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Abstract and Figures

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.
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ARTICLE
Television and DVD/Video Viewing in Children
Younger Than 2 Years
Frederick J. Zimmerman, PhD; Dimitri A. Christakis, MD, MPH; Andrew N. Meltzoff, PhD
Objective: To determine the television-, DVD-, and
video-viewing habits of children younger than 2 years.
Design: A telephone survey of 1009 parents of chil-
dren aged 2 to 24 months.
Setting: Parents in Minnesota and Washington state were
surveyed.
Participants: A random sample of parents of children
born in the previous 2 years was drawn from birth cer-
tificate records. Households in which English was not spo-
ken were excluded, as were children with major disabili-
ties.
Main Outcome Measure: The amount of regular tele-
vision and DVD/video viewing by content, reasons for
viewing, and frequency of parent-child coviewing.
Results: By 3 months of age, about 40% of children regu-
larly 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 baby-
sitting as major reasons for media exposure in their chil-
dren younger than 2 years.
Conclusions: Parents should be urged to make edu-
cated choices about their children’s media exposure. Pa-
rental hopes for the educational potential of television
can be supported by encouraging those parents who are
already allowing screen time to watch with their chil-
dren.
Arch Pediatr Adolesc Med. 2007;161:473-479
T
HE PUBLIC HEALTH IMPLICA-
tions of early television and
video viewing are poten-
tially large.
1,2
There are both
theoretical
2
and empiri-
cal
3-6
reasons to believe that the effects of
media exposure on children’s develop-
ment are more likely to be adverse before
the age of about 30 months than after-
ward. The results of 1 study suggest that
what children younger than 2 years
watch may be important for subsequent
vocabulary development.
7,8
Because of
the importance of parental interaction
to development, it is believed that how
children watch—in particular, whether
they watch alone or with a parent—is
also relevant.
2,9
Recent studies have found that 64% to
100% of all infants and toddlers watch tele-
vision before the age of 2 years.
10-12
These
reports are provocative but present an in-
complete picture of early television view-
ing. For example, a recent report stated that
“61% of babies under 2 years old use screen
media.”
11
This finding is interesting and
important, but does not tell us how many
children will become regular media con-
sumers before they are aged 2 years. These
surveys have also not identified what types
of content young children are viewing.
Our understanding of why young chil-
dren watch television deserves enhance-
ment. Two recent reports documented the
results of focus group assessments of par-
ents’ reasons for having their children
watch television,
11,13
which included the
use of television as an electronic babysit-
ter and a belief that television is entertain-
ing for their children. In addition, many
parents believe the positive educational
claims made for infant videos and televi-
sion programs.
7,10,11,14
A limitation of the current research is
the paucity of recent data on media view-
ing among children younger than 2 years.
While the findings outlined for older chil-
dren have been illuminating, it is unclear
to what extent they can be generalized to
younger children; also, the reasons for
viewing may be different for children
younger than 2 years than for those aged
Author Affiliations: Child
Health Institute
(Drs Zimmerman and
Christakis), and Departments of
Health Services
(Drs Zimmerman and
Christakis) and Pediatrics
(Dr Christakis), and the
Institute for Learning and Brain
Sciences (Dr Meltzoff),
University of Washington, and
the Children’s Hospital and
Regional Medical Center
(Dr Christakis), Seattle, Wash.
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from 2 to 6 years. Finally, prior analyses have not at-
tempted to identify the average age of first viewing or the
effects of demographic variables, such as the number of
older siblings on viewing habits.
Our study uses a large sample of parents of children
aged 2 to 24 months to determine the amount of televi-
sion, video, and DVD material viewed by young chil-
dren, and to characterize the content of the viewing by
age. Sociodemographic factors were tested for their as-
sociations to viewing time. The reasons parents gave for
their child’s viewing are also reported.
METHODS
DATA
The data were collected in a telephone survey in February 2006.
Birth certificates were obtained from Washington state and Min-
nesota for all births in the 2 years prior to the survey. Only 1
child per household was eligible. From this population of births,
a random sample of 7500 families was selected and stratified
into 4 age categories: 0 to 5 months, 6 to 11 months, 12 to 17
months, and 18 to 23 months. Those in the random sample were
mailed a letter informing them about the survey. Letters that
came back as undeliverable were dropped from the sample. Re-
maining parents were called in random order until a desired
sample size of 1000 or more families was surveyed.
To be eligible for the study, parents had to speak English flu-
ently and have a working telephone number. In addition, chil-
dren with significant disabilities were excluded. Eight callbacks
were made per telephone number at various times during the
day and week. Parents gave verbal consent to participate in the
study and all study procedures were approved by the institu-
tional review board at the University of Washington.
