Transcription
All right, thank you for joining us today. Today we have very special guests. We have two of them, and I'm just going to read their bio, and you're going to see how awesome these ladies are.
Karen F. Heer, MD, is an associate professor of psychiatry at Drexel University College of Medicine. Her research focuses on early childhood brain development and the impact of environmental factors such as screen exposure. She has published studies linking early screen use to increase autism risk and emphasizes the importance of caregiver interaction and sensory engagement in embassy. Dr. Heer is a founding member of GAIN, a global initiative promoting healthy neurodevelopment. She is committed to educating families and professionals on practices that support optimal developmental outcomes.
Her partner, Jennifer Joy Madden, is a multimedia journalist, speaker, producer, and author with a focus on health and science reporting. She began her career at WJET TV in Erie and later worked for ABC News, contributing to World News Tonight, Good Morning America, and Nightline. Her writing has appeared in outlets including PBS Health Week, the Washington Post, Discovery Health, and the Huffington Post. Madden is a founder of durablehum.com, author of two books on digital age well-being, and a co-founder of GAIN, a global initiative promoting healthy neurodevelopment in children. She has spoken at TEDx Tyson's and teaches journalism for the Newhouse Schools in Washington, DC capstone program.
[Music]
Thank you so much, Dr. Heer and Jennifer, for joining me today.
Thank you for having us. We're very happy to be here and so excited that you're interested in sharing the information that we would like to get to a greater audience. You know, this is so important because just last week, the CDC increased the rate of autism in the U.S. So, the rate increased to 1 in 31 kids and in California, 1 in 12.5 boys. This is alarming. And your GAIN initiative comes at a very important time.
Why do you think this is such an important critical age for kids in terms of neurodevelopment, in terms of autistic symptoms and development of autism when they're exposed to environmental hazards like screens and too much screen time? Start talking about um the earliest brain development and how that's so critical.
It's really a special time because kids, babies aren't born with fully developed brains. They develop through the neurons connecting, and that's the building blocks of the brain. That's how they learn to process what they experience, and they experience the world through their senses. So what they see, hear, what they feel, touch, smell, those uh experiences cause the brain to develop. Um and then the development of the brain determines how they behave. So very early on, children don't know—the babies, they don't understand the importance of eyes and faces and voices. These are learned social brain connections that help them to recognize those as important and different from other sounds that they hear. So this is a critical time where the brain develops the uh ability to allow that child to process information related to social and related to language. So language development in the first few years of life. It's a it's a critical period where it's very easy to learn language when you're exposed as a as a baby and young child. But if children don't learn language in the first several years of life, it makes it much more difficult later.
You know, that's very interesting. There was a California case of abuse, and this is a terrible case of abuse where the dad literally tied his daughter to a chair, and she was stuck to a chair for I think the majority of her childhood. And so the question was, could she ever develop language? And there's a news article that just highlighted her recently because now she's in—she's an elderly woman—and she never could develop language, even with all the therapists and everybody uh trying to get her to speak and understand language. And so I think that kind of highlights, you know, on an extreme side, what's happening to these kids.
And so you're also describing, for example, you say both of you use the term serve and return interactions are important during language development in infancy, right? So can you explain exactly how screens interfere with that serve and return?
Well, I guess I could take this one. Uh, the serve and return is this responsiveness that Karen was talking about—that the baby makes a little noise, and then you respond. You express something back to them, a word or smile or something like that, and it registers in the child's mind, and they're making connections between what they do and how you react. And that's early—that's setting them up for early conversations and managing the world basically. And so it's really important that they learn how to do that. If there is a device around that is also emitting sounds and has very attractive, you know, flashy things on the screen, and that attracts the baby's attention very quickly and almost holds them like a magnet, and they could stare at it for hours, which is what happens. And that's why parents get used to it because they're like, "Oh, I can get something done because my baby's staring at the screen." Problem is the screen does not respond. Um the baby um cannot interpret what's on the screen. Um they've done a lot of studies; they call that the video deficit—that the baby can't really understand. Yes, they're attracted to the changes in colors and and lighting, but they're not understanding what they're seeing. And so the babies are missing out on hours and hours of interaction where they have to learn how to speak. And that's the serve and return we're talking about. It's a little like playing ball—that they they throw you something, they serve you something, and you return the serve with something else. And um all the while they're looking at your face, they're studying you. They're like little sponges. They're like, "Okay, the mouth is moving, words are coming out, all these things are connecting in their brains extremely quickly." I mean, it—I I don't think you mentioned it—a million neuro connections per second for babies 0 to 1. And there's a really beautiful graph um that Harvard has, and it shows specifically between birth and age one is this huge learning—beautiful learning curve—right, right within that one year for communication skills, um learning early understanding of language, and as you say, if they miss that window like that unfortunate woman that you just described, they they may not develop those really strong neural connections in that first year. And this trickles down through the entire lifetime of the child; if they miss those foundational skills, they may not learn how to—well, speak well enough in preschool and then later learn how to read. So it's absolutely—it's like building a house. You got to have that foundation and then go from there. So, we just don't want to blow away the foundation or have it built on sand um for these for these babies by not allowing them to to have a lot of face-to-face interaction.
