Optimizing the interaction of children with information and communication technologies

"It helps and it doesn't help": maternal perspectives on how the use of smartphones and tablet computers influences parent-infant attachment

As families increase their use of mobile touch screen devices (smartphones and tablet computers), there is potential for this use to influence parent-child interactions required to form a secure attachment during infancy, and thus future child developmental outcomes. Thirty families of infants (aged 9-15 months) were interviewed to explore how parents and infants use these devices, and how device use influenced parents' thoughts, feelings and behaviours towards their infant and other family interactions. Two-thirds of infants were routinely involved in family video calls and one-third used devices for other purposes. Parent and/or child device use served to both enhance connection and increase distraction between parents and infants and between other family members. Mechanisms for these influences are discussed. The findings highlight a new opportunity for how hardware and software should be designed and used to maximise benefits and reduce detriments of device use to optimise parent-infant attachment and child development.Practitioner Summary: Many families with infants regularly use smartphones and tablet computers. This qualitative study found that how devices were used either enhanced or disrupted feelings of parent-infant attachment. Practitioners should be aware of the potential beneficial and detrimental impacts of device use among families given implications for attachment and future child development.

"Coronavirus Changed the Rules on Everything": Parent Perspectives on How the COVID-19 Pandemic Influenced Family Routines, Relationships and Technology Use in Families with Infants

This study explores how the first wave of the COVID-19 pandemic influenced family routines, relationships and technology use (smartphones and tablet computers) among families with infants. Infancy is known to be an important period for attachment security and future child development, and a time of being susceptible to changes within and outside of the family unit. A qualitative design using convenience sampling was employed. A total of 30 mothers in Perth, Western Australia participated in semi-structured interviews by audio or video call. All mothers were parents of infants aged 9 to 15 months old. Interviews were audio-recorded and transcribed, and data were analysed using thematic analysis to code and identify themes in an inductive manner. Families described staying home and stopping all external activities. Three themes relating to family interactions and wellbeing were found: enhanced family relationships; prompted reflection on family schedules; and increased parental stress. Two themes related to family device use were found: enabled connections to be maintained; and source of disrupted interactions within the family unit. Overall, participants described more advantages than downsides of device use during COVID-19. Findings will be of value in providing useful information for families, health professionals and government advisors for use during future pandemic-related restrictions.

Determining factors in children's screen time in early childhood

The use of media by children in early childhood is increasingly common, and it is necessary to investigate the determinants of screen time, which is understood as the total child screen exposure time, including television and interactive media. This is a descriptive, exploratory, and cross-sectional study conducted with 180 children between 24 and 42 months of age, allocated in Group 1, less than two hours daily screen exposure time; Group 2, daily screen exposure time equal to or more than two hours. Bivariate and binary logistic regression analyses were performed. Screen time determining factors studied were family environment, evaluated with the Family Environment Resource Inventory; socioeconomic factors; nutritional status and child development status, evaluated with the Bayley III test. As a result, 63% of children had daily screen time exceeding two hours, and television still is the main culprit for children screen exposure. We observed that screen time exposure was positively associated with family resources, economic level, and language development. However, only the last two factors explained the longer screen time.

Quality of interactive media use in early childhood and child development: a multicriteria analysis

OBJECTIVES

(1) To develop an index that allows the measurement of the quality of interactive media used by children in early childhood. (2) To verify whether there is an association between the index and cognitive development, expressive language, and fine and gross motor development.

METHODS

A quantitative, cross-sectional, exploratory study with 103 children, aged 24 to 42 months, evaluated by the Bayley Scale of Infant and Toddler Development. The criteria for the index were selected from the literature: (1) media use by parents; (2) time of daily media use; (3) media type; (4) what do you use the media for; (5) who do you use the media with (6) monitoring (limits time, content, interacts during use); (7) purpose of use; (8) parents' opinion of the media. For development of the multicriteria index, the multi-attribute utility theory was applied, and Spearman correlation and simple linear regression (p<0.05) were used to verify the association between the index and child development.

RESULTS

The index showed a positive and significant correlation with child development in the following domains: language (r=0.40, p<0.001), cognitive (r=0.23, p=0.04), and fine motor=0.22, p=0.04). Simple linear regression analysis showed that the use of interactive media accounts for 22% of language development (p<0.001).

CONCLUSION

The multicriteria index developed to verify the quality of interactive media used by children in early childhood showed that it has the potential to be used. The positive and significant associations between the quality of interactive media use and child development was verified, mainly regarding language.

Rationale, design and methods for a randomised and controlled trial of the impact of virtual reality games on motor competence, physical activity, and mental health in children with developmental coordination disorder

BACKGROUND

A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR) game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder.

