Memory Constraints on Infant Learning From Picture Books, Television, and Touchscreens

Developmental trajectories of picture-based object representations during the first year of life

Experience with an object's photograph changes 9-month-olds' preference for the referent object, confirming they can represent objects from pictures. However, picture-based representations appear weaker than object-based representations. The current study's first objective was to investigate age differences in object recognition memory after familiarization with objects' pictures. The second objective was to test whether age differences in object permanence sensitivity with picture-based representations match those found with object-based representations, whereby 7-month-olds search more for familiar hidden objects but 11-month-olds search more for novel ones. Six- and 11-month-olds were familiarized with an object's photo and tested on their representation of the real object by comparing their reaching for it versus a novel object. Objects were visible under conditions testing recognition memory and hidden under conditions testing object permanence. Like 9-month-olds, 6- and 11-month-olds preferred novelty with visible objects, showing early object recognition after picture familiarization, as well as developmental continuity. Unlike 9-month-olds, who switched to preferring familiarity with hidden objects, 6- and 11-month-olds switched to null preference. This pattern fails to match 7- and 11-month-olds' hidden-object preferences after familiarization with real objects, revealing discontinuity in sensitivity to object permanence after picture familiarization, and suggesting that picture-based representations are weaker than object-based ones.

Touchscreens can promote infant object-interlocutor reference switching

We re-examine whether the type of object played with influences parent-infant joint attention. A within-participants comparison of 24 parent-9-month-old dyads, used head-mounted eye-tracking to measure parental naming and infant attention during play with touchscreen apps on a touchscreen tablet or matched interactive toys. Infants engaged in sustained attention more to the toy than the tablet. Parents named objects less in toy play. Infants exhibited more gaze shifts between the object and their parent during tablet play. Contrasting previous studies, these findings suggest that joint tablet play can be more interactive than with toys, and raise questions about the recommendation that infants should not be exposed at all to such technology.

Sleep-dependent memory consolidation of televised content in infants

Infants face the constant challenge of selecting information for encoding and storage from a continuous incoming stream of data. Sleep might help in this process by selectively consolidating new memory traces that are likely to be of future relevance. Using a deferred imitation paradigm and an experimental design, we asked whether 15- and 24-month-old infants (N = 105) who slept soon after encoding a televised demonstration of target actions would show higher imitation scores (retention) after a 24-h delay than same-aged infants who stayed awake for ≥4 h after encoding. In light of infants' well-known difficulties in learning and remembering information from screens, we tested if increasing the relevance of the televised content via standardised caregiver verbalisations might yield the highest imitation scores in the sleep condition. Regardless of sleep condition, 24-month-olds exhibited retention of target actions while 15-month-olds consistently failed to do so. For 24-month-olds, temporal recall was facilitated by sleep, but not by parental verbalisations. Correlational analyses revealed that more time asleep within 4 h after encoding was associated with better retention of the target actions and their temporal order in 24-months-olds. These results suggest that sleep facilitates memory consolidation of screen-based content in late infancy and that this effect might not hinge on caregivers' verbal engagement during viewing.

Predictors of screen exposure among infants under 2 years of age during the COVID-19 pandemic

Contradicting pediatric societies' recommendations, studies show that screen exposure begins at the first year of life for many children worldwide, with parental needs, educational purposes, and parental stress emerging as associated factors. However, the COVID-19 pandemic has likely worsened this scenario. This study aims to: 1) estimate the average daily screen exposure time for Brazilian infants aged 0-23 months during the COVID-19 pandemic based on caregiver report; 2) analyze the correlation between average exposure time, parental motivations for exposure, parental burnout levels and infant age; and 3) test the predictive role of parental motivations, burnout, and infant age on infant screen exposure. For this purpose, 139 parents (living in Brazil) answered online to questionnaires on infant screen exposure, parental motivations for exposure (four subscales: Parental Needs; Educational; Child's Desires/Family Routine; Behavioral Control), and parental burnout (Total score; four subscales: Emotional Exhaustion; Contrast; Feelings of Being Fed Up; Emotional Distancing). On average, infants were exposed to screens for 131 min/day. Higher scores on the four parental motivation subscales and higher parental burnout (specifically the Contrast subscale) correlated with longer exposure times. Furthermore, the motivation subscales Parental Needs and Child's Desires/family routine, the burnout subscale Contrast and infant age predicted greater screen exposure, while the burnout scale Feelings of Being Fed Up predicted less exposure. Our results suggest that infants in Brazil were exposed to substantial amounts of screen time during the pandemic. Interventions aiming to reduce screen time must consider parental motivations and parental burnout/mental health along with infant age.

Knowledge is power: Relationship between professional recommendations, maternal attitudes, and screen time exposure of infants

PURPOSE

The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend infants avoid screen media exposure, yet most infants are regularly exposed. This study aimed to explore screen exposure, maternal attitudes regarding screen media effects, and pediatricians' recommendations to better understand widespread screen media use with infants younger than 18 months of age in hopes of informing mitigation efforts.

DESIGN AND METHODS

Surveys consisting of 10 Likert-style questions were distributed real-time to a purposive sample of 193 mothers with infants 18 months of age or younger in Georgia, Pennsylvania, and New York.