Wow. So you know, as an ophthalmologist, what we see with visual deprivation is something called amblyopia, where the visual cortex—the centers in the brain that control vision, which is the back of the the head here—um actually will shut down and and just not work because the eye is not connecting to that brain, and so the brain favors the good eye. And so what you're describing is that you know, it could be permanent. This is, you know, this could be permanent damage to the brain. And so explain to parents who are saying to right now, okay, so my baby's watching—not like just cartoons, but watching people who are talking to them through the screen and teaching them ABCs and numbers and smiling and animated on the screen. How that is not sufficient for childhood development.
For children to learn, they have to be responded to. So when they see images on a screen, so they are attracted to the lights, the color, and the movement even before they recognize other things are important, but they don't understand it. It doesn't have any relationship to them. So they're not making a sound and having a response. They're not looking at something and hearing words regarding to the toy that they're playing with or having somebody touch them and say, "This is your arm." So, the the uh images and the sounds that they're that they're viewing and hearing are not related to their experiences—to what they're experiencing in the world. So, they're not meaningful in terms of building the connections that help them to understand what goes on around them. Uh but the uh screens with the lights, the movement, the colors, the fast pace, we would expect the brain to be developing connections, but not meaningful in a way that they can build on to further uh understand and interact with their environment.
So during the pandemic, we saw a huge, huge problem with media. I mean, I was—okay, I got to confess—I was playing Fortnite online with kids who were supposed to be in school, but because the schools shut down, instead of being on online school, they would just have online school on one screen and then they're playing Fortnite or other games on the other screen. So, what do you guys see as a direct ramification of the pandemic and screen time?
Well, I wanted to—there there is one telling study that's just recently come out in JAMA Pediatrics, and it looks at COVID-19 and the developmental health of kindergarteners, and it finds that there is a great reduction in their language and their cognitive abilities—their social competence—that means sort of being able to communicate with others—and general knowledge—just general knowledge about the world, the sun, you know, daytime, that kind of stuff that only that kindergarteners could understand. And the first thing on the list for why these these rates have fallen off of kids' language development in kindergarten is because of excessive screen time. Now you know that that happened in COVID, but if you look at the graphs that were in this particular study, you can see the fall off in those skills happens before the pandemic. So around 2016 to 2018, they started falling off. Coincidentally, a number of very popular programs designed for very young children were introduced online. And so, you know, Dr. Heer will say there's no, you know, can't tell there's causation, but you can see that the lines are going down. Um, language and cognitive development in particular is falling off and getting really low. If you look at it, um, yeah, doesn't look good as it approaches 2023, which is after the pandemic. So, not only did it start before the pandemic, it kept going after the pandemic. So, you can go ahead and mention the pandemic as they did in the study, but we're talking about longer trend lines than that. And so, it's really important to know that.
Then, there's another study, very interesting. This one might motivate parents even more is that um Caroline Fitzpatrick out of Canada uh studied toddlers with tablets, and she saw toddlers who have their hand on the devices. Remember we said we we really hold on to those devices. The adults keep control. No, these are—they have these very powerful devices in their hands at age two. By the time they turn age five, they are watching more; they're doing more and spending more hours, and they are angrier. She actually looked at their social-emotional responses, and she found they're angrier—probably angrier about having the the tablets taken away. Another reason not to introduce this powerful technology in a growing age. So um and just to hold off—tech can wait. That's one of those phrases that we use. So um that's very telling research.
