Tag Archives: technology

Should babies watch TV?

This question seems to trouble many parents, and can cause a lot of guilt too.

“Will the TV numb my baby’s brain?”

“Are they destined for a sedentary life?”

“AM I CONDEMNING THEM TO LIFE AS A MINDLESS AUTOMATON?!”

This is why an interview last week with psychologist Annette Karmiloff-Smith on the BBC’s The Life Scientific caught my ear (thanks to a pointer from mum-in-law, Jenny). It’s a fascinating insight into how babies learn to learn, and how their brains develop to understand the world around them. You can listen here: The Life Scientific.

But on TV watching, Prof Karmiloff-Smith, an expert in developmental disorders, argues that if the subject matter of the programme is carefully chosen and scientifically based, then the TV can be better for a child’s learning than even a book.

This was largely in response to advice reissued by the American Academy of Pediatrics (AAP) that babies under two shouldn’t watch any TV or DVDs. There are three main concerns: poorer language skills, a negative effect on sleep, and less time spent taking part in other types of unstructured play that are critical for the proper development of mental capabilities.

This is based on a growing body of scientific research. TV/DVD watching is common: in the US at least, by two years old over 90% of children regularly watch TV, spending an average of 1-1.5 hrs a day in front of the box. Very young babies (under 1.5 years old) cannot, however, really understand TV programmes, and are instead mainly attracted by obvious changes like applause or visual surprises.

Children learn new words or actions better when an adult is teaching it to them live, rather than via a television screen, and the worry is that parents talk to their kids less when the TV is on. And a growing number of studies suggest that children who spend longer watching TV/DVDs have delayed language development, at least in the short-term, and may also develop a worse attention span.

A child’s play may also be hindered by the distraction of a TV that’s on in the background, so the AAP advise to turn it off altogether. Many parents also use TV/DVDs as a sleep aid, but there is evidence that bedtime viewing may lead to more disturbed and shorter sleep.

Karmiloff-Smith, on the other hand, argues that we live in a media saturated world and it’s unrealistic to expect parents to shut down all media use. This view has support from some of the evidence cited in AAP report itself. Despite the original recommendation in 1999 that parents should be discouraged from letting their babies watch TV/DVDs, over 90% of them in the US currently do so by the time their child is two years old. What’s more, the average age that TV is introduced is 9 months, so the advice is clearly not striking a loud enough chord.

From my experience, I can certainly appreciate this. The AAP report says that many parents use the TV so that they can have a shower or cook dinner. Absolutely! Even these seemingly mundane activities can feel like an exercise in military-like efficiency when you’re looking after a child. A 10-minute respite when they’re quiet and content gazing at a TV or prodding an iPad can be just too tempting.

It’s also interesting to consider that throughout history many new technologies have been treated with caution. Dr Vaughan Bell, a psychologist based at King’s College London, has highlighted how the printing press, popularisation of the radio, and now the Internet have been damned for ruining kids’ brains.

Karmiloff-Smith goes on to say that, rather than banning TV for babies, TV programmes just need to be made better and based on science developments. For instance, the visual system is attracted by movement, but most kids’ TV programmes have their focus on the centre of screen. Instead, objects and features that come in from the sides, move across screen and encourage the child to interact promotes the active participation that’s good for mental development. For very young babies, moving image media may even have advantages over books, which are static and whose main attraction is the rustling of the pages.

The caveat in this is that Karmiloff-Smith reveals herself to be a scientific consultant to a DVD company that is designing such programmes. This could cause suspicion of a financial conflict of interest. But her honesty and gusto make me suspect that she became a consultant so that she could promote these ideas, rather than the other way around.

She finished the interview by emphasising that parents still need to interact with their children and the TV shouldn’t be used as a babysitter. But we should think more carefully about which types of media can stimulate the visual and auditory systems, so as to help train the attention and memory systems early.

I’ve written before about the various kinds of programmes and the various contexts in which kids can watch TV, which may have different effects on child development. And some of the evidence cited in the AAP report highlights these complexities. The effects on children’s attention, for instance, seem to depend on the programme content and style, with problems seen not when the content is deemed educational but only when it’s geared towards entertainment. And when a parent watches a programme with an infant and talks them through it, the child tends to become more attentive and responsive. The AAP report also points to evidence that watching Sesame Street can have a negative effect on expressive language in children under two. But the same study showed that watching other programmes, such as the North American-based shows Dora the Explorer, Blue’s Clues, Arthur, Clifford, or Dragon Tales, was associated with greater vocabularies and higher expressive language scores. So it appears that not all ‘screen time’ is equal.