RESULTS

Seventy-nine percent of infants exceeded AAP/WHO guidelines and 61% of respondents couldn't recall receiving pediatrician recommendations regarding screen exposure for their infant. Mothers with higher levels of education were associated with an accurate reflection of the adverse effects of screen usage on infant development (ANOVA; F = 10.122; df = 3; p < .001). Accurate maternal attitudes regarding adverse effects on infants was associated with less daily screen exposure (Spearman correlation; r = -0.428; p < .001).

CONCLUSIONS

Findings suggest that knowledge about adverse side effects of screen media usage with infants is associated with less daily exposure; and, that pediatricians may not routinely review guidelines for infants with their families, underscoring the importance of other methods of knowledge dissemination.

PRACTICE IMPLICATIONS

Nurses, as trusted healthcare providers, can provide counseling on infant screen media usage creating an opportunity for augmented knowledge dissemination across maternal demographics potentially leading to less screen exposure in this vulnerable population.

Screen media exposure and young children's vocabulary learning and development: A meta-analysis

This meta-analysis synthesizes research on media use in early childhood (0-6 years), word-learning, and vocabulary size. Multi-level analyses included 266 effect sizes from 63 studies (Ntotal  = 11,413) published between 1988-2022. Among samples with information about race/ethnicity (51%) and sex/gender (73%), most were majority White/Non-Hispanic and between 40%-60% female. Analyses revealed a small overall positive relation between screen media exposure and vocabulary (r = .23). Experimental studies yielded a small-to-medium effect (r = .30), with stronger effects for e-books than TV/video or games/apps, and non-significant effects for video chat. In correlational studies, there was no overall association between vocabulary size and naturalistic media exposure (r = .07), with the exception of naturalistic exposure to educational media (r = .17).

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.

Searching in the sand: Protracted video deficit in U.S. preschoolers' spatial recall using a continuous search space

Young children exhibit a video deficit for spatial recall, learning less from on-screen than in-person demonstrations. Some theoretical accounts emphasize memory constraints (e.g., insufficient retrieval cues, competition between memory representations). Such accounts imply memory representations are graded, yet video deficit studies measuring spatial recall operationalize memory retrieval as dichotomous (success or failure). The current study tested a graded-representation account using a spatial recall task with a continuous search space (i.e., sandbox) rather than discrete locations. With this more sensitive task, a protracted video deficit for spatial recall was found in children 4-5 years old (n = 51). This may be due to weaker memory representations in the screen condition, evidenced by higher variability and greater perseverative bias. In general, perseverative bias decreased with repeated trials. The discussion considers how the results support a graded-representation account, potentially explaining why children might exhibit a video deficit in some tasks but not others. RESEARCH HIGHLIGHTS: The task used a continuous search space (sandbox), making it more difficult and sensitive than spatial recall tasks used in prior video deficit research. Spatial recall among 4- and 5-year-old children was more variable after watching hiding events on screen via live video feed than through a window. Children's spatial recall from screens was more susceptible to proactive interference, evidenced by more perseverative bias in an A-not-B design. The results demonstrate memory representations blend experiences that accumulate over time and explain why the video deficit may be protracted for more difficult tasks.

Should I follow your virtual gaze? Infants' gaze following over video call

From 10 months of age, human infants start to understand the function of the eyes in the looking behavior of others to the point where they preferentially orient toward an object if the social partner has open eyes rather than closed eyes. Thus far, gaze following has been investigated in controlled laboratory paradigms. The current study investigated this early ability using a remote live testing procedure, testing infants in their everyday environment while manipulating whether the experimenter could or could not see some target objects. A total of 32 11- and 12-month-old infants' looking behavior was assessed, varying the experimenter's eye status condition (open eyes vs closed eyes) in a between-participant design. Results showed that infants followed the gaze of a virtual social partner and that they preferentially followed open eyes rather than closed eyes. These data generalize past laboratory findings to a noisier home environment and demonstrate gaze processing capacities of infants to a virtual partner interacting with the participants in a live setup.

Excessive audio-visual stimulation leads to impaired social behaviour with an effect on amygdala: Early life excessive exposure to digital devices in male rats

Today, the effect of extreme early-life exposure to digital devices is suggested as a risk factor for neurodevelopmental disorders. However, the multitude of factors that influence brain development with subsequent behavioural abnormalities have not been fully elucidated. Herein, we simulated extreme early-life exposure to digital devices in rats by audio and visual stimulation and investigated its effects on autism-related behaviours and brain structural alteration. Male rat pups were exposed to excessive audio-visual stimulation (EAVS) from PND (post-natal day) 12 to PND 35, with and without maternal separation (MS). Autism-related behaviours including abnormal sociability, stereotype behaviours, anxiety and locomotor dysfunction were tested at PND 42. Brain structural alternation was examined by considering the amygdala, mPFC (medial prefrontal cortex) and hippocampal regions while performing 3D quantitative stereological analysis. We found that EAVS led to social behaviour deficit and higher locomotion in rats, which were associated with increases in the number of neurons and volume of the amygdala. We also showed that MS did not exaggerate the effect of extreme sensory stimulation on behaviour and the structure of the brain. This study proposed EAVS in rats as an animal model of early exposure to digital devices for investigating possible neurobiological alternations underlying autistic-like behaviours with an emphasis on the amygdala area.

