Too much TV screen time for kids: 5 things to know about the risks

When a parent flips on the TV, it often affords them 30 minutes or more of relative silence. That's enough time to make dinner, fold a load of laundry, or quickly chat with a friend. TV makes achieving certain parenting goals possible.

Their kid often enjoys it, too. It's time spent in an imaginary world when, importantly, their parent isn't bugging them to put on their shoes or do homework.

But research increasingly suggests that too much TV at a young age may come with risks.

A study published this week in JAMA Pediatrics found an association between TV screen time and what's known as atypical sensory processing. This can include developing sensory-seeking behaviors, like obsessively watching a spinning object, as well as becoming slower to respond to stimuli, like hearing one's name called, and avoiding certain sensory experiences, such as resisting new foods and noisy environments.

Though the researchers did not study children with autism spectrum disorder or attention deficit hyperactivity disorder, such sensory processing difficulties can be common with both conditions.

The study's association between screen time and atypical sensory processing builds on past research suggesting a similar link between TV-watching at a young age and language delay, attention problems, emotional dysregulation, brain findings, autism symptoms, and sleep problems.

However, there is no evidence that too much TV causes autism, ADHD, or other conditions. Currently, the Centers for Disease Control and Prevention does not consider watching too much TV as a risk factor for autism.

Known risk factors for autism include advanced parental age, genetics, and very low birth weight. Genetics also plays a role in the development of ADHD; other potential risk factors for ADHD include environmental pollutants and premature delivery.

The study's lead author, Dr. Karen Heffler, an associate professor in the department of psychiatry at Drexel University College of Medicine, was drawn to this field of research after her own son was diagnosed with autism.

If TV-watching is a risk factor for atypical sensory processing, it is one that can potentially be changed, Heffler said.

"We want to empower parents, we want kids to develop to their potential," she added.

To better understand the role of TV screen time in your child's life, here are five things you should know about the subject:

1. What the guidelines say about screen time for young kids

Heffler strongly urges parents to follow the American Academy of Pediatrics (AAP) guidelines for media, which say to avoid digital media use for children younger than 18 to 24 months. The guidelines make an exception for video-chatting, which may be enriching and appropriately engaging when done with family members, for example.

When you do play digital media for toddlers between 18 to 24 months, the AAP recommends turning to high-quality programming and watching it together.

Children between the ages of 2 and 5 should be limited to one hour of high-quality programming per day, which you should also watch with them.

2. Research findings on risks of TV screen time

Heffler's study analyzed data reported between 2011 and 2014 by the parents of 1,471 babies and toddlers. The parents shared how frequently their children watched TV or DVDs. The parents weren't asked about mobile devices, since they were less prevalent at the time.

She and her co-authors found that for 1-year-olds, any TV screen exposure was associated with a doubled likelihood that they would go on to exhibit atypical sensory behaviors when they were nearly 3 years old compared to children with no screen time.

Toddlers between the ages of 18 and 24 months also had higher odds of a similar outcome, but not as marked as infants exposed to TV.

For every hour of TV screen time beyond no screen time at all, 18-month-olds were 23 percent more likely to display behaviors related to avoiding certain sensations and being less responsive to stimuli when they were older.

It's important to remember that while many young children have sensory processing differences, such as sensitivity to a specific noise, those reactions may be fleeting or short-lived. Heffler and her co-authors were specifically looking for atypical behavior in four distinct categories of sensory processing, including sensitivity and avoidance, as reported by the children's parents.

While it's unclear how TV exposure could affect sensory processing, Heffler said one possible explanation is that young children's brains aren't yet prepared to take in and process sensory features of TV, like lights, movement, and colors. It's also possible that TV displaces other behaviors and activities that contribute to typical processing development, like talking, babbling, cooing, playing, and being outside.

3. Does it matter if screen time involves television or a smartphone or tablet?

Heffler's study couldn't evaluate screen time that takes place on a smartphone or tablet, but she suspects that it could lead to similar results. Some research already indicates that screen time on mobile devices is associated with language delay and dysregulation for young children.

If anything, Heffler worries that exposure to screen time at young ages is far more pervasive than it was a decade ago, though more research on smartphone use among babies and toddlers is needed.

"The concern is that children have access to video through mobile devices at a much higher rate than they did even when the study was done," Heffler said.

4. Testing what happens when you reduce screen time for young kids

In her research, Heffler is exploring what happens when parents reduce screen time for young kids, particularly those with autism symptoms.

In the very limited research on the topic, there are glimmers of improvement for some children and their families.

In a pilot study Heffler published in 2022, nine children between the ages of 18 to 40 months old with an autism diagnosis had a history of watching an average of five hours of screen content per day. After their parents received educational information and one-on-one in-home support visits to help them replace screen time with social engagement, testing revealed significant improvements in core autism symptoms and reduced stress for parents.

Heffler said that parents who notice that their child's atypical sensory processing is interfering with their everyday routine could consider doing a trial run of turning off screens and integrating more social, sensory, and play activities to see if it leads to improvements.

Importantly, screen time is just one potential risk factor for atypical sensory processing; some families may reduce screen time and see little or no improvement.

5. Alternatives to TV screen time

Heffler understands just how pressed parents are for time, and that some may experience mental health challenges, like postpartum depression. She believes society should consider the needs of families so that parents can have more support as they raise young children, rather than putting them in a position where TV presents their one break between work and parenting.

Lori Frome, an early childhood interventionist who co-authored Heffler's 2022 pilot study, said parents who feel comfortable with reducing TV time can try various strategies.

That starts with removing the screens themselves, as much as possible. Some parents Frome has worked with have put TVs away or draped them with a blanket. Removing remotes, unplugging TVs, and placing phones and tablets out of reach (for both a child and a parent) can help, too.

Frome recommends that parents frequently involve their children in household routines instead of turning on the TV in order to get something done. Helping with dinner could be as simple as putting carrot sticks in a bowl or napkins on the table. As an alternative to screen time when a parent is present but not available, children can play in a nearby safe, closed-off environment with standard toys, like dolls, blocks, cups, and balls. Children might particularly enjoy toy characters or stuffies featured in their favorite movie or TV show.

But Heffler isn't expecting parents to perform miracles.

"We just hope that they can use this information to the best of their ability under their circumstances," Heffler said.