SURVEY INSTRUMENTS
Parents were asked detailed questions about the time their child
spent playing with toys and interacting with adults (eg, being
read to, listening to stories, and listening to music). Parents were
asked whether their child ever watched television, DVDs, or
videos. Those answering yes were asked to report the amount
of viewing by the content their child typically viewed. This ques-
tion emphasized foreground viewing. Although background
viewing (in which the television is on but the child is not ac-
tively viewing) is also believed to have an effect on develop-
mental outcomes
2
; this study focuses only on foreground view-
ing, to be consistent with previous work in this area and to
generate a conservative estimate of children’s media exposure,
and because it was believed that parents could more accu-
rately report on their child’s foreground exposure.
Six content types were identified a priori, based on previ-
ous work
12,15
: (1) children’s educational programs on televi-
sion (eg, Blue’s Clues and Arthur), (2) children’s educational
programs on video or DVD (eg, Sesame Street), (3) children’s
noneducational television shows (eg, SpongeBob SquarePants
and Cartoon Network), (4) children’s movies on DVD or video
(eg, Toy Story), (5) baby DVDs/videos (eg, Baby Einstein), and
(6) grown-up television (eg, Oprah and sports programming).
Parents were provided these categories with these examples and
asked to report their child’s viewing by category for a typical
weekday and weekend day.
The programs given as examples of educational television
have been shown by formal research to promote reading or vo-
cabulary development among preschool-aged children. How-
ever, because the capacity of these shows to promote learning
among children aged 0 to 2 years has never been evaluated, our
categorization should be seen only as labels.
Parental reporting of children’s television viewing has been
used extensively in the literature
10-12,16
and has been shown to
be highly correlated with media time, as observed by video re-
corders in the home.
17,18
Although parental reporting has more
error than more intrusive methods, it has been shown not to
exhibit any systematic bias.
18
Parents who affirmed some viewing of either television or
DVDs/videos were read a list of 6 possible reasons for doing so
and asked which applied to them. They were then asked which
was the most important. Another question asked parents to re-
port the frequency with which they watched television or DVDs/
videos with their child. Parents were also asked to report on
average how much television they estimated their child’s peers
to watch.
Parents were also asked demographic questions, including
how many other children were in the household, and ques-
tions about maternal and paternal education. The parents were
asked to report the child’s race. The child’s age was available
from the birth certificate.
OUTCOME AND COVARIATES
The primary outcome for this analysis is the amount of media
viewing by content type. The 6 content categories were re-
duced to 4 by consolidating educational content on television
and on DVDs/videos, and by consolidating children’s movies
with children’s noneducational television. The 4 content cat-
egories were (1) children’s educational, (2) children’s nonedu-
cational, (3) baby DVDs/videos, and (4) grown-up television.
Average daily viewing was used in all analyses. In addition to
race and age, analyses controlled for whether both parents were
living in the household, the child’s hours in daycare, house-
hold income, and maternal and paternal education.
ANALYSES
Demographic data were compared with US census data for Wash-
ington state and Minnesota. The age of initiation of viewing either
television or DVDs/videos was assessed by using a locally
weighted smoothing regression (Lowess) with a binary indi-
cator of whether the child watched as the outcome and the child’s
age as the main predictor.
19,20
Similarly, Lowess was used to pre-
sent the relationship of the child’s age to the total viewing time,
subdivided by content type. Logistic regression was used to test
the independent associations of demographic variables with any
viewing by content type. Linear regression was used to test the
independent associations of demographic variables with the
amount of viewing by content type, conditional on any view-
ing of that content type. All analyses were conducted using Stata
Statistical Software, version 9.0 (Stata Corp, College Station,
Tex).
RESULTS
Of the 7267 families whose letters about the study were
not returned as undeliverable, 297 mailed back refusals
to participate, 1430 were determined by the investiga-
tors to have nonworking or wrong telephone numbers,
and 3341 were pending at the time of the conclusion of
the study, meaning that the requisite 8 attempts to call
had not been made. Of 2199 households reached, 1791
were eligible. Of the 1791 eligible households plus the
297 who had mailed in refusals, 1009 families agreed to
participate. Using standard definitions, the sample had
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a contact rate of 48.0%, a cooperation rate of 45.2%, a
refusal rate of 24.3%, and a response rate of 20.1%.
21
Table 1 reports demographics and the television and
DVD/video viewing for the sample and for 2000 census
data for Minnesota and Washington. Compared with the
census data, the sample is more highly educated, less likely
to be African American, more likely to report multiple
races, and has higher incomes.
