Screen time and infants: evidence summary

Literature summary of key points

- There is a lack of UK based research evidence on the effect of media on infant development with much of the research from U.S sources.  Much of that is correlational rather than causal in nature and unclear about effects of different content and contexts.
- Further research is needed but there is enough to indicate concern and an increased role for parental guidance, particularly around the effects on parent-child interactions.
- Early exposure to television has been associated with negative or neutral outcomes, but often within the normal ranges. Television watching does not have any advantages for the brain development in children under two, though there is faint evidence that some content can be more beneficial.
- Use of media can cause parental distraction resulting in decreased parent-child interactions.
- There may be reduced parental responsiveness in the presence of media. (Parental responsiveness has been identified as vital in establishing a secure attachment and developing communication skills.)
- Young children have a poor ability to filter irrelevant stimuli ie background noise from media, and background TVs etc have been shown to reduce quality of play and interaction.
- Quality as well as quantity of parent-child interactions diminishes in presence of background television.
- The type of toys in an interaction can influence the amount of parent-child interaction, with more interaction gained with traditional toys than electronic toys/devices.
- Most brain development occurs within the first three years of life. Research on early brain development shows the need for direct interactions with parents.
- It is not enough to turn tv/media off, rather parents should be aware of the importance of parent-child communication. Key messages need to focus on this since reducing screen use does not in itself improve physical activity or adult-child interactions.

Screen time key messages - prebirth to 8 weeks

Your baby needs you to talk to her or him.
This helps your baby feel safe and secure, and learn how to communicate. Even before birth, hearing your voice is important to your baby. Talking to baby as often as you can about what you are doing or what you can see around you will help their language and communication skills to develop.

Make sure there are times when baby has your full attention.
It can be helpful to have a quiet time each day to interact and talk with your baby.  Look out for times when baby seems alert (or before birth, is moving about), and avoid any distractions or background noise, such as TV or mobile phones. This will help baby to focus on your voice.  Even short periods at a time are great in the early days.

Look out for your baby trying to get in touch with you.
At first this might be huge cries or very small attempts to communicate – little movements or just a sense that they are looking at you differently.  If you spot some of these and respond positively with talking, and a tuneful voice, your baby will learn so much about communication. Wait for a response – it might take over 10 seconds, but it will come.

Be aware of how much YOU are on screens!
TV and tablets/phones are a big part of our lives now, and that’s fine. Just be aware of how much time you are spending talking and playing with your baby – and whether you are missing opportunities because of the TV or phone. And even a TV in the background can be distracting for your baby as they can’t listen/tune in to your voice. Sometimes it can be a habit to leave the television turned on most of the time.

Good times to put down the phone or turn off the box!
Try and find times each day when you are away from the screens so you can focus on playing and talking with your baby.  For example, when your baby is just awake and interested; when you are feeding; when out and about. If you are feeling stressed or lonely, sometimes chatting with your baby will help you feel better more than any app can.

Should parents just avoid screens?
Not at all! Apps can be great for sharing with family and friends the experiences you and your baby are having. Parents can feel lonely or cut off from friends or work, and social media helps keep in touch. Just look out for spending more time posting photos of your baby than talking and playing with them! Also, if you have a partner, make sure you have time to talk with each other too.  And, screens at bedtime can be bad for sleep – if you are as tired as most parents are, try and have an hour or so before bed without the phone.

Having trouble putting the phone down?
Everyone finds this hard sometimes!  Here are some ideas that might help you focus more on baby.
• Set aside special times for talk and play, even really short
• when you talk with baby, put the phone in another room on silent
• use times when baby is asleep for social media catch up (also cute photos)
• use timers to be aware how long you are on
• consider installing apps that help reduce screen use.

Anticipatory guidance

What about when baby is older?
Despite what the adverts say, babies don’t gain much from TV or apps for at least a year or so. They do learn from interacting with you, though. Research that shows harm from screen use tends to be because it replaces time talking and playing with adults.
Here are some tips for the future:
• Use the screens as a way of talking and playing with your baby i.e., talk about what you can see and what is happening.
• Turn off the TV sometimes – even when on silent it can be a huge distraction for your baby reducing learning
• Make sure your baby gets enough sleep and physical play – to help them grow the skills they will need
• Avoid any violence in content
• Play and check games yourself first
• Try not to use screens as a soother, and certainly not in the bedtime routine
• Have lots of enjoyable family interactions, including some “unplugged time”. 
• Make sure your baby gets enough sleep and physical play
• Remember the importance of songs, rhymes, stories and traditional play activities in your babies development. These have much more value than electronic toys/devices. Babies will learn the most from the everyday interactions and play they have with you.
Don’t spend your money on apps and videos – the most valuable investment for your baby is time playing and talking with you!

Selected evidence

Anderson, D. (2005) . Television and very young children. American Behavioural Scientist, 48, 5, 505-522.
Barr, R. (2013). Memory constraints on infant learning from picture books, television, and touchscreens. Child Development Perspectives, 7(4), 205-210.
Barr, R., Calvert, S. L., & Wilson, B. J. (2008). Attention and learning from media during infancy and early childhood.  In Calvert, S. L., & Wilson, B. J. (Eds.). (2009). The handbook of children, media and development. John Wiley & Sons.
Biddle, S. J., Gorely, T., Marshall, S. J., Murdey, I., & Cameron, N. (2004). Physical activity and sedentary behaviours in youth: issues and controversies. The Journal of the Royal Society for the Promotion of Health, 124(1), 29–33.
Carson, V., & Janssen, I. (2012). Associations between factors within the home setting and screen time among children aged 0–5 years: a cross-sectional study. BMC Public Health, 12(1), 539.
Christakis. D. (2009). The effects of infant media usage:what do we know and what should we learn? Acta Paediatrica. 98, 1 8-16.
Downing, K. L., Hinkley, T., & Hesketh, K. D. (2015). Associations of parental rules and socioeconomic position with preschool children’s sedentary behaviour and screen time. Journal of Physical Activity and Health, 12(4), 515-521.
Etchells, P., Fletcher-Watson, S., Blakermore, S-J., … (2017). Screen time guidelines need to be built on evidence, not hype, The Guardian, https://www.theguardian.com/science/head-quarters/2017/jan/06/screen-time-guidelines-need-to-be-built-on-evidence-not-hype, retrieved 17 July 2017.
Fidler, A., Aack, E., & Barr, R. (2010). Television viewing patterns in 6-18 month olds: the role of caregiver-infant interaction quality. Infancy. 15, 2 176-196.
Foster, E. M., & Watkins, S. (2010). The value of reanalysis: TV viewing and attention problems. Child Development, 81(1), 368-375.
Hamer C. 2012. NCT Research overview: Parent-child communication is important from Birth. Perspectives – NCT’s journal on preparing parents for birth and early parenthood. March 2012
Hinkley, T., Cliff, D. P., & Okely, A. D. (2015). Reducing electronic media use in 2–3 year-old children: feasibility and efficacy of the Family@ play pilot randomised controlled trial. BMC public health, 15(1), 779.
Hinkley, T., Salmon, J., Okely, A. D., & Crawford, D. (2013). The correlates of preschoolers' compliance with screen recommendations exist across multiple domains. Preventive medicine, 57(3), 212-219.