Ask the Doctors: 'Digital free-for-all' not the answer for young kids

Q: My daughter always gives my grandson her cellphone to play with — and he's only 18 months old. I read that this can cause speech delays. How serious is the risk? Does it stunt children in other ways?

A: The allure of the screen is powerful. We've all seen pairs of diners in restaurants, rows of parents at the playground and groups standing together at a party, each absorbed in the solo glow of their smartphone.

Now, with handheld devices taking so many forms, it's no surprise that children who haven't yet begun to speak know their way around an iPad. Perhaps nothing drives this point home better than a YouTube video (almost 5 million views so far) that shows a 1-year-old tapping and swiping on a magazine, frustrated as she tries to make it behave like the tablet she so clearly prefers.

Now comes a study that suggests this early affinity for digital gadgets may come at a price. Led by Catherine Birken, M.D., a staff pediatrician and scientist at The Hospital for Sick Children in Toronto, the findings suggest a link between the amount of time children under 18 months old spend with a handheld screen, and a delay in their use of expressive language.

Over the course of the four-year study, parents of 894 children between the ages of 6 months and 2 years clocked how much time their kids spent with handheld screens. By the time of their 18-month check-ups, one-fifth of the children logged 28 minutes per day.

By using a test that measures language delay, researchers found a link between increased screen time and a lag in the use of expressive language. They looked at behaviors like whether a child used words or sounds to interact with others, how each child put words together, and how many words a child knew and understood.

It turns out that every 30-minute increase in screen time resulted in an additional 50 percent risk of language delay. But there was reassuring news as well. Developing other forms of communication, such as social interaction, body language and gestures, didn't slow down due to screen time.

These results back recommendations made by the American Academy of Pediatrics last year. The academy suggests that, other than the occasional video chat, kids younger than 18 months should be completely unplugged. And while that makes wrangling a cranky infant (or two) at the grocery store checkout line even more challenging, the payoff is you increase the odds that your child will develop well-rounded and age-appropriate communication skills.

Once kids pass the 18-month threshold, a digital free-for-all is not the answer. Instead, this is the time to gradually introduce them to high-quality programming. Spend time with them as they explore; help them understand what they're seeing. And just as importantly — teach them there's a time to put the screens away.

The truth is — and here we circle back to the universal allure of screens — we all have to lead by example. Read a book, play a board game, go for a walk. Put the phone down. If we won't, why will they?

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health. Send your questions to, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.


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