News & Perspective

Risk of autism spectrum disorder–like symptoms linked with social and digital media exposure at an early age

Psychiatry
4 months ago, OP Editor

Children’s early exposure to screen media usage is on the rise. In the United States (US), 90% toddlers at 2 years of age spend an average screen time of more than 1.5 hours daily.1 Various studies have suggested a link between early screen media usage by toddlers of ≤2.5 years and the prevalence of many detrimental effects.2 Toddlers’ exposure to screen media increases the risk of developing autism spectrum disorder (ASD)-like symptoms later. Recently, a multicenter national children’s study found that toddlers with less television or video exposure and who play with parents daily for at least 12 months are less likely to experience ASD-like symptoms as measured on the Revised and Modified Checklist for Autism in Toddlers (M-CHAT-R) at 2 years.

ASD is a neurodevelopmental disorder with an increasing prevalence in the recent decade. Although the diagnosis of autism can occur at any age, emerging research has shown that ASD symptoms generally appear in the first two years of life. Adverse developmental outcomes in children and higher television or video usage are interconnected.4 Notably, a parallelism between the increase in ASD incidence which started in 1996, and the rise of infant television viewing from a mean age of 4 years in 1970 to 4 months in 2006, was observed.2

Interestingly, a new study conducted by Dr. David Bennett, Drexel University in Philadelphia, and his team found that early screen time can increase the risk of ASD-like symptoms. “This is the first prospective study to examine if screen viewing at such an early age of 12 months can lead to the development of autism symptoms at a later stage. The findings highlighted that environmental factors in the first year of life, specifically playing with one’s child regularly and avoiding screens, could decrease the risk of autism symptoms at age 2 years,” Bennett shared.

In the study, information from the National Children’s Study (NCS) on 2,152 children who had been enrolled at birth from October 1, 2010, to October 31, 2012, were examined to determine if television, video exposure and social experiences with a caregiver can affect scores on the Modified Checklist for Autism in Toddlers (M-CHAT) and the Revised M-CHAT (M-CHAT-R) for children at 2 years.3

The M-CHAT-R total score in multiple regression models predicted a significant association of exposure with ASD risk by ASD-like symptoms and M-CHAT. Primary caregivers responded to a 23-item M-CHAT survey containing questions regarding the total amount of screen viewing time and parental playtime spent on 1-year-old infants. A follow-up study was conducted on this cohort of toddlers when they turned 18 months of age. Researchers also examined maternal age at birth, child sex, prematurity, household income, race/ethnicity, and caregiver English-language status as another indicator of ASD-like symptoms.3

The findings showed a lack of association with ASD risk, but rather with ASD-like symptom. The results indicated television or video viewing for 12 months had a higher percentage of association to more significant ASD-like symptoms at 2 years (change: 4.2%; 95% CI: 0.1%-8.3%) as compared to no viewing. The follow up findings revealed that high screen viewing at 18 months of age was not significantly associated with ASD-like symptoms (change, 10.7%; 95% CI: -20%-0.23%) or ASD risk by M-CHAT (AOR, 1.18; 95% CI: 0.56-2.49) at 2 years of age.3

In parallel, daily play with parents was linked to less ASD-like symptoms at 2 years of age (change -8.9%; 95% CI: -16.5% to -0.9%) in comparison to reduced daily play. No ASD risk (risk prevalence rates 6.4% vs. 14.0%; adjusted OR=0.58; 95% CI: 0.31-1.08) was observed.3 Also, the M-CHAT analysis established that perinatal and demographic risk factors such as minority race/ethnicity, prematurity, and lower family income were related to greater ASD risk and ASD-like symptoms.3

Bennett summarized his findings by stating, “Whether screen viewing and lack of social engagement lead to autism symptoms or correlates to autism symptoms is not clear, but there are ways screens may raise autism symptom risk. During infancy, screen viewing has been found to cause increased specialization of brain pathways involved in the processing of audiovisual stimuli in a non-social manner, which can compete with and negatively affect social processing pathways.”

Fundamentally, the findings suggested that toddlers with less exposure to television and video who engage in daily playtime with their parents for 12 months are less likely to experience ASD-like symptoms. The study adds credence to limiting or no media usage for children in the first year of their life.

  1. Zimmerman J et al. Television and DVD/video viewing in children younger than 2 years. Arch Pediatr Adolesc Med. 2007;161(5):473–9.
  2. Christakis DA et al. Early Media Exposure and Autism Spectrum Disorder. JAMA Pediatr. 2020.
  3. Bennett S et al. Association of early-life social and digital media experiences with the development of autism spectrum disorder-like symptoms. JAMA Pediatr. 2020.
  4. Hermawati D et al. Early electronic screen exposure and autistic-like symptoms. Intractable Rare Dis Res. 2018;7(1):69-71.

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