The AAP report seems to fall into the trap of treating all TV and DVD viewing as the same:

For the purposes of this policy statement, the term “media” refers to television programs, prerecorded videos, Web-based programming, and DVDs viewed on either traditional or new screen technologies.

Another major limitation of the AAP report is that all of the cited studies are, by necessity, observational. These investigations are good at highlighting whether two factors are associated with each other, but they cannot tell you whether one causes the other. As the report itself asks, are children with poor language skills simply placed in front of the TV more? Are children with shorter attention spans more attracted to screens? Are parents who are less attentive on the whole, more prone to resort to screen time? If so, then turning the TV off would not necessarily lead to more parent-child interactions.

And some results are just contradictory. One study in the US showed that when the mother’s educational status and household income were taken out of the equation, the association between TV viewing and poor language development disappeared. This appears to have been glossed over by the AAP.

So how do I answer my original question?

The AAP are right to caution against a lot of TV for under twos (over four hours a day, say), as this is when the damaging effects are really apparent. But Karmiloff-Smith is also right to say it’s unrealistic to expect no TV at all, and that the right programme in the right environment is fine and potentially beneficial.

And I’ll leave you with this quote in Time from Dr Dimitri Christakis, a paediatrician at Seattle Children’s Hospital:

Ask yourself why you’re having your baby watch TV. If you absolutely need a break to take a shower or make dinner, then the risks are quite low. But if you are doing it because you think it’s actually good for your child’s brain, then you need to rethink that, because there is no evidence of benefit and certainly a risk of harm at high viewing levels.

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Telly addicts: alarm over kids’ TV viewing habits

There was a flutter of activity across Twitter and blogs the other day, in response to some reports that suggested kids’ increasing TV viewing was having a detrimental effect on mental health. According to the reports, TV viewing should be limited for children even into their teens and banned altogether for under-threes. The issues highlighted here will be familiar to detractors of Bad Science and Bad Reporting, but I wanted to record some thoughts for posterity.

I first saw the story in The Guardian and it was also picked up by BBC News, The Independent, The Telegraph, Daily Mail, Metro and many other outlets. Whilst it’s an interesting and worthwhile area of study, the paper published in the journal Archives Of Disease In Childhood and the subsequent press statements, had a few problems that undermine the stark headlines.

The paper was not an original research paper, but an opinion piece that looked back at some previous research. The chief agitator in this is Aric Sigman, a psychologist whose method of ‘cherry-picking’ evidence Ben Goldacre has had much to say about in the past. ‘Cherry-picking’ is essentially picking the bits of evidence that support a particular claim, whilst ignoring other evidence that doesn’t. As Goldacre points out, a better way to analyse previous research is to perform a ‘systematic review‘. These reviews say exactly how the literature was searched and compiled, which means it is more free from bias and allows others to reproduce it.

As for this specific case, Pete Etchells at SciLogs does a good job at highlighting the problems with the selective nature of the analysis and why it’s important to understand the cause of something before issuing guidance on fixes. I worry that many developmental outcomes – such as empathy, attention, educational performance – are lumped in under the banner of ‘mental health’, but that is probably for someone more qualified to comment on. Professor Dorothy Bishop‘s remarks in the Guardian article are salient too – if Sigman’s concerns are to do with kids just sitting for long periods, you shouldn’t advocate reading books for too long.

My first thought on reading the reports was that the conclusions seem to be based entirely on correlative studies, so it’s hard to determine cause-and-effect. What if children who watch more TV are also more likely to have inattentive parents? You may still see an association between more TV watching and developmental problems if these are both caused in some way by inattentive parenting, but enforcing a reduction in TV time wouldn’t do anything – getting parents to interact more at other times would have the most effect. (For the record, this is just an example of ‘correlation does not imply causation’ and I’m not suggesting this is supported by the evidence!)

On a more general but related point, there is a real problem with defining ‘screen time’, because you’re essentially describing a medium and not an activity. The Mind Hacks blog (written by KCL psychologist Vaughan Bell and Sheffield University psychology lecturer Tom Stafford) has written about this in relation to internet use. Bell has also written about how there have been worries throughout modern history over new technology. Even ‘education’ was once considered a risk to mental health.

