Toddlers’ Screen Time Tied to Atypical Sensory Outcomes

Screen time early in life was associated with atypical sensory outcomes, an observational study showed.

Children who watched any television or videos at age 12 months had a significant, two-fold greater risk of a high degree of failing to notice obvious stimuli (low registration) compared with those who didn’t spend any time in front of a screen, reported Karen Heffler, MD, of Drexel University College of Medicine and Tower Health in West Reading, Pennsylvania, and colleagues.

These children were also significantly less likely to have a low degree of low registration, sensation seeking (actively seeking stimuli throughout the day), and sensation avoiding (trying to control the environment to limit exposure to stimuli), with odds ratios of 0.64 (95% CI 0.44-0.92), 0.55 (95% CI 0.35-0.87), and 0.69 (95% CI 0.50-0.94), respectively.

Some similar findings were seen at ages 18 and 24 months, the researchers noted in JAMA Pediatrics.

Atypical sensory processing is common in neurodevelopmental disorders, affecting approximately 60% of children with attention deficit-hyperactivity disorder (ADHD) and up to 90% of children with autism, Heffler told MedPage Today in an email.

“Sensory symptoms are associated with hyperactivity, restricted/repetitive behavior, irritability, behavioral problems, and emotional dysregulation,” she said. “Sensory-related meltdowns and behaviors can be very disruptive to family-life, interfere with family participation in community events, and are associated with increased caregiver stress.”

“This study adds atypical sensory processing to the list of other developmental outcomes, including autism, ADHD, language delay, negative brain findings, and behavioral problems associated with early-life screen exposure,” she further noted.

The study could not determine that screen time caused sensory issues, Heffler cautioned.

However, “potential mechanisms for this association include screen time displacing other important social and play opportunities which are important for typical sensory development, and/or the audiovisual stimulation of early-life screen time may be directly impacting early brain development,” she said.

The research team used data from the National Children’s Study, a cohort study of environmental influences on health and development, with enrollment from 2011 to 2014. Data were analyzed in 2023.

The study categorized nearly 1,500 kids for high, low, or typical levels of sensory outcomes, grouped according to Dunn’s Model of Sensory Processing: low registration (failing to notice obvious stimuli), sensation seeking (actively seeking stimuli throughout the day), sensory sensitivity (being overly irritated or upset by stimuli), and sensation avoiding (trying to control the environment to limit exposure to stimuli).

Specifically, parents or caregivers rated their children’s behavior based on the Infant/Toddler Sensory Profile (ITSP) at approximately age 33 months. ITSP items were then regrouped to obtain quadrant scores based on Dunn’s Model of Sensory Processing.

Half of the children included were male. Information on screen time was missing for 26.6% of kids at 12 months, 14.5% at 18 months, and 9% at 24 months. There were 910 kids with viewing information from all three measurement periods.

Overall, most of the 1,471 children studied were in the typical sensory group. About one-fifth exhibited less frequent sensory sensitivity and sensation avoiding.

Greater screen time at age 18 months was associated with an increased risk of being in the high category of sensation avoiding (OR 1.23, 95% CI 1.03-1.46) and low registration (OR 1.23, 95% CI 1.04-1.44).

And greater screen time at age 2 was associated with an increased risk of being in the high category of sensation seeking (OR 1.20, 95% CI 1.02-1.42), sensory sensitivity (OR 1.25, 95% CI 1.05-1.49), and sensation avoiding (OR 1.21, 95% CI 1.03-1.42).

Limitations of the study included use of the ITSP. Although it is a validated caregiver questionnaire, a more objective measure of sensory processing would be important in future research, Heffler and colleagues noted.

Additionally, only children whose parents completed the ITSP were included, and other developmental delays that might impact sensory processing were not accounted for in analyses.

“Further research is needed to determine if high early-life screen time is a risk factor contributing to the sensory hyper-connectivity and audiovisually oriented attention mechanisms found in some children with autism,” Heffler said.

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