METHODS

This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (≤ 15th percentile) will be recruited and randomised to a balanced ordering of 'no active electronic games' and 'active electronic games'. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentary behaviour will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. A sample of 30 will provide a power of > 0.9 for detecting a 5 point difference in motor coordination on the MABC-2 TIS scale (mean 17, sd = 5).

DISCUSSION

This is the first trial to examine the impact of new virtual reality games on motor coordination in children with developmental coordination disorder. The findings will provide critical information to understand whether these electronic games can be used to have a positive impact on the physical and mental health of these children. Given the importance of adequate motor coordination, physical activity and mental health in childhood, this project can inform interventions which could have a profound impact on the long term health of this group of children.

TRIAL REGISTRATION

Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000400965.

Lifestyle and demographic correlates of poor mental health in early adolescence

AIM

To determine the constellation of lifestyle and demographic factors that are associated with poor mental health in an adolescent population.

METHODS

The Raine Study 14-year follow-up involved primary care givers and their adolescent children (n= 1860). The Child Behaviour Checklist (CBCL) was used to assess adolescent mental health. We examined diet, socio-demographic data, family functioning, physical activity, screen use and risk-taking behaviours with mental health outcomes using linear regression.

RESULTS

Adolescents with higher intakes of meat and meat alternatives and 'extras' foods had poorer mental health status. Adverse socio-economic conditions, higher hours of screen use and ever partaking in the health risk behaviours of smoking and early sexual activity were significantly associated with increasing CBCL scores, indicative of poorer functioning.

CONCLUSIONS

By identifying the lifestyle and demographic factors that accompany poorer mental health in early adolescence, we are able to better understand the context of mental health problems as they occur within an adolescent population.

Evidence-based guidelines for the wise use of computers by children: physical development guidelines

Computer use by children is common and there is concern over the potential impact of this exposure on child physical development. Recently principles for child-specific evidence-based guidelines for wise use of computers have been published and these included one concerning the facilitation of appropriate physical development. This paper reviews the evidence and presents detailed guidelines for this principle. The guidelines include encouraging a mix of sedentary and whole body movement tasks, encouraging reasonable postures during computing tasks through workstation, chair, desk, display and input device selection and adjustment and special issues regarding notebook computer use and carriage, computing skills and responding to discomfort. The evidence limitations highlight opportunities for future research. The guidelines themselves can inform parents and teachers, equipment designers and suppliers and form the basis of content for teaching children the wise use of computers. STATEMENT OF RELEVANCE: Many children use computers and computer-use habits formed in childhood may track into adulthood. Therefore child-computer interaction needs to be carefully managed. These guidelines inform those responsible for children to assist in the wise use of computers.

Principles for the wise use of computers by children

Computer use by children at home and school is now common in many countries. Child computer exposure varies with the type of computer technology available and the child's age, gender and social group. This paper reviews the current exposure data and the evidence for positive and negative effects of computer use by children. Potential positive effects of computer use by children include enhanced cognitive development and school achievement, reduced barriers to social interaction, enhanced fine motor skills and visual processing and effective rehabilitation. Potential negative effects include threats to child safety, inappropriate content, exposure to violence, bullying, Internet 'addiction', displacement of moderate/vigorous physical activity, exposure to junk food advertising, sleep displacement, vision problems and musculoskeletal problems. The case for child specific evidence-based guidelines for wise use of computers is presented based on children using computers differently to adults, being physically, cognitively and socially different to adults, being in a state of change and development and the potential to impact on later adult risk. Progress towards child-specific guidelines is reported. Finally, a set of guideline principles is presented as the basis for more detailed guidelines on the physical, cognitive and social impact of computer use by children. The principles cover computer literacy, technology safety, child safety and privacy and appropriate social, cognitive and physical development. The majority of children in affluent communities now have substantial exposure to computers. This is likely to have significant effects on child physical, cognitive and social development. Ergonomics can provide and promote guidelines for wise use of computers by children and by doing so promote the positive effects and reduce the negative effects of computer-child, and subsequent computer-adult, interaction.

Rationale, design and methods for a randomised and controlled trial to investigate whether home access to electronic games decreases children's physical activity

BACKGROUND

Many children are reported to have insufficient physical activity (PA) placing them at greater risk of poor health outcomes. Participating in sedentary activities such as playing electronic games is widely believed to contribute to less PA. However there is no experimental evidence that playing electronic games reduces PA. There is also no evidence regarding the effect of different types of electronic games (traditional sedentary electronic games versus new active input electronic games) on PA. Further, there is a poor understanding about how characteristics of children may moderate the impact of electronic game access on PA and about what leisure activities are displaced when children play electronic games. Given that many children play electronic games, a better understanding of the effect of electronic game use on PA is critical to inform child health policy and intervention.

