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Ricci C, Ordnung M, Rothenbacher D, Genuneit J. Substituting Book Reading for Screen Time Benefits Preschoolers' Sleep Health: Results from the Ulm SPATZ Health Study. Nat Sci Sleep 2024; 16:315-324. [PMID: 38524767 PMCID: PMC10961022 DOI: 10.2147/nss.s448736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/19/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose Healthy sleep is essential for the physical, cognitive, and social development of children. Several studies have reported the increase in digital media use in preschool children and its association with impaired sleep. However, there is relatively little evidence on the effects of book reading as a potentially safe alternative. The objective of this study, therefore, was to investigate whether sleep in children could benefit from book reading, and whether the negative effects of media use on sleep can be mitigated by substituting book reading for screen time. Participants and Methods We used longitudinal data from three consecutive waves of the SPATZ Health study, including children at the ages of 4 (n=581), 5 (n=508), and 6 (n=426) years. All data were collected by self-administered questionnaires. Parent-reported child sleep was assessed by the Children's Sleep Habits Questionnaire. Results Across the three waves, screen-based media use increased and was associated with lower sleep quality. In contrast, the time spent with book reading decreased; however, book reading appeared to be beneficial for children's sleep. Substitution models revealed that the theoretical substitution of an equal amount of book reading for 50% of the time spent with screen-based media benefits several domains of preschoolers' sleep health, including parasomnias, sleep anxiety, daytime sleepiness, and sleep onset delay. Conclusion Besides implications for population-wide and individual prevention, book reading may also be incorporated as a useful intervention to improve sleep quality in children who are already affected by sleep problems. Given that book reading is perceived as a safe alternative, the presented evidence may suffice to support recommendations in this direction.
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Affiliation(s)
- Cristian Ricci
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
| | - Madeleine Ordnung
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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2
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Hudspeth KM, Lewis C. Touchscreens can promote infant object-interlocutor reference switching. Infant Behav Dev 2024; 74:101914. [PMID: 38065036 DOI: 10.1016/j.infbeh.2023.101914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 03/17/2024]
Abstract
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.
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3
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Ponti M. Screen time and preschool children: Promoting health and development in a digital world. Paediatr Child Health 2023; 28:184-202. [PMID: 37205134 PMCID: PMC10186096 DOI: 10.1093/pch/pxac125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/27/2022] [Indexed: 05/21/2023] Open
Abstract
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.
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Affiliation(s)
- Michelle Ponti
- Canadian Paediatric Society, Digital Health Task Force, Ottawa, Ontario, Canada
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4
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Stuckelman ZD, Strouse GA, Troseth GL. Value added: Digital modeling of dialogic questioning promotes positive parenting during shared reading. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:1010-1020. [PMID: 34735183 PMCID: PMC9664943 DOI: 10.1037/fam0000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
American parents describe bonding with their child as a primary reason for engaging in shared picture book reading. One prominent reading intervention (dialogic reading) reliably increases language outcomes, but until recently, has not been evaluated for how well it promotes warm parent-child interactions. In this study, a digital application designed to promote parent-child conversation by modeling dialogic questioning also increased mutuality, positivity, and on-task behaviors. Three- and 4-year-old American children (n = 73) and their parents were randomly assigned to read 10 times at home either: (a) an eBook with a character who modeled dialogic questioning (experimental); (b) a version of the same eBook without modeling (control); or (c) to choose between versions for each reading (choice). An adaption of the PARCHISY coding scheme was used to evaluate parent, child, and dyadic behaviors during in-lab readings at the beginning and end of the 2-week home reading period. At the final visit, experimental group families showed significant growth in mutuality (i.e., responsiveness, reciprocity, and cooperation), on-task behaviors, and parent and child positivity, and displayed more of these behaviors than families not exposed to modeling. Some increases in mutuality and positivity also emerged in families in the choice condition, but fewer than in families who only read the eBook with modeling. Parents and children exhibited no significant changes in negativity in any condition. This study suggests that carefully designed digital technology has the potential to foster positive shared reading interactions between parents and young children. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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5