The relationship between executive functions and naturalistic use of screen-based activities in children

Engagement in interactive game-playing and passive TV watching has become an integral part of young children's routines. While there is a consensus regarding the harmful effect of long passive TV viewing on child development, the influence of interactive game playing is much less clear. This study seeks to specifically explore the association between passive TV watching and interactive-game playing, to executive functions (EF) in typically developing children in their natural environment. A convenience sample of 194 Israeli children (aged 5-7 years) was recruited for our cross-sectional study. Parents provided information on the average daily time their children spent watching TV and playing interactive games. In addition, parents fulfilled the Behavior Rating Inventory of Executive Function (BRIEF) to assess everyday executive skills in natural settings. Our findings revealed significant correlations between TV viewing and poor EF in five out of eight subscales of BRIEF, in addition to the indexes and the global executive composite (p < 0.05). However, the time spent on playing interactive games was not correlated with any of the BRIEF's subscales except one. Moreover, longer time spent watching TV was found to be a significant predictor of low EF among children (F(1,189) = 8.37; p = .004, R² = 3.7%). The current study results show that passive viewing led to worse EF performance than active digital gaming. As a consequence, our study supports previous professional recommendations to limit passive TV viewing.

Effects of screen exposure on young children's cognitive development: A review

The past decade has witnessed a rapid increase in the use of screen media in families, and infants are exposed to screens at younger ages than ever before. The objective of this review is twofold: (1) to understand the correlates and demographic factors determining exposure to screens, including interactive screens, when available, and (2) to study the effects of watching screens and using touchscreens on cognitive development, during the first 3 years of life. We argue that the effects of screen viewing depend mostly on contextual aspects of the viewing rather than on the quantity of viewing. That context includes the behavior of adult caregivers during viewing, the watched content in relation to the child's age, the interactivity of the screen and whether the screen is in the background or not. Depending on the context, screen viewing can have positive, neutral or negative effects on infants' cognition.

Age differences in orienting to faces in dynamic scenes depend on face centering, not visual saliency

The current study investigated how infants (6-24 months), children (2-12 years), and adults differ in how visual cues-visual saliency and centering-guide their attention to faces in videos. We report a secondary analysis of Kadooka and Franchak (2020), in which observers' eye movements were recorded during viewing of television clips containing a variety of faces. For every face on every video frame, we calculated its visual saliency (based on both static and dynamic image features) and calculated how close the face was to the center of the image. Results revealed that participants of every age looked more often at each face when it was more salient compared to less salient. In contrast, centering did not increase the likelihood that infants looked at a given face, but in later childhood and adulthood, centering became a stronger cue for face looking. A control analysis determined that the age-related change in centering was specific to face looking; participants of all ages were more likely to look at the center of the image, and this center bias did not change with age. The implications for using videos in educational and diagnostic contexts are discussed.

From Moral Panic to Systemic Change: Making Child-Centered Design the Default

Academic scholarship and public discourse about children's digital media use often invokes concepts such as 'screen time' that place the locus of responsibility on individual users and families rather than on designers creating digital environments. In this vision article, we argue that research, design, and policy frameworks that assume individual responsibility contribute to intensive parenting messaging about children's media use, are less likely than systemic approaches to achieve population-level change, and produce inequities in children's access to positive, child-centered media. Platforms (e.g., app marketplaces, video streaming services) act as entry points for children's use of digital spaces, and thus are strong determinants of children's experiences. As such, platforms are an ideal point of intervention for systemic change and have the potential to create equitable and child-centered digital environments at an ecosystem level. We contend that policies that encourage platforms to establish child-centered design as the default user interface will both create better experiences for children and relieve pressure on parents as gatekeepers. Finally, we review the types of research questions that could examine how to measure and optimize platforms for their impact on child wellbeing and outline steps researchers can take to provide evidence-based guidance to industry about designing ecosystems for children's best interests.

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.

Can infants use video to update mental representations of absent objects?

Before their second birthday, infants can update their knowledge based on what someone tells them, but can they do so based on what a video shows them? The current study explored whether infants can update their representation of an absent object's properties after seeing a video of something happening to it, following seminal work showing that they can update their representation after being told about something happening to it (Ganea et al., 2007). It thus adapted an existing paradigm for testing infants' understanding of references to absent objects (using language) to investigate a different symbolic medium (video). Twenty-two-month-olds first played with a toy and later saw on video that the toy underwent a change in state while they were out of the room. Infants in the current study did not subsequently identify the toy based on this new information, whereas those in previous research did. Infants this age thus appear less likely to update their representation of an absent object's properties using video than using language. This result is consistent with the possibility that infants may understand the representational function of symbolic objects later in development than they understand the representational function of language. It also aligns with evidence of the video deficit in which infants learn less effectively from video than from firsthand experience.

Infant media use: A harm reduction approach

There are a myriad of potentially harmful developmental outcomes associated with infant digital media use. Studies revealing risk associated with early media use have informed the current American Academy of Pediatrics (AAP) recommendations that discourage most digital media use among children under 18 months of age. Recent research advances, however, suggest potential benefits of technology engagement in this age group. Additionally, surveys of parents reveal that most infants engage with digital media for at least 30 min a day, exceeding the AAP recommendations. In response to these discoveries and cultural trends, some scholars have made compelling cases to adapt the AAP guidelines for infants. A helpful model for developing infant digital media use guidelines for families may be the harm reduction approach. The intent of this review is to suggest adaptations to the AAP guidelines for infant media engagement using a harm reduction framework. This review describes the challenge of restrictive guidelines, briefly summarizes the harm reduction approach, provides a review of risks and benefits associated with infant media use in each developmental domain (physical, cognitive, and socioemotional), summarizes correlates of infant screen media use, and examines intervention strategies for reducing screen time. The paper concludes with examples of possible adaptations to current AAP infant media use recommendations using harm reduction and bioecological frameworks.

