ArticlePDF Available

THE CONSUMPTION OF VIRTUAL ENVIRONMENT MORE THAN 4 HOURS/DAY, IN THE CHILDREN BETWEEN 0-3 YEARS OLD, CAN CAUSE A SYNDROME SIMILAR WITH THE AUTISM SPECTRUM DISORDER

Authors:

Abstract

This survey describes the incidence of the excessive consumption of virtual environment in children recently diagnosed with ASD, between 2012-2017, in two specialized rehabilitation centres. The survey was conducted longitudinally, following the progress in the therapeutic process, by measuring QD/IQ in 62 children with autism, in Romania. The analysis compared two groups who presented or not a consumption of more than 4 hours/day of virtual environment in their anamnesis history, between 0-3 years old. The results of the survey are the following: children diagnosed with ASD who had an anamnesis history of excessive consumption of virtual environment, between 0 – 3 years old have recorded QD/IQ higher by 37%, between the first and the second complex psychological evaluation, while resources used were three times lower compared to the control group. This suggests that sensory-motor and socio-affective deprivation caused by the consumption of more than 4 hours/day of virtual environment can activate behaviours and elements similar to those found in children diagnosed with ASD. Follwing our survey, we defined this form of autism: Virtual Autism.
1
THE CONSUMPTION OF VIRTUAL ENVIRONMENT MORE THAN 4
HOURS/DAY, IN THE CHILDREN BETWEEN 0-3 YEARS OLD,
CAN CAUSE A SYNDROME SIMILAR WITH THE
AUTISM SPECTRUM DISORDER
Marius Teodor Zamfir
Clinical psychologist, mrd „Spiru Haret” University
Abstract: This survey describes the incidence of the excessive consumption of virtual environment in children
recently diagnosed with ASD, between 2012-2017, in two specialized rehabilitation centres. The survey was
conducted longitudinally, following the progress in the therapeutic process, by measuring QD/IQ in 62
children with autism, in Romania. The analysis compared two groups who presented or not a consumption of
more than 4 hours/day of virtual environment in their anamnesis history, between 0-3 years old. The results
of the survey are the following: children diagnosed with ASD who had an anamnesis history of excessive
consumption of virtual environment, between 0 3 years old have recorded QD/IQ higher by 37%, between
the first and the second complex psychological evaluation, while resources used were three times lower
compared to the control group. This suggests that sensory-motor and socio-affective deprivation caused by
the consumption of more than 4 hours/day of virtual environment can activate behaviours and elements
similar to those found in children diagnosed with ASD. Follwing our survey, we defined this form of autism:
Virtual Autism.
Keywords: virtual autism , virtual environment, TV, ASD, screen-time.
Introduction
Seven years ago, some psychologists in Romania observed, in the case of recently diagnosed
with ASD, who started a recovery programme, a very different pace of recovery. Specifically,
patients had dramatic improvments, compared to previous cases, in all development areas, with the
start of recovery protocol.
Looking more in detail their anamnesis history, we have identified a common point of these
children who recovered more quickly. It is about a minimum average consumption of 4-5 hours/day
virtual environment
1
, between 0-3 years old. An interesting aspect is the fact that some of these
children have been integrated in the mainstream education system, functionally, without needing
special expert help; generally, they presented only problems related to understanding, correct
expression and complex expression of the human emotions and relationships. Specifically,
understanding abstract things, hints, sarcasm and generally sign language used much by people
during communication. After recovery, these children are very much alike the people with Aspeger
disorder type. We defined this form of autism: Virtual autism
2
.
In Romania, virtual environment consumption rate is very high, largerly due to the political
and economical framework. According to a survey named Une année de télévision dans le monde
achieved by the French Institute Médiamétrie and published in 2013
3
, in 2012, Romania occupied
the first place among the European countries, as regarding the TV programmes consumption;
Romanians’ average time of looking TV is about 5 hours and 30 minutes, daily. Other statistics
showed that first tablets emerged in 2010, as well as the first mobile phone with Android system, at
1
Virtual environment is represented by any electronic device with a screen and which has an attraction and interest in
children: mobile phone, tablet, TV, computer, laptop, etc.
2
Virtual autism is a term used in present paper, referring to disorder of children’s functionality and development, due to
the excessive consumption of virtual environment in the first years of life, that is similar to the autistic disorder, meets
the diagnosis criteria described in special manuals DSM IV, as well as ICD 10. The main difference between the two
types of disorder is the direct relation between the autism diagnosis and the consumption of virtual environment, as a
trigger
3
https://www.challenges.fr/high-tech/les-pays-les-plus-frappes-par-la-crise-regardent-plus-la-television_11372 (site
accessed on January 24, 2018).
2
prices that provide the access to these new technologies to a growing number of people. Since
2012, these technologies have arrived in Romania, at affordable prices; this is also the year of
introducing 4G technology which provides unlimited access to Internet, for mobile phones
4
.
Unfortunately, these new technologies which can be accessed in any place, beside TV, laptop and
computer, come gradually to take over in many families the roles of parents, nanny, babysitter, and
thus occupying much time of children’s time, without realizing their long term effects.
In recent years, several studies
5
warn about the danger of using virtual environment, for
children between 0-5 years old, both from point of view of their physical and mental development.
Despite the renewed recommendations issued by the American Academy of Pediatrics
(AAP)
6
, that Tv and mass-media use should be discouraged totally before 2 years old, the early
exposure to TV increased dramatically in the last decade. More than 90% of infants and young
children worldwide are regularly exposed to electronic media. Though children daily interact with
these virtual devices, they have difficulties to overcome the symbolic source and transfer learning in
real life
7
.
4
http://solutiipc.ro/topul-celor-mai-interesante-telefoane-4g/ (site accessed on January 24, 2018)
5
We refer to the follwing special studies: 1) Council on Communications and Media, Brown A , et al. Media use by
children younger than 2 years. Pediatrie .2011 ; 128 ( 5 ): 1040-1045 pmid: 22007002;
http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-1753 2) Kabali HK, Irigoyen MM, Nunez-
Davis R, et al. Exposure and use of mobile devices by young children. Pediatrics. 2015;136 (6): 1044
1050pmid:26527548; https://www.ncbi.nlm.nih.gov/pubmed/26527548 3) Barr R , Danziger C , Hilliard M , et
al . Amount, content and context of infant media exposure: A parental questionnaire and diary
analysis.. 2010 ; 18 ( 2 ): 107 - 122pmid: 20890405 http://pediatrics.aappublications.org/content/131/2/e390 ; 4)
Rideout VJ , Hamel E . Media family: Electronic media in child's life, small children, preschoolers and their
parents. Menlo Park, CA : Kaiser Family Foundation, 2006;
https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7500.pdf ; 5)
Mendelsohn AL , Berkule SB , Tomopoulos S , et al . Infant television and video exposure associated with limited
parent-child verbal interactions in low socioeconomic status households. Arch Pediatr Adolesc
Med . 2008 ; 162( 5 ): 411 - 417 pmid: 18458186; https://www.ncbi.nlm.nih.gov/pubmed/18458186 6)
Zimmerman FJ,Christakis DA , Meltzoff AN . Television and DVD/video viewing in children younger than 2 years.
