As parents, many of us embark on the journey with the best intentions, only to find our lofty ideals swiftly yielding to the demands of reality. The use of screen time becomes evident as a potent and practical tool; whether stuck on an airplane or in a waiting room, pulling up a video on your phone or iPad proves to be a reliable method for quietly engaging a young child. Farewell to our initial aspirations, and hello to the convenience of shows like Bluey.

Parents harbor no illusions about the benefits of screen time for children. Instead, we find ourselves seeking ways to navigate the challenges of the day, often accompanied by a lingering sense of guilt regarding these choices.

We acknowledge the growing body of evidence suggesting that screen time can adversely affect children, especially the youngest ones. The American Academy of Pediatrics advises against any media exposure (except for video chatting) for children under the age of 18-24 months.

This guideline naturally triggers anxiety and fosters disagreement among parents who are well-acquainted with the captivating influence of a TV show or YouTube video in soothing a tantrum-prone toddler. Such digital distractions offer a moment of tranquility to enjoy a restaurant meal or accomplish tasks around the house.

The cognitive impact of screen time remains unclear, with the question of whether it is the act of viewing itself or the substitution of interactive and communicative activities that hinders healthy brain development. However, experts unanimously advise minimizing screen time for the youngest children.

Despite our understanding of the association between screen time and negative outcomes, there is limited data on how it directly impacts children's brains. Recent research focusing on kids' sensory processing sheds some light on the influence of screen time on cognitive development.

A study published in JAMA Pediatrics this month revealed a correlation between toddlers' screen usage and atypical sensory processing. This finding provides insight into how children's cognitive development may be affected by screen time, addressing a gap in our understanding of its impact.

What exactly is sensory processing, and what prompts pediatricians to keep a close eye on it?

Consider the traditional five senses: sight, hearing, smell, taste, and touch. Our brains receive information through these channels and endeavor to interpret it—a phenomenon known as sensory processing. It's the reason we instinctively recoil from a hot stove or lean in to catch a whispered conversation.

Various behaviors may indicate a sensory processing issue. For instance, a child might engage in sensory-seeking behaviors like spinning their body, or conversely, they may avoid certain sensory experiences, such as refusing to try new foods.

Individually, these responses don't necessarily signal a problem. Many children enjoy activities like spinning, exhibit food preferences, or have clothing-related sensitivities. It becomes a concern when these behaviors impede daily life and cause distress.

Pediatricians closely monitor children's sensory processing for several reasons. The first three years witness significant brain development, and early detection allows for more effective intervention. 

Treatment options, such as occupational, behavioral, or physical therapy, are available for children with sensory processing issues. Screening and addressing these conditions are crucial not only for the child's well-being but also because sensory processing problems correlate with lower quality of life for children and heightened stress for caregivers, a clinical director at the Center for Youth Mental Health at NewYork-Presbyterian.

Furthermore, sensory issues often coexist with ADHD and autism spectrum disorder (ASD). The study notes that a significant percentage of children with ADHD and ASD also exhibit atypical sensory processing. While not every child with sensory processing concerns has one of these neurological conditions, recognizing these issues may contribute to a more comprehensive diagnostic understanding.

What impact do screens have on the sensory processing of children?

data from nearly 1,500 families. Parents provided information on their children's exposure to TV/videos at 12 and 24 months. At 33 months, they completed the "Infant/Toddler Sensory Profile," a tool used to screen for potential issues in children's sensory processing. The questionnaire covered auditory, visual, tactile, vestibular (balance), and oral sensory processing, categorizing behaviors into low registration, sensation seeking, sensory sensitivity, and sensation avoiding. For instance, a child displaying resistance to trying new foods and resisting teeth brushing exhibits sensation-avoiding behaviors in oral sensory processing.

The study identified various forms of atypical sensory processing associated with any screen exposure, providing valuable insights for both parents and healthcare providers. The study adds atypical sensory processing to the list of developmental and behavioral outcomes linked to early-life screen exposure, including autism, attention problems, language delay, impaired problem-solving abilities, brain differences, behavioral problems, and disordered sleep.

Crucially, the study does not establish a causal relationship between screen time and atypical sensory processing disorders; it only identifies a correlation. The authors propose that screen time might replace necessary face-to-face interactions for healthy neurodevelopment in young children. Alternatively, parents might be more inclined to allow higher levels of screen time for children with challenging sensory behaviors. In other words, if a child is challenging to soothe or manage in certain situations, parents may be more likely to resort to screen use.

The authors also highlight previous research suggesting that children with autism showed symptom reduction when some screen time was replaced with socially-oriented activities, and symptoms worsened with a return to high levels of screen time.

How can parents reduce the influence of screen time?

While experts recommend parents to reduce screen time, recognizing the occasional necessity of its use, they argue against relying on judgment and guilt as motivators. Enforcing strict time limits may not be universally beneficial, as not all screen time is equal, and the needs of various children and families differ.

These experts also highlight the need for additional research on the topic, emphasizing that each family should determine what works best for them. They stress the overall importance of high-quality content during screen time, coupled with opportunities for children to laugh, play, read, and engage in physical activity throughout the day. Additionally, having access to caregivers who assist children in understanding and appropriately managing their emotions and behavior is crucial. The focus is on the duration of screen time, the activities during screen use, and the overall engagement when screens are not in use—a holistic approach to the issue.