Study links early screens exposure to unusual sensory processing

Infants and young children who are exposed to television or video content may demonstrate unconventional sensory behaviors, including disengagement, lack of interest in activities, a preference for heightened environmental stimulation, or being easily overwhelmed by sensations like loud sounds or bright lights. This information is based on research conducted by Drexel’s College of Medicine and was published in the journal JAMA Pediatrics.

early exposure to screens with unusual sensory processing in toddlers

According to the study findings, children with increased exposure to television before their second birthday showed a higher likelihood of developing unconventional sensory processing behaviors by the age of 33 months. These behaviors include tendencies towards “sensation seeking” and “sensation avoiding,” along with “low registration,” indicating reduced sensitivity or delayed responses to stimuli like their name being called.

The proficiency of sensory processing skills indicates the body’s capacity to react effectively and suitably to information and stimuli received through its sensory systems, encompassing what the toddler hears, sees, touches, and tastes.

The research team extracted data from the National Children’s Study, covering the years 2011 to 2014, regarding television or DVD-watching habits of infants and toddlers at 12, 18, and 24 months. The study included 1,471 children, with an equal distribution of 50% male participants from across the nation.

The study evaluated sensory processing outcomes at 33 months through the use of the Infant/Toddler Sensory Profile (ITSP). This questionnaire, filled out by parents or caregivers, is specifically designed to provide insights into how children process various sensory inputs such as sight, sound, smell, and more.

The ITSP subscales analyze children’s tendencies in low registration, sensation seeking (such as excessive touching or smelling of objects), sensory sensitivity (being overly upset or irritated by lights and noise), and sensation avoiding (actively attempting to control their environment, for instance, avoiding activities like having their teeth brushed). Children are categorized into “typical,” “high,” or “low” groups based on the frequency of their display of various sensory-related behaviors. Scores are deemed “typical” if they fall within one standard deviation from the ITSP norm’s average.

Screen exposure measurements at 12 months relied on caregivers’ responses to the query: “Does your child watch TV and/or DVDs? (yes/no).” Meanwhile, at 18 and 24 months, the measurements were determined by the question: “Over the past 30 days, on average, how many hours per day did your child watch TV and/or DVDs?”

The results indicate the following:

At 12 months, any exposure to screens, compared to no screen viewing, was linked to a 105% higher likelihood of displaying “high” sensory behaviors instead of “typical” sensory behaviors associated with low registration at 33 months.
At 18 months, each additional hour of daily screen time was correlated with a 23% increased likelihood of demonstrating “high” sensory behaviors related to later sensation avoiding and low registration.
At 24 months, each additional hour of daily screen time was connected with a 20% increased likelihood of exhibiting “high” sensation seeking, sensory sensitivity, and sensation avoiding at 33 months.

The researchers accounted for variables including age, premature birth status, caregiver education, race/ethnicity, and other factors such as the frequency of the child’s play or walks with the caregiver in their adjustments.

The results contribute to an expanding list of worrisome health and developmental consequences associated with screen time in infants and toddlers. These include language delay, autism spectrum disorder, behavioral issues, sleep difficulties, attention problems and delays in problem-solving abilities.

“This association could have important implications for attention deficit hyperactivity disorder and autism, as atypical sensory processing is much more prevalent in these populations. Repetitive behavior, such as that seen in autism spectrum disorder, is highly correlated with atypical sensory processing. Future work may determine whether early life screen time could fuel the sensory brain hyperconnectivity seen in autism spectrum disorders, such as heightened brain responses to sensory stimulation.” — Karen Heffler, MD, lead author, associate professor of Psychiatry in Drexel’s College of Medicine

Unusual sensory processing in children diagnosed with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) is expressed through various negative behaviors. In ASD, heightened sensation seeking or sensation avoiding, increased sensitivity to sensory stimuli, and low registration are correlated with challenges such as irritability, hyperactivity, difficulties in eating and sleeping, and social issues. For children with ADHD, atypical sensory processing is associated with difficulties in executive function, increased anxiety and a lower quality of life.

“Considering this link between high screen time and a growing list of developmental and behavioral problems, it may be beneficial for toddlers exhibiting these symptoms to undergo a period of screen time reduction, along with sensory processing practices delivered by occupational therapists,” said Heffler.

The American Academy of Pediatrics (AAP) advises against screen time for infants under 18-24 months. However, the AAP acknowledges that live video chat is acceptable, recognizing potential benefits from the interaction. For children aged 2 to 5 years, the AAP recommends limiting digital media use to typically no more than 1 hour per day.

“Parent training and education are key to minimizing, or hopefully even avoiding, screen time in children younger than two years,” said senior author David Bennett, PhD, a professor of Psychiatry in Drexel’s College of Medicine.

Despite the available evidence, numerous toddlers are exposed to screens frequently. A 2019 research letter in JAMA Pediatrics reported that as of 2014, children aged 2 and under in the United States averaged 3 hours and 3 minutes of daily screen time, a significant increase from 1 hour and 19 minutes in 1997. A study in the Journal of Nutrition and Behavior from July 2015 found that some parents attribute this screen time to exhaustion and the unavailability of affordable alternatives.

While the recent study specifically focused on television or DVD watching and not media consumed on smartphones or tablets, it represents one of the initial pieces of data connecting early-life digital media exposure to subsequent atypical sensory processing across various behaviors. The authors emphasized the necessity for future research to delve deeper into the mechanisms underlying the correlation between early-life screen time and atypical sensory processing.