Arch Pediatr Adolesc Med . 2007. 161 ( 5 ): 473 - 479 pmid: 17485624;
https://www.ncbi.nlm.nih.gov/pubmed/17485624 7) Miller SA , Taveras EM , Rifas-Shiman SL , et al . Association
between television viewing and poor diet quality in young children. Int J Pediatr Obes . 2008 ; 3 ( 3 ): 168-176
pmid: 19086298; https://www.ncbi.nlm.nih.gov/pubmed/19086298 8) Tomopoulos S , Dreyer BP , Berkule S , et
al . Infant media exposure and toddler development. Arch Pediatr Adolesc Med . 2010 ; 164 ( 12 ): 1105-1111
pmid: 2113533; https://www.ncbi.nlm.nih.gov/pubmed/16199693 9) Zimmerman FJ , Christakis DA . Children's
television viewing and cognitive outcomes: a longitudinal analysis of national data.. Arch Pediatr Adolesc
Med . 2005 ; 159 ( 7 ): 619 - 625 pmid: 15996993; https://www.ncbi.nlm.nih.gov/pubmed/15996993 10) Hoyos
Cillero I , Jago R . Systematic review of correlates of screen-viewing among young children. Prev
Med . 2010 ; 51 ( 1 ): 3 - 10 pmid: 20417227; https://www.ncbi.nlm.nih.gov/pubmed/20417227 11)
Taveras EM, Hohman KH, Price S, et al . Televisions in the Bedrooms of Racial/Ethnic Minority Children: How Did
They Get There and How. Do We Get Them Out? Clin pediatru (Phila) . 2009 ; 48 ( 7 ): 715 - 719 pmid: 19420181 ;
https://www.ncbi.nlm.nih.gov/pubmed/19420181 12) Certain LK , Kahn RS . Prevalence, correlates, and trajectory of
television viewing among infants and toddlers. Pediatrie .2002 ; 109 ( 4 ): 634-642 pmid: 11927708;
https://www.ncbi.nlm.nih.gov/pubmed/11927708 13) Conners NA , Tripathi SP , Clubb R , et al. Maternal
characteristics associated with television viewing habits of low-income preschool children. Journal of Child and
Family Studies. 2007 ; 16 ( 3 ): 415-425; https://link.springer.com/article/10.1007/s10826-006-9095-0 14) Vandewater
EA , Rideout VJ , Wartella EA , et al. Digital childhood: electronic media and technology use among infants, toddlers,
and preschoolers. Pediatrie . 2007 ; 119 ( 5 ): e1006 - e1015pmid: 17473074;
http://pediatrics.aappublications.org/content/119/5/e1006?download=true 15) Elizabeth M. Cespedes , Matthew W.
Gillman, et al. Television viewing, bedroom television, and sleep duration from infancy to mid-childhood.Pediatrie Mai
2014, VOLUM 133 / ISSUE 5; http://pediatrics.aappublications.org/content/133/5/e1163 16)
Saelens BE , Sallis JF , Nader PR , et al . Home environmental influences on children's television watching from early
to middle childhood. J Dev Behav Pediatru . 2002 ; 23 ( 3 ):127-132 pmid: 12055494;
https://www.ncbi.nlm.nih.gov/pubmed/12055494 17) Thompson DA , Christakis DA. The association between
television viewing and irregular sleep schedules among children less than 3 years of
age. Pediatrie . 2005 ; 116 ( 4 ): 851 - 856 pmid: 16199693 https://www.ncbi.nlm.nih.gov/pubmed/16199693
6
American Academy of Pediatrics, Council on communications and media, Media and Young Minds, Pediatrics,
October 2016 http://pediatrics.aappublications.org/content/early/2016/10/19/peds.2016-2591..info
7
1) Barr R, Memory Constraints on Infant Learning From Picture Books, Television, and Touchscreens 2013;7(4):205
210; http://onlinelibrary.wiley.com/doi/10.1111/cdep.12041/abstract ; 2) Barr R. Transfer of learning between 2D and
3
Objectives
- Identify the percentage of recently diagnosed children with ASD who present in their anamnesis
history an excessive consumption
8
of virtual environment, in the first three years of life,
recorded in our institutions
9
, between 2012-2017;
- Identify the percentage of therapy time resources, as well as the therpeutic resources, between
the first and the second complex psychological evaluation, compared in two groups of children
with ASD, who have experienced and excessive consumption of virtual environment, in the first
three years of life;
- Identify the percentage of resources, therapy hours and therapeutic results, compared in two
groups of children with ASD, who have experienced or not an excessive consumption of virtual
environment, in the first three years of life, on subjects integrated in the mainstream education
system, without professional help, at independent, adaptative and functional level.
Hypotheses
- Is there any connection between increased incidence of children with ASD, with anamnesis
history of excessive consumption of virtual environment and increased incidence of ASD, in
general?
- Can the excessive consumption of virtual environment between 0-3 years old cause a delay in
children’s psychomotor development and a clinical syndrome similar to autism spectrum
disorder?
Methods
Participants
The data resulted from the analysis of the children diagnosed with ASD , evaluated and
surveyed longitudinally between 2007-2017, in the recovery centres for children with autism of the
Asociația pentru Sănătate Mintală a Copilului (ASMC) and Fundatia Copii în Dificultate
România (CID- România). We mention that both organizations provide services , both in the centres
and at home. The analysed group included 110 children from the country (23,21%) and towns
(76,97%). The incidence on sexes is the following: 1) 76,36% - boys; 2) 23,64% - girls. At the
initial assessments, the minimum age of total subjects group was between 12 and 122 months, with
an average of 39 months.
Design and implementation
Since in Romania, the recovery services for children with autism are not reimbursed by
Government, parents pay almost all of these costs. Therefore, after initial assessment, only 54, 55 of
the benefitiaries’ representatives have requested professional care services. Of the total number of
benefitiaries, 84,26% had home services, while 15,38% were in the above mentioned centres.
Home services included: 1) initial and periodical complex psychological assessment; 2)
training, preparation customized intervention plan, both initilally and periodically; 3) training and
coordination for the team who applies the therapeutic protocol; 4) periodical monitor.
Services in special centres included initial and/or periodical recovery psychological
assessments for children with autism.
