Baby unplugged: a novel, market-based approach to reducing screen time and promoting healthy alternatives

Randomized Trial of a Mobile App Introduced During Well-Visits to Enhance Guidance for Reading With Young Children

OBJECTIVE

To estimate feasibility, usability and efficacy of a mobile parenting app (Rx for Success; RxS) to enhance reading guidance provided to parents of young children during well-visits.

METHODS

This trial was conducted at a clinic serving primarily families of Hispanic ethnicity and low-socioeconomic status (SES) where Reach Out and Read (ROR) is standard practice. It involved 252 parent-child dyads in 2 age groups (~6-months old, ~18-months old) randomized during well-visits to receive RxS or a children's book modeling alternatives to screen time (Control) by research coordinators. RxS involves videos, activities and "push" messages. Follow-up assessments were conducted approximately 6 months later, including impression and use, shared reading behaviors, child language and screen time.

RESULTS

A total of 217 dyads completed both visits (110 RxS, 107 Control). Time to introduce RxS was under 3 minutes and 32% of parents experienced largely minor performance issues. Parent impression of RxS was favorable for both age groups at baseline and follow-up, though use was infrequent, attributable to a desire for more relevant and updated content. Significant findings favoring RxS included shared reading as a favorite activity, more frequent shared reading reported at 12 months and higher language scores at 24 months. Screen time was equivalent between cohorts, exceeding American Academy of Pediatrics guidelines.

CONCLUSIONS

A mobile app introduced to parents of young children from low-SES backgrounds was feasible during well-visits, rated as helpful, and effective to enhance shared reading at younger and language at older ages. While a potentially impactful enhancement to ROR, features needing improvement were identified.

Exposure to salient, dynamic sensory stimuli during development increases distractibility in adulthood

It has been suggested that excessive exposure of children to the dynamic and highly salient audio-visual stimuli conveyed by electronic media may induce attention-related deficits in adulthood. This study was designed to evaluate this hypothesis in a controlled animal model setup. Building on their natural responsiveness to odors, we exposed juvenile rats for 1 h daily to a dynamic series of interchanging, highly salient odors, while controls were exposed to a non-changing mixture of these odors. Upon reaching adulthood, we tested the attentional capacity of the rats and measured their brain-derived neurotrophic factor (BDNF) levels as a proxy of neuronal plasticity. As compared with controls, rats exposed to the dynamic stimulation showed no attentional deficits under baseline task conditions, but their performance was dramatically impaired when an auditory distractor was introduced in the task. In addition, BDNF levels in the dorsal striatum of these rats were significantly increased relative to controls. These findings provide first empirical evidence that a continuous exposure to dynamic, highly salient stimuli has long-term effects on attentional functions later in life, and that these effects may have neural correlates in the dorsal striatum.