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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34

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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

Questions?

ulrika.lofkvist@isp.uio.no