So that's the thing that we do. We we look to the research. We're like, we're not making this up. Look at the research. And you know what's really cool is that we look at the research, and again the the biggest push back I see is people say, "Well, where are your huge randomized clinical trials?" Right? So that's the argument. Where's your hundreds of thousands of patients and and and following um and then following them? But you don't need it because you have described very powerful research, and and some of them are not very big numbers. But what parents can do is actually take the screens away, and what they see is a powerful transformation in their kids almost immediately—within a month. So you really don't need more research. Those who say we want more research are just using it as a scapegoat. And I'm saying that because I've been in clinical practice for about 25 years. When when patients look at me and say there's not enough research, even though I'm giving them clinical advice and things that are not published because we have a lot of patients that we just don't compile and publish those results, it's a scapegoat. It's the same scapegoat saying that, you know, autism is all genetic and that environmental has no role. Because if it's all genetic, it takes away what Dr. Heer said about the shame and the guilt and the other negative feelings associated with having a child or a young adult with autism in the home. It's a tough topic. By the way, that UCLA study is 475,000 children, kindergarteners. So, that's no small study.
Yeah, that was in JAMA Pediatrics. That was a huge, huge massive study. Add to that that um, for instance, they're watching a show, and it has ABCs over and over or might have colors over and over. Yeah, they won't be able to parrot the ABCs, but turn the screen off, and they won't necessarily know how to just communicate or talk with regular words. And I know Karen's seen that in her research that the kids will just be stuck on whatever they saw on the screen, and they they don't really have anything else to understand or offer at that point.
So Dr. Heer, in your review of early screen time and autism risk, what stood out the most in terms of the uh strength or consistency of the evidence?
Well, we first became involved with this because we were concerned about the rise in autism, and perhaps screen time could be uh a variable that could have some uh have some risk associated with it. So, we looked at the study; we looked at the National Children's Study and uh screen time at a year of age and autism-like symptoms at two years. And what we found was that if the children were viewing screens at a year, they had higher autism-like symptoms at two years. And we also looked at toy play with the parents. So if the parents played with the children every day, then they had—compared to less than every day—they had less autism symptoms um shown in that study. But there have been—there's been a lot of research since that was published in 2020. In 2022, there was a study out of Japan uh by uh Kushima and colleagues that showed that—and it was a large study involving over 80,000 children—and they looked at screen time at a year of age also and found that in boys that viewed 2 to 4 hours of screen time daily at one year of age that they had a three and a half times increased risk of developing an autism diagnosis by the age of three compared to children that were not viewing screens. There are now many articles. So over the past five years or so, there have—there have been a lot of articles around the world that show that earlier screen time, more hours of screen time, those are associated with an increase in autism symptoms and an increase in autism diagnosis. In addition, children that are in the autism spectrum that have a diagnosis, more screen time equates to poorer development. So these—this—this research, this the this now growing and extensive body of research suggests that screen time is a risk factor for developing autism symptoms and autism diagnosis. This doesn't mean that screen time causes autism. That's a leap that would require more research. There may be many factors that you know contribute to how a child develops, including their genetics, their other experiences, their social experiences, their—maybe parent age has been associated with autism, prenatal infections, other things have been associated with an increased risk of developing autism. Screen time appears to be one factor. The difference with screen time and some of these other factors—and people are concerned about toxins uh and whether they could potentially be a factor—screen time can be modified. So we talk about modifiable risk factors in child development. So if through parent education the children's experiences can be different, then that's a modifiable risk factor. So not only through early parent education or prenatal sharing of the these risks—this information about child development and um screen time. Um but parents who know about the the recommendations they allow less screen time for their children. So again, it's a risk factor, and now there is fairly significant evidence of those findings.