The origins of touchscreen competence: Examining infants' exploration of touchscreens

Infants' exposure to images presented on screens is increasing with the accelerating use of technology in society and at home. Touchscreen technology provides numerous interactive screen opportunities geared toward infants and toddlers. Touchscreens are unique in that they possess the 2D qualities of a picture, but a set of manipulation possibilities similar to, but distinct from, a 3D object. Research comparing infants' manual exploration of photographs, objects, and screen images has demonstrated that although 7-10-month-old infants direct different actions towards 3D objects, their exploration of screen images does not differ significantly from their exploration of 2D photographs (Ziemer & Snyder, 2016). The current investigation compares the ways in which 7-10-month-old infants and 15-18-month-old infants manually explore screen images, photographs, and objects. Infants in the older age group were shown examples of objects, photographs, and screen images presented within a well in a table with a Plexiglas® cover to create identical tactile feedback. Coders noted the presence or absence of appropriate actions displayed toward the various surfaces. Results were compared to data collected earlier (Ziemer & Snyder, 2016) to demonstrate the evolution of touchscreen competence across the first years of infant development. By 15-18 months, infants demonstrate an emerging repertoire of touchscreen-appropriate behaviors directed towards touchscreens that is not demonstrated by 7-10-month-old infants. Differences in haptic exploration suggest the beginnings of a touchscreen competence that enables infants to understand and interact with touchscreens in a new way.

Technology integration for young children during COVID-19: Towards future online teaching

To support young children's learning during the coronavirus 2019 (COVID-19) pandemic, preschool educators in Hong Kong were required to teach with digital technologies. In this study, 1035 educators from 169 preschools reported their views and practices in an online survey, which we examined via multilevel mixed-response analysis and thematic analysis. More than half of the respondents (53%) expected future online teaching to continue, and only 11% of educators believed that parents would reject this form of delivery. Administrators and teaching assistants were more likely than teachers to expect online preschool teaching to continue in the future. In addition, respondents with existing online platform experience, who taught the upper levels of preschool, or incorporated specific teaching practices (eg, after the online lesson, they assessed children and assigned homework tasks), were more likely than others to expect online teaching in the future. Many of these respondents also reported (a) difficulty with engaging their children when online and (b) inadequate support from parents for learning activities, which reduced the respondents' perceived likelihood of future online teaching. Administrators and teaching assistants were more likely than teachers to believe that parents would accept online teaching in the future. Respondents who felt they had inadequate training to teach online, children in families with inadequate technical skills and parents who believed that online lessons harmed children's well-being, were less likely than others to believe that parents would accept online teaching in the future. These educators believed that online learning communities could connect parents and schools and foster interaction that could help align with educator's support for children's learning needs.

Social learning from media: The need for a culturally diachronic developmental psychology

Since the proliferation of television sets into households began over half a century ago there has been widespread interest in the impact that viewing has on young children's development. Such interest has grown with the increasing availability of smart phones and tablets. In this review we examine the literature documenting human social learning and how this learning is impacted when the instructing agent appears on a screen instead of face-to-face. We then explore the shifting nature of screen-based media, with a focus on the increasingly socio-normative manner information is portrayed. We discuss how the changing nature of screen technology might be altering how children interpret what they see, and raise the possibility that this may render prevailing evidence as historical documentation, rather than setting out established developmental milestones that transcend the period in which they were documented. We contend that recognizing the significance of historically changing contexts in developmental psychology is timely when the COVID-19 climate is pushing data collection on-line for many labs, often using tasks that were developed primarily for face-to-face contexts.

Exposure to screens and children's language development in the EDEN mother-child cohort

Studies in children have reported associations of screen time and background TV on language skills as measured by their parents. However, few large, longitudinal studies have examined language skills assessed by trained psychologists, which is less prone to social desirability. We assessed screen time and exposure to TV during family meals at ages 2, 3 and 5–6 years in 1562 children from the French EDEN cohort. Language skills were evaluated by parents at 2 years (Communicative Development Inventory, CDI) and by trained psychologists at 3 (NEPSY and ELOLA batteries) and 5–6 years (verbal IQ). Cross-sectional and longitudinal associations were assessed by linear regression adjusted for important confounders. Overall, daily screen time was not associated with language scores, except in cross-sectional at age 2 years, where higher CDI scores were observed for intermediate screen time. Exposure to TV during family meals was consistently associated with lower language scores: TV always on (vs never) at age 2 years was associated with lower verbal IQ (− 3.2 [95% IC: − 6.0, − 0.3] points), independent of daily screen time and baseline language score. In conclusion, public health policies should better account for the context of screen watching, not only its amount.

