A controversial new study is suggesting a link between a baby’s exposure to screens at the age of 12 months and the development of autism spectrum disorder (ASD)-like symptoms later in childhood. Experts not affiliated with the study have criticized the research, calling it “fatally flawed”, “misleading”, and potentially “harmful”.

“The literature is rich with studies showing the benefits of parent-infant interaction on later child development, as well as the association of greater screen viewing with developmental delays,” explains lead author on the new study, Karen F. Heffler. “Our study expands on this previous research by associating early social and screen media experiences with later ASD-like symptoms.”

The study investigated data from the National Children’s Study (NCS), a multi-center epidemiological project examining the relationship between child development and environmental influences. A cohort of 2,152 children was investigated.

Screen viewing frequency was assessed using two data points from the NCS. At 12 months of age caregivers were asked if their child watches TV or DVDs, and at 18 months of age caregivers were asked to estimate how many hours per day their child watched TV or DVDs. At two years of age symptoms of ASD were measured in the children using a scale called M-CHAT (Modified Checklist for Autism in Toddlers).

The new research found those children who watched TV or DVDs at 12 months of age were 4.2 percent more likely to present with ASD-like symptoms at 24 months. Conversely, the study examined rates of daily play and found children who played with parents daily were 8.9 percent less likely to develop ASD-like symptoms at 24 months compared to those children playing with parents less than daily.

It is important to note the study also found absolutely no association between hours per day of screen time at 18 months and ASD-like symptoms at 24 months. Reading to a child daily at 12 months of age was also found to have no association with a reduction in ASD-like symptoms at 24 months.

David Bennett, senior author on the study, says these findings strengthen the importance of parent-child play time relative to screen time. The authors of the study also suggest parents avoid exposing children younger than 18 months to screens, in accordance with the American Academy of Pediatrics’ recommendation.

Many experts not affiliated with this new study are expressing surprise this kind of research passed peer-review and was published in a legitimate journal. James Cusack, director of science at UK charity Autistica, calls the study’s claim of a link between screen time and ASD symptoms “absurd”.

“First of all the effect of screen time observed in the study is small,” explains Cusack. “Secondly, the tool used to observe the effect is not particularly effective at detecting autism. Thirdly, the measure is used at two years old, an age where children develop at different rates and where we know it is hard to accurately diagnose autism.”

Cusack suggests this research is “unhelpful” and could cause unnecessary concern for families worried about the effect of screens on their children.

“Scientists and journal editors must do a better job of serving families than this,” says Cusack. “Families should not be concerned that allowing their young children to watch screens will cause autism – it would be absurd to reach this conclusion based on this evidence.”

Andrew Przybylski, a scientist from the University of Oxford with significant experience studying the effect of screen time on children, suggests this study is an example of, “a failed peer review process.” He points out the link between simply watching TV or DVDs at 12 months of age, and presenting with ASD-like symptoms at 24 months needs much more justification than what is delivered here if one is implying a causal connection.

“… there was no mechanism proposed or tested in the data linking screens to autism,” says Przybylski. “If a scientist is going to make a bold sweeping claim that answering yes to the question ‘Does your child watch TV/DVDs?’ at 12 months is associated with greater Autism-like symptoms six months later it should [be] incumbent upon them to do the research required to explore before publishing. This was not done.”

As well as noting how small, and potentially clinically irrelevant, the effect size identified in the study is, David Nunan from the University of Oxford says the timing of this study being published is questionable.

“If there are worrying news headlines from this study there may well be many anxious parents as a result,” says Nunan. “This would be no help whatsoever to children or their families. It is ridiculous to publish this study in its current format when almost half the world are in lockdown, including millions of families and teachers already worried about the impact of all of this on children’s physical and mental wellbeing.”

The press release from Drexel University announcing the publication of the study in the journal JAMA Pediatrics, recognizes the unique timing, but simply notes, “The authors suggest that these findings come at a critical time during this coronavirus pandemic with many children at home all day and parents juggling working from home or other new responsibilities while watching their children.”

Uta Firth, from University College London’s Institute for Cognitive Neuroscience, suggests increased screen time may well be a consequence of ASD-like symptoms rather than a cause, as children uncomfortable with social interactions may increase screen-based behaviors from an early age. Firth also adds to the chorus of concern regarding the implications of this study on parents stuck at home in lockdown with young children.

“I worry that the paper will do harm, if it feeds the ‘blame the parents’ meme,” says Firth.

The new study was published in the journal JAMA Pediatrics.

Source: Drexel University