Figure 1 shows the initiation of viewing by medium
and by age. Initiation of television and DVD/video view-
ing was similar. By 3 months of age, about 40% of in-
fants were watching television or DVDs/videos. The me-
dian age of initiating media time is 9 months. By 2 years,
about 90% of children were regularly viewing television
or DVDs/videos. The average amount of viewing time
across the entire sample of children from 2 to 24 months
of age was 40.2 minutes per day. Parents estimate their
child’s peers’ viewing to be considerably higher, at 69.6
minutes per day (significant at P.001).
Figure 2 shows the evolution of viewing by content
type with age. Those who watched any television or DVDs/
videos watched just less than an hour per day at 3 months
of age, rising to just more than 1.5 hours per day by age
24 months. Approximately half of the viewing was of
shows that parents reported to be in the children’s edu-
cational category. The remaining half was approxi-
mately equally split among children’s noneducational con-
tent, baby DVDs/videos, and grown-up television.
Table 2 presents the most commonly cited reasons
for having young children watch television or DVDs/
videos. The most common “most-important reason,” en-
Table 1. Study Population and Census Sample Demographic Characteristics*
Characteristic Study Sample Minnesota and Washington Census Sample† P Value of Difference
Age, mean (SD), mo 13.1 (6.0) NA NA
Sex, F 47 NA NA
No siblings 31 39 .001
1 Sibling 39 35 .009
2 Siblings 30 26 .005
Both parents present 95 83 .001
Time in daycare, mean (SD), h/wk 11.0 (15.9) NA NA
Mother’s education
No high school 3 7 .001
High school 16 23 .001
Some college 22 36 .001
College degree 40 33‡ NA
Postcollege education 19 NA
Father’s education§
No high school 2 6 .001
High school 20 25 .001
Some college 21 34 .001
College degree 36 35‡ NA
Postcollege education 17 NA
Annual family income, $
20 000 6 13 .001
20 000-40 000 15 23 .001
40 001-60 000 26 24 .15
60 001-100 000 35 26 .001
100 000 18 13 .001
Race
Latino 5 6 .19
White 88 87 .36
African American 1 4 .001
Multiracial 9 3 .001
Other 2 9 .001
Abbreviation: NA, not applicable.
*Values are presented as percentages unless otherwise indicated.
†From the 2000 US Census 5% Public Use Microsample.
‡Minnesota and Washington census information did not separate college and postcollege data.
§Father’s education was imputed as some college if the father was absent.
100
60
80
40
20
0
3 6 9 12 15 18 21 24
Age of Viewer, mo
Viewing Population, %
Either Television or DVDs/Videos
DVDs/Videos
Television
Figure 1. Initiation of television or DVD/video viewing by medium and age
(locally weighted smoothing regression).
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dorsed by 29% of parents, was the belief that television
is educational or good for their child’s brain. The sec-
ond most popular “most-important reason,” at 23% of
parents, was that it is enjoyable or relaxing for the child.
Twenty-one percent of parents reported that the “most-
important reason” was that they needed time to get things
done.
Table 3 presents results of fully adjusted logistic re-
gressions of watching any television or DVDs/videos, over-
all and by 4 specific content types. Compared with chil-
dren without siblings, children with 2 or more siblings
were less likely to view grown-up television (odds ratio
[OR], 0.41; 95% confidence interval [CI], 0.26-0.64) and
baby DVDs/videos (OR, 0.53; 95% CI, 0.36-0.78). Chil-
dren with 1 sibling were more likely to watch children’s
noneducational content than children with no siblings
(OR, 1.66; 95% CI, 1.16-2.38). Parental perception of
more viewing by other children of a similar age (mea-
sured in hours per day) is associated with a greater like-
lihood of viewing overall (OR, 1.64; 95% CI, 1.41-1.91)
of every type of content (Table 3; ORs: range, 1.29-
1.76).
Table 4 presents fully adjusted regression results of
the amount of viewing (minutes per day) among those
who reported any viewing by content type. Those with
2 or more siblings watched about 18 fewer minutes per
day in all content types (95% CI, −32.2 to −3.2) than those
with no siblings. Children living in households with
both parents present watched about 42 minutes per day
(95% CI, −71.3 to −12.4) less of children’s educational
content than children in households with only 1 parent
present.
Parents who reported higher viewing among chil-
dren of their child’s age also reported higher amounts of
viewing by their own child. The effect was significant for
overall viewing and for every content type besides
grown-up television. Each additional hour of perceived
average viewing for the age was associated with about 13
additional minutes per day of viewing on the part of the
respondent’s child, whether defined as overall viewing
(estimated regression coefficient, 13.1; 95% CI, 8.5-
17.7) or as children’s educational or children’s nonedu-
cational content specifically (Table 4).