Processes and pathways in development via digital media: Examples from word learning

Word learning unfolds over multiple, cascading pathways which support in-the-moment processing and learning. The process is refined with each exposure to a word, and exposures to new words occur across a variety of forms and contexts. However, as children are exposed to more and more digital media, the ways in which children encounter, learn, and build on their vocabulary is also shifting. These shifts represent changes in context, content, and at the level of the child that can lead to negative outcomes. Less work, however, has discussed what these differences mean for how things change in the underlying developmental cascade and learning processes. Here, we suggest that the increasing presence of digital media may shift the developmental pathways for learning (the chain of events that support future learning) but not necessarily the developmental processes (the mechanisms underlying learning). Moreover, the interaction of the two may lead to different behavior and outcomes for learning in a digital era. We argue it is imperative for researchers to not only study how digital media differs from everyday learning, but directly measure if the well-worn pathways, processes, and variables found with decades of research with real items translate to a digital media era.

Media exposure and language experience: Examining associations from home observations in Mexican immigrant families in the US

The current exploratory study describes exposure to digital media in young children from Mexican immigrant homes and its association with language input and output. Using multiple recordings of children's home environments, we report on the rate (i.e., percentage of total recording time), language (Spanish or English), and type (adult- or child-directed programming) of auditory media exposure in toddlers under three years of age (N = 30; M_age = 20;3 months). We also examine total adult words and adult-child conversational turns, as indicators of child language input, and the number of child language vocalizations as a measure of early language development. Findings showed that digital media comprised approximately 14 % of the child language environment that families selected to record, with wide variability observed. Children were more likely to be exposed to media in Spanish than English and adult-directed than child-directed programming. Children's general media exposure was negatively associated with the amount of children's vocalizations and conversational turns but not the quantity of adult words in the environment, suggesting that the relation between media exposure and child language development is likely not mediated by a general decrease in adult input in Mexican immigrant homes. Instead, media exposure may decrease opportunities for children to engage in conversation and practice language expression, both critical mechanisms for successful language acquisition. Selection of child-directed programming may encourage child vocalizations but is less likely to be in Spanish in these homes, which may reduce opportunities for engagement with Spanish-dominant adults. Together these findings provide a window into the nature of media exposure in children from Mexican immigrant homes and into the associations between media and language input and output. Directions for future research are discussed.

Parents and Mobile Devices, from Theory to Practice: Comparison between Perception and Attitudes to 0-5 Year Old Children's Use

Pediatrics associations recommend avoiding the use of mobile devices (MDs) in children aged 0–2 years and limiting them to one hour per day for children aged 3–5 years. This study aimed to explore public risk perception on MDs use by children aged 0–5 years and attitudes of parents to children’s use. Participants were recruited on a voluntary basis by social media using a self-administered survey. The study included 3115 participants, most of whom were parents of children aged under 5 years (n = 1901; 61%). Most of the respondents (74%) considered that MDs use could be harmful for children’s health. The awareness on a correct use did not always translate into avoiding MDs use as recommended, especially in parents of children aged 0–2 years. Half of the sample (54%) received or sought information on risks related to MDs use. The most consulted information sources were the web (78%), and pediatricians in only 22% of cases. Understanding the determinants of parents’ risk perception and behavior is necessary to design effective family-based interventions in order to guide parents to a moderate and more careful use of MDs by their children. To do so, public health actions must aim to strengthen awareness about conscious use of MDs.

Targeted adaptation in infants following live exposure to an accented talker

Infants struggle to understand familiar words spoken in unfamiliar accents. Here, we examine whether accent exposure facilitates accent-specific adaptation. Two types of pre-exposure were examined: video-based (i.e., listening to pre-recorded stories; Experiment 1) and live interaction (reading books with an experimenter; Experiments 2 and 3). After video-based exposure, Canadian English-learning 15- to 18-month-olds failed to recognize familiar words spoken in an unfamiliar accent. However, after face-to-face interaction with a Mandarin-accented talker, infants showed enhanced recognition for words produced in Mandarin English compared to Australian English. Infants with live exposure to an Australian talker were not similarly facilitated, perhaps due to the lower vocabulary scores of the infants assigned to the Australian exposure condition. Thus, live exposure can facilitate accent adaptation, but this ability is fragile in young infants and is likely influenced by vocabulary size and the specific mapping between the speaker and the listener's phonological system.

How educational are 'educational' apps for young children? App store content analysis using the Four Pillars of Learning framework

Experts have expressed concerns about the lack of evidence demonstrating that children's "educational" applications (apps) have educational value. This study aimed to operationalize Hirsh-Pasek, Zosh, et al.'s (2015) Four Pillars of Learning into a reliable coding scheme (Pillar 1: Active Learning, Pillar 2: Engagement in the Learning Process, Pillar 3: Meaningful Learning, Pillar 4: Social Interaction), describe the educational quality of commercially-available apps, and examine differences in educational quality between free and paid apps. We analyzed 100 children's educational apps with the highest downloads from Google Play and Apple app stores, as well as 24 apps most frequently played by preschool-age children in a longitudinal cohort study. We developed a coding scheme in which each app earned a value of 0-3 for each Pillar, defining lower-quality apps as those scoring ≤ 4, summed across the Four Pillars. Overall scores were low across all Pillars. Free apps had significantly lower Pillar 2 (Engagement in Learning Process) scores (t-test, p < .0001) and overall scores (t-test, p < .0047) when compared to paid apps, due to the presence of distracting enhancements. These results highlight the need for improved design of educational apps guided by developmental science.

