background—have potentially negative effects and no known positive effects for children younger than 2 years. Thus, the AAP reaffirms its recommendation to discourage media use in this age group. This statement also discourages the use of background television intended for adults when a young child is in the room. Although infant/toddler programming might be entertaining, it should not be marketed as or presumed by parents to be educational.

No longitudinal study has determined the long-term effects of media use on infants and children younger than 2 years. The AAP supports research to understand the consequences of early electronic media exposure.

Lead Author

Ari Brown, MD

Council on Communications and Media Executive Committee, 2010–2011

Deborah Ann Mulligan, MD, Chairperson

Tanya Remer Altmann, MD

Ari Brown, MD

Dimitri A. Christakis, MD, MPH

Kathleen Clarke-Pearson, MD

Holly Lee Falik, MD

David L. Hill, MD

Marjorie J. Hogan, MD

Alanna Estin Levine, MD

Kathleen G. Nelson, MD

Gwenn Schurgin O'Keeffe, MD

Past Executive Committee Members

Benard P. Dreyer, MD

Gilbert L. Fuld, MD, Immediate Past Chairperson

Regina M. Milteer, MD

Donald L. Shifrin, MD

Victor C. Strasburger, MD

Liaisons

Michael Brody, MD

American Academy of Child and Adolescent Psychiatry

Brian Wilcox, PhD

American Psychological Association

Staff

Gina Ley Steiner

Veronica Laude Noland