When babies watch television: Attention-getting, attention-holding, and the implications for learning from video material

Infant sustained attention differs by context and social content in the first 2 years of life

Sustained attention (SA) is an endogenous form of attention that emerges in infancy and reflects cognitive engagement and processing. SA is critical for learning and has been measured using different methods during screen-based and interactive contexts involving social and nonsocial stimuli. How SA differs by measurement method, context, and stimuli across development in infancy is not fully understood. This 2-year longitudinal study examines attention using one measure of overall looking behavior and three measures of SA-mean look duration, percent time in heart rate-defined SA, and heart rate change during SA-in N = 53 infants from 1 to 24 months across four unique task conditions: social videos, nonsocial videos, social interactions (face-to-face play), and nonsocial interactions (toy engagement). Results suggest that developmental changes in attention differ by measurement method, task context (screen or interaction), and task stimulus (social or nonsocial). During social interactions, overall looking and look durations declined after age 3-4 months, whereas heart rate-defined attention measures remained stable. All SA measures were greater for videos than for live interaction conditions throughout the first 6 months, but SA to social and nonsocial stimuli within each task context were equivalent. In the second year of life, SA measured with look durations was greater for social videos compared to other conditions, heart rate-defined SA was greater for social videos compared to nonsocial interactions, and heart rate change during SA was similar across conditions. Together, these results suggest that different measures of attention to social and nonsocial stimuli may reflect unique developmental processes and are important to compare and consider together, particularly when using infant attention as a marker of typical or atypical development. RESEARCH HIGHLIGHTS: Attention measure, context, and social content uniquely differentiate developmental trajectories of attention in the first 2 years of life. Overall looking to caregivers during dyadic social interactions declines significantly from 4 to 6 months of age while sustained attention (SA) to caregivers remains stable. Heart rate-defined SA generally differentiates stimulus context where infants show greater SA while watching videos than while engaging with toys.

Screen time and preschool children: Promoting health and development in a digital world

COVID-19 transformed the family media environment and spurred research on the effects of screen media exposure and use on young children. This update of a 2017 CPS statement re-examines the potential benefits and risks of screen media in children younger than 5 years, with focus on developmental, psychosocial, and physical health. Four evidence-based principles-minimizing, mitigating, mindfully using, and modelling healthy use of screens-continue to guide children's early experience with a rapidly changing media landscape. Knowing how young children learn and develop informs best practice for health care providers and early years professionals (e.g., early childhood educators, child care providers). Anticipatory guidance should now include child and family screen use in (and beyond) pandemic conditions.

Body-object interaction effect in word recognition and its relationship with screen time in Chinese children

A sample of 144 s- and 150 fourth-grade Chinese children was recruited to investigate the influence of body-object interactions (BOIs) on word recognition, i.e., how easily they could interact physically with each word's referent. The moderation on this relationship of children's screen time for entertainment purposes (i.e., the viewing or use of any device with a screen) was also examined. In a lexical decision task, the children were asked to judge whether each item was a real Chinese word. Each real word was assigned a BOI rating score. Model analysis showed that the BOI rating was a significant predictor of the children's word recognition performances. The children recognized the words with higher BOI ratings at higher accuracy rates and higher response speeds more than the words with lower BOI ratings, showing a BOI effect. These results suggest an involvement of sensorimotor information in processing concepts. As well, the results showed a moderating effect of screen time on the BOI effect. With the increase of screen time, the BOI effect was reduced in terms of response speed. Moreover, the influence of the screen time on the BOI effect was larger in the second graders than in the fourth graders.

Association between screen time and hyperactive behaviors in children under 3 years in China

BACKGROUND

Screen time during early life has increased dramatically among Chinese children. Excessive screen time has raised growing concerns about the neuropsychological development of children. The effects of screen exposure on early life and the boundary between screen time and hyperactive behaviors are well worth investigating. We examined associations between screen time and hyperactive behaviors in children under the age of 3 years using data from the Longhua Children Cohort Study (LCCS).