Analyses were conducted between the development coefficiencies (QD) recorded at the first
complex psychological evaluation, compared to the second psychological evaluation. There were
taken into consideration both general coefficients and coefficients on the three worst affected areas
for children diagnosed with ASD. It is about the social area, the area of language and cognition
3D sources during infancy: Informing theory and practice. Dev Rev. 2010 Jun 1; 30(2): 128154.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2885850/
8
In the present paper, excessive consumption, in the children case, represents a 4-5 hours/day average consumption of
the virtual environment, between 0-3 years old.
9
Asociaţia pentru Sănătate Mintală a Copilului (ASMC) and Fundaţia Copii în Dificultate – România (CID- România).
4
area. The time distance between the two evaluations varied between 2 and 10 months, and it was
settled by the case manager, depending on child’s response at the therapeutic protocol.
In order to achieve the targets, subjects were distributed, as following:
- A group called „Control group”, including subjects diagnosed with ASD, who did not present
in the anamnesis history consumption of virtual environment or the consumption represented an
average of 2 hours/ day;
- A group called “Screen group”, including subjects diagnosed with ASD , who presented in the
anamnesis history an excessive consumption of virtual environment, between 0-3 years old.
On these two groups, there were analysed both general data and those referring to the
differences between resources and results and between the first and the second complex
psychological evaluation.
- A group called „Integrated children group” included both subjects from Control group and
Screen group.
This group included children diagnosed with ASD who presented significant improvements, up
to the level of integration into the mainstream education system, without professional help, being
independent and functional, even if alongside, in parallel some of them continue special therapy, to
improve certain areas and /or poor behaviours. In order to be included in this group, subjects should
receive a QD/IQ higher than 90 at the assessment with WISC IV
10
or Portage Scale and a Scor T
< 59 at the assessment with ASRS
11
.
After applying the selection criteria for the survey, the two groups were composed, as
follwing: 1) Control group - 29 subjects; 2) Screen group - 33 subjects.
Since 2012, until 2017, we analysed the data related to the incidence of the excessive
consumption of virtual environment in the first three years of life, on the group including all the
children recently diagnosed with ASD in the two institutions, in total number of 110 subjects.
One of the variables we were not able to maintain constant, for the total groups was the first
assessmentaverage age. This happened due to the increasing media of the autism phenomenon and
the existence of multiple information on the Internet. Thus, parents observed children’s behaviours,
at younger ages than ever and communicated this aspect to specialist doctors. In the recent five
years (2012-2017), the diagnosis age decreased dramatically. If ten years ago, in Romania, children
were diagnosed, generally, after 36 months old, in present, children are diagnosed even at 12
months old, the average being around 22-24 months old.
Thee average age of the Control group was 42 months, up to nine months older than Screen
group, which was 33 months old. In order to verify if this variable may influence the final data, we
selected from both groups five subjects presenting the same age at the moment of first evaluation,
and compared the differences between the two groups, related to the first and second assessment.
The minimum duration of therapy applied to subjects between the first and the second
complex psychological assessment was of 36 hours/month, and the maximum duration of 88
hours/month, with an avearge of 40,39 hours/month.
Selection criteria and final statistical data
In order to calculate the incidence of number of children diagnosed with ASD who present
in the anamnesis history an excessive consumption of virtual environment, in the first years of life,
we used the total group including 110 children recenlty diagnosed with ASD , evaluated in the
programmes provided by the two special centres, between 2012-2017.
The criteria for the other objectives were the following:
- Subjects diagnosed with ASD , aged 12-68 months, at the initial assessment;
- Parents were notified about the content of the specific therapeutic protocol provided through our
services and they agreed to be applied;
- The recovery therapeutic protocol was continuing and included at least 2 complex
psychological assessments;
10
Wechsler Intelligence Scale for Children - fourth edition
11
Autism Spectrum Rating Scales
5
- In the case of children presenting in their anamnesis history virtual environment consumption,
parents agreed to remove this variable, in order to optimize the therapeutic protocol results.
The recovery therapeutic protocol
It was designed within the Asociaţia pentru Sănătate Mintală a Copilului (ASMC), as a
special protocol based on the combination of various therapies specific to the children with ASD ,
and adapted to every subject psycho-motric-sensitive needs of each subject, and developed in a
working system 1/1, excepting the stages of generalization and socialization.
The protocol includes specific elements from the following therapies: sensitive integration
therapy, play therapy, occupation therapy, language stimulation and logopedy, psychomotor
stimulation therapy, cognition behaviour therapies, behaviour analysis and experiential orientation
techniques and methods. In order to optimize the therapeutic process, a systemic approach is
applied, by involving parents, extended family and other relevant people who take care of children.
The therapeutic protocol aims also to increase pacient’s level of functionality and approaches
multisiciplinary the development and distribution of concentrated attention, memory, level of
thinking, processing speed, vizo motor and vizo spatial processing, as well as increased
independence and self-esteem.
The protocol was applied to all the subjects, being adapted to every patient, according to the
specific particularities revelead by the complex psychological assessments, both initially and
periodically.
The methodology for calculating of differences between resources and outcomes in the two
groups
Since the programme of applying the therapeutic protocol could not be implemented as
standard to all subjects, as there were different variables
12
between the two groups, in order to
make comparative analyses, as objective as possible, we created the following calculation
methodology and indices:
- The variable „resources” includes the number of therapy hours/month and duration expressed in
months. On the two groups, we achieved an average of therapy duration and number of hours,
between the two moments of assessments (first, second and final ones, etc);
- The variable „outcomes” includes the percentage difference between the two moments of
assessments, it includes the percentage difference between the two moments of assessement,
and general QD/IQ, as weel as the three main development areas affected in ASD :
socialization, language and cognition.
We settled the following codes and calculation formulas:
- EV1 initial assessment; EV2 second assessment;
- QD coefficient of development;
- LC Control group; LE Screen group;
- IRT therapeutic resources index = average care per hours/month* average number of
months/100;
- IET therapeutic efficiency index = IRT LC/IRT LE ;
- ERT real therapeutic efficiency = QD EV2 LE/QD EV2 LC * 100 100;
- IGE overall efficiency index = IET * (ERT QD + 100) /100.
Explanations:
- Therapeutic resources index (IRT) represents therapeutic cost between two moments;
- Therapeutic efficiency index (IET) represents the difference between the therapeutic resources
index of some different groups or subjects (fewer resources consumed, for a group or another).
- Real therapeutic efficiency (ERT) represents the percentage difference between two
development coefficients or number of children integrated from some groups or different
subjects (the comparison of the efectivness of results in the two groups).
12
It is about observing a number of therapy hours/day, days/ week, holidays, therapy duration, etc.
6
- The overall efficiency index (IGE) represents and average of the efficiency index (IET) and real
therapeutic efficiency (IRT) of some groups or different subjects (the comparison of the
efectivness of the therapeutic protocol between groups, in general).