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Radesky JS, Seyfried JL, Weeks HM, Kaciroti N, Miller AL. Video-Sharing Platform Viewing Among Preschool-Aged Children: Differences by Child Characteristics and Contextual Factors. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2022; 25:230-236. [PMID: 35426731 PMCID: PMC9051865 DOI: 10.1089/cyber.2021.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Free video-sharing platforms such as YouTube are highly popular among young children but may contain low-quality and highly commercialized content. This study aimed to describe the prevalence, duration, and timing of objectively measured mobile YouTube viewing in preschool-aged children and test hypotheses about associations with child individual differences and contextual factors. We analyzed mobile sampling data from 349 English-speaking children aged 3-4.99 years whose parents completed surveys about child, parent, and household characteristics. We assessed whether the child ever viewed YouTube during the sampling week and calculated average daily duration in a subsample of 121 participants with their own mobile devices. We built multivariable logistic regression models to test correlates of mobile YouTube viewership and duration. Children were 3.82 years (SD 0.53), 74.6 percent white non-Hispanic; parents were mostly mothers (93.7 percent), 34.0 (SD 4.6) years, and 37.9 percent had less than a college degree. Mobile YouTube viewing (37.0 percent of children) was more likely in children who used Android devices, shared mobile devices with family members, were older, attended home-based childcare, or had parents with lower educational attainment. Median YouTube duration was 61.2 min/day, with longer durations in children whose parents had lower educational attainment. These results demonstrate that many young children use free video-sharing platforms on mobile devices for long durations, and this practice may be disproportionately higher in children from lower socioeconomic status. Longitudinal research is needed on video-sharing platform viewing and child outcomes.
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Affiliation(s)
- Jenny S. Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Address correspondence to: Dr. Jenny S. Radesky, Department of Pediatrics, University of Michigan Medical School, 300 N Ingalls Street, #1107, Ann Arbor, MI 48109, USA
| | - Jennifer L. Seyfried
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Alison L. Miller
- Department of Health Behavior and Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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6
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Radesky J, Hiniker A. From Moral Panic to Systemic Change: Making Child-Centered Design the Default. INTERNATIONAL JOURNAL OF CHILD-COMPUTER INTERACTION 2022; 31:100351. [PMID: 35340408 PMCID: PMC8942378 DOI: 10.1016/j.ijcci.2021.100351] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Jenny Radesky
- Department of Pediatrics, University of Michigan Medical School
| | - Alexis Hiniker
- University of Washington Information School, Seattle, WA
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7
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Munzer TG, Miller AL, Yeo S, Wang Y, McCaffery H, Kaciroti N, Radesky J. Parent Verbalizations and Toddler Responses With Touchscreen Tablet Nursery Rhyme Apps. Pediatrics 2021; 148:e2021049964. [PMID: 34841433 PMCID: PMC10777329 DOI: 10.1542/peds.2021-049964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In some studies, parents and toddlers verbalize less when engaging with a tablet versus a print book. More needs to be known regarding child contributions to specific parent verbalizations. We examined parent-toddler contingent interactions with tablet applications versus print books, as well as moderators of these associations. METHODS We conducted a laboratory-based, within-subjects counterbalanced study of 72 parent-toddler dyads engaging with a nursery rhyme application (with enhanced + autonarration [E+A] and enhanced formats) and print book. We coded parent verbalizations (eg, dialogic, nondialogic) and proportions of child responses to these in 5-second epochs. Poisson regressions were used to analyze within-subjects variance by tablet or print format. We tested effect modification by child emotion regulation and home media practices. RESULTS Children responded more to parent overall (print 0.38; E+A 0.31, P = .04; enhanced 0.11, P = .01), dialogic (print 0.21; E+A 0.13, P = .04; enhanced 0.1, P = .02), and nondialogic (print 0.45; E+A 0.27, P < .001; enhanced 0.32, P < .001) verbalizations during print book versus tablet. Stronger child emotion regulation, greater frequency of co-viewing, and instructive practices moderated associations such that differences between conditions were no longer significant for some parent verbalizations and child responses. CONCLUSIONS Parent-toddler reciprocal verbal interactions occurred less frequently with tablet versus print book use. Child emotion regulation and parent home media practices moderated some of these associations. Pediatricians may wish to promote co-viewing and instructive media practices but may also consider that child emotion regulation may determine response to interactive tablet design.