As for TV, there are clearly different types of programmes kids can watch – some are aimed at learning and education, some are musical and participatory, some are interactive, and so on. And there are also different contexts in which to watch TV – alone, with parents talking things through, in the background whilst doing other things, etc. Understanding whether different types of TV interaction have different effects or whether other factors in the child’s environment tend to lead to a particular sort of behaviour, are critical in getting to the root of the issue.

The evidence just isn’t strong or reliable enough to make the sort of alarmist claims Sigman has made. And this is why it is again so disappointing to see the same blanket coverage across much of the press, with little in the way of a proper critique (Prof Bishop’s comments aside). It was once again left to bloggers and commentators on social media to provide a more discerning look at the issues.

I want to emphasise that I’m not dismissing these issues, and there may well be problems caused by excessive use – however that’s defined – of certain types of ‘screen time’ (as Etchells notes too). But it’s important to know what you’re measuring and understand the nuances. It is also crucial to have proper evidence before issuing supposed evidence-based guidance.

Spuriouser and spuriouser: the Greenfield effect

Baroness Susan Greenfield, Professor of Pharmacology at University of Oxford, has been in the news a bit recently. She’s being getting a lot of coverage due to her views on the (possible) effects of computer-based activities on children’s mental development. The most striking claims are that the use of social media tools, such as Facebook and Twitter, can lead to autism and/or shortened attention span, and more recently that playing computer games can cause dementia and alter risk-taking behaviours.

These claims have attracted a lot of criticism from bloggers and fellow scientists alike for, amongst other things, being totally unsupported by any peer reviewed research and contradictory to known biological effects. Baroness Greenfield has responded at various points by accusing her detractors of stifling open debate and likening them to those who denied a link between smoking and lung cancer. She also asserts that she’s ‘just asking questions’, which prompted an inventive stream of similarly spurious links on Twitter (#greenfieldism). The serious point behind the humour being that, without any evidence behind, it is just as valid to juxtapose internet use and autism as it is to link Rebecca Black and the Greek sovereign debt (courtesy of @alsothings).

A similar thing happened when Glenn Beck started ‘just asking questions‘, which lead to counter questions about Glenn Beck’s personal history. Although this was an overly extreme question with which to respond, it does highlight the danger of suggesting causal links without any empirical support whatsoever.

Putting unsupported claims in the spotlight to push personal viewpoints about computer games and social media, especially when they’re packaged as scientifically validated ideas, is a dangerous path to lay. The effect of technology use on brain development is clearly an important topic to consider, but any guidance must have some scientific proof behind it. Even a single study that has been through the peer review process and published in an academic journal is not enough to make the sort of bold claims Susan Greenfield has made . Only once hypotheses have been discussed, repeated, followed-up, tested on different groups by other scientists do theories start to become accepted (or rejected) by the scientific community. Baroness Greenfield hasn’t even got as far as the first step.

Tentative evidence can be found to suggest we need to seriously consider the effect of increased computer activity, such as whether violent computer games can alter brain activity and wiring. These types of studies, however, are fraught with potential confounding factors – do violent computer games change the brain activity of gamers or are gamers with particular types of brain activity more drawn to violent computer games? This is why a body of evidence is needed to eliminate these confounding factors and tease out the true causal link.

Parents have a hard enough time in drawing out the best advice, many of which appears to be based on personal opinion and gut-feeling, and so a scientist making raising serious doubts without going through the proper scientific process first can only add to anxiety and confusion. These effects are often long-lasting too. While Andrew Wakefield’s dodgy claims about the link between the MMR vaccine and autism has been thoroughly refuted by the scientific community, culminating in the original research paper being retracted and Dr Wakefield being struck off the General Medical Council register (see this for a brief history), doubts linger in parents’ minds and huge efforts are still being made to bring the vaccination rate up to the required level (e.g.).

Technology now available to children provides unparalleled access to information resources, creative tools and network sharing, and my inclination is that this is A Good Thing for broadening and challenging the mind (see Carmen Gets Around for a similar conclusion). Of course, I await the evidence to support this, but one thing is clear, computer technology has changed the way our kids behave forever. Just watch this YouTube clip…