Instruments
1. The anamnesis interview and questionnaires applied to parents, both initaially and periodically.
It represents the most important method of collecting information, as we can find all the pre-
and post natal history of children, mother and all people who contributed to children’s growth,
care and education, the type of parenting and all the existing resources that can contribute to a
harmonius development. 60,86, % of the initial and periodical assessements have been achieved
at home;
2. Instruments to diagnose autism. When entering our services, 83,88% of the children presented
the diagnosis of ASD , at the psychiatrist. Despite of all that, diagostics have been confirmed by
the following instruments: for 90% it was applied ASRS, which a standard test in Romanian
people with ASD , aged 2 and 18. For the rest of 10 %, there were applied M-CHAT (Modified
Checklist for Autism in Toddlers ) and CARS (The Childhood Autism Rating Scale). All results
have been compared and confirmed with the diagnostic criteria described in the special manual
DSM IV. For 93.64%, diagnosis was confirmed, the rest of 6,36% presented elements in autism,
however they did not meet all the diagnosis conditions, so they have been recorded with atypical
autism.
3. Instruments to diagnose QD or IQ: WISC IV Wechsler intelligence scale for Children fourth
edition. It is a clinical instrument, applied individually, assessing cognitive ability of children
between 6 years old and 0 months and 16 years old and 11 months. The WISC-IV Scale
provides composite scores representing intellectual functioning in specific cognitive domains
(ex. Speech Understanding Index, Perceptual Reasoning Index, Working Memory Index and
Speed processing Index), however it provides a composite index representing children general
intellectual ability (ex. Total intelligence Coefficient). It was used the 90% trust interval;
Portage Scale scale for assessing the level of psycho-motric development in children between
0 6 years old. This instrument helped us to design personal intervention plans and observe the
therapeutic quantitative progress.
Data and findings
In the first stage, we synthetized data on virtual environment consumption, between 2012-
2017, on the total group of 110 subjects observed in this time, since we have had standards, in this
matter. The incidence of the excessive use of virtual environment among children diagnosed with
ASD throught the entire period 2012-2017 was of 75,45%, namely 83 subjects. The percentage
data for each year are showed in the following table:
7
The significant increase in the incidence of excessive consumption of virtual environment
from 37,5% in 2012, to 97,06%, in 2017 seems to be directly connected with the tablets and
Android mobile phones, with affordable prices, in Romania, 2012 being the year of introduction of
4G technnology providing unlimited access to Internet and completing the cunsumption of
computer, laptop and TV, through a supplementary access and much easier to any location (car,
restaurant, park, etc).
Comparative statistical data between the first and the second psychological assessment
Control group
Screen group
Number of children
29
33
Average age
42 months
33 months
Therapy months average
4.6
3.2
Average hours/month
88.76
40.39
Therapeutic Resources Index (IRT)
4.08
1.29
Therapeutic Efficiency Index (IET)
3.16
IGE
QD General
Ev 1
58.63
59.00
4.34
Ev 2
65.31
89.69
QD Socialization
Ev 1
51.81
49.63
4.53
Ev 2
59.56
85.31
QD Language
Ev 1
28.25
26.63
5.05
Ev 2
39.56
63.19
QD Cognition
Ev 1
53.00
47.94
4.76
Ev 2
64.88
97.63
Data show a therapeutic efficiency of 3,16 higher for the Screen group, compared to Control
group. This aspect means that resources (time/therapy hours) between the two assessments were
3.16 lower in Screen Group. In spite of all that, the therapeutic progress is higher with percentages
between 37,33% in general QD and 59,73% in language QD in Screen Group, meaning that the
general efficiency index (IGE) show that the therapeutic protocol applied to subjects had an overall
efficiency on QD generally higher than 4 times in Screen Group, compared to the Control Group
and even more than five times, in language, between the two assessments.
Compared general statistical data and on the group of Integrated Children Group
Control group
Screen group
Nr
%
Nr
%
Total
29
-
33
-
Boys
22
75,86
29
87,88
Minimum age in months
28
12
Minimum age in months
42
33
Minimum age in months
68
58
Under therarapy
22
75.86
14
75.86
Integrated Children Group
7
24,14
19
57,58
IET
ERT
Minimum IRT
10,56
0.88
12.00
Average IRT
14,40
4,84
2,98
138,53%
Maximum IRT
78,00
11,44
7,39
For the Integrated Children Group, in the calculation of the average therapeutic resources
index,(Average IRT), the average values from all the integrated children were the following: the
average for the Control group is 58.15 hours/months, duration 24,76 months, and the average in
Screen group is 44,45 hours/month, duration 11,14 months.
Data show a real therapeutic efficiency (ERT) for the pentru Integrated Children Groupi,
138,53% higher than in Screen group, compared to Control Group. This means that Screen group
8
consumed 2,98 less resources, but they recorded 2,39 higher number of integrated children than the
Control group, resulting an global efficiency index (IGE) 7,12 times higher.
As we mentioned before, one of the variables we could not maintain constant for total groups
was the average age, for the first assessment. In order to verify if this aspect can influence the final
data, we made the following comparison:
Statistical data between the first and the second assessment
- 10 subjects groupwith average identical age at the first assessment -
Control group
Screen group
Average age
34,20 months
34,00 months
Average therapy months
6,2
3,2
Average hours/month
88,10
63,84
Therapeutic Resources Index (IRT)
5,46
2,04
Therapeutic Efficiency Index (IET)
2.67
ERT QD D
IGE
QD General
Ev 1
40,60
47,40
65,88
4,44
Ev 2
51,00
84,60
QD Socialization
Ev 1
42,20
41,40
60,25
4,28
Ev 2
48,80
78,20
QD Language
Ev 1
32,40
29.00
84,08
4,92
Ev 2
40,20
74,00
QD Cognition
Ev 1
40,80
48,80
86,53
4,99
Ev 2
49,00
91.40
The above mentioned statistic data show that the 9 months difference of age between the
Control group and Screen group total cannot influence the final data, at least until an average age of
34 months, as the differences in the general efficiency index (IGE) between the total group and the
group with identical ages show values under 10%, between 2.12% and maximum 5.72%.
Disscutions
Children, in front of virtual environment are not a part of the experiences of common
language, thinking and reflexion stimulation by dialogue which parents, grandparents or family, or
human environment generally provide. Auditory and visual stimuli perceived in front of screens are
quite aggressive for brains in full development, move so quickly, so they overpass children capacity
to control them. Invariably, the effect is the significant inhibition of some mental processes or the
poor development of neuronal areas. Children get used to the virtual environment and they do not
want to understand what is happening in the world around them and they are content only with
sensations.