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Affiliation(s)
| | | | | | - Yujie Wang
- Department of Pediatrics, Medical School
| | | | - Niko Kaciroti
- Department of Pediatrics, Medical School
- Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
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8
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Guevara JP, Erkoboni D, Gerdes M, Winston S, Sands D, Rogers K, Haecker T, Jimenez ME, Mendelsohn AL. Promoting Early Literacy Using Digital Devices: A Pilot Randomized Controlled Trial. Acad Pediatr 2021; 21:1001-1008. [PMID: 34022425 DOI: 10.1016/j.acap.2021.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/17/2021] [Accepted: 05/12/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine feasibility and explore effects of literacy promotion using e-books versus board books on the home reading environment, book reading, television use, and child development. METHODS Randomized controlled trial comparing digital literacy promotion (DLP) using e-books to standard literacy promotion (SLP) using board books among Medicaid-eligible infants. DLP participants received e-books on home digital devices, while SLP participants received board books at well visits between 6 and 12 months of age. Differences in StimQ Read Subscale (StimQ-Read) scores, parent-reported reading and television use, and Bayley Scales of Infant Development-3rd Edition (Bayley-3) scores between groups were assessed using intention-to-treat analysis. RESULTS A total of 104 Medicaid-eligible infants were enrolled and randomized from 3 pediatric practices. There were no differences in sociodemographic characteristics between groups at baseline. Children in the DLP group initially had lower StimQ-Read scores but showed similar increases in StimQ-Read scores over time as children in the SLP group. Parents in the DLP group reported greater use of digital devices to read or engage their child (65% vs 23%, P < .001) but similar board book reading and television viewing. There were no differences between groups in cognitive or motor scale scores, but DLP participants had marginally lower language scales scores (DLP 85.7 vs SLP 89.7; P = .10) at the 6-month follow-up. CONCLUSIONS/DISCUSSION Literacy promotion using e-books was feasible and associated with greater e-book usage but no difference in board book reading, television viewing, or home reading environment scores. A potential adverse impact of e-books on language development should be confirmed in future study.
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Affiliation(s)
- James P Guevara
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at Penn, Roberts Center for Pediatric Research (JP Guevara, D Erkoboni, and M Gerdes), Philadelphia, Pa.
| | - Danielle Erkoboni
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at Penn, Roberts Center for Pediatric Research (JP Guevara, D Erkoboni, and M Gerdes), Philadelphia, Pa
| | - Marsha Gerdes
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at Penn, Roberts Center for Pediatric Research (JP Guevara, D Erkoboni, and M Gerdes), Philadelphia, Pa
| | - Sherry Winston
- Department of Pediatrics, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research (S Winston and D Sands), Philadelphia, Pa
| | - Danielle Sands
- Department of Pediatrics, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research (S Winston and D Sands), Philadelphia, Pa
| | - Kirsten Rogers
- Reach Out and Read Greater Philadelphia, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research (K Rogers), Philadelphia, Pa
| | - Trude Haecker
- Department of Pediatrics, Reach Out and Read Greater Philadelphia, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research (T Haecker), Philadelphia, Pa
| | - Manuel E Jimenez
- Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, Child Health Institute of New Jersey (ME Jimenez), New Brunswick, NJ
| | - Alan L Mendelsohn
- Departments of Pediatrics and Population Health, New York University School of Medicine (AL Mendelsohn), New York, NY
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9
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Hutton JS, DeWitt T, Hoffman L, Horowitz-Kraus T, Klass P. Development of an Eco-Biodevelopmental Model of Emergent Literacy Before Kindergarten: A Review. JAMA Pediatr 2021; 175:730-741. [PMID: 33720328 DOI: 10.1001/jamapediatrics.2020.6709] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE Literacy has been described as an important social determinant of health. Its components emerge in infancy and are dependent on genetic, medical, and environmental factors. The American Academy of Pediatrics advocates a substantial role for pediatricians in literacy promotion, developmental surveillance, and school readiness to promote cognitive, relational, and brain development. Many children, especially those from minority and underserved households, enter kindergarten unprepared to learn to read and subsequently have difficulty in school. OBSERVATIONS Emergent literacy is a developmental process beginning in infancy. Component skills are supported by brain regions that must be adequately stimulated and integrated to form a functional reading network. Trajectories are associated with genetic, medical, and environmental factors, notably the home literacy environment, which is defined as resources, motivation, and stimulation that encourage the literacy development process. Eco-biodevelopmental models are advocated by the American Academy of Pediatrics, and these models offer insights into the neurobiological processes associated with environmental factors and the ways in which these processes may be addressed to improve outcomes. Emergent literacy is well suited for such a model, particularly because the mechanisms underlying component skills are elucidated. In addition to cognitive-behavioral benefits, the association