2-Year-Olds Learning From 2D Media With and Without Parental Support: Comparing Two Forms of Joint Media Engagement With Passive Viewing and Learning From 3D

The study investigates to what degree two different joint media engagement (JME) strategies affect children’s learning from two-dimensional (2D)-media. More specifically, we expected an instructed JME strategy to be more effective than a spontaneous, non-instructed, JME strategy. Thirty-five 2-year old children saw a short video on a tablet demonstrating memory tasks together with a parent. The parents were randomized into two groups: One group (N = 17) was instructed to help their child by describing the actions they saw on the video while the other group (N = 18) received no specific instruction besides “do as you usually do.” The parents in the instructed group used significantly more words and verbs when supporting their child but both groups of children did equally well on the memory test. In a second step, we compared the performance of the two JME groups with an opportunistic comparison group (N = 95) tested with half of the memory tasks live and half of the tasks on 2D without any JME support. Results showed that the JME intervention groups received significantly higher recall scores than the no JME 2D comparison group. In contrast, the three-dimensional (3D) comparison group outperformed both JME groups. In sum, our findings suggest that JME as implemented here is more effective in promoting learning than a no JME 2D demonstration but less so than the standard 3D presentation of the tasks.

Digital Devices Use and Language Skills in Children between 8 and 36 Month

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 and 36 month, also considering the influence of several factors. Materials and Methods: We conducted a cross-sectional observational study on digital devices use and language abilities in260 children (140 males = 54%) aged between 8 and 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-Bates). Linear regression analysis was used to evaluate the relation between different variables. Subsequent moderation analysis were performed to verify the influence of other factors. Results: We found a statistically significant negative relation between the total daily time of exposure to digital devices and the Actions and Gestures Quotient (ß = -0.397) in children between 8 and 17 months, and between the total daily time of exposure to digital devices and Lexical Quotient (ß = -0.224) in children between 18 and 36 months. Gender, level of education/job of parents, modality of use/content of digital device did not significantly affect the result of the regression analysis. 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 and 36 months, regardless of age, gender, socio-economic status, content, and modality of use. Further studies are needed to confirm and better understand this relation, 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.

Mirror, Peephole and Video - The Role of Contiguity in Children's Perception of Reference in Iconic Signs

The present study looked at the extent to which 2-year-old children benefited from information conveyed by viewing a hiding event through an opening in a cardboard screen, seeing it as live video, as pre-recorded video, or by way of a mirror. Being encouraged to find the hidden object by selecting one out of two cups, the children successfully picked the baited cup significantly more often when they had viewed the hiding through the opening, or in live video, than when they viewed it in pre-recorded video, or by way of a mirror. All conditions rely on the perception of similarity. The study suggests, however, that contiguity – i.e., the perception of temporal and physical closeness between events – rather than similarity is the principal factor accounting for the results.

Comparison of Imitation From Screens Between Typically Developing Preschoolers and Preschoolers With Autism Spectrum Disorder

Typically developing (TD) children exhibit a transfer deficit imitating significantly less from screen demonstrations compared to a live demonstrations. Although many interventions for children with autism spectrum disorder (ASD) include video materials, little research exists comparing the effectiveness of video demonstration over live instruction. The current study compared imitation learning from live and screen-based demonstrations of how to make a puzzle by 3- to 4.5-year-old TD children (n = 68) and children with ASD (n = 17). Children were tested on either on a three-dimensional (3D) magnet board (MB) with magnetic puzzle pieces or a 2D touch screen (TS) with virtual puzzle pieces. Neither TD nor ASD children exhibited a transfer deficit suggesting that for this task, the transfer deficit ends around 3 years of age. Children with ASD were less efficient overall than TD children on the task and performed worse than their TD counterparts when they were tested with the 3D MB puzzle. These findings suggest that children with ASD have greater difficulty acting on 3D objects than 2D TSs. Future studies should investigate if TSs can be used to teach children with ASD other tasks (184 words).

Effects of parent-child interaction training on children who are excessively exposed to digital devices: A pilot study

Objective

In the last decade, the use of digital devices among children has increased. This study examines the effects of parent–child interaction training on the amount of time children use digital devices, conflict and closeness in parent–child relationships, executive functions, and the electroencephalogram absolute power in children who excessively use the digital devices.

Method

The sample group consisted of 12 children (24 to 47 months) who spent more than half of their waking hours using digital devices. Parents were trained to intensive interaction with the child for two months. Electroencephalogram absolute power, parent–child interaction, the amount of time children use digital devices, and children’s executive function skills were assessed.

Results

Parent–child intensive interaction reduces the use of digital devices; decrease the conflicts and increase the closeness in parent–child relationships; decrease executive functioning problems; and increase the absolute power of alpha and alpha 2 (F3), beta 1 (F3), and beta and beta 2 (F3, Fp2).

Conclusion

These findings provide evidence of the negative effects of the excessive use of digital devices in children, the importance of parent–child interaction, and its positive impacts on cognitive and brain functions in children. It might contribute to better understand the importance of parent–child interaction in the early years.

Pediatric Speech-Language Pathologists' Use of Mobile Health Technology: Qualitative Questionnaire Study

BACKGROUND

While technology use in pediatric therapies is increasing, there is so far no research available focusing on how pediatric speech-language pathologists (SLPs) in the United States use technology.

OBJECTIVE

This paper sought to determine if, and to what extent, pediatric SLPs are using mobile apps, to determine what purpose they are using them for, and to identify gaps in available technology to provide guidance for future technological development.