The experience of watching the virtual environment is not a real one, in space and time,
distances, but a virtual one, suggested or only encouraged, within the virtual world. Children lack
the possibility to learn, by touching and physisical manipulation of materials, one of the conditions
governing the process of knowledge and therefore structuring neural pathways. Virtual environment
deprive young children of peace and respite necessary to develop the internal language mechanisms
of thinking and reflexivity. This does not favour an interactive participation into the proccess of
knowledge, on the contrary, it encourages a passive and passivated experience for human mind. By
the excessive consumption of virtual environment, children are deprived of the capacity of
developing and imagining games and weaknes their mintal dynamism. After prolonged viewing,
children tend to maintain the same status of passivity or non-involvment in the knowledge of real
wolrd. Experiments on mice subjected on virtual environments showed that those exposed were
hyperactive, not aware of danger and showed more liabilities to any new challenge
13
.
13
Dimitri Christakis - "Understanding Media’s Impact on Infants and Toddlers – a Pediatrician’s Perspective",
min.21:22 - 23:56 https://www.youtube.com/watch?v=HbUtvPfXt24 (site accessed on 26.01.2018)
9
Following comments captured in this survey,the way of improving children’s maladaptive
elements that were excessive in the virtual environment in children between 0-3 years old are
similar to the case of the Romanian children with the autist post-institutional syndrome, after
adoption.
14
. The autistic-like or semi-autistic symptoms of the Romanian orphanes is reported for
the first time, by Rutter and his co-workers, in two successive studies, published in 1999, and 2001.
They identified at the children adopted from the Romanian orphanages with too high frequency,
to be considered a simple coincidence a group of symptoms meeting mostly those included into
the diagnostic criteria of autism pathology, indicated by the DSM-IV. There are mentioned
defficiencies in the socio-communicative abilities which determine, at their turn, social integration
issues, language and speech issues, self-aggressive and aggressive behaviour, rigid behaviour and
obsessive interests (Rutter et al., 1999; Rutter et al., 2001). It is important to mention that
behaviour syndrome was described in the special literature, not only for the children who grew up
in an institutional environment, but also for the children who grew in an unproper family
environment, characterized by the lack of socio-affective stimuli (Shin, 1999). The differences
between the simptomatically picture of classic autism and that characteristic to the above
mentioned children, determined scholars to be more reluctant, in identifying totally this behaviour
syndrome with ASD. Unlike classic autism, for the autistic-like syndrome, the feature is not the
self-impossed isolation (though there are important problems in social integration and
communication), but the existence of behavioral stereotypes. The unusually deep interests for a
certain type of sensation, motor mannierisms, strange and obssesive concerns are those prevailling
in the symptoms picture in the behavioral syndrome above mentioned. Moreover, it seems that this
semi-autist symptoms tend to improve in the post-adoption time, the age between 4-6 years old
being particularly important for future favourable development (Rutter et al., 1999; Zeanah et al.,
2003). Despite the above mentioned differences, the existence of this autistic-like symptom in
children who grew in a deviant and traumatic environment arise a series of theroretical issues, able
to shade the discussion about the role of the epigenetic factors in autist pathology
15
.
All these aspects have been also confirmed by specialists in our centres who interacted with
this category of children. This fact leads to conclude that one of the factors which influenced a lot
the emergence of the ASD elements described by DSM IV, was represented by the excessive
consumption of virtual environment, between 0-3 years old, by senzory-motor and socio-affective
deprivation, the first three years representing an essential time, in the brain and neuronal networks
development. Between 0-2 years old, brain triples its size and it depends a lot of external
stimulation
16
. The maximum density of synapses is reached under a year of birth in brain sensory
areas and at 3.5 years in the middle frontal gyrus (Blakemore, 2008). This stage is dominated
initially by „expectancy of experiences” mechanisms, and then, by „dependent on experience”
mechanisms. This means that the proccess of emerging the synapses is modulated by external
experiences in the environment, more exactly by the epigenetic factors
17
.
This senzory-motor and socio-affective deprivation
18
, in certain circumstances of genetic
predisposition (Elise B. Robinson, 2016)
19
, can lead, through the action of epigenetic factors, to the
structure of a neurological system, similar to those of the children with ASD.
14
Hoksbergen R , ter Laak J , Rijk K , et al. Post-Institutional Autistic Syndrome in Romanian adoptees. J Autism Dev
Disord. 2005 Oct; 35 (5): 615-23. https://www.ncbi.nlm.nih.gov/pubmed/16167089
15
Muraru O, Zhang S H, Bocian M. Simptomatologia „autistic-like” a copiilor proveniti din orfelinatele Romanesti
posibile consideratii cu privire la etiopatologia autismului . Revista Română de Psihiatrie- Asociatia Română de
Psihiatrie si Psihoterapie. http://www.romjpsychiat.ro/article/simptomatologia-autistic-like-a-copiilor-proveniti-din-
orfelinatele-romanesti-posibile-consideratii-cu-privire-la-etiopatogenia-autismului (site accessed on 25.01.2018)
16
Conferinţa TEDxRainier - Dimitri Christakis - Media and Children, min.1:22 si 3:53-4:42,
https://www.youtube.com/watch?v=BoT7qH_uVNo (site accessed pe 25.01.2018).
17
Cîrneci Dragoş, 2015, Testarea psihologică II - Psihodiagnoza personalităţii, pag 51. Editura Fundaţiei România de
Mâine.
18
More than 5 hours/day of virtual environment can represent, as quantity, percentages between 50-70% of the
wakefulness of a child between 0-3 years old.
19
Elise B. Robinson et al, Genetic risk for autism spectrum disorders and neuropsychiatric variation in the general
population. Nat Genet. 2016 mai; 48 (5): 552-555. https://www.nature.com/articles/ng.3529
10
The outcomes of present paper as well as the personal expertise in children with ASD
recovery, the differential diagnosis between this new form of autism, called Virtual Autism and the
„classical“ forms of autism can be achieved only by applying two cumulative conditions. It is about
eliminating the consumption of virtual environment and start a special recovery programme.
According to the patients response to the recovery protocol, we can distinguish one to another.
Present paper show that a global efficiency index is necessary (IGE), minimum four times higher
than „classic” cases, in order to distinguish a patient in this form of Virtual Autism.
This survey, even if it is not the first to bring into discussion this aspect
20
, it is the first
clinical survey applied on certain population, achieved in Romania. The first survey to bring about
this phenomenon goes back to 2006
21
and it investigated empirically, based on statistic data, the
hypothesis that childhood television viewing serves as a trigger in ASD . The survey concluded that
autism rates were higher in states like USA, where the level of rainfalls was higher and increased
the number of TV cable subscriptions.
In present, specialists in different countries
22
bring about this phenomenon
23
, there are
campaigns on different web pages
24
and international meetings on this subject have been
organized
25
.
Limitations and restraints
Present paper, although discusses a new phenomenon, it presents certain limitations linked
to matters of conscience, as well as ethics and deontology, both personal and professional. This si
because the survey show that a differential diagnosis cannot be achieved, unless it eliminates the
consumption of virtual environment and starts a special recovery protocol; a complete survey
should introduce an alternating random of subjects who eliminate or not the consumption of virtual
environment, and/or a group of subjects to start or not a specific recovery protocol.
