Infants’ Screen Time, Less Play with Parents Linked to Higher Risk of Autism-Like Symptoms

April 30, 2020

Controversial Study Suggests Parents to Blame for Autism

According to a new study which has received criticism from some scientists and advocates, 12-month-old babies who spend time viewing images on a smartphone, tablet or television, are more likely to exhibit symptoms of autism by age 2. On the other hand, 12-month-old babies who spend part of their day playing with their parents have decreased odds of developing symptoms of autism by age 2. These new findings were released by Drexel University’s School of Medicine and Dornsife School of Public Health. The study was published online April 20 in JAMA Pediatrics.

As a recent study shows, genetic factors only compose 50% to 80% of risk of autism spectrum disorder (ASD), indicating that non genetic or environmental factors also contribute to the risk of the condition. However, these external factors are yet to be properly understood.

Since media exposure in infants coupled with parental social interaction and its possible relationship to autism had not been studied before, the research team at Drexel University decided to examine this intriguing hypothesis. Co-author David Bennett, PhD, said in a MedPage Today article, “This is the first prospective study to examine screen viewing at such an early age—12 months—and later autism symptoms to our knowledge.”


To conduct the study, Bennett and his team examined data on 2152 children from the National Children’s Study (NCS). NCS collected data on children from across the country, who were enrolled at birth, for two years, 2010 to 2012. During this period, caregivers were given simple surveys about daily habits. They reported if their child viewed television or videos (yes or no) at 12 months. At age 18 months, caregivers were asked how many hours their child spent viewing television each day. Finally, caregivers were asked about the frequency of play they had with their child (daily or less than daily) at age 12 months. The study then used the Modified Checklist for Autism in Toddlers (M-CHAT) or revised M-CHAT to screen these children to determine their risk of ASD and ASD-like symptoms at age 2.


Their conclusions were surprising. Twelve-month-old infants who spent time in front of screens were associated with 4.2% more autism-like symptoms than infants who did not view screens. Daily play time with parents affected autism risk even more. Infants who spent their days interacting with their parents had 8.9% fewer autism-like symptoms compared to infants who had less frequent play.

It’s important to note that this study did not include data on definitive autism diagnoses in these toddlers. Instead, the research team looked for symptoms of autism, such as repetitive behaviors or lack of eye contact. Ultimately, the study could not prove that screen time caused symptoms of autism.

In an associated editorial in JAMA Pediatrics, Dimitri Christakis, MD, MPH, of the Seattle Children’s Research Institute, weighs in on two potential negative effects media viewing may have on development. He states, “In the case of infants, who do not cognitively process what they watch, the direct pathway relies primarily on the formal features of the programs — the pacing and the edits — which for infant shows are unusually rapid and abrupt. The second is indirect; time spent with media comes at the expense of time spent with other activities, including social interactions.”

Backlash from the Scientific Community

The study has drawn abundant criticism from scientists. In an article by The Science Times, Dr. James Cusack, Director of Science at Autistica, declared, “Families deserve better science than this—particularly now when many young children are stuck at home…” He further condemned the study’s small scale and insufficient tools used to measure the effect of increased screen time on autism. Dr. Cusack also believes that examining children at age two was premature to diagnose autism since children at this age develop at different rates.

Professor Andrew Przybylski, Associate Professor and Director of Research at the Oxford Internet Institute was also disparaging. In a Daily Mail report Przybylski expressed disappointment that the study authors did not register an analysis plan before the data was collected or analyzed. He feels their study design created a situation that was ideal for “cherry picked” results.

Przybylski ended his critique by saying, “It’s difficult to understand how the publication of this paper is not an example of a failed peer review process.”

The criticisms continued. Science Media Center published disparaging comments from ten different European scientists regarding this paper.

Prof Kevin McConway, Emeritus Professor of Applied Statistics, The Open University, stated to Science Media Center, “This is an observational study, and as with all such studies, it is pretty well impossible to draw conclusions about what causes what from just one study. For example, in looking at a possible association between whether the children used screens at age 12 months and whether their caregivers reported autism-like symptoms later, there will inevitably be many differences between the children (and their families) who used screens and those who did not, apart from the screen use. Any combination of those other differences might be, partly or wholly, the cause of any differences in the prevalence of ASD-like symptoms, rather than the screen use itself.”

Uta Firth, a developmental psychologist from University College of London’s Institute for Cognitive Neuroscience, provided her views to a News Atlas article. She submits that increased screen time could be a consequence of autism-like symptoms rather than a cause. Firth theorizes that children who are attracted to screens may use those devices as a crutch to escape social interactions with others. She, like Cusack, is concerned about the effect this study will have on parents who are currently stuck at home with young children but also expressed concerned for parents for other reasons.

“I worry that the paper will do harm, if it feeds the ‘blame the parents’ meme.”

The Study’s Conclusions

Finally, the study’s authors call for further research to investigate the relationship of infant screen viewing and autism-like symptoms. They especially want parents to understand the downfalls of early screen viewing. As early as 1999, and again in 2016, the American Academy of Pediatrics (AAP) recommended no screen time for infants under 18 months of age. The authors agree with this suggestion and conclude, “We suggest pediatricians thoroughly educate parents regarding the AAP’s recommendation to avoid screen viewing in children younger than 18 months.”


Karen Frankel Heffler, MD; Danielle M. Sienko, MS; Keshab Subedi, MS, MSc; et al. Association of Early-Life Social and Digital Media Experiences With Development of Autism Spectrum Disorder-Like Symptoms. JAMA Pediatrics. April 20, 2020.

Dan Bai, MSc; Benjamin Hon Kei Yip PhD; Gayle C. Windham, PhD, MSPH; et al. Association of Genetic and Environmental Factors With Autism in a 5-Country Cohort. JAMA Psychiatry. July 17, 2019.

Judy George. Screen Time for Babies Tied to Autism Symptoms Later. MedPage Today. April 20, 2020.

Dimitri A. Christakis, MD, MPH. Early Media Exposure and Autism Spectrum Disorder. JAMA Pediatrics. April 20, 2020.

Staff Reporter. Children Glued to Tablets Could Develop Symptoms of Autism, Study Claims. The Science Times. April 21, 2020.

Joe Pinkstone. Babies glued to tablets of television during the coronavirus lockdown ‘could develop autism-like symptoms’ controversial study warns. Daily Mail. April 20, 2020.

Science Media Center. Expert reaction to study looking at screen time in infants and autism spectrum disorder-like symptoms. April 20, 2020.

Rich Haridy. Experts slam new study linking baby screen time to autism-like symptoms. News Atlas. April 20, 2020.

American Academy of Pediatrics. Babies and Toddlers Should Learn from Play Not Screens. October 18, 2011.

Anya Kamenetz. American Academy of Pediatrics Lifts ‘No Screen Under 2’ Rule. National Public Radio. October 21, 2016.

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