Table 5 presents the proportions of children whose
parents watched television or DVDs/videos with them by
frequency of watching. Approximately 11% of chil-
dren’s parents rarely watched with them; 6% watched with
them less than half of the time; 23% watched with them
about half of the time; 27% watched with them more than
half of the time; and 32% always watched with them.
COMMENT
It is clear that the American Academy of Pediatrics’ rec-
ommendation of no screen time for children younger than
2 years has not been widely heeded. Approximately 40%
of these young children are already watching by 3 months
of age, and about 90% are watching by 24 months. The
median age of initiating viewing is 9 months. These re-
sults are consistent with previous assessments.
10-12,14,16
The results here show that only 32% of parents re-
port watching television or videos with their child every
time the child watches. Responses to similar questions
in 2 previous studies range from 26% to 47%.
10-12
This
finding is noteworthy in the context of the claim by pro-
ducers of content for young children that their goal is to
promote parent-child interaction.
14,22
It is a common view that parents turn to television and
DVDs/videos as an electronic babysitter for their chil-
dren. The results here support a more nuanced picture
that has emerged in the literature, one that suggests that
babysitting is in fact not the single overriding reason chil-
dren watch television.
11,23
In reporting on the reasons for
having their children watch television or DVDs/videos,
parents themselves emphasize the educational potential
first.
Another reason is that viewing is perceived by the par-
ents to be fun or relaxing for the child. About 1 in 5 par-
ents cited a need to get things done as a major reason for
having their children watch television or videos. It is pos-
sible that parents are responding to social expectations
in citing these reasons. However, the regression results
also would suggest that babysitting is not the major mo-
tivation. One would expect that single parents or par-
ents with many children would have less time available
per child and would therefore have more need for baby-
sitting. Yet families with more children—and those with
a single parent present—are no more likely to report that
their child watches any media than families with 1 child
2.0
1.0
1.5
0.5
0
3 6 9 12 211815 24
Age of Viewer, mo
Average Time Spent Viewing, h/d
Grown-Up Television
Baby DVDs/Videos
Children’s Noneducational
Children’s Educational
Figure 2. Television and DVD/video viewing by content and age among those
with any viewing (locally weighted smoothing regression).
Table 2. Reasons Parents Gave as Being the Most Important
for Their Children Watching Television or DVDs/Videos
Reason
Most
Important
Reason,
%
Of Total
Cited
Reasons,
%
The television and video programs that I have
my child watch teach him/her something or
are good for his/her brain
28.9 22.4
It is something he/she really enjoys doing 22.7 23.3
I need some time to get things done on my own 20.5 19.7
It is time he/she spends together with a sibling 9.1 12.8
The child needs or wants to relax 4.4 10.9
It teaches the child to get along well with others 1.4 8.0
It is family time, bonding time, or quality time 0 1.0
It grabs and holds my child’s attention 0 0.7
Other reasons 13.0 1.4
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or with both parents present. Similarly, children in such
families are also no more likely to watch more televi-
sion or DVDs/videos, if they watch any. On balance, these
results suggest that the widespread notion that parents
turn to television only as an electronic babysitter is a mis-
conception. Other rationales (eg, the child’s education
and entertainment) appear to be as important. These re-
sults are similar to those for older children,
11
a similar-
ity that is remarkable, given the very different educa-
tional potential of television for children younger than
2 years vs that for preschoolers and older children. Par-
ents are clearly hungry for truly educational content for
children younger than 2 years. More research is ur-
gently required to determine whether it is realistic to pro-
duce genuinely educational content for children younger
than 2 years, and if so, what it would be.
The presence of siblings is not significantly associ-
ated with the likelihood of watching any content, but is
associated with less viewing when viewing takes place.
The presence of siblings also appears to be related to the
type of content viewed, with those with siblings more
likely to watch entertainment television and less likely
to watch baby videos/DVDs and grown-up television.
These findings underscore the role that siblings play in
shaping the early cognitive environment of young chil-
dren. Given the research that demonstrates how infants
and young children learn from and imitate their older
siblings and peers,
24,25
these results suggest that it may
not only be the amount or content type that children view
but also the role of siblings in helping to process this con-
tent that may affect whether television viewing helps or
hinders development.
As with other health behaviors, including drinking,
26
perceived norms of others’ television viewing are higher
than actual viewing and highly correlated with a child’s
own viewing. Parents believe their children watch less
than the average amount; the perceived average viewing
by other children is 73% higher than the actual average.
The more their own children watch, the higher parents
believe the average viewing by others to be. Research for
other health behaviors has shown that communication
of true norms of behavior can be a powerful motivator
of behavior change.