of home literacy environment with the developing brain before kindergarten has recently been described via neuroimaging. Rather than a passive approach, which may subject the child to stress and engender negative attitudes, early literacy screening and interventions that are administered by pediatric practitioners can help identify potential reading difficulties, address risk factors during a period when neural plasticity is high, and improve outcomes. CONCLUSIONS AND RELEVANCE Neuroimaging and behavioral evidence inform an eco-biodevelopmental model of emergent literacy that is associated with genetic, medical, and home literacy environmental factors before kindergarten, a time of rapid brain development. This framework is consistent with recommendations from the American Academy of Pediatrics and provides insights to help identify risk factors and signs of potential reading difficulties, tailor guidance, and provide direction for future research.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Lauren Hoffman
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Educational Neuroimaging Center, Faculty of Education in Science and Technology, Technion, Haifa, Israel.,Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Perri Klass
- Department of Pediatrics, New York University School of Medicine, New York
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10
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Courage ML, Frizzell LM, Walsh CS, Smith M. Toddlers Using Tablets: They Engage, Play, and Learn. Front Psychol 2021; 12:564479. [PMID: 34135793 PMCID: PMC8200401 DOI: 10.3389/fpsyg.2021.564479] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 04/26/2021] [Indexed: 11/15/2022] Open
Abstract
Although very young children have unprecedented access to touchscreen devices, there is limited research on how successfully they operate these devices for play and learning. For infants and toddlers, whose cognitive, fine motor, and executive functions are immature, several basic questions are significant: (1) Can they operate a tablet purposefully to achieve a goal? (2) Can they acquire operating skills and learn new information from commercially available apps? (3) Do individual differences in executive functioning predict success in using and learning from the apps? Accordingly, 31 2-year-olds (M = 30.82 month, SD = 2.70; 18 female) were compared with 29 3-year-olds (M = 40.92 month, SD = 4.82; 13 female) using two commercially available apps with different task and skill requirements: (1) a shape matching app performed across 3 days, and (2) a storybook app with performance compared to that on a matched paper storybook. Children also completed (3) the Minnesota Executive Functioning Scale. An adult provided minimal scaffolding throughout. The results showed: (1) toddlers could provide simple goal-directed touch gestures and the manual interactions needed to operate the tablet (2) after controlling for prior experience with shape matching, toddlers’ increased success and efficiency, made fewer errors, decreased completion times, and required less scaffolding across trials, (3) they recognized more story content from the e-book and were less distracted than from the paper book, (4) executive functioning contributed unique variance to the outcome measures on both apps, and (5) 3-year-olds outperformed 2-year-olds on all measures. The results are discussed in terms of the potential of interactive devices to support toddlers’ learning.
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Affiliation(s)
- Mary L Courage
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Lynn M Frizzell
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Colin S Walsh
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Megan Smith
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
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11
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McArthur BA, Browne D, McDonald S, Tough S, Madigan S. Longitudinal Associations Between Screen Use and Reading in Preschool-Aged Children. Pediatrics 2021; 147:peds.2020-011429. [PMID: 34031229 DOI: 10.1542/peds.2020-011429] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The home literacy environment has been identified as a key predictor of children's language, school readiness, academic achievement, and behavioral outcomes. With the increased accessibility and consumption of digital media, it is important to understand whether screen use impacts off-line enrichment activities such as reading or whether reading activities offset screen use. Using a prospective birth cohort, we examined reading and screen use at 24, 36, and 60 months to elucidate the directional association between screen use and reading over time. METHODS This study included data from 2440 mothers and children in Calgary, Alberta, drawn from the All Our Families cohort. Children's screen use and reading activities were assessed via maternal report at age 24, 36, and 60 months. Sociodemographic covariates were also collected. RESULTS Using a random-intercepts cross-lagged panel model, which statistically controls for individual-level confounds, this study revealed that greater screen use at 24 months was associated with lower reading at 36 months (β = -.08; 95% confidence interval: -0.13 to -0.02). In turn, lower reading at 36 months was associated with greater screen use at 60 months (β = -.11; 95% confidence interval: -0.19 to -0.02). Covariates did not modify the associations. CONCLUSIONS A reciprocal relationship between screen use and reading was identified. Early screen use was associated with lower reading activities, resulting in greater screen use at later ages. Findings emphasize the need for practitioners and educators to discuss screen use guidelines and encourage families to engage in device-free activities to foster early literacy exposure.
