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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Monday, March 10, 2014

"Screen Time" for Infants and Toddlers

I don’t usually double-dip by putting the same post on different blogs, but I think this topic is so important that I’m putting on childmyths a version of a post that will be on the website of the Pennsylvania Association for Infant Mental Health ( This post is a summary of an important presentation by  Dr. Stacey Hoffman, child clinical psychologist at Children’s Hospital of Philadelphia, and the discussion following the presentation. Dr.Hoffman’s presentation title was “Screen time in early childhood: Promoting parent-child relationships in the digital age”.

Dr. Hoffman began her presentation with some concerning figures. The average age for beginning TV/screen watching in the United States is 5 months. Ninety percent of children under age 2 years watch TV. Half of the young children in the U.S. live in homes where the television is turned on more than 6 hours each day. Seventy percent of children have TV sets in their bedrooms. Watching TV is the most common activity (so to speak) for young children, after eating. The average number of hours watched per day is 4.4 in homes. 3.2 in center-based day care, and 5.5. in home-based day care.

But, as was noted several times during the presentation, one of the reasons for this heavy use is that parents generally believe they are doing the right thing by facilitating screen use. They think that this kind of screen exposure will make their children “smart”. This belief persists in spite of the recommendations made by the American Academy of Pediatrics in 1999 and again in 2011: that all forms of screen use are inappropriate for children under 2 – a position that, as several members of the audience noted, is somewhat weakened by the almost universal presence of TV screens in doctors’ offices.

When parents say they believe screen use is beneficial and makes kids “smart”—in contradiction to the AAP recommendation—where do they get this idea? A major source is the marketing of screen media, targeting parents of young children, who often depend on ages for use of media as suggested by marketers. Product packages may recommend media as appropriate for babies from 6 months. Parents become convinced that there are suitable media presentations for infants and toddlers, as claimed by the 24-hour “Baby TV” channel. Marketing materials call such media ”learning activities” and imply that a baby without access to these may be “left out” developmentally. They also state that media are intended to be used for the shared experience of parents and babies (although this is not usually what happens).

A report by the Kaiser Family Foundation in 2005 stated that 58% of the parents surveyed thought that available material was “educational” for babies. Most did not watch with the baby, but took the opportunity to do something else. They felt that the screen was calming for the baby and that intent watching for longer and longer periods indicated that the baby was developing a longer attention span and getting “smarter”. One mother was surprised that her baby seemed to have language delays even though he watched “Baby Einstein” every day.

Is there any support for the marketing claims? No, and in fact the highest levels of infant learning may be incompatible with screen use. The Campaign for Commercial-Free Childhood brought to the FTC a complaint of fraud against the leading marketer, the “Baby Einstein” company, and forced the manufacturers to back down to some extent. Refunds were given to purchasers who applied, but the company did not admit deceptive marketing and couched the issue in terms of “customer satisfaction”.

What problems are associated with infant screen use? Why does exposure to new information on the screen not “make babies smarter”? The researchers Anderson and Pempek (2005; see below for reference) used the term “video deficit effect” to describe the additional time needed for infants to learn material from a screen, as compared to learning from a live model. Part of the problem is that infants do not readily generalize from the two-dimensional screen image to the three-dimensional real world. Neither have they developed the ability for symbolic representation that lets them see the equivalence between the small, flat screen image and what they see around them (DeLoache & Chiong, 2009; see below).
Infants’ natural ways of learning involve not only the visual experience that is so crucial to adult learning,  but also movement and touch, often using the mouth as well as the hands. Despite the occasional chomps infants give to screen devices, this kind of exploration really not be done with a screen image.

Caregivers contribute to infant learning in ways that screen devices cannot imitate (so far, at least). A critical contribution is scaffolding, observing what is easy or difficult for the child and providing just enough support to enable the child to be successful with more difficult tasks. An everyday example is providing a spoon or finger food for a baby who wants to self-feed but cannot handle a fork. Scaffolding can involve hastening or slowing an activity in response to a child’s needs at the moment, or asking a series of questions to guide a sequence of tasks, as needed.

Some aspects of baby learning have to do with infants’ sensory and motor abilities, which facilitate active learning through real experience, but do not fit well with learning from a screen. As has been shown by Smith, Yu, and Pereira (2011; see below), sitting is a breakthrough to examination of objects and learning from them (and, notably, the average age for starting infant screen use is prior to the average age for sitting alone!). Linda Smith and her colleagues have talked about “good naming moments” when infants are likely to learn the names of objects. These are times when the sitting baby holds an object not far from her face  (because her arms are short) and has it in the center of her visual field. The holding position helps to stabilize the child’s head and give a clear view of the object. Object names experienced during these situations are learned more quickly than is the case when the object is being held by the mother. Pretend play is also encouraged by handling and looking at objects.

So, here we are: there is plenty of evidence that playing with real objects is better for learning than watching a screen, and that interacting with a real person involves experiences that can’t occur when watching someone on a screen. How, then, do we encourage young parents to abandon the screen use that has been sold to them by clever but deceptive marketing? Discussion at Dr. Hoffman’s presentation focused on the idea that it does not help merely to tell parents not to do something. A good substitute must be offered, whether it’s singing, talking, reading aloud, or playing games like pat-a-cake. Unfortunately, many young parents do not believe they can teach their children anything worthwhile, and they need help to see  how many important things they have taught and will teach in the future. A final and important point is that we need not try to get parents to go at one step from 24 screen hours a day to none at all. Anything that reduces screen use, and increases interactions with the real world, is a step in the right direction.

Anderson, D., & Pempek, T. (2005). American Behavioral Scientist, 48, 505-522.
DeLoache, J., & Chiong, C. (2009). Babies and baby media. American Behavioral Scientist, 52, 1115-1135.
Smith, L. Yu, C. & Pereira, A. (2011). Not your mother’s view: The dynamics of infant visual experience. Developmental Science, 14, 9-17.


  1. Fifteen years ago, the Onion had the final word on this controversy:,626/