27
Several aspects of the sample make any conclusions
drawn from it tentative. The sample is not highly repre-
sentative of the population from which it is drawn, though
Table 3. Fully Adjusted Logistic Regressions of Any Viewing by Content Type*
Variable
Content Type, Odds Ratio (95% Confidence Interval)
Total Screen Time
(n = 1004)
Children’s
Educational
(n = 998)
Children’s
Noneducational
(n = 999)
Baby DVD/Videos
(n = 1003)
Grown-Up
Television
(n = 1005)
Female sex 0.85 (0.64-1.12) 0.96 (0.72-1.28) 0.93 (0.69-1.26) 1.21 (0.91-1.61) 0.91 (0.65-1.26)
Siblings (reference category, no siblings)
1 Sibling 0.99 (0.71-1.39) 1.17 (0.83-1.64) 1.66 (1.16-2.38)† 0.68 (0.49-0.95)‡ 0.57 (0.40-0.83)†
2 Siblings 0.73 (0.50-1.05) 0.97 (0.66-1.41) 1.12 (0.74-1.67) 0.53 (0.36-0.78)† 0.41 (0.26-0.64)†
Both parents present in home 0.59 (0.26-1.36) 0.76 (0.33-1.73) 0.46 (0.20-1.05) 1.07 (0.46-2.50) 1.12 (0.45-2.79)
Time in daycare, h/wk 1.00 (0.99-1.01) 1.00 (0.99-1.01) 1.01 (1.00-1.02) 0.99 (0.99-1.00) 1.00 (0.99-1.01)
Mother’s education (reference category,
college degree)
High school 1.57 (0.59-4.19) 1.79 (0.68-4.73) 4.44 (1.65-11.95)† 1.72 (0.65-4.53) 1.93 (0.71-5.27)
High school 0.81 (0.49-1.33) 0.97 (0.59-1.60) 1.23 (0.74-2.05) 1.03 (0.63-1.67) 0.7 (0.40-1.24)
Some college 1.33 (0.90-1.98) 1.21 (0.81-1.80) 1.29 (0.85-1.96) 1.04 (0.70-1.55) 0.87 (0.54-1.39)
Postcollege education 0.75 (0.50-1.13) 0.63 (0.42-0.95)‡ 0.68 (0.43-1.08) 0.53 (0.34-0.81)† 0.72 (0.44-1.19)
Father’s education
High school 1.33 (0.47-3.75) 0.71 (0.25-2.02) 0.75 (0.25-2.27) 0.7 (0.23-2.11) 1.64 (0.55-4.91)
High school 1.35 (0.86-2.13) 1.01 (0.64-1.60) 1.23 (0.76-1.98) 1.15 (0.73-1.82) 1.25 (0.75-2.10)
Some college 1.06 (0.70-1.60) 1.27 (0.84-1.93) 1.27 (0.82-1.96) 1.08 (0.71-1.65) 0.96 (0.59-1.57)
Postcollege education 1.05 (0.68-1.60) 1.00 (0.65-1.54) 0.90 (0.56-1.44) 1 (0.65-1.55) 0.85 (0.50-1.45)
Annual family income (reference category,
100 000), $
20 000 1.02 (0.46-2.25) 1.63 (0.73-3.61) 0.97 (0.43-2.18) 0.57 (0.25-1.27) 1.33 (0.53-3.32)
20 000-40 000 1.07 (0.62-1.84) 1.5 (0.87-2.60) 1.18 (0.66-2.09) 0.71 (0.41-1.23) 1.8 (0.93-3.50)
40 001-60 000 1.06 (0.68-1.66) 1.11 (0.70-1.75) 0.69 (0.42-1.12) 0.45 (0.28-0.71)† 1.83 (1.05-3.19)‡
60 001-100 000 1.3 (0.86-1.96) 1.35 (0.89-2.06) 0.79 (0.51-1.23) 0.76 (0.50-1.14) 1.38 (0.81-2.34)
Race
Latino 0.59 (0.30-1.18) 0.97 (0.50-1.89) 0.79 (0.40-1.56) 0.98 (0.49-1.97) 0.72 (0.33-1.57)
African American 9.64 (1.98-46.85)† 7.99 (1.60-39.79)‡ 8.63 (2.18-34.18)† 1.94 (0.60-6.27) 2.33 (0.65-8.41)
Multiracial 1.53 (0.92-2.55) 1.32 (0.78-2.21) 1.86 (1.10-3.13)‡ 0.62 (0.35-1.09) 1.48 (0.85-2.59)
Other 2.57 (0.96-6.87) 1.77 (0.66-4.71) 2.21 (0.80-6.06) 0.66 (0.21-2.08) 1.71 (0.57-5.13)
Minnesota residence 1.1 (0.81-1.48) 1.28 (0.94-1.73) 1.11 (0.80-1.53) 1.2 (0.89-1.63) 1.08 (0.76-1.53)
Parental report of other children’s viewing 1.64 (1.41-1.91)† 1.76 (1.50-2.06)† 1.42 (1.23-1.64)† 1.29 (1.13-1.48)† 1.71 (1.47-1.98)†
R
2
0.15 0.16 0.14 0.06 0.11
*Results also adjusted for child’s age in months.