METHODS

Pediatric SLPs completed an online survey containing five sections: demographics, overall use, use in assessment, use in intervention, barriers, and future directions.

RESULTS

Mobile app use by 485 pediatric SLPs in the clinical setting was analyzed. Most (364/438; 83.1%) pediatric SLPs reported using technology ≤50% of the time in their clinical work, with no differences evident by age group (<35 years and ≥35 years; P=.97). Pediatric SLPs are currently using apps for intervention (399/1105; 36.1%), clinical information (241/1105; 21.8%), parent education (151/1105; 13.7%), assessment (132/1105; 12%), client education (108/1105; 9.8%), and other uses (55/1105; 5.0%). Cost (46/135; 34.1%) and lack of an evidence base (36/135; 26.7%) were the most frequently reported barriers. Most SLPs (268/380; 70.7%) desired more technology use, with no difference evident by age group (P=.81).

CONCLUSIONS

A majority of pediatric SLPs are using mobile apps less than 50% of the time in a pediatric setting and they use them more during intervention compared to assessment. While pediatric SLPs are hesitant to add to their client's screen time, they would like more apps to be developed that are supported by research and are less expensive. Implications for future research and app development are also discussed.

Growing up in the digital age: Early learning and family media ecology

Media is so pervasive that it should no longer be considered a nuisance variable that could affect development but rather, a fundamental part of the context in which development occurs. Despite the rapid growth in access to digital media, there is a scarcity of research examining changes in the family media ecology and the subsequent effects of early media exposure on socio-cognitive development. Early research erroneously focused on the absolute amount of exposure by the child. Current research now considers the entire household, including both intentional exposure to child-directed content and unintended exposure to background media sources. Such research demonstrates that young children can and do learn from well-designed media particularly when they engage with others during digital play.

Screen Media and Autism Spectrum Disorder: A Systematic Literature Review

OBJECTIVE

Previous studies suggest that psychiatric disorders are associated with problematic use of screen media. This article systematically reviews the literature on the associations between screen media and autism spectrum disorder (ASD). The review uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

METHOD

Electronic databases were searched from inception to April 2018, using the term "ASD/autism" along with one of the following terms: "screen time"/"media"/"computer"/"phone"/"television"/"video game."

RESULTS

A total of 16 studies met the inclusion criteria. The studies support the view that children and adolescents with ASD are exposed to more screen time than their typically developing peers or other clinical groups and that the exposure starts at a younger age. The content and context of screen use (e.g., with parents vs alone) may affect the behaviors associated with media exposure. Correlates and long-term consequences of early screen exposure (before the age of 3 years) remain largely unexamined.

CONCLUSION

The current review provides important information about how ASD is associated with screen use and exposure. Future longitudinal research should examine the impact of early screen exposure on child development while accounting for potential moderating environmental factors (e.g., socioeconomic status, parent-child relationship). This will help determine whether-and if so, how much-exposure is detrimental and allow appropriate recommendations and interventions related to screen time among children with ASD.

Differences in Parent-Toddler Interactions With Electronic Versus Print Books

OBJECTIVES

Previous research has documented less dialogic interaction between parents and preschoolers during electronic-book reading versus print. Parent-toddler interactions around commercially available tablet-based books have not been described. We examined parent-toddler verbal and nonverbal interactions when reading electronic versus print books.

METHODS

We conducted a videotaped, laboratory-based, counterbalanced study of 37 parent-toddler dyads reading on 3 book formats (enhanced electronic [sound effects and/or animation], basic electronic, and print). We coded verbalizations in 10-second intervals for parents (dialogic, nondialogic, text reading, format related, negative format-related directives, and off task) and children (book related, negative, and off task). Shared positive affect and collaborative book reading were coded on a scale of 1 to 5 (5 = high). Proc Genmod and Proc Mixed analyzed within-subjects variance by book format.

RESULTS

Parents showed significantly more dialogic (print 11.9; enhanced 6.2 [P < .001]; basic 8.3 [P < .001]), text-reading (print 14.3; enhanced 10.6 [P = .003]; basic 14.4 [P < .001]), off-task (print 2.3; enhanced 1.3 [P = .007]), and total (29.5; enhanced 28.1 [P = .003]; basic 29.3 [P = .005]) verbalizations with print books and fewer format-related verbalizations (print 1.9; enhanced 10.0 [P < .001]; basic 8.3 [P < .001]). Toddlers showed more book-related verbalizations (print 15.0; enhanced 11.5 [P < .001]; basic 12.5 [P = .005]), total verbalizations (print 18.8; enhanced 13.8 [P < .001]; basic 15.3 [P < .001]), and higher collaboration scores (print 3.1; enhanced 2.7 [P = .004]; basic 2.8 [P = .02]) with print-book reading.

CONCLUSIONS

Parents and toddlers verbalized less with electronic books, and collaboration was lower. Future studies should examine specific aspects of tablet-book design that support parent-child interaction. Pediatricians may wish to continue promoting shared reading of print books, particularly for toddlers and younger children.