METHODS

This randomised and controlled trial will examine whether PA is decreased by access to electronic games and whether any effect is dependent on the type of game input or the child's characteristics. Children aged 10-12 years (N = 72, 36 females) will be recruited and randomised to a balanced ordering of 'no electronic games', 'traditional' electronic games and 'active' electronic games. Each child will participate in each condition for 8 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is PA, assessed by Actical accelerometers worn for 7 days on the wrist and hip. Energy expenditure will be assessed by the doubly labelled water technique and motor coordination, adiposity, self-confidence, attitudes to technology and PA and leisure activities will also be assessed. A sample of 72 will provide a power of > 0.9 for detecting a 15 mins difference in PA (sd = 30 mins).

DISCUSSION

This is the first such trial and will provide critical information to understand whether access to electronic games affects children's PA. Given the vital importance of adequate PA to a healthy start to life and establishing patterns which may track into adulthood, this project can inform interventions which could have a profound impact on the long term health of children.

TRIAL REGISTRATION

This trial is registered in the Australia and New Zealand Clinical Trials Registry (ACTRN 12609000279224).

Survey Response Comparisons between Student and Teacher Participants in a Mobile Instructional Technology Program in a High School Setting

Questionnaire responses were compared between high school students and teachers, all of whom participate in their school's 24/7 access tablet PC (TPC) program. Primary areas of interest were students' and teachers' experiences with and attitudes about the TPCs, physical discomfort associated with TPC use, and patterns of TPC use. Results showed students' and teachers' attitudes were generally quite positive towards the TPCs, including both groups appreciating the TPC as an organizational aid. However, neither group tended to think TPCs had improved student grades. It is important to explore the similarities and differences between people who share a classroom and much more as they proceed through a school year together. This type of assessment provides a useful complement to more common assessments of impact of digital technology on academic performance.

The ergonomics of learning: educational design and learning performance

The application of ergonomics/human factors (E/HF) principles and practices, and the implementation of ergonomics programmes, have achieved proven success in improving performance, productivity, competitiveness, and safety and health in most occupational sectors. However, the benefits that the application of E/HF science might bring to promoting student learning have yet to be widely recognized. This paper deals with the fundamental purpose of education - student learning - and with the question of how the ergonomic design of the learning environment influences learning performance. The underlying premise, embodied in the quote below, is that student learning performance to a substantial degree is context specific - influenced and specialized in relation to specific design factors in the learning environment. The basic scientific question confronting learning ergonomics is which design characteristics in the learning environment have the greatest influence on variability in learning performance. Practically, the basic challenge is to apply this scientific understanding to ergonomic interventions directed at design improvements of learning environments to benefit learning. This paper expands upon these themes by addressing the origins and scope of learning ergonomics, differing perspectives on the nature of learning, evidence for context specificity in learning and conclusions and research implications regarding an ergonomics perspective on learning.

School children's use of computers and teachers' education in computer ergonomics

A national survey to investigate the education of teachers in computer-related ergonomics was carried out by postal questionnaire. The use of computers by primary school children (age 4-12 years) was also investigated. Data were collected from a random sample of 25% (n = 830) of primary schools in the Republic of Ireland. Questionnaires (n = 1863) were returned from 416 schools giving a response rate of 50.1%. Almost all schools (99.7%) had computers for children's use. The computers were most often (69.8%) used in the classroom. The majority (56.3%) of children worked in pairs. Most teachers (89.6%) had received computer training, but few (17.6%) had received ergonomics information during the training. Respondents were not satisfied with their current knowledge of ergonomics. Over 90% stated that they would like to receive further information by printed format or during a training course, rather than by computer (web or CD-ROM).

An investigation of children's posture and discomfort during computer use

This study investigated schoolchildren's posture and discomfort while working at computers. Sixty-eight children (mean age 9.5 years) were observed at school during normal computer sessions lasting 15-25 min. Rapid upper limb assessment (RULA) was used to evaluate posture, and a body discomfort chart (BDC) and a modified visual analogue scale (VAS) were used to record site and intensity of discomfort. Computer tasks were noted and in accordance with RULA, postures were classified as Action Level (AL) 1 (acceptable) to 4 (needs immediate change). Most children adopted postures at an unacceptable level while working at computers. None of the postures were in AL 1; 60% were in AL 2; 38% were in AL 3; and 2% were in AL 4. Posture became worse over time. Poor posture was associated with discomfort, but it is not clear if it was related to the sitting posture or to the computer use. Children who reported discomfort had a higher mean RULA grand score (5.0) than those who did not report discomfort (4.4). The type of computer task influenced the children's posture. RULA proved generally to be a suitable method for evaluating children's posture.

