Screen exposure has become a global public health issue and a research hotspot in the field of children's health. Screen exposure refers to the behavioral activity of using electronic products with screens. Early excessive screen exposure can adversely affect children's language, sleep, vision, attention, social skills, and other mental behaviors. Relevant studies at home and abroad have shown that prolonged screen exposure is negatively correlated with early childhood cognitive and language development. In clinical work, we often encounter a series of growth and development problems in children aged 2~5 years old such as delayed language development and low communication interest due to excessive screen exposure.
Speech-language delay
Xiaojia (pseudonym) is 2 years old and 8 months old this year and came to the hospital for "talking less". At the age of 1 year and 3 months, Xiaojia began to take the initiative to call "dad, mother", but after more than 1 year, Xiaojia basically had no other language. Xiaojia will say "ah, ah" when expressing things of interest or needs, accompanied by gestures, will answer "um" when questioned, and say something that parents cannot understand while playing by herself. It is understood that when Xiaojia was 1 year old, his family often played children's songs to him and made rhythms together, half an hour in the morning and half an hour in the afternoon every day. After a period of time, Canon turned on his own electronic device to watch the video, often for 1 hour. After the age of 2, Xiaojia spends at least 4 hours a day on screens and reading pens. During the visit, Xiaojia was very cooperative, had good interaction, and had normal hearing, but a comprehensive neuropsychological and language assessment showed that Xiaojia's oral expression ability was significantly behind, gesture language was slightly behind, and language comprehension, social communication and game ability were within the normal range.
In clinical practice, it is not uncommon for children like Xiaojia to lag behind in the development of language expression due to excessive screen exposure. The development of language skills requires an environment of interactive communication, and focusing on screen time for too much time can reduce the frequency and interaction between children and their caregivers. Infant language learning is inseparable from the stimulation of environmental factors, such as the speaker's lip movement, body movements and auditory information, which can stimulate children's active cognitive language processing. However, when screens are exposed, children's auditory and visual stimuli are passively processed and lack interactivity, so it is likely to lead to underdeveloped brain networks related to cognitive language control, which can affect language development.
Our recommendation for Xiaojia's visit is to control the screen and reading pen for about half an hour a day. When the family accompanies Xiaojia to play, timely match the language related to the situation. Communicate effectively with children in family parenting, become playmates with children, and choose interactive games and activities that children love, such as hide-and-seek, housekeeping, etc. Parents give their children timely and appropriate responses and sufficient language input in life. After 2 months, Canon's vocabulary has increased significantly, he can speak more than 30 words, and can imitate and say phrases with 3 structures. It can be seen that screen time is controlled, and reasonable guidance is given, and children's language ability improves rapidly.
Interest in social communication is not high
Yeon-yeon (pseudonym) is 2 years old, but she doesn't say anything, she doesn't like to play with children, and she sometimes responds to her family and what she says and asks her to help do, and sometimes ignores them. Everyone thinks she is a "cold fan". The family took her for a hearing and oral examination, and the results were normal. We learned that Yeon-yeon's parents, although they usually work from home, are very busy and have fewer opportunities to talk to their children. Since Yeon-yeon is 6 months old, various music, cartoons or children's programs have been playing at home for a long time. Yeon-yeon enjoys watching and listening to TV shows. Watching TV, she basically does not disturb her family's work, and often twists her body to the rhythm of the music, and will laugh when she sees scenes that make people laugh. She also learned about colors, numbers, and shapes. When her parents are not busy with work, they will play games with her, but she is always not interested and sometimes ignores her. During the visit, we used various toys and games to guide her participation, but she only occasionally glanced at the doctor. After a comprehensive neuropsychological assessment, Yeon-yeon's language development, social communication and gaming skills lagged significantly behind.
In the pre-language stage, children communicate through gaze, common attention, alternating activities, emotional sharing and gestures, which is the basis for later oral development. Excessive and premature screen use can negatively affect children's ability to communicate and express their own needs. The sound emitted by electronic products is a mechanical sound, can not human-computer interaction, children can only listen passively, can not actively communicate with it, affecting the development of children's communication ability. When exposed to electronic products, children's language skills are better than those of children watching alone, and parents' timely and effective response, oral expression and parent-child interaction help stimulate the connection between neurons in the child's brain to obtain cognitive stimulation, emotional regulation and social participation. Through interactive play, parents can establish an emotional connection with infants and young children, and provide an environment that stimulates language development.
Our advice to Yeon-yeon is to control screen time and have your parents with your parents when touching the screen. At the same time, observe the child face-to-face in the family parenting environment to understand the child's interests and increase eye contact; Give your child a timely and appropriate response, with adequate language input related to what they want and do; Patiently wait for the child to express, follow the child's rhythm, and give appropriate encouragement; Create more opportunities for communication, such as offering choices, deliberately making mistakes, and not rushing games to be completed all at once. Two months later, when Yeon-yeon came for a follow-up visit, she offered us cookies and started calling "dad and mom", waving "goodbye" when she left.
Screen time recommendations
Screen exposure habits in infancy and early childhood not only affect language and social development, but can also extend into school age and even adulthood, and have a profound impact on their growth and lifestyle. In recent years, children's screen exposure has been listed as an important goal of children's health management. The Outline for the Development of Children in China (2021-2030) lists popularizing healthy lifestyles, promoting children's healthy behavior habits, and controlling the use of electronic products as priorities for children's health management. The "Bright Action Plan for the Prevention and Control of Myopia in Children and Adolescents (2021-2025)" pointed out that it is necessary to strengthen the management of the use of children's mobile phones, computers and other electronic products, strictly control screen time, and eliminate "electronic nannies". The "Ten Core Knowledge of Prevention and Control of Myopia in Children and Adolescents" pointed out that infants and young children aged 0~3 do not use video electronic products such as mobile phones, tablets, and computers; Children aged 3~6 should avoid contact and use of mobile phones, tablets, computers and other video electronic products; Primary and secondary school students should not use electronic screens for non-learning purposes for more than 15 minutes at a time, and the cumulative time should not exceed 1 hour per day.
Parents should be the guide of children's screen use and strictly control the screen exposure time. It is recommended that parents choose high-quality programs to watch with children during reasonable screen time, actively carry out responsive care, stimulate children's potential, and cultivate children's self-control to use screens reasonably to better benefit from them.
(Author: Wang Jianhong, Deputy Chief Physician of the Health Center of Children's Hospital Affiliated to Capital Institute of Pediatrics)
Source: Guangming Network - Guangming Daily