However, this survey does not represent or intends to be an exhaustive research, and we
resume it in an improved version, according to the development of this phenomenon and the
emergence of newer special research in the area. Taking into consideration it is a recent
phenomenon, similar research should be replicated, in other conditions, especially in other
countries, in order to observe if this hypothesis is verified completly.
Conclusions
Different and favourable ways that children between 0- 3 years old, diagnosed with ASD,
who presented in their anamnesis history an average consumption over 4 hours/ day of virtual
environment, reacted to the therapeutical process, compared to the control group, suggests a direct
causal link between this excessive screen consumption and and similar behaviours and elements to
those found with ASD. This excessive consumption of virtual environment between 0-3 years old,
cumulative with a genetic predisposition can produce even a neuro-cognitive structure typically for
the children with ASD, affecting brain structures on the long term, by the influence of the
epigenetic factors, caused by sensory-motor and socio-affective deprivation, leading to high
20
Heffler KF , Oestreicher LM . Causation model of autism: Audiovisual brain specialization in infancy competes with
social brain networks.. Med Ipoteze. 2016 Jun; 91: 114-122. two: 10.1016 / j.mehy.2015.06.019. Epub 2015 27 June.
https://www.ncbi.nlm.nih.gov/pubmed/26146132
21
Michael Waldman, Sean Nicholson, Nodir Adilov, Does Television Cause Autism?. Johnson School Research Paper
Series No. 01-07. Posted: 30 May 2007; https://papers.ssrn.com/sol3/papers.cfm?abstract_id=989648
22
Romania, United States of America, France, Qatar
23
https://www.youtube.com/watch?v=9-eIdSE57Jw (site accessed on 24.01.2018)
https://www.youtube.com/watch?v=nXRBv7kvD9s (site accessed on 24.01.2018)
https://www.youtube.com/watch?v=x9RdP8W3bK8 (site accessed on 24.01.2018)
https://www.youtube.com/watch?v=lyAe75uPFCo (site accessed pe 24.01.2018)
24
http://www.surexpositionecrans.org/qui-sommes-nous/ (site accessed on 24.01.2018),
http://www.stopautismvirtual.ro (site accessed on 24.01.2018), https://esmautism.wixsite.com/website (site accessed on
24.01.2018)
25
https://www.youtube.com/watch?v=DbJOBNWj374 (site accessed on 24.01.2018)
https://www.youtube.com/watch?v=yHoB4aLd4II&list=PLi9jHTk1Lc9urvOGLSNPFZ750jM6TT4vs&index=10 (site
accessed on 24.01.2018).
11
incidence of autism, at national and international level, through this new form of autism, called in
the present paper virtual autism.
Recommendations:
For parents:
- Avoid the use of electronic devices with screens for children younger than 24 months and
off devices when not in use, mostly in children rooms;
- Limit the electronic devices within an hour/day and only in the presence of adults, to help
children understand what intended, for children between 2 and 3 years old;
- For children between 3 and 6 years old, limit the screens to maximum an hour/day, select
high quality programmes and avoid to use them when eating or an hour before sleeping;
- Consult reccomendations of the National Broadcasting Council about the measures to be
taken for protecting children in the families, available at the address:
http://www.cna.ro/article6548,6548.html.
For specialists pediatric, family, neuropsychiatric, neurologists, psychologists etc.
- Inform directly parents about the risks of exposure to electronic devices with screen of
children and especially children between 0-3 years old;
- Advise parents the maximum amount of use of screen devices, according to children’s age;
- Advise parents quality alternative and recreational activities, to physical and mental
development, replacing time viewing screens.
For public institutions Ministry of Health, National Broadcasting Council, Bodies
designated for Consummer Protection (ANPC, InfoCons), etc.
- Organizing national education and awarness campaigns about the risks of use of virtual
environment (mobile phone, TV, laptop, tablet, computer) on children aged 0-3 years.
Acknowledgements
We express our gratitude especially to the two institutions, Asociaţia pentru Sănătate
Mintală a Copilului (ASMC) and Fundaţia Copii în Dificultate România (CID- România), who
contributed and supported this survey, as well as all donors who supported them, and all
participants and volunteers who have helped to completion. We also express our gratitude to the
team of specialists from USA, France and Qatar who provide information and media this
phenomenon.
Bibliography
American Academy of Pediatrics, Council on communications and media, Media and Young Minds,
Pediatrics, October 2016;
http://pediatrics.aappublications.org/content/early/2016/10/19/peds.2016-2591..info
Artur S. Bard, Mitchell G. Bard. Să întelegem creierul. Editura Curtea Veche, 2006.
Barr R, Transfer of learning between 2D and 3D sources during infancy: Informing theory and
practice. Dev Rev. 2010 Jun 1; 30(2): 128154;
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2885850/
Barr R, Memory Constraints on Infant Learning From Picture Books, Television, and Touchscreens
2013;7(4):205210; http://onlinelibrary.wiley.com/doi/10.1111/cdep.12041/abstract
Cîrneci Dragoş. Bazele genetice ale comportamentului uman. Editura Fundaţiei România de Mâine,
2016.
Cîrneci Dragoş. Testarea psihologică II - Psihodiagnoza personalităţii. Editura Fundaţiei România
de Mâine, 2015.
Chantal Sicile-Kira. Tulburarea de spectru autist. Editura Herald, 2017.
Daniel J. Siegel, Tyna P. Bryson. Creierul copilului tău. Editura For You, 2014.
Diane E. Papalia, Sally W. Olds, Ruth D. Feldman. Dezvoltarea umană. Editura Trei, 2010.
12
Elise B. Robinson et al, Genetic risk for autism spectrum disorders and neuropsychiatric
variation in the general population. Nat Genet. 2016 mai; 48 (5): 552-555;
https://www.nature.com/articles/ng.3529
Florinda Golu. Psihologia dezvoltării umane. Editura Universitară, 2010.
Heffler KF , Oestreicher LM . Causation model of autism: Audiovisual brain specialization in
infancy competes with social brain networks.. Med Ipoteze. 2016 Jun; 91: 114-122. doi:
10.1016 / j.mehy.2015.06.019. Epub 2015 27 iunie;
https://www.ncbi.nlm.nih.gov/pubmed/26146132
Hoksbergen R , ter Laak J , Rijk K , et al. Post-Institutional Autistic Syndrome in Romanian
adoptees.. J Autism Dev Disord. 2005 Oct; 35 (5): 615-23;
https://www.ncbi.nlm.nih.gov/pubmed/16167089
Manfred Spitzer. Digital dementia in the age of new media. Conference on youtube
https://www.youtube.com/watch?time_continue=84&v=VBopndZ4uhI (site accessed on
24.01.2018)
Michael Waldman, Sean Nicholson, Nodir Adilov, Does Television Cause Autism?. Johnson School
Research Paper Series No. 01-07. Posted: 30 May 2007;
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=989648
Mielu Zlate. Fundamentele psihologiei. Editura Polirom 2009.
