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:
Keywords: virtual autism , virtual environment, TV, ASD, screen-time.
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
, 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
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
, 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
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.
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
accessed on January 24, 2018).
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
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
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
, 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
http://solutiipc.ro/topul-celor-mai-interesante-telefoane-4g/ (site accessed on January 24, 2018)
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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
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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
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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
1) Barr R, Memory Constraints on Infant Learning From Picture Books, Television, and Touchscreens 2013;7(4):205–
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- Identify the percentage of recently diagnosed children with ASD who present in their anamnesis
history an excessive consumption
of virtual environment, in the first three years of life,
recorded in our institutions
, 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.
- 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
- 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
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): 128–154.
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.
Asociaţia pentru Sănătate Mintală a Copilului (ASMC) and Fundaţia Copii în Dificultate – România (CID- România).
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
- A group called „Integrated children group” included both subjects from Control group and
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
or Portage Scale and a Scor T
< 59 at the assessment with ASRS
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
Wechsler Intelligence Scale for Children - fourth edition
Autism Spectrum Rating Scales
- 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
The methodology for calculating of differences between resources and outcomes in the two
Since the programme of applying the therapeutic protocol could not be implemented as
standard to all subjects, as there were different variables
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
- 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.
- 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).
It is about observing a number of therapy hours/day, days/ week, holidays, therapy duration, etc.
- 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).
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
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
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:
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
Number of children
Therapy months average
Therapeutic Resources Index (IRT)
Therapeutic Efficiency Index (IET)
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
Minimum age in months
Minimum age in months
Minimum age in months
Integrated Children Group
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
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 -
Average therapy months
Therapeutic Resources Index (IRT)
Therapeutic Efficiency Index (IET)
ERT QD D
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%.
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
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
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)
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
. 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
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
. 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
This senzory-motor and socio-affective deprivation
, in certain circumstances of genetic
predisposition (Elise B. Robinson, 2016)
, can lead, through the action of epigenetic factors, to the
structure of a neurological system, similar to those of the children with ASD.
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
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)
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).
Cîrneci Dragoş, 2015, Testarea psihologică II - Psihodiagnoza personalităţii, pag 51. Editura Fundaţiei România de
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.
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
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
, 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
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
bring about this phenomenon
, there are
campaigns on different web pages
and international meetings on this subject have been
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.
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
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.
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
Romania, United States of America, France, Qatar
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)
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incidence of autism, at national and international level, through this new form of autism, called in
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- 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:
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.
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
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