METHODS

A cross-sectional study was conducted among 42,841 3-year-old children from Longhua District, Shenzhen. Information on socio-demographic characteristics, children's annual screen time since birth, and hyperactive behaviors (measured by the Conners Parental Symptom Questionnaire) was collected through self-administered structured questionnaires completed by the primary caregiver. A series of logistic regression models assessed the association between screen time and hyperactive behaviors.

RESULTS

The average daily screen time of children under the age of 3 years was 55.83 ± 58.54 min, and screen time increased with age. Binomial logistic regression analysis found that the earlier the screen exposure, the greater the risk of hyperactive behaviors. Using binary logistic regression model, after controlling for confounding factors, the study found that more screen time was more associated with hyperactive behaviors. For children aged 0-3 years with daily screen time exceeding 90, 120, 150, and 180 min, the risk values for hyperactive behaviors were 1.98 [95% confidence interval (CI): 1.05, 3.78), 2.71 (95%CI:1.38, 5.30), 3.17 (95% CI: 1.50, 6.65), and 4.62 (95% CI: 2.45, 8.71)], respectively.

CONCLUSION

Early screen exposure may be associated with hyperactive behaviors in children under the age of 3 years. More than 90 min of screen time per day in children under 3 years was associated with hyperactive behaviors. The findings support the importance of screen time interventions for children under 3 years.

Mobile technology usage in early childhood: Pre-COVID-19 and the national lockdown period in North Cyprus

COVID-19 has affected North Cyprus since the beginning of March 2020. On March 10^th 2020, the council of ministers in North Cyprus announced a lockdown and listed some restrictions to prevent the spread of the virus; schools and entertainment centres were closed, and children had to spend most of their day at home. This study aims to examine the use of mobile technology before and during the COVID-19 lockdown period by children aged three to six, based on parents' opinions. This is a descriptive study with a sample of 319 parents. Data and demographic information were collected with a questionnaire and analysed with SPSS (24.0). Comparing the duration of mobile technology device usage before the pandemic and during the lockdown period, an increase is evident, as expected. Of note, when compared to the pre-pandemic period, it is found that there is a decrease in the rate of mobile technology device usage for video viewing during the lockdown period. The findings also suggest that children mostly first experienced mobile technology devices in some way before 36 months of age. This study has determined that most children do not have their own mobile technology device.

Screen Time Exposure in Preschool Children with ADHD: A Cross-Sectional Exploratory Study from South India

BACKGROUND

Concern is mounting regarding screen exposure among young children and its association with mental health. Children with attention deficit hyperactivity disorder (ADHD) may be more vulnerable to its effects such as increased externalizing behaviors and problems with language and cognitive development and biological functions such as sleep. We aimed to assess screen exposure in preschool children with ADHD and to study the correlation of screen time with the severity of ADHD and parental stress levels.

METHODS

Children of age 2.5-6 years, diagnosed with ADHD (n = 56) were included, and details of the total duration of screen exposure, maximum continuous screen exposure time, and types of screen-based devices used, reasons for screen exposure were collected from primary caregivers. ADHD symptom severity was assessed on Conner's Abbreviated Rating Scale. Family interview for stress and coping, adapted for ADHD, was used to measure parental stress.

RESULTS

Total screen exposure time in preschool children with ADHD was more than the recommended standards in 80.4% of children, with a median of 140.00 minutes (range: 20-500 minutes). The most commonly used modality was television (98.2%), followed by mobile phones (87.3%), tablets (17.9%), and laptops (10.7%). The severity of ADHD (r = 0.29, P = 0.02) and parent stress levels (r = 0.29, P = 0.03) were positively correlated to increased screen time exposure in the child.

CONCLUSIONS

Preschool children with ADHD have screen exposure above the recommended duration of one hour/day. Structured parent training programs for children with preschool ADHD and providing developmentally appropriate interventions are essential in curtailing screen time exposure and also to address parental stress.