Muraru O, Zhang S H, Bocian M, Simptomatologia „autistic-like” a copiilor proveniţi din
orfelinatele Româneşti – posibile consideraţii cu privire la etiopatologia autismului. Revista
Română de Psihiatrie - Asociaţia Română de Psihiatrie şi Psihoterapie.
http://www.romjpsychiat.ro/article/simptomatologia-autistic-like-a-copiilor-proveniti-din-
orfelinatele-romanesti-posibile-consideratii-cu-privire-la-etiopatogenia-autismului (site
accesat la 25.01.2018)
Taylor Jill Bolte. Revelatii despre creier. Editura Curtea Veche, 2011.
Tinca Creţu. Psihologia Vârstelor. Editura Polirom, 2009.
Tomopoulos S , Dreyer BP , Berkule S , et al . Infant media exposure and toddler
development. Arch Pediatr Adolesc Med . 2010 ; 164 ( 12 ): 1105-1111 pmid: 2113533;
https://www.ncbi.nlm.nih.gov/pubmed/21135338
Vandewater EA , Rideout VJ , Wartella EA , et al. Digital childhood: electronic media and
technology use among infants, toddlers, and preschoolers. Pediatrie .
2007 ; 119 ( 5 ): e1006 - e1015pmid: 17473074;
http://pediatrics.aappublications.org/content/119/5/e1006?download=true
Virgiliu Ghe . "Efectele televiziunii asupra minţii umane" , Bucureşti, Editura Podromos, 2006.
Virgiliu Ghe, Criveanu N, Drăgulinescu A. Efectele micului ecran asupra minţii copilului. Editura
Prodromos, 2007.
Zimmerman FJ , Christakis DA . Children's television viewing and cognitive outcomes: a
longitudinal analysis of national data.. Arch Pediatr Adolesc Med . 2005 ; 159 ( 7 ): 619 -
625 pmid: 15996993 ; https://www.ncbi.nlm.nih.gov/pubmed/15996993
Zimmerman FJ,Christakis DA , Meltzoff AN . Television and DVD/video viewing in children
younger than 2 years. Arch Pediatr Adolesc Med . 2007. 161 ( 5 ): 473 -
479 pmid: 17485624; https://www.ncbi.nlm.nih.gov/pubmed/17485624
... To this date, a most interesting cohort was described by Zamfir, [16] showing that his younger ASD patients who were exposed more than 2 h of screen media a day improved faster, when screen removal was implemented, with less intervention time from professionals. In addition, more of them could go back to the normal schooling system within months, when compared to his non-exposed ASD patients who evolved as any professional would classically expect (i.e., slowly even with intensive behavioural therapy). ...
... The time spent on screen media at 6 months and its increase between six and 18 months were both predictors of Pervasive Development Disorders (the DSM-IV label for ASD) symptoms as screened by the CBCL (standardised ??=0. 16 and 0.15 respectively) in a multilinear regression model adjusted for many covariates (age, gender, parental income and education, temperament). ...
Article
Intensive Early Screen Exposure (IESE) has been associated with detrimental outcomes on different variables including attention, language, emotion regulation and socialisation, some of which are central to the diagnosis of neurodevelopmental disorders, such as ADHD and learning disorders. Following Bradford-Hill's recommendations, we argue that there is growing clinical and empirical evidence supporting a causal relationship between intensive early screen exposure (more than 4 h a day) and subsequent symptoms of Autism Spectrum Disorders in some possibly vulnerable younger children (less than 6 years old). Clinicians should also be aware of the existence of cases of recovery or dramatic improvement after parents accept to stop screen exposure for a few months, associated with daily moments of dyadic interaction, since this intervention has repeatedly been found to be effective with no known side-effects.
Să întelegem creierul. Editura Curtea Veche, 2006. Barr R, Transfer of learning between 2D and 3D sources during infancy: Informing theory and practice
  • Artur S Bard
  • Mitchell G Bard
Artur S. Bard, Mitchell G. Bard. Să întelegem creierul. Editura Curtea Veche, 2006. Barr R, Transfer of learning between 2D and 3D sources during infancy: Informing theory and practice. Dev Rev. 2010 Jun 1; 30(2): 128-154;
Article
Full-text available
Almost all genetic risk factors for autism spectrum disorders (ASDs) can be found in the general population, but the effects of this risk are unclear in people not ascertained for neuropsychiatric symptoms. Using several large ASD consortium and population-based resources (total n > 38,000), we find genome-wide genetic links between ASDs and typical variation in social behavior and adaptive functioning. This finding is evidenced through both LD score correlation and de novo variant analysis, indicating that multiple types of genetic risk for ASDs influence a continuum of behavioral and developmental traits, the severe tail of which can result in diagnosis with an ASD or other neuropsychiatric disorder. A continuum model should inform the design and interpretation of studies of neuropsychiatric disease biology.
Article
Full-text available
Earliest identifiable findings in autism indicate that the autistic brain develops differently from the typical brain in the first year of life, after a period of typical development. Twin studies suggest that autism has an environmental component contributing to causation. Increased availability of audiovisual (AV) materials and viewing practices of infants parallel the time frame of the rise in prevalence of autism spectrum disorder (ASD). Studies have shown an association between ASD and increased TV/cable screen exposure in infancy, suggesting AV exposure in infancy as a possible contributing cause of ASD. Infants are attracted to the saliency of AV materials, yet do not have the experience to recognize these stimuli as socially relevant. The authors present a developmental model of autism in which exposure to screen-based AV input in genetically susceptible infants stimulates specialization of non-social sensory processing in the brain. Through a process of neuroplasticity, the autistic infant develops the skills that are driven by the AV viewing. The AV developed neuronal pathways compete with preference for social processing, negatively affecting development of social brain pathways and causing global developmental delay. This model explains atypical face and speech processing, as well as preference for AV synchrony over biological motion in ASD. Neural hyper-connectivity, enlarged brain size and special abilities in visual, auditory and motion processing in ASD are also explained by the model. Positive effects of early intervention are predicted by the model. Researchers studying causation of autism have largely overlooked AV exposure in infancy as a potential contributing factor. The authors call for increased public awareness of the association between early screen viewing and ASD, and a concerted research effort to determine the extent of causal relationship. Copyright © 2015. Published by Elsevier Ltd.