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Affiliation(s)
- Brae Anne McArthur
- University of Calgary, Calgary Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Dillon Browne
- University of Waterloo, Waterloo, Ontario, Canada; and
| | - Sheila McDonald
- University of Calgary, Calgary Alberta, Canada.,Alberta Health Services, Calgary, Alberta, Canada
| | - Suzanne Tough
- University of Calgary, Calgary Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Contributed equally as joint senior authors
| | - Sheri Madigan
- University of Calgary, Calgary Alberta, Canada; .,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Contributed equally as joint senior authors
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12
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Madigan S, McArthur BA, Anhorn C, Eirich R, Christakis DA. Associations Between Screen Use and Child Language Skills: A Systematic Review and Meta-analysis. JAMA Pediatr 2020; 174:665-675. [PMID: 32202633 PMCID: PMC7091394 DOI: 10.1001/jamapediatrics.2020.0327] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/22/2020] [Indexed: 11/14/2022]
Abstract
Importance There is considerable public and scientific debate as to whether screen use helps or hinders early child development, particularly the development of language skills. Objective To examine via meta-analyses the associations between quantity (duration of screen time and background television), quality (educational programming and co-viewing), and onset of screen use and children's language skills. Data Sources Searches were conducted in MEDLINE, Embase, and PsycINFO in March 2019. The search strategy included a publication date limit from 1960 through March 2019. Study Selection Inclusion criteria were a measure of screen use; a measure of language skills; and statistical data that could be transformed into an effect size. Exclusion criteria were qualitative studies; child age older than 12 years; and language assessment preverbal. Data Extraction and Synthesis The following variables were extracted: effect size, child age and sex, screen measure type, study publication year, and study design. All studies were independently coded by 2 coders and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Main Outcomes and Measures Based on a priori study criteria, quantity of screen use included duration of screen time and background television, quality of screen use included co-viewing and exposure to educational programs, and onset of screen use was defined as the age children first began viewing screens. The child language outcome included assessments of receptive and/or expressive language. Results Participants totaled 18 905 from 42 studies included. Effect sizes were measured as correlations (r). Greater quantity of screen use (hours per use) was associated with lower language skills (screen time [n = 38; r = -0.14; 95% CI, -0.18 to -0.10]; background television [n = 5; r = -0.19; 95% CI, -0.33 to -0.05]), while better-quality screen use (educational programs [n = 13; r = 0.13; 95% CI, 0.02-0.24]; co-viewing [n = 12; r = 0.16; 95% CI, 0.07-.24]) were associated with stronger child language skills. Later age at screen use onset was also associated with stronger child language skills [n = 4; r = 0.17; 95% CI, 0.07-0.27]. Conclusions and Relevance The findings of this meta-analysis support pediatric recommendations to limit children's duration of screen exposure, to select high-quality programming, and to co-view when possible.
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Affiliation(s)
- Sheri Madigan
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Ciana Anhorn
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Rachel Eirich
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Dimitri A. Christakis
- Seattle Children’s Hospital Research Institute, University of Washington, Seattle
- Editor, JAMA Pediatrics
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13
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Milkovich LM, Madigan S. Using Mobile Device Sampling to Objectively Measure Screen Use in Clinical Care. Pediatrics 2020; 146:peds.2020-1242. [PMID: 32482772 DOI: 10.1542/peds.2020-1242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Libby Matile Milkovich
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri; .,Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada; and.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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