Toddlers with Screen Time as Infants Experience Developmental Delays

New research sheds light on how detrimental screen time is for babies. In this Parents article, Mindpath Health’s Zishan Khan, MD, explains the study and other activities to keep their babies occupied.

It’s challenging to escape screens in today’s world. Some employers expect working parents to stay constantly plugged into email or messaging apps like Slack or Microsoft Teams. Giving infants access to a tablet may temporarily distract them in the short term.

The study, published in JAMA Pediatrics, found babies who spent one to four hours with screens daily were more likely to have developmental delays, especially in problem-solving and communication skills, by age 2.

“Experts have been saying for years that parents should be limiting screen time exposure, and now we are starting to see specific data coming in about the possible effect of too much exposure,” says Scott A. Roth, PsyD

The American Academy of Pediatrics (AAP) does not recommend screen time for children younger than 2 years old.

The impact of screen time on infants

Researchers looked at children’s screen time duration by age 1. They assessed their performance in developmental categories, such as communication, fine motor, personal and social, and problem-solving skills at ages 2 and 4, through self-reported information from participating mothers. Children with up to four hours of daily screen time had a three-fold higher risk of communication and problem-solving skill delays.

Children with four or more hours of screen time per day were nearly five times more likely to be experiencing communication skill delays and twice as likely to be behind on personal and social milestones at age 2. Moreover, these children were 1.74 times more likely to have underdeveloped fine motor skills.

The risks of developmental delays based on daily screen time were only significant in communication and problem-solving by the time the participating children reached their fourth birthdays.

Overall, Zishan Khan, MD, a board-certified psychiatrist with Mindpath Health, says the sample size and focus on specific developmental areas impacted by an infant’s exposure to electronic devices is impressive.

“This study clearly shows that the more screen time a baby receives, the greater risk a parent places them of struggling in some developmental regions,” Dr. Khan says.

The issue with screen time

Screen time is distracting and can allow parents to get other tasks done, such as work when an infant is home sick from daycare, but they cannot take off. It may also help while an adult is cooking, cleaning, and showering. However, experts say it’s true that there are potential harms in screen time.

“Children develop their language skills and ability to communicate by interacting with others, including their parents and siblings,” Dr. Khan says. “By engaging with a parent, for instance, they observe facial expressions and learn to decipher emotions and responses to various motions and communication methods.”

The nature of face-to-face encounters is also why social skills are affected by passively consuming on-screen content.

“A human being thrives on back-and-forth interaction, and our brains must be exposed to stimuli that can guide our behavior and allow us to learn how to appropriately interact with the people and things in our environment,” Dr. Khan says.

Is there such a thing as quality screen time?

In 2016, the AAP updated its policy statement to say videoconferencing (think Zoom and FaceTime) was an exception. However, the organization stressed that parental support is needed for infants and toddlers to “understand what they are seeing.”

“The question arises, ‘What is the screen time taking the place of?’” Dr. Roth notes. “With FaceTiming Grandma, it might be taking the place of not having frequent communication with Grandma.”

In these instances, isolation could be hard on families, including toddlers forming relationships with extended relatives.

How to keep a baby entertained sans screens

Can we be real for a second? Face-to-face interactions are critical, but so are cooking dinner and showering.

Sogand Ghassemi, MD, says high-contrast toys and books can engage children and aid visual development. Soft, cloth books with texture, rattles, and sensor bottles with colorful contents engage numerous senses and help with motor skills like grip and strength.

Cooking is also ripe with opportunities to spark conversations and develop communication skills—yes, even with an infant who isn’t talking.

“A parent may wish to narrate what they are doing while cooking dinner,” Dr. Roth says. “Anything that can engage your babies’ senses can be helpful, and remember, the more interactive, the better.”

That said, screens are a part of our everyday lives, and some parents may be concerned that the damage is already done. So, one last thing:

“This study is not meant to shame a parent who decides to let their child spend a short while in front of the television or on a tablet while they take a moment to quickly shower or prepare a meal for the family,” Dr. Khan says. “Parents should not fear they have ruined their baby if they have allowed them to enjoy an educational show on the TV or tablet, and they absolutely should not avoid letting distant family members interact with their child over FaceTime. They should try their best to positively interact with their child and spend as much quality time with them as possible.”

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