You know, it's it's fascinating because I I see kids um as an ophthalmologist; I see kids who are uh having like problems with ASD diagnosis, ADHD, or developmental delay. So they they want to make sure their vision's okay. So they send them to me and and basically make sure their visual system is functioning. Uh then I'll take a complete history on those that um are 20/20 vision, perfect eyesight, and they have like 8 to 10 hours of screen time a day. You're talking about 2-year-olds with tablet time of like eight hours a day. So they have severe autism at two. We discuss with the parents, you know, hey, this could be a problem. This is a risk factor. Cite your research that you're citing. And the amazing thing to me when I'm a clinician and I take it away, you know, take away the screens in six months, I've seen this a time and time again—six months, there is an incredible improvement, and in many kids even dropping the diagnosis of autism completely. So, I know you're you're you're playing it like really gentle and political about not being a cause. I understand that. You don't want to get in trouble. But since this is my channel, I'm going to tell people who are listening, just take it away. Go to my videos already on virtual autism and and autism. Actually, just autism videos. Uh we have one on Lorie Fro talking about her son and her experience and the research. People are now coming into the comment section and sharing their own little individual case report saying, "Hey, I took this away from my son or daughter," and one to two months later they have dramatically improved, and now they're having—they're talking, eye contact, they're not spinning as much. So anyway, I just want to give you a plug there that these are, you know, very powerful—that you don't have to wait for these huge studies to show you evidence before you take action; you know, you basically take action now in your young children, see if it works, take it away, and see what happens in a month, two months, six months, a year, and if they're better, continue the course. Wouldn't you agree, ladies?
And and there is also preliminary research studies that have been published, including one of ours from Drexel um showing—and it was in a small group of children—that in children who were three and a half years and younger who had a diagnosis of autism and they also had high screen time. So these children had an average of five hours of screen time daily when they came into the study. That if the parents are educated and they remove the screens along with strategies to increase the the social connection and social interactions um in addition to regular early intervention strategies that children can make remarkable improvements over a fairly short period of time. And when I talk about the improvements, uh, they're in eye contact, in responsivity and wanting to be near the parents, in verbalization. Um, and so there there is evidence and reports about what you're saying. Um there is in the works more research being done on this, but I agree—parents, if they have very young children and they're showing developmental delays, there's no harm in turning off the screens. In fact, our pilot study showed that the parent stress went down when they turned off the screens over a six-month period. So looking at the stress at the beginning of the study to six months later, parent stress decreased.
Interesting. I'm going to add in why I think that is. So Jonathan Haidt wrote a book called *The Anxious Generation*, saying that he blames tablets and screens and phones for causing increased anxiety in children. So therefore, if you take the screens away, and this is actually what what Victoria Dunckley, who's a pediatric psychiatrist, says out in LA, she wrote a book called *Reset Your Child's Brain*. She says, "Take it away in one month; you reduce anxiety and depression." So if you reduce mental symptoms or mental disorder type symptoms in your children, guess what? You're going to feel better, too. And I think that's—that's right there what Dr. Heer was saying—is that the the the parents feel better. They're less anxious, less depressed. They're actually mental health improved when they took the screens away, and their kids also improved. And then for those who are worried about your kids being behind or not behind, you know, if they don't get the the screens, the Waldorf schools did a research study for their parents because they were worried that delaying until age 16 was too long in terms of delaying screen time and technology and all that kind of stuff until age 16. They found that at age 16, when they gave back the screens or gave the screens for the first time to those students, it took only six months for those students to catch up to the digital natives. So you have nothing to lose, just as what Dr. Heer says.
Yeah, you definitely have nothing to lose. And in fact, I have a good friend who has her children are screen-free, and she's like, just tell them—tell the parents—it's easier because there's no—heranging—once you start showing them screens, it's—her—you're going to be bothered, and it's going to become a factor in your family. So that's one thing that I write about is um giving that first device. It's like, are you ready? Do you want your life to become more complicated? Do you want your child to be arguing with you? Do you want them to be setting up social engagements you have nothing to do with, and they're doing it on their own, and then they'll spring it on you? No, you don't need that. And if you look at the flip side, you can be like, I want to tell you about this family that has no screens. They can knit, they can crochet, four kids, boys and girls. They can play multiple instruments. They have a huge library of books in their house. They're Renaissance kids. That's what they are. And so awesome. You know, do you want your child to be a contributor, or do you want your child just to be kind of a follower or even a person that doesn't think very much because they've always been ingesting information and they haven't had time to digest or produce their own and create their own? So, it's um becomes—that's what maybe parents can think about, and I say this in my my course for for early parents—is how do you want your life to be with your child? Do you want it to be constant arguing, or do you want to have a nice relationship where they're experiencing the world? They might ask a question, and then you talk to them about it. It's this partnership going through, and uh you can do that very easily without that other aspect drawing their attention—drawing their attention.