P.01.
P.05.
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it is comparable to recent work in this area.
10-12
A par-
ticular group of interest would be non-native speakers
of English, who were excluded from this study and whose
viewing patterns would presumably be different in in-
teresting ways from the results presented here.
The content categorization was provided by parents,
with some guidance from the wording of the questions.
That said, the research base is so thin at present that there
is little sound rationale for coding any particular show
as educational vs entertainment. As such, the content cat-
egorization of viewing presented here, while suggestive
of overall patterns and a major advance on previous re-
search, is not highly precise.
Even with these limitations, this survey represents a sig-
nificant contribution to the literature in which the only pre-
vious studies were conducted years ago,
16
limited to the sub-
urbs of 1 city,
12
or not focused on young children.
10,11,16
No
previous studies have collected detailed data on content chil-
dren are watching, and no large-scale surveys have as-
sessed parents’ reasons for having children watch.
The phenomenon of very young children watching tele-
vision and DVDs or videos is now routine. Children start
watching television at a very young age and watch a lot
of it. This phenomenon would seem to be driven as much
by parental beliefs in the educational and entertainment
value of television for very young children as by paren-
tal need for an electronic babysitter. More research is ur-
gently needed to determine whether these parental be-
liefs are justified and whether future public health
interventions targeting this age group’s viewing should
be mindful of parental motivations for use.
In the meantime, these results have relevance for pe-
diatric practice. The finding that parents perceive that
television has the potential for educational benefit can
Table 4. Fully Adjusted Regressions Among Those With Any Viewing by Category*
Characteristic
Regression Coefficient (95% Confidence Interval)
Total Screen Time
(n = 456)
Children’s Educational
(n = 454)
Children’s
Noneducational
(n = 309)
Baby DVD/Videos
(n = 298)
Grown-Up Television
(n = 210)
Female sex −2.8 (−13.42 to 7.82) 3.71 (−6.84 to 14.26) −1.66 (−13.49 to 10.18) 6.21 (−0.91 to 13.32) 1.89 (−10.84 to 14.62)
1 Sibling −4.18 (−16.57 to 8.21) 4.09 (−8.40 to 16.58) 3.8 (−10.55 to 18.15) −2.44 (−10.41 to 5.52) −2.35 (−16.39 to 11.70)
2 Siblings −17.72 (−32.20 to −3.23)† −4.18 (−18.43 to 10.08) −4.94 (−21.73 to 11.85) −2.7 (−12.30 to 6.90) −10.14 (−27.58 to 7.30)
Both parents present −5.06 (−34.38 to 24.26) −41.85 (−71.28 to −12.42)‡ −19.45 (−48.30 to 9.40) 4.04 (−20.44 to 28.53) 7.57 (−33.44 to 48.57)
Time in daycare, h/wk −0.12 (−0.46 to 0.22) −0.25 (−0.59 to 0.10) 0.01 (−0.35 to 0.38) −0.12 (−0.35 to 0.12) −0.14 (−0.54 to 0.27)
Mother’s education
High school 32.94 (−3.34 to 69.22) 7.3 (−27.51 to 42.12) 27.68 (−3.86 to 59.22) 34.44 (8.21 to 60.66)† 29.73 (−9.63 to 69.09)
High school 13.38 (−4.81 to 31.56) 2.43 (−15.00 to 19.87) 6.09 (−13.73 to 25.91) 4.46 (−7.03 to 15.95) 15.29 (−6.28 to 36.86)
Some college 6.18 (−8.27 to 20.62) 3 (−11.41 to 17.40) −2.42 (−18.95 to 14.10) −2.35 (−12.23 to 7.53) 15.21 (−2.60 to 33.02)