Exposure to and use of mobile devices in children aged 1-60 months

The present study was conducted to determine young children's (aged 1-60 months) exposure to and use of mobile devices. The study included 422 parents of children aged 1-60 months admitted to pediatric outpatient clinics. A questionnaire was administered to the parents via face-to-face interview. Children's overall exposure to mobile devices was 75.6% (n = 319). Of the children, 24.4% (n = 103) had never used a mobile device. Among the children that had used a mobile device, 20.6% (n = 66) were aged between 1 and 12 months; 24.5% (n = 78) were aged between 13 and 24 months. The median age at the first time use of a mobile device was 12 months. The youngest child that used a mobile device was 6 months old. Tablets had a significant difference in the age at first use compared with other mobile media types (P < 0.01). Children's overall mobile device ownership was 30.7% (98/319) in frequency. There was a positive relationship between mobile device ownership and age (p < 0.001). The most commonly owned mobile device was a "tablet" at a frequency of 68.4% (67/98). The frequency of tablet ownership was inversely associated with household income (P < 0.01). Of the children that used mobile devices, 25.7% (82/319) used multiple mobile devices simultaneously. Among 422 children, 15.9% (n = 67) had a tablet in their room. The frequency of tablet use and ownership was inversely related to the mother's educational level (P < 0.01). The parents reported that 22.3% (n = 71) never received help while navigating the mobile device. The most frequent activity with mobile devices was watching videos (70.8%, n = 226). Of the parents, 59.6% (190/319) let their children use mobile devices while they are doing daily tasks or domestic chores. Of the parents, 91.5% (n = 386) reported not having been informed by a doctor about the effects of mobile devices on their children.Conclusion: This study demonstrates a high prevalence of exposure to mobile devices in young children. The frequency of tablet use and ownership of offspring was inversely related with maternal educational level and household income. What is Known: • Mobile phones and other similar mobile devices are now embedded in the daily lives of children. • There are limited data about mobile media use in early childhood, and few guidelines on which clinicians can base their recommendations. What is New: • The exposure to mobile devices is high in young children aged 1-60 months. • The frequency of tablet use and ownership of offspring was inversely related to household income and maternal educational level.

Mobile Media Device Use is Associated with Expressive Language Delay in 18-Month-Old Children

OBJECTIVE

The objective was to examine the association between mobile media device use and communication delays in 18-month-old children.

METHODS

A cross-sectional study was conducted from September 2011 and December 2015 within the TARGet Kids! primary care research network. Children were included if parents reported their child's mobile media device use and completed a validated questionnaire for communication delay at the 18-month well child visit. Mobile media device use was measured using a parent-reported survey instrument. Daily mobile media device use was calculated as a weighted average of typical weekday and weekend day mobile media device use. Two communication outcomes were investigated: (1) expressive speech delay and (2) other communication delays, as measured by the Infant Toddler Checklist.

RESULTS

The study sample included 893 children (mean age 18.7 months, 54.1% male). Most parents reported 0 minutes per day of mobile media device use in their children (n = 693, 77.6%). Among children whose parents reported any mobile media device use (n = 200, 22.4%), the median daily mobile media device use was 15.7 minutes (range 1.4-300). The prevalence of parent-reported expressive speech delay was 6.6%, and the prevalence of other parent-reported communication delays was 8.8%. For children who used a mobile media device, each additional 30-minute increase in daily mobile media device use was associated with increased odds of parent-reported expressive speech delay (ORa = 2.33, 95% confidence interval, 1.25-4.82). No relationship was observed between mobile media device use and other parent-reported communication delays.

CONCLUSION

Our study demonstrated a significant association between mobile media device use and parent-reported expressive speech delay in 18-month-old children.

How self-generated labelling shapes transfer of learning during early childhood: The role of individual differences

Multiple factors influence imitation during toddlerhood, including task complexity, social contingency, and individual differences. We conducted a secondary data analysis of individual differences in self-generated labelling using data collected from a complex puzzle imitation task with 355 2- to 3-year-olds. This analysis indicated that toddlers' ability to label the completed puzzle (fish or boat) was associated with better imitation performance. Labelling occurs during social interactions; therefore, our second analysis tested how labelling differed as a function of the level of social scaffolding in each condition. This analysis revealed that self-generated labelling was lower when the social demonstrator was removed and the task was presented on a touchscreen. This study is one of the first to examine self-generated labelling during a complex imitation task in toddlers and increases our understanding of the complexity of memory processing needed for imitation learning. Statement of contribution What is already known on this subject? Toddlers exhibit a transfer of learning deficit from 2D media, including books, TV, and tablets. Self-generated labelling enhances children's learning, through attentional and cognitive mechanisms. Children are sensitive to reduced social cues in screen media contributing to the transfer deficit. What does this study add? Self-generated labelling is associated with better goal imitation performance. Self-generated labelling occurs more frequently under social conditions.

Media devices in pre-school children: the recommendations of the Italian pediatric society

Background

Young children are too often exposed to mobile devices (MD) and most of them had their own device. The adverse effects of a early and prolonged exposure to digital technology on pre-school children has been described by several studies.

Aim of the study is to analyze the consequences of MD exposure in pre-school children.

Methods

We analyzed the documented effects of media exposure on children’s mental and physical health.

Results

According to recent studies, MD may interfere with learning, children development, well being, sleep, sight, listening, caregiver-child relationship.

Discussion

Pediatricians should be aware of both the beneficial and side effects of MD and give advice to the families, according to children’s age.

Conclusion

In according to literature, the Italian Pediatric Society suggest that the media device exposure in childhood should be modulated by supervisors.