And what we're saying in our alerts this week is that no screens under age two. Just let them get a foothold—get them those foundational skills uh for at least two years and more. I mean, Bulgaria wants you to hold off till age nine. So going to age two is the bare minimum. France, Germany, it's age three. Um some countries maybe going toward age six. So it's like, just give the child a head start. Let them have—let them learn in the human way, which is experience and exploring with their senses and also very carefully scheduling communication—the faces of of loved ones. Not just the parents—just every single person—any person that leans over the stroller and says hello. The child is learning about interacting and about caring and and understanding how to operate in the world—you know, how not to run away screaming, but you know, be happy that somebody said hello and smile back. Something simple like that.
Yeah, that's wonderful. And I just want to emphasize, you know, parents, you want your babies to bond to you. You don't want them to bond to a a digital AI or a digital image of a human online. So, what are some of the early red flags that a child may be showing if they're having screen-related problems?
If a baby is not making sounds, is not smiling, is not looking to a caregiver when they hear their voice, then that suggests that they are potentially having some early developmental delays. As a child gets older—to about age one—they should be starting to say some words. Um some children uh have difficulty with sleep, and that may be another indication that
Screens may be impacting or, uh, contributing to a sleep disorder. Um, also social-emotional regulation; a lot of meltdowns can sometimes be related to the screens. Um, sensory issues. Atypical sensory processing is also related to early, uh, screen use, uh, and such as—think such as—a child that is seeking out sensory input or always attracted to bright lights and fans and staring at things, spinning wheels on cars, or they may be avoiding—and they don't want to be touched or have their teeth brushed. They, or they may run out of the room when there's, you know, a a some type type of sound, uh, and they're trying to avoid it. They may also have sort of less interaction and responsivity.
So, that's kind of like, uh, they they're not as, uh, responsive when you call their name. Um, they they don't—again, they're not attracted or interested in the people around them. So there's various ways that that you can see if a young child is not responding, interacting, using language. Gestures is another thing. So by a year of age or by 18 months of age, they should be waving bye-bye or hello or maybe blowing a kiss. If they're not doing any of those things, though, that's concerning. If a child has those concerns regarding developmental delay and additionally is viewing screens for several hours a day, that's when the parents may wish to do a screen fast. Go without screens.
And from our experience with parents, it's much easier to go cold turkey. Turn the screens off. It's very difficult to try to limit it because if children have been very focused on the screens, they may have favorite shows and everything sort of orients around those characters. Then anytime they have access to the screens, they want more, and it's a whole difficult process. In the children in our pilot study where we educated the parents, parents turned off the screens within a week or two; the parent—the the children weren't even asking for the screens. They wanted to be with the parents. That's amazing.
And also in the gaining parent alert, you mentioned that screens can be used to, um, soothe the child, and people are using it, but then they also increase tantrums, poor coordination, and even sleep problems. So for parents who are already using it like a digital pacifier to soothe their children, what do you recommend, or how can the parents move away from that habit? There is research to show that when a child is given a screen to soothe them, that they have worse behavioral problems as time goes on, and it's harder for them to learn to self-soothe. So holding a child if they're upset, talking to them gently, trying to, you know, distract them, but not with tech, um, are other ways to handle a child that you know is, uh, having a meltdown, but using screens has been shown to worsen the problem—actually, not make it better over time. It's a it's a short fix that they pay for later.
And if you're on a plane, other passengers pay for it because I've been on planes where literally I've seen it, and because I'm aware of the research, I watched the parent use the device the entire flight to soothe their their child—like a six-month-old. When the pilot announces to turn off the devices and we're getting ready for landing and and basically, you know, put away your big devices like tablets, the baby or the young child just breaks down and happens almost like 90% to 95% of the time. It is crazy. So they—So the parents are paying for it as well as other people, right? So—So what do you guys recommend? I know this is going off script here a little bit. What do you recommend for people that do when you're in public and you know you're in a plane and you're stuck with parents who are are misinformed and are literally—I would say—poisoning their kids' minds?