Assessing the play and learning environments of children under two years in peri-urban Lima, Peru: a formative research study

BACKGROUND

Home-based interventions have potential for improving early child development (ECD) in low-resource settings. The design of locally acceptable strategies requires an in-depth understanding of the household context. In this formative research study, we aimed to characterize the home play and learning environments of children 6-23 months of age from low-income households in peri-urban Lima, Peru.

METHODS

Drawing on the developmental niche framework, we used quantitative and qualitative methods to understand children's physical and social settings, childcare practices, and caregiver perspectives. We conducted interviews, unstructured video-recorded observations, and spot-checks with 30 randomly selected caregiver-child dyads, 10 from each child age group of 6-11, 12-17, and 18-23 months of age, as well as key informant interviews with 12 daycare instructors. We analyzed the data for key trends and themes using Stata and ATLAS.ti and employed an adapted version of the Indicator of Parent-Child Interaction to evaluate the observations.

RESULTS

Children's social settings were characterized by multi-generational homes and the presence of siblings and cousins as play partners. Access to books and complex hand-eye coordination toys (e.g., puzzles, building blocks) in the home was limited (30.0 and 40.0%, respectively). Caregivers generally demonstrated low or inconsistent levels of interaction with their children; they rarely communicated using descriptive language or introduced novel, stimulating activities during play. Reading and telling stories to children were uncommon, yet 93.3% of caregivers reported singing to children daily. On average, caregivers ascribed a high learning value to reading books and playing with electronic toys (rated 9.7 and 9.1 out of 10, respectively), and perceived playing with everyday objects in the home as less beneficial (rated 6.8/10). Daycare instructors reinforced the problems posed by limited caregiver-child interaction and supported the use of songs for promoting ECD.

CONCLUSIONS

The features of the home learning environments highlighted here indicate several opportunities for intervention development to improve ECD. These include encouraging caregivers to communicate with children using full sentences and enhancing the use of everyday objects as toys. There is also great potential for leveraging song and music to encourage responsive caregiver-child interactions within the home setting.

Environmental and Cognitive Enrichment in Childhood as Protective Factors in the Adult and Aging Brain

Some recent studies have highlighted a link between a favorable childhood environment and the strengthening of neuronal resilience against the changes that occur in natural aging neurodegenerative disease. Many works have assessed the factors – both internal and external – that can contribute to delay the phenotype of an ongoing neurodegenerative brain pathology. At the crossroads of genetic, environmental and lifestyle factors, these relationships are unified by the concept of cognitive reserve (CR). This review focuses on the protective effects of maintaining this CR through the cognitive aging process, and emphasizes the most essential time in life for the development and strengthening of this CR. The in-depth study of this research shows that early stimulation with regard to social and sensory interactions, contributes to the proper development of cognitive, affective and psychosocial capacities. Childhood thus appears to be the most active phase in the development of CR, and as such we hypothesize that this constitutes the first essential period of primary prevention of pathological aging and loss of cognitive capacities. If this hypothesis is correct, early stimulation of the environment would therefore be considered as a true primary prevention and a public health issue. The earlier identification of neurodevelopmental disorders, which can affect personal and professional development across the lifespan, could therefore have longer-term impacts and provide better protection against aging.

Children's Environmental Health in the Digital Era: Understanding Early Screen Exposure as a Preventable Risk Factor for Obesity and Sleep Disorders

The quantity, accessibility and focus on child-targeted programming has exponentially increased since it entered American households in the early 1900s. It may have started with the television (TV), but technology has evolved and now fits in our pockets; as of 2017, 95% of American families own a smartphone. Availability and child-tailored content has subsequently led to a decrease in the age at initial screen exposure. The negative effects that accompany the current culture of early screen exposure are extensive and need to be considered as technology continues to enter the home and inundate social interactions. Increased levels of early screen exposure have been associated with decreased cognitive abilities, decreased growth, addictive behavior, poor school performance, poor sleep patterns, and increased levels of obesity. Research on the adverse effects of early screen exposure is mounting, but further epidemiological studies are still needed to inform prevention and regulation policies.

