The effects of children’s and parents’
digital media use on children’s
linguistic development
Ulrika Löfkvist, Associate professor, cert. SLP, LSLS cert. AVEd,
Research coordinator, University of Oslo & Karolinska Institutet
Oulu 2020-02-03
Learning outcome
• General background – screen time
• Focus on developmental aspects
• Infants or young children and their parents
• Typical hearing
• Hearing impairment
• Preliminary research results (case, cohort)
'ScreenTime: Diane Sawyer Reporting,' 2-
hour ABC News special, challenges families
to rethink technology consumption
https://6abc.com/technology/abc-special-challenges-
families-to-rethink-screen-time/5282005/
Conclusion: Human interaction suffer
New digital landscape of childhood
Negative effects:
Obesity
Sleeping problems
Emotional understanding
Executive functioning
Previous ”red flag” concerns
• Passive smoking
• Video games
• Violent movies
Passive and Active use
• Watching alone
• Playing in a room with screen exposure
• Skyping with grandparents
• Watching together, or playing/reading online
with caregiver
A hot topic – and huge source of
disagreement
• Research-based guidelines?
• Opinion-based guidelines?
• Few studies
Current recommendations - WHO
Children under age 2 – no screen time
Children aged 2-5 years – no more than an
hour a day
Children aged 5-18 years – no more than two
hours a day.
The less-is-better-hypothesis
N=960
Conclusions:
More TV watching among girls at age 4 predicted lower levels
of emotion understanding at age 6.
TV in a child’s bedroom at age 6 forecasted lower levels of
emotion understanding at age 8.
The Goldilocks hypothesis
Moderation should be the goal, like in the fairytale
about Goldilock and the three bears:
The porridge should not be too hot, and not too cold,
and the bed should not be too hard or too soft = but
“just right” (lagom)
= the same goes for screen time
We live in a digital world – (and it is
not going to be different in a nearby
future)
Children are born into a digital world, and they
need to learn how to deal with it
Ongoing study program: Att växa upp i en digital
värld (children 9-12 months)
https://liu.se/forskning/att-vaxa-upp-i-en-digital-varld
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Mikael Heimanns advice from preliminary results:
Anpassa innehållet till barnets ålder, personlighet och intresse. Titta
gärna tillsammans!
•Barn tar snabbare efter musik från digitala medier och att få lyssna på en
barnsång under tiden du får middagsmaten på bordet är bra hjälp i
stunden för alla.
•Låt inte skärmarna stjäla tid för lek och att ni tillsammans upptäcker den
verkliga världen.
•Låt inte skärmen bli huvudkälla för inlärning i tidig ålder.
•Stäng av TVn så att ni slipper bakgrundsljudet när ingen tittar.
•Begränsa din egen användning av digitala medier när du är tillsammans med
ditt barn.
Key 1: Awareness
• Caregiver behavior
• Child behavior
• Screen time use in the family
• Screen time use at daycare/school
• Screen time use in the society
Ongoing research project at KI
Introduction of LittlEARS Early Speech
Production Questionnaire (LEESPQ) in a
Swedish context
+Screentime habits in children 0-18 months
and their families
Prel. results (parent report) N=34
Chronological age: 11 months (3-18)
Age at first screentime: 8 months (2-14)
Screentime (minutes per day): on average 30 minutes
TV: 12; Ipad: 2; Mobile: 2; Computor: 0; No screens: 8
Different types of screens: 10
30 parents report that their child has ”lagom” amount of screen time, 4
parents report that it is too much
Words make a difference – an international research program
LENA – pedometer for words and
communication
Language Environmental Analysis (LENA)
Adult word count (AWC) (key female & key male)
Child vocalisation (CV) (key child)
Conversational Turn count (CTC)
Percentage of televison or radio
Percentage of silence
Percentage of noise
Percentage of ”meaningful language” or ”distant language”
Developmental snapshot – parent questionnaire
Ref: www.lena.org
Visual feedback of LENA results in combination with coaching/parent
education programs promotes change in communicative behavior of adults,
regardless of SES (Aragon & Yoshinaga-Itano, 2012; Leffel & Suskind, 2013)
20 Föreläsningens
namn
All-day recording (12-16 hours)
Child Vocalizations
Conversational Turns
Audio environment
Adult Words
Some results from the american LENA norm study (n=315)
– Most talk occured in early morning and early evening
– Talkative parents had talkative children and the opposite
– Children from higher SES background generally heard more talk than children from lower
SES background
– Children with language delay had low results on vocalization frequency, vocalization
duration and conversational turns
– General patterns of talk were similar for Spanish-speaking families
– The more the TV was on, the lower the adult word count
“Children with hearing loss require three times the
exposure to learn new words and concepts due to a
reduced acoustic bandwidth” (Pittman, 2008)
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One year later
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Key 2: Attention
• Lack of attention affects social interactions
• Multitasking
• Lack of attention affects learning
N=44
2-years-old children
Dyadic interaction
Word learning in laboratory
Conclusion: phone calls
interupts learning, children
learn best when parents are
attentive
Key 3: Meaningful interaction
• Active and balanced screen use – together
with a caregiver can be positive
• Affects language learning
• Builds relationships
The Social Brain Theory, Patricia Kuhl
“Infants appear to gain something critical from social context in natural
language-learning situations that is not available in the absence of
another human being” (Kuhl et al., 2013)
https://www.youtube.com/watch?v=G2XBIkHW954
Social interaction with caregivers
Affects the brain development and neural network – even morethan socioeconomical factors
Language Exposure Relates to Structural Neural Connectivity in Childhood, Romeo et al. (2018)
N=28, 24 months (+-6 months)
Children with HI who were engaged
in more conversational turns
demonstrated stronger linguistic
outcomes than children who were
engaged in fewer conversational
turns.