It doesn't pay to go up to a perfect stranger and say something. I've imagined having a little card with some information that I give them. But I saw some dad—big dad—with a baby in a restaurant just leaned over the baby just the whole time just engrossed with the baby. And I was like, I wish I had a card for him. I would just like to just hug him and give him—give him a card and say good job. But I think that parents have forgotten about other—sometimes screens can make your life like neat and tidy, and babies are not really neat and tidy. And so people don't even carry stuff with them anymore. They might not bring a board book. They might not bring a rattle or thing that the baby can really work with their hands.
So, I would say go ahead, um, get some things handy in the diaper bag, in your purse, you know, just somewhere in your satchel if you're a guy, and just—Yeah, you're going to have to pull them out and entertain the the child. Um, but that's okay. It's building a relationship, and um, everything's taped now. Everything's, um, you can just pull it up. So if you don't have your show on the airplane, you know, you could see it later, see it another time, maybe when the baby's asleep. So this matter of being comfortable with messiness and life, you know, and just—just carry the stuff with you and, uh, go to the, you know, little dollar store or even not. I mean, um, you can have entertain a kid with like an empty, um, paper towel roll and a plastic container with a lid and put some stuff in there, shake it; that can entertain them. So, it really doesn't have to cost money to find some things that are going to entertain kids, but just—they need that palpability. They need to be able to feel these things. Again, that's what's blooming the baby's brain; they're making connections through their senses, and that, you know, that's why we, uh, don't put a—never put a device in—in a baby's hand, uh, because they—everybody loses control at that point, you know. So, always maintain control of a device around a baby and don't give them one for themselves because they can't control it, and they—it becomes compulsive—their use.
And Jennifer, you're—you're an expert in this. You've written about this. You're an author, and you've talked a lot about the durable human. What does that look like in a modern parenting context where literally digital devices are everywhere? Well, you have to know the difference between durable and resilient. So during COVID, we heard so much about resilient—that the kids are just down in the dumps, and if they can kind of get out of the dumps, then isn't that great? Well, no. When you're durable, what you want to do is sort of take the bumps in life but stay upright. So, and also recognize those things about you as a human being to strengthen and build up. So, what makes us different from machines? We have these amazing capabilities, uh, called curiosity, compassion for other people, our intuition. We have this innate sense—if we've experienced life enough—we can develop a sense of intuition. And so it's kind of becoming proud as a human being in this age of AI. We have to know what we have and to keep that really strong. And so you build compassion in a child by being with them—available. With—with machines to be efficient is to have them churning out stuff as fast as they can. How many copies can you shoot out of the copy machine? But with human beings to be efficient is to slow down and listen. Really listen to what your child is saying. And so that's how you develop compassion in them and curiosity. Every child is born with a sense of curiosity. It can be snuffed out right away. Just keep giving them screens. They'll never know who they are. They won't know what they're interested in. But if you can keep the screens away from them, little clues are going to come out. What are they like? Maybe they are really good with people. Maybe they're really good with a pen—not a pen at that age, but you know, chalk or crayon or anything like that. You're going to see their abilities come out. And we as parents, it's our job to bring those abilities out in our children. And if we're not observing them and they have no chance to express them, it's a sad waste. It really is. And so it's a matter of parents to sort of be proud of themselves and what they can do and how they naturally can give their—parent—the babies what they need at that time and to respect the babies, respect their brains, respect how they need to feel the world and explore it and hold hands and be hugged and all those beautiful things that build all those beautiful durable human skills. And so that's really what I think is important. And then when we get into school, we need to allow them to learn basic functions such as reading, writing, and arithmetic before introducing AI that is going to do all the things for them. Those are some basic skills that we can manage and master, and it's going to give—those skills are what are going to help us have perspective on AI and our use of technology. So that starts at—in babyhood—respecting the baby and all their needs. And then it carries through into the school years to make sure that they are building up all their human skills that they need to build.