Postcollege education −0.77 (−16.60 to 15.06) −3.29 (−19.55 to 12.96) −1.12 (−20.12 to 17.88) 5.62 (−5.61 to 16.85) −8.01 (−27.33 to 11.32)
Father’s education
High school 40.00 (0.22 to 79.78)† 57.55 (17.78 to 97.32)‡ 25.97 (−15.30 to 67.24) −11.05 (−43.50 to 21.40) −19.93 (−64.06 to 24.20)
High school −1.87 (−19.17 to 15.43) 13.12 (−4.28 to 30.52) 20.13 (0.35 to 39.91)† −4.21 (−15.48 to 7.06) −3.6 (−24.58 to 17.39)
Some college 2.05 (−13.20 to 17.30) 0.35 (−14.58 to 15.27) 6.54 (−10.39 to 23.47) −0.3 (−10.40 to 9.81) −8.44 (−27.22 to 10.34)
Postcollege education −4.64 (−20.90 to 11.61) −1.52 (−18.24 to 15.20) 2.58 (−16.87 to 22.03) −4.76 (−15.57 to 6.05) −6.87 (−27.40 to 13.67)
Annual household
income, $
20 000 1.09 (−28.00 to 30.18) −10.35 (−38.73 to 18.03) 10.51 (−18.67 to 39.69) −11.46 (−32.97 to 10.06) 11.12 (−26.27 to 48.52)
20 000-40 000 7.06 (−14.47 to 28.59) 5.19 (−16.12 to 26.51) 3.14 (−19.72 to 26.00) 8.37 (−4.74 to 21.47) −1.9 (−27.68 to 23.88)
40 001-60 000 3.62 (−13.96 to 21.20) −3.34 (−21.11 to 14.42) −1.62 (−21.66 to 18.43) −2.6 (−13.91 to 8.71) 9.29 (−12.80 to 31.38)
60 001-100 000 0.26 (−15.29 to 15.81) 5.83 (−10.04 to 21.69) 2.08 (−15.38 to 19.54) 2.64 (−7.14 to 12.42) 7.45 (−13.13 to 28.03)
Child’s race
Latino −30.03 (−55.76 to 4.29)† −14.5 (−37.89 to 8.88) 4.19 (−20.64 to 29.01) 6.58 (−10.78 to 23.93) 10.41 (−19.43 to 40.25)
African American 38.06 (2.77 to 73.34)† 90.23 (55.38 to 125.08)‡ 33.92 (−0.16 to 67.99) 14.93 (−10.87 to 40.72) −3.68 (−45.85 to 38.48)
Multiracial 23.17 (5.20 to 41.14)† 12.95 (−5.05 to 30.95) −2.31 (−21.22 to 16.60) 1.57 (−12.82 to 15.97) 5.39 (−14.79 to 25.56)
Other −3.8 (−36.87 to 29.28) −17.58 (−53.67 to 18.51) −18.89 (−56.75 to 18.97) −0.59 (−31.62 to 30.43) 11.8 (−29.73 to 53.33)
Minnesota residence −2.87 (−14.34 to 8.60) −1.47 (−12.86 to 9.93) −0.45 (−13.30 to 12.39) −0.58 (−8.15 to 7.00) −4.96 (−18.40 to 8.48)
Parental report of other
children’s viewing, h/d
13.08 (8.47 to 17.69)† 13.41 (8.88 to 17.94)† 12.97 (7.81 to 18.13)† 6.86 (3.53 to 10.20)† 4.28 (−0.55 to 9.10)
R
2
0.19 0.22 0.21 0.17 0.11
*Results also adjusted for child’s age in months. Reference categories are the same as in Table 3.
P.05.
P.01.
Table 5. Parental Report of Watching Media With Children
Among Parents Whose Children Watch Any Media
Frequency of Viewing With Children Value, No. (%)
Rarely 72 (11.45)
Half the time 40 (6.36)
About half the time 142 (22.58)
Half the time 169 (26.87)
Always 203 (32.27)
Don’t know 3 (0.48)
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be used to reinforce the message to increase the propor-
tion of viewing that is with a parent, which may serve to
foster the parent-child interactions that have been asso-
ciated with vocabulary acquisition during infancy. In ad-
dition, special attention and sensitive intervention may
be warranted for heavy television households. Finally,
parents could be given realistic comparative informa-
tion about how much television viewing is being done
by age-matched peers, so they can make more informed
choices for their own families in relation to actual (not
simply perceived) societal norms.
Accepted for Publication: November 8, 2006.
Correspondence: Frederick J. Zimmerman, PhD, Child
Health Institute, University of Washington, 6200 NE 74th
St, Seattle, WA 98115 (fzimmer@u.washington.edu).
