A child in a hospital bed stares at a TV screen.

Limit your toddler’s screen time

A recent study published in JAMA Pediatrics discusses an alarming association between screen time use greater than 2 hours in children under the age of 24 months and poorer executive function in the same children at 9 years. The researchers collected neurodevelopmental data at 12 months and child attention and executive function at 9 years. Infant screen time was by parent report.

An EEG was done at 18 months of age. An electroencephalogram (EEG) is a test that measures electrical activity in the brain using small metal discs attached to the scalp. Brain cells communicate via electrical impulses and are active all the time, even during sleep. This activity shows up as wavy lines. These wavy lines can diagnose seizures and other brain disorders, such as brain dysfunction, from a variety of causes.

Since the beginning of the use of mobile electronic devices and TVs, infants between 6 months and 18 months are exposed to 2-3 hours of screen time per day. This amount exceeds the recommendations of the American Academy of Pediatrics, which discourages screen media use before the age of 18 months, except for video chatting with family. This is based on findings of the use of screen time in early childhood (6 months to 4 years) and problems with attention and executive functions.

Executive function refers to skills that help people to focus, plan, prioritize, work towards goals, self-regulate behaviors and emotions. It helps people to adapt to new and expected situations and ultimately engage in thinking and planning. It is like a conductor of an orchestra that supervises and coordinates a multitude of cognitive, behavioral, and emotional tasks. Executive function skills begin to develop in the first year of life and are not fully developed until early adulthood.

Certain kinds of wavy lines (theta waves) in the EEG are associated with poorer attentional control. This study showed that increased screen time before age 12 months, the EEG studies known to be with poor attention control found at 18 months could predict impairment of attention and executive function at 9 years of age.

The developing human brain has never been exposed to any electronic mobile devices, much less for hours. The fact that infant screen use is associated with altered cortical EEG activity before the age 2 years has serious implications for the long-term consequences to our population.

Limiting screen time for infants and toddlers has the positive effect of limiting screen time for their caregivers so that there is much more face-to-face time. Shared screen time has less two-dimensional effect, but best of all is face-to-face time like peek-a-boo.

Not only should infants put down their devices, but so should parents. It is strongly recommended that there be no TVs or devices allowed in bedrooms and when a selected show is finished, the TV gets turned off.

While robots with artificial intelligence get smarter and smarter, we shouldn’t let our children get less so.

Dr. Sally Robinson, MD

Dr. Sally Robinson is a clinical professor of pediatrics at UTMB. This column isn’t intended to replace the advice of your child’s physician.

Children's Health Services