Thursday, August 1, 2013

Media Use in Infants

We've all done it. I desperately need to take a shower and need something to entertain my child for a few minutes so I plop them down in front of the television. No harm right? Most people would say not at all, and for the most part I agree. Television and iPads can be great ways to distract a child so us moms can sneak away for a few minutes to take care of our basic needs. But where do we draw the line? Obesity is the most commonly discussed reason for the movement of decreasing media exposure in children. We all know that childhood obesity has become an increasing issue in the United States and many people attribute a portion of that to a sedentary lifestyle. It's no secret that the combination of moving less and eating more leads to weight gain so I don't think I need to go into detail about how excessive television viewing and computer/ipad usage can lead to obesity in children. But is media exposure actually that harmful to babies, I mean we do tend to love our babies chubby, right? My answer: it depends on how much. The American Academy of Pediatrics recommends parents "strongly avoid screen exposure for infants under the age of 2." As an occupational therapist, my problem with the use of media is not what the exposure does to the baby, its what the exposure doesn't do for the baby.

Visual Interpretation
Exposure to media screens does not provide a baby an accurate visual interpretation of our world. Sure they have bright colors and flashing lights but they are 2 dimensional. They don't have shadows and they don't teach a baby how to focus their eyes in different depths of field. Staring at a screen for too long can actually cause a baby's eye muscles to atrophy just as they do with adults. Have you ever gotten a headache from staring at a computer screen for too long? You have the sense to look away and rest your eyes but babies don't understand what is making them feel that way and they can't communicate to you that they have a headache.

Sensory Stimulation
Exposure to media screens does not provide a baby with enough sensory stimulation. Sure they have plenty of visual stimulation but screens don't have texture variation or a form, they don't have much of a smell and the auditory stimulation comes from a speaker. Compare playing a piano app on the iPad to playing with a piano toy.

The iPad is flat. You touch the screen and a sound comes out of the speaker. The screen may light up to show the key you push. The definition between keys is shown by color (only visual), the feedback for pushing the button is the sound (auditory and maybe visual if the key lights up), and the sound from all the keys comes from one location (the speaker). When using the toy piano, there is space between the keys that can be felt with your hands, you receive feedback that you hit the key by your finger moving in a downwards direction, and the sound that comes from hitting the key comes from wherever the key is that you hit. The toy stimulates your senses in more ways than the iPad, therefore you have the opportunity to learn more and understand the experience better.

Social Interaction
Exposure to media screens does not provide a baby with social interaction. Language development is extremely important for infants which is why talking to your baby all day long is one of the best things you can do for them. I often get stares in the grocery store as I'm walking down the aisles having a full out one way conversation with Joanna. "Joanna, where is the BBQ sauce? It must be by the ketchup because they are similar condiments." Now Joanna has no idea what ketchup is, or condiments, but hearing words all day long gets that little brain of hers working as she tries to figure out what all of them mean. Maybe all she got out of that was the word Joanna, but she recognized it and realized I was talking to her. Social interchanges are the basis of early language development. Baby smiles, Mom smiles back and then baby smiles again and Mom laughs. This is the foundation for conversational turn taking and establishes a pattern of coordinated behavior. Baby learns that when she says something, Mom will respond and vice versa. A screen can not respond to baby in the same way, decreasing its ability to improve language skills as well as good old fashioned communication. A baby gets so much more out of singing, reading a book with you, playing peek-a-boo, watching you cook dinner or listening to you talk about ketchup in a grocery store than what they get from playing on an iPad or watching television.

Mobility
Exposure to media screens does not provide baby with the opportunity to increase mobility and endurance. Sitting on the couch and playing on an iPad or watching television do not encourage much range of motion or strength building. When playing on the floor, baby has many opportunities to work on problem solving (how to get to a toy, how to make a toy do what they want it to do, ect.), engage their core muscles (by reaching for toys, rolling over, maintaining a sitting position, getting into 4-point, ect.) and improve balance (as they are reaching for items or maintaining a position).

Crossing the midline
Crossing the midline is an important term that we use frequently in the therapy world. Crossing the midline refers to one hand reaching across to the other side of the body. When a child crosses the midline, both sides of their brain are communicating with each other and they are building stronger neural pathways within their brain. This communication taking place within the brain will eventually aid in crawling, standing, walking and later on, school related tasks such as handwriting and reading. When a child is playing on a computer or watching television, they are doing very little crossing the midline. Some may argue that many educational tablet apps encourage crossing the midline and that may be true, however moving your hand across a 6 inch screen is a very minimal movement. Larger, gross motor movements are much more beneficial to motor learning. I have a whole post on the importance of crossing the midline coming in the near future.

Do I need to avoid ALL media exposure with my infant?
Some may argue yes. In fact, there are mixed opinions in research regarding whether children under the age of 2 are even capable of learning from media. The American Academy of Pediatrics said in a 2011 policy statement that the educational benefits of media in children under the age of 2 have not been proven despite the fact that many infant based television shows or tablet applications claim they have such benefits. The same policy statement even states that research may indicate that background media could interfere with cognitive processing, memory and reading comprehension and they stress the importance of parents understanding the effects of having the television on in the background.

So how much is too much? Well, that's gotta be your call. For me personally, I try to avoid media exposure as much as possible with my baby. I have a husband who loves having the television on at all times so I try to keep it off during the day because I know it will be on in the background when he gets home at night. As far as the iPad, it comes out maybe once per week for about ten minutes and when we do use the iPad, we play together and interact with one another the entire time. My personal goal for my child is that she develop interests in non-media related activities that promote creativity, physical activity and problem solving prior to introducing much media exposure. I believe that when a child gets used to watching television or playing on an iPad too often, it stunts their development, they don't learn how to entertain themselves, and their communication skills, creativity and imagination lack. They don't explore their world and learn from it and therefore live in an imaginary two dimensional world. 

But that is my way. The right way for my family may not be the right way for your family and there is nothing wrong with that. I am just simply stating what I know from my experience as a therapist and what I have learned from personal research. I don't believe that media use in babies and children is ALL bad. It can actually be a great resource, especially as children develop the ability to learn from it. But that is all it should be for a child, a resource and not a way of life. All in moderation.

For more information on the American Academy of Pediatrics guidelines in relation to media in children, see the links below.

AAP - Media Use by Children Younger than 2 Years

AAP - Policy Statement: Children, Adolescents, Obesity and the Media

AAP - Parents of Preschoolers: Expert Media Recommendations

AAP - Digital Childhood: Electronic Media and Technology Use Among Infants, Toddlers and Preschoolers