Author Contributions: Throughout this project, Dr Zim-
merman had full access to all of the data in the study and
takes responsibility for the integrity of the data and the
accuracy of the data analysis. Study concept and design:
Zimmerman, Christakis, and Meltzoff. Acquisition of data:
Zimmerman and Christakis. Analysis and interpretation
of data: Zimmerman, Christakis, and Meltzoff. Drafting
of the manuscript: Zimmerman, Christakis, and Melt-
zoff. Critical revision of the manuscript for important in-
tellectual content: Zimmerman, Christakis, and Melt-
zoff. Statistical analysis: Zimmerman, Christakis, and
Meltzoff. Obtained funding: Meltzoff. Administrative, tech-
nical, and material support: Zimmerman and Meltzoff.
Study supervision: Meltzoff.
Financial Disclosure: None reported.
Funding/Support: We gratefully acknowledge the gen-
erous financial support provided by the Tamaki Foun-
dation. Dr Zimmerman is supported by grant
1K01MH06446-01A1 from the National Institute of Men-
tal Health.
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... In particular, all the children between 18 and 36 months (100%) used DD against 89% of the children between 8 and 17 months. Our result is in line with the study of Zimmerman et al. (2007) [31] in which 90% of parent reported that their children younger than 24 months use some form of electronic media. ...
... In particular, all the children between 18 and 36 months (100%) used DD against 89% of the children between 8 and 17 months. Our result is in line with the study of Zimmerman et al. (2007) [31] in which 90% of parent reported that their children younger than 24 months use some form of electronic media. ...
... In our opinion, it is also important to underline that in the group of younger children the ages of first use of DD are always lower than in the group of older children, for all the digital devices analyzed. This data would suggest a sort of "anticipation" of the age to DD exposure, which would seem increasingly early [31,32]. ...
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Background: Over the past decade, the use of digital tools has grown and research evidence suggests that traditional media and new media offer both benefits and health risks for young children. The abilities to understand and use language represent two of the most important competencies developed during the first 3 years of life through the interaction of the child with people, objects, events, and other environmental factors. The main goal of our study is to evaluate the relationship between digital devices use and language abilities in children between 8-36 month, considering also the influence of several variables. Materials and Methods: We conducted a cross-sectional observational study on 260 healthy children (140 males = 54%) aged between 8-36 months (mean=23.5±7.18 months). All the parents completed a self-report questionnaire investigating the use of digital devices by their children, and a standardized questionnaire for the assessment of language skills (MacArthur). Multiple linear regression was used to evaluate the relationship between different variables. Subsequent moderation analysis were performed to verify the influence of other factors. Results: W found a statistically significant negative correlation between the total daily time of exposure to digital devices and the Actions and Gestures Quotient (ß=-0.397) in children between 8-17 months, and between the total daily time of exposure to digital devices and Language Quotient (ß=-0.224) in children between 18-36 months. Sex, level of education/job of parents, modality of use/content of digital device do not significantly affect these relationships. Conclusion: In our study we found that a longer time of exposure to digital devices was related to lower mimic-gestural skills in children from 8-17 months and to lower language skills in children between 18-36 months, regardless of age, sex, socio-economic status, content and modality of use. Further studies are needed to confirm and better understand this relationship, but parents and pediatricians are advised to limit the use of digital devices by children and encourage the social interaction to support the learning of language and communication skills in this age group.
... Yet, research suggested that although television did change how children spent their time, it did not lead to major drops in time spent doing activities like homework or reading books (Schramm et al. 1961). In fact, most research finds no definitive, causal effects of television viewing-either positive or negative-on children's behavioral outcomes (e.g., Barr 2010, Christakis et al. 2004, Foster & Watkins 2010, Huston 1992, Mistry et al. 2007, Stevens & Mulsow 2006, Zimmerman & Christakis 2005, Zimmerman et al. 2007. ...
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... (Nie et al., 2005) Consumption of a high dose of screen media starts early in life. By 3 months of age 40 per cent of infants are regular viewers of television, DVDs or videos, and by the age of 2, this number increases dramatically to 90 per cent (Zimmerman et al., 2007b). In the United States as elsewhere, children under 8 are spending more time than ever in front of screens. ...
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... The debate around children's digital activities covers many aspects: the potential consequences on the brain development of toddlers (Johnson, 2015;Reid Chassiakos et al., 2016), the risks related to children's exposure to inappropriate images (Tomopoulos et al., 2010), and the unpermitted use of a child's image [risks that have been very well covered by Sziron and Hildt (2018)], to name but a few. From a cognitive developmental perspective, some research considers that access to screens facilitates the stimulation of communication, literacy or executive function development (Courage and Setliff, 2010;Neumann, 2016;Huber et al., 2018), while others consider that it diminishes experiences, quality of interpersonal relationships (i.e., communication, empathy), outdoor activities, healthy living (i.e., well-being, sleep and food) (Zimmerman et al., 2007;Lin et al., 2015;Kirkorian, 2018;Stiglic and Viner, 2019). ...
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