Changes in infant visual attention when observing repeated actions

Infants' early visual preferences for faces, and their observational learning abilities, are well-established in the literature. The current study examines how infants' attention changes as they become increasingly familiar with a person and the actions that person is demonstrating. The looking patterns of 12- (n = 61) and 16-month-old infants (n = 29) were tracked while they watched videos of an adult presenting novel actions with four different objects three times. A face-to-action ratio in visual attention was calculated for each repetition and summarized as a mean across all videos. The face-to-action ratio increased with each action repetition, indicating that there was an increase in attention to the face relative to the action each additional time the action was demonstrated. Infant's prior familiarity with the object used was related to face-to-action ratio in 12-month-olds and initial looking behavior was related to face-to-action ratio in the whole sample. Prior familiarity with the presenter, and infant gender and age, were not related to face-to-action ratio. This study has theoretical implications for face preference and action observations in dynamic contexts.

Screen time and young children: Promoting health and development in a digital world

The digital landscape is evolving more quickly than research on the effects of screen media on the development, learning and family life of young children. This statement examines the potential benefits and risks of screen media in children younger than 5 years, focusing on developmental, psychosocial and physical health. Evidence-based guidance to optimize and support children's early media experiences involves four principles: minimizing, mitigating, mindfully using and modelling healthy use of screens. Knowing how young children learn and develop informs best practice strategies for health care providers.

Predicting US Infants' and Toddlers' TV/Video Viewing Rates: Mothers' Cognitions and Structural Life Circumstances

There has been rising international concern over media use with children under two. As little is known about the factors associated with more or less viewing among very young children, this study examines maternal factors predictive of TV/video viewing rates among American infants and toddlers. Guided by the Integrative Model of Behavioral Prediction, this survey study examines relationships between children's rates of TV/video viewing and their mothers' structural life circumstances (e.g., number of children in the home; mother's screen use), and cognitions (e.g., attitudes; norms). Results suggest that mothers' structural circumstances and cognitions respectively contribute independent explanatory power to the prediction of children's TV/video viewing. Influence of structural circumstances is partially mediated through cognitions. Mothers' attitudes as well as their own TV/video viewing behavior were particularly predictive of children's viewing. Implications of these findings for international efforts to understand and reduce infant/toddler TV/video exposure are discussed.

The Nature and Predictive Value of Mothers' Beliefs Regarding Infants' and Toddlers' TV/Video Viewing: Applying the Integrative Model of Behavioral Prediction

Viewing television and video programming has become a normative behavior among US infants and toddlers. Little is understood about parents' decision-making about the extent of their young children's viewing, though numerous organizations are interested in reducing time spent viewing among infants and toddlers. Prior research has examined parents' belief in the educational value of TV/videos for young children and the predictive value of this belief for understanding infant/toddler viewing rates, though other possible salient beliefs remain largely unexplored. This study employs the integrative model of behavioral prediction (Fishbein & Ajzen, 2010) to examine 30 maternal beliefs about infants' and toddlers' TV/video viewing which were elicited from a prior sample of mothers. Results indicate that mothers tend to hold more positive than negative beliefs about the outcomes associated with young children's TV/video viewing, and that the nature of the aggregate set of beliefs is predictive of their general attitudes and intentions to allow their children to view, as well as children's estimated viewing rates. Analyses also uncover multiple dimensions within the full set of beliefs, which explain more variance in mothers' attitudes and intentions and children's viewing than the uni-dimensional index. The theoretical and practical implications of the findings are discussed.

Transfer of learning between 2D and 3D sources during infancy: Informing theory and practice

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.