Article
Full-text available
The ability to transfer learning across contexts is an adaptive skill that develops rapidly during early childhood. Learning from television is a specific instance of transfer of learning between a 2-Dimensional (2D) representation and a 3-Dimensional (3D) object. Understanding the conditions under which young children might accomplish this particular kind of transfer is important because by 2 years of age 90% of US children are viewing television on a daily basis. Recent research shows that children can imitate actions presented on television using the corresponding real-world objects, but this same research also shows that children learn less from television than they do from live demonstrations until they are at least 3 years old; termed the video deficit effect. At present, there is no coherent theory to account for the video deficit effect; how learning is disrupted by this change in context is poorly understood. The aims of the present review are (1) to review the conditions under which children transfer learning between 2D images and 3D objects during early childhood, and (2) to integrate developmental theories of memory processing into the transfer of learning from media literature using Hayne's (2004) developmental representational flexibility account. The review will conclude that studies on the transfer of learning between 2D and 3D sources have important theoretical implications for general developmental theories of cognitive development, and in particular the development of a flexible representational system, as well as policy implications for early education regarding the potential use and limitations of media as effective teaching tools during early childhood.
Article
Full-text available
Romanian adoptees have a background of severe neglect. International research has shown that this can give rise to symptoms of autistic behavior. Rutter et al. (1999, Journal of Child Psychology Psychiatry, 40(4), 537–549.) refers to “quasi-autistic patterns”, and Federici (1998, Help for the hopelss child: A guide for families. Alexandria: Federici & Assocoates.) to Post-Institutional Autistic Syndrome (PIAS). Eighty Romanian adoptees, averaging 8 years of age, who had resided in the Netherlands for 5 years were studied. Parent interviews and the Auti-R scale showed the extent to which the children exhibited PIAS. In one third of these children we observed (in addition to other behavioral problems) stereotypic behaviors and communication and language disorders. Our findings resembled the Rutter et al. (1999, Journal of Child Psychology Psychiatry, 40(4), 537–549). data. Six of the children were classified within the autistic spectrum pursuant to the Auti-R, and seven within the so-called intermediate group. No difference was found between the girls and the boys. Children who had been in their adoptive families for 5 years or more showed fewer behavior problems than children who had been in their adoptive families for four or less years.
Article
Full-text available
The objectives of this study were to describe media access and use among US children aged 0 to 6, to assess how many young children fall within the American Academy of Pediatrics media-use guidelines, to identify demographic and family factors predicting American Academy of Pediatrics media-use guideline adherence, and to assess the relation of guideline adherence to reading and playing outdoors. Data from a representative sample of parents of children aged 0 to 6 (N = 1051) in 2005 were used. Descriptive analyses, logistic regression, and multivariate analyses of covariance were used as appropriate. On a typical day, 75% of children watched television and 32% watched videos/DVDs, for approximately 1 hour and 20 minutes, on average. New media are also making inroads with young children: 27% of 5- to 6-year-olds used a computer (for 50 minutes on average) on a typical day. Many young children (one fifth of 0- to 2-year-olds and more than one third of 3- to 6-year-olds) also have a television in their bedroom. The most common reason given was that it frees up other televisions in the house so that other family members can watch their own shows (54%). The majority of children aged 3 to 6 fell within the American Academy of Pediatrics guidelines, but 70% of 0- to 2-year-olds did not. This study is the first to provide comprehensive information regarding the extent of media use among young children in the United States. These children are growing up in a media-saturated environment with almost universal access to television, and a striking number have a television in their bedroom. Media and technology are here to stay and are virtually guaranteed to play an ever-increasing role in daily life, even among the very young. Additional research on their developmental impact is crucial to public health.
Article
Full-text available
To determine the television-, DVD-, and video-viewing habits of children younger than 2 years. A telephone survey of 1009 parents of children aged 2 to 24 months. Parents in Minnesota and Washington state were surveyed. A random sample of parents of children born in the previous 2 years was drawn from birth certificate records. Households in which English was not spoken were excluded, as were children with major disabilities. The amount of regular television and DVD/video viewing by content, reasons for viewing, and frequency of parent-child coviewing. By 3 months of age, about 40% of children regularly watched television, DVDs, or videos. By 24 months, this proportion rose to 90%. The median age at which regular media exposure was introduced was 9 months. Among those who watched, the average viewing time per day rose from 1 hour per day for children younger than 12 months to more than 1.5 hours per day by 24 months. Parents watched with their children more than half of the time. Parents gave education, entertainment, and babysitting as major reasons for media exposure in their children younger than 2 years. Parents should be urged to make educated choices about their children's media exposure. Parental hopes for the educational potential of television can be supported by encouraging those parents who are already allowing screen time to watch with their children.
To test the independent effects of television viewing in children before age 3 years and at ages 3 to 5 years on several measures of cognitive outcomes at ages 6 and 7 years. Using data from a nationally representative data set, we regressed 4 measures of cognitive development at ages 6 and 7 years on television viewing before age 3 years and at ages 3 to 5 years, controlling for parental cognitive stimulation throughout early childhood, maternal education, and IQ. Before age 3 years, the children in this study watched an average of 2.2 hours per day; at ages 3 to 5 years, the daily average was 3.3 hours. Adjusted for the covariates mentioned earlier, each hour of average daily television viewing before age 3 years was associated with deleterious effects on the Peabody Individual Achievement Test Reading Recognition Scale of 0.31 points (95% confidence interval [CI], -0.61 to -0.01 points), on the Peabody Individual Achievement Test Reading Comprehension Scale of 0.58 points (95% CI, -0.94 to -0.21 points), and on the Memory for Digit Span assessment from the Wechsler Intelligence Scales for Children of -0.10 points (95% CI, -0.20 to 0 points). For the Reading Recognition Scale score only, a beneficial effect of television at ages 3 to 5 years was identified, with each hour associated with a 0.51-point improvement in the score (95% CI, 0.17 to 0.85 points). There are modest adverse effects of television viewing before age 3 years on the subsequent cognitive development of children. These results suggest that greater adherence to the American Academy of Pediatrics guidelines that children younger than 2 years not watch television is warranted.
Article
The year 2005 brought record numbers of hurricanes and storm damages to the United States. Was this a foretaste of increasingly destructive hurricanes in an era of global warming? This study examines the economic impacts of U.S. hurricanes. The major conclusions are the following: First, there appears to be an increase in the frequency and intensity of tropical cyclones in the North Atlantic. Second, there are substantial vulnerabilities to intense hurricanes in the Atlantic coastal United States. Damages appear to rise with the eighth power of maximum wind speed. Third, greenhouse warming is likely to lead to stronger hurricanes, but the evidence on hurricane frequency is unclear. We estimate that the average annual U.S. hurricane damages will increase by $8 billion at 2005 incomes (0.06 percent of GDP) due to global warming. However, this number may be underestimated by current storm models. Fourth, 2005 appears to have been a quadruple outlier, involving a record number of North Atlantic tropical cyclones, a large fraction of intense storms, a large fraction of the intense storms making landfall in the United States, and an intense storm hitting the most vulnerable high-value region in the country.