Ergonomics in schools

This Special Issue on Ergonomics in Schools is dedicated to the memory of my co-guest editor Cheryl Bennett who sadly and unexpectedly passed away peacefully on 2 July 2007 - only 10 days before this editorial was completed. Cheryl was inspirational in her vigorous championing of this new area of ergonomics activity, most prominently and to great effect through her foundation chairmanship of the International Ergonomics Association (IEA) Technical Committee on Ergonomics for Children in Educational Environments (ECEE) (see www.iea.cc).

Computer use and habitual spinal posture in Australian adolescents

OBJECTIVE

Computer use is common in adolescents, and there is evidence that adolescent spinal posture alters during computer use. However, it is unknown if computer use and habitual postures are associated. The objective of this study was to evaluate associations between adolescent computer use and habitual postures.

METHODS

Eight hundred eighty-four adolescents (408 females, 476 males, mean age, 14.0 years, standard deviation, 0.2) completed a questionnaire assessing weekly computer use. Habitual spinal posture was assessed by photographic analysis while standing and sitting.

RESULTS

Computer use was associated with adolescent habitual postures. In males, increased computer use was associated with increased head flexion and neck flexion. In females, increased computer use was associated with increased lumbar lordosis.

CONCLUSIONS

The amount of weekly computer use was associated with changes in habitual spinal postures, and these depended on gender. These associations may result from temporary computer postures leading to adaptive neuromusculoskeletal changes, though further multivariate and longitudinal studies are needed to confirm causality. As some habitual posture changes may place a greater strain on the musculoskeletal system, computer use by adolescents should be viewed as a possible health concern.

A survey of high school students with ubiquitous access to tablet PCs

This paper presents findings of a study of high school students participating in a tablet PC (TPC) programme. Primary areas of interest were students' experiences with and attitudes about the TPCs, physical discomfort associated with use of TPCs and temporal and task-driven patterns of TPC use. Data were collected via questionnaire and computer use-monitoring software. Results showed students' attitudes were generally quite positive towards the TPCs, although they did not tend to think TPCs had improved their grades, few disagreed that TPCs were a distraction in class, and visual and musculoskeletal discomfort was prevalent. Understanding how to use the TPC and recognizing its organizational capacity were associated with several positive attitudes towards the TPC, including making school more enjoyable. Children's exposure to computers will only increase, so study of the many dimensions of their impact is critical in order to understand what is effective, constructive and healthful for children.

Human factors engineering and patient safety

The pediatric population has features different from those of adults and that are dynamic during the pediatric age range. Pediatric-specific issues result in potential risks for harm during medical care. Basic and applied human factors research has resulted in improvements in the performance of health adults and those adults who have functional limitations. Future work should focus on systematically understanding the human factors needs of children with the goal of redesigning systems of health care to optimize the safety of children and the performance of their care providers.

The association between information and communication technology exposure and physical activity, musculoskeletal and visual symptoms and socio-economic status in 5-year-olds

BACKGROUND

Increasing use of computers by children has raised concerns over the potential impact on their cognitive, social, educational, visual and physical development. Despite this concern, there are no large-scale studies relating the use of computers to specific health indicators in children as they reach school age.

METHODS

A cross-sectional analysis of 1600 5-year-old Western Australian children participating in a longitudinal cohort study was conducted to ascertain their computer use, other activities (watching television and videos, playing electronic games, reading and looking at books, drawing on paper and moderate to vigorous physical activity), and specific health indicators.

RESULTS

More than half (56%) of the children used computers each week. Computer use was significantly related to TV viewing (OR 1.97 weekday) and electronic game use (console games OR 2.48 weekday, 1.81 weekend; hand-held games OR 1.88 weekend) and negatively associated with vigorous physical activity on weekends (OR 0.72). Computer use was also significantly related to socio-economic indicators such as the mother being older (40+ years, OR 1.70 weekend, 1.73 weekday), tertiary educated (OR 1.63 weekend) and studying (OR 1.52 weekend, 1.41 weekday). Almost 1% children were reported to have complained of tired or sore muscles, and 2.2% had complained of tired or sore eyes, after watching television or using a computer.

CONCLUSION

A substantial proportion of 5-year-old Western Australian children are using computers. Computer use was related to other sedentary activities and less vigorous activity. While musculoskeletal and vision problems are not widespread, their presence and the sedentary nature of computer use is of public health concern.