Mobile media device use is associated with language delay in infants

As technology becomes an increasingly significant part of daily life, “screen time” is becoming an increasingly broad term. It is no longer limited to time spent in front of televisions and has come to include time spent on handheld mobile media devices like smartphones, tablets and video game consoles. While children and adults alike use mobile media devices for entertainment and education, the association between mobile media device use and child development was, until recently, somewhat unclear.

A recent study by researchers at the Hospital for Sick Children (SickKids), published in the Journal of Developmental and Behavioural Pediatrics, revealed a significant association between mobile media device use and expressive speech delay.

“Other studies have reported an association between television screen time and language delays in children, but this is the first study to examine time spent on mobile media devices and communication delay in children,” said Dr. Meta van den Heuvel, first author of the study and a paediatrician at SickKids.

This cross-sectional study assessed 893 children between the ages of six months and two years from 2011 to 2015. Researchers concluded that toddlers and babies who spent increased time on screens were at a higher risk of delays in their expressive language.

This study did not find any link between screen time and delays in other forms of communication like gestures or social interaction. The study’s findings were consistent regardless of sex, household income level, maternal education, child non-mobile screen time and parent’s own mobile media device use.

The research team collected data during regular 18-month well-child check-ups at the doctors’ offices. All participants were patients of primary care practices in the Greater Toronto Area (GTA). This was facilitated through a community-based research network called The Applied Research Group for Kids! (TARGet Kids!). TARGet Kids! is a network of primary care practices participating in research that aims to find connections between early life exposures and health problems including obesity, micronutrient deficiencies, and developmental problems.

At well-child visits, parents were asked to fill out a standardized questionnaire to estimate how much time their child spent each day using mobile media devices like smartphones, tablets and electronic games.  Parents also filled out the Infant Toddler Checklist (ITC), a parent-reported questionnaire that measures early communication and symbolic skills in young children. The ITC assessment looks at a range of language development indicators, including the child’s use of sounds or words to get attention, how many words the child uses and their ability to put words together.

Researchers found that by their 18-month check-up, 22.4 per cent of children were using handheld devices on a daily basis for an average of 16 minutes per day. This group of children was more likely to score below the 10th percentile on the speech domain of the ITC, indicating risk for significant speech delay. The study also indicated that every 30-minute increase in handheld screen time per day resulted in a 2.3 times increased risk of expressive speech delay.

“The use of smartphones and tablets with young children has become quite common. While new pediatric guidelines suggest limiting screen time for babies and toddlers, we need a better understanding of the context of the use of these devices to provide effective guidance to families,” says Dr. Catherine Birken, the study’s senior investigator and a paediatrician and scientist at SickKids. “Though our findings do not prove cause and effect, the study has shone a light on this potential issue.”

To further explore this topic, the research team hopes to investigate the types of activities that children were engaging in on screens, and how this related to parent screen time. Going forward, they are also interested in addressing longer-term communications outcomes in early childhood.

This study was supported by the Canadian Institute of Health Research (CIHR), St. Michael’s Hospital Foundation, Physician Services Incorporated and SickKids Foundation. It is an example of how SickKids is making Ontario healthier, wealthier and smarter (www.healthierwealthiersmarter.com).

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