The frequency of interactions was
decreased in households with high
rates of electronic media exposure.
Still face experiment -
the core of the dyad
• https://www.youtube.com/watch?v=apzXGEb
Zht0
• https://www.youtube.com/watch?v=6czxW4R
9w2g
(similar as when a caregiver watch a screen)
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Preliminary results, children 2-50 months (N=69)
(Mean, min-max)
Percentage/day NH (n=34) CI (n=23) HA (n=12)
Silence (%) 46 (21-73) 37 (9-69) 40 (19-56)
TV/Ipad (%) 3 (1-7) 5 (1-13) 7 (1-32)
Meaningful (%) 23 (16-36) 27 (16-45) 23 (13-30)
Distant (%) 24 (8-46) 28 (9-49) 27 (11-51)
Noise (%) 4 (1-6) 3 (1-8) 3 (1-6)
Initial analysis of dyadic patterns from
LENA recordings/diary reports
More AV communication:
- Meaningful listening
- Meals
- Reading books
- Morning and evening
Less AV communication:
- TV/Ipad-time
- Outdoor activities
- Distant listening (could be a masked child-child interaction)
- Silence
PEPP- a new intervention model
P reventive
E ducation
P rogram for
P arents
A preventive education program for parents of children who have
recently been diagnosed with a hearing impairment.
LENA and videoanalyses are used pre-, post- and as part of the
intervention.
FCEI practice – two active process categories
Relational practice
Active listening, empathy, compassion, partnership-building skills,
professional attitudes, sensitivity towards families and cross-
cultural competencies
Participatory practice
Respond to family-identified needs and engage the family in
activities that strengthen existing competencies, promote
collaboration and joint decision making
Moeller et al. (2016), p. 79
The DYAD
Preventive Education Program for Parents (PEPP)
12-week dyadic education model with focus on seven short-term goals
from time at diagnosis (0-18 months)
1. Full-time use of hearing technology (HA or CI)
2. Increase parental sensitivity to the child’s own audio-verbal initiatives and promote attachment/socioemotional development
3. Increase spoken language communication with the child in everyday situations
4. Promote the child’s audio-verbal turn-taking skills
5. Reduce TV-time/electrical sounds (if necessary)
6. Increase the percentage of “meaningful listening time”
7. Introduce books and singing as part of early every-day activities from Day 1
Step 1: Parental sensitivity/attachment/socioemotional dev + HA/CI use
Step 2: Integrate hearing/listening and audio-verbal strategies in every day life
First pilot: 7 families so far
Aim: RCT cohort study in the future
Is there a need of PEPP in Sweden?
1-3-6?
1-2-3
AVT implemented in 2005
No national follow-up, and few LSLS cert. AVT:s/AVEd:s
Possible impact of PEPP
Generally better understanding of the environmental factors like for instance screen time use in everyday life which are involved in early spoken language acquisition and its possible influence on unexplained variability in general outcome
New knowledge of parent involvement effects, not only in children with HI, but also in the typical population of young children with NH
The results might ultimately have a positive impact on the lives of many children with HI and their families, irrespectively of which kind of hearing technology they use and language- or socio-economical background they have