Screen time for kids under 2 linked to sensory differences in toddlerhood: Study

For children under the age of 2, television screen time is associated with sensory differences later in toddlerhood, according to a new study.

Children who watched any television or DVDs at 12 months of age were twice as likely by 36 months to experience “atypical sensory processing” – that is, challenges in processing day-to-day sensory input – compared to others of that age. After 18 months of age, each extra hour of screen exposure per day was associated with around a 20% increased likelihood of sensory processing differences, according to the study, published Monday in JAMA Pediatrics.

For the study, researchers analyzed 1,500 caregiver surveys regarding their child's sensory preferences, such as sensitivity to, preference for, or avoidance of different noises, lights, and textures. The study only looked at children who watched television, not smartphones or tablets, because the survey data was gathered prior to 2014.

The study, led by researchers at Drexel University, follows previous research showing how screen time impacts the ways kids speak, hear, feel and think.

A study published last year found that screen time for 1-year-olds was associated with developmental delays in problem-solving and communication as early as ages 2 and 4.

Examples of sensory processing issues can include everything from a child feeling uncomfortable in clothes to handling bright lights or loud noises differently than others, according to the Child Mind Institute, a nonprofit organization focused on kids' mental health and learning disorders. Sensory processing issues run the spectrum from possibly minimally affecting a child's life to interfering with their daily function.

Sensory issues can exist on their own, but are sometimes seen with conditions like autism, attention-deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD), according to the Institute. The Drexel study was not able to comment on the prevalence of autism, ADHD, or OCD with screen time.

Dr. Karen Heffler, an associate psychiatry professor at Drexel University and lead author of the new study on screen time, said she became interested in research on the impact of screen time on young children after her own son was diagnosed with autism.

"I'm very interested in any potential factors that could help other families whose children are diagnosed with autism," Heffler told ABC News, adding that this study adds data about screen time for very young children, especially those under one year of age. Prior studies have mostly focused on children older than a year.

The American Academy of Pediatrics (AAP) currently recommends against any screen time for children under the age of 2, excluding live video chats, like FaceTime with family members. The AAP further recommends a 1-hour per day time limit on screen time for children ages 2 to 5.

Research shows, however, that the majority of children under the age of 5 are watching more screen time than is recommended, due in part to the increasing prevalence of mobile devices as well as digital accessibility, content targeted to children, and increases in screen-time use during COVID-19.

Takeaways for parents on screen time and young kids

While experts agree that limiting screen time is generally better for brain development, they caution against concluding that the screen time itself is leading to sensory differences.

Dr. Emily Myers, a neurodevelopmental pediatrician at the University of Washington and Seattle Children's Hospital, told ABC News that while non-interactive screen time does decrease opportunities for children to learn self-regulation skills and connection to their physical environment, there are cases where children might use screens more to self-regulate, because of pre-existing sensory differences.

She also said that home and family environments matter, too, and that screen time can sometimes be a proxy for something else going on in the home that might affect development.

The study out of Drexel University associated screen time only with sensory differences, and not necessarily with conditions like ADHD or autism, although past studies have shown that children with these conditions tend to also experience sensory differences.

However, although some specific sensory changes at 18 and 24 months of age can be associated with developing autism, it's difficult to predict if sensory differences will positively or negatively impact that child's lived experience, according to Dr. Jade Cobern, a pediatrician and neonatal hospitalist at Johns Hopkins.

"If the sensory differences are getting in the way of them meaningfully engaging in the world or they are distressing to a point that it becomes a problem, that's when we start to worry about some of the negative impacts of these sensory differences," Cobern said.

When she counsels parents on decreasing screen time, Myers said she acknowledges the modern ubiquitousness of screens, even for adults, saying, "It's very difficult to unplug a specific age population when everyone around them has screens on all the time."

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Prior studies have identified lack of affordable alternative activities, parental fatigue, and burnout as barriers to decreasing screen time for children, and note that parents can often experience guilt when regulating screen time for their child.

In her practice, Myers recommends a more holistic approach to identifying possible barriers to decreasing screen time, such as assessing whether a family's basic housing, food, and safety needs are being met. She said she also spends a lot of time on helping families promote relationships with their child, as well as problem-solving with them.

"I haven't seen a lot of families actually have a lot of success with decreasing screen time," Myers said. "Usually there's some other really significant contextual factors which are interfering and need to be addressed, in addition to screen time."

Cobern also recommends tailoring approaches to the specific family and patient, and collaboratively brainstorming accessible ways to decrease non-interactive screen time and increase healthy developmental activities, such as reading, playing with objects, and socializing with other children, even if those activities might entail screens.

"Everyone has to be realistic when we're talking about how parents can support their children's development," Cobern said, adding of research like the Drexel study, "It's not to shame screentime exposure because the reality is we live in a world where screens are part of our daily lives."

She continued, "It really is inevitable that most kids will see some screen time even early in life, but it is something I encourage families to be mindful of."

Angela Y. Zhang, MD (she/hers), is a pediatric resident and a member of the ABC News Medical Unit.