That's beautiful, Jennifer. And I just want to emphasize again that the babies will lose all these abilities or not be as proficient in these abilities. I interviewed Dr. Nicholas Cardaris a couple of weeks back, and he said that the the young men in therapy who are addicted to gaming and digital media, they have trouble with creativity in their head. Meaning that they're reading a book together and they're reading out loud and they're reading these words, but they can't imagine what these words mean or the imagery that's associated with what they're reading. They've lost that ability because they didn't grow up with the ability to read and then imagine in their head what that scene or situation would look like. And that's one of the things that really stuck out to me was like when you were saying creativity is dependent on the child interacting with their 3D real-world environment. There's so much research coming out about reading—even as adults—maintaining our faculties—reading fiction because of this mental exercise that happens in the mind. These kids that have only played video games have been deprived of reading, and reading and putting pen to paper really connects the brain and allows access to previous memories and imagining and creativity, um, of writing and that sort of thing. So reading is a really, really important thing to do from birth with the child.
Yes. From birth. Let them hear words. Even if it's you talking quietly—reading Frog and Toad or something—even when they don't quite understand it. I'm really referring to my daughter and my grandson because he's really bloomed a lot because she made reading a priority. And so, um, reading is so much fun—to cuddle up with them and read a book anytime of day, not just at night, anytime. And so just not forget about reading. How about audiobooks? Reading a book on a computer that doesn't talk may be okay, but if it talks, it's going to interfere. So anything that makes sounds, has lights, that interferes. And I want to get back also to the parent-child interactions that Jennifer was talking about that are so critical for babies learning. So when screens are on, even if they're on in the background, they interfere with how much parents are responding to a child, talking about what a child is doing; they interfere with the child verbalizing, giving the parents less opportunity to respond to the child. Babies play less when screens are on. And additionally, if we think about a mother nursing a baby and she's cuddling the baby and talking to the baby and singing to the baby and looking and smiling, but if she has her phone in front of her because she's, you know, checking her texts or emails or scrolling, which sometimes people think, oh, my baby's comfortable and happy and I can go ahead and do all of these things. But what they might not realize is if they're doing it for a large portion of the day, the baby's not really seeing their face and their response. So that's called technoference. So the the parents' screen time interferes as well with them being involved with with their baby and their young child. And they're also modeling for the child. So at a very—at—when the baby's forming these connections early on in life, they're seeing that the screens have this ultimate importance, and that's what they're going to want is the screens because that's what's been modeled for them. So those are important considerations.
We also suggest that parents—when they—if they decide to turn off the screens—that they want to include their baby in as much of the family routines during the day because babies can learn from everything—they can learn. If you're sorting laundry, big shirt, little shirt, green, blue, this goes on my pants—everything that you're doing, setting a table, um, cleaning various rooms and talking about the rooms that you're in. Babies learn incidentally throughout the day if they're given the opportunity. Um, especially if they're paying attention to people; we want them to learn the importance of faces and human language so that they are learning from everything that happens around them. Wow. This—that's so important. And so how do you communicate with pediatricians and family doctors to support parents in navigating this issue without, you know, feeling judged? So the first thing that's important is that pediatricians get the information from their—the parents. So how much screen viewing is a child doing? And I—I think that that's something that isn't asked. So the pediatricians don't necessarily have that information. Um, and to support the parents by explaining to them how important they are, how important their interaction, their time—the babies need them, their faces, their reaction, their touch. That's what's critical to that early brain development—that the screens interfere with that. And babies don't learn from screens; young—pea—children a couple of years and younger, they do not learn well from screens, and but the screen is likely affecting their early brain development. Pediatricians need to be able to share that information. Um, we have alerts for parents that we're are sharing, um, as part of the World Infant, Child, and Adolescent Mental Health Day, um, that they can use to help them share that information. But parents need to understand the importance of their interactions, their play, their time with the baby and what is lacking when the screens are on and what is being disrupted when the screens are on and what is associated with higher screen use. Par—the pediatricians also have to be sensitive to the parents' needs. Raising babies is hard and tiring, and parents don't get a lot of sleep if the—if the babies are up a lot during the night. So, they're exhausted. So, nonjudgmental sharing information I think is very helpful because then parents can make their own decisions based on information and then hopefully they—they won't feel judged. We also suggest that even prior to birth that perhaps with their prenatal appointments that they could get some information to prepare for the baby so that they understand some of this information so they can prepare the environment even before their child is born. Um, I think those are are very helpful. Like Jennifer said, reading to the baby, including the baby in family routines, eating with the babies. I mean, some people put on a screen for the baby to eat, but then the baby isn't processing about the textures and the flavors and the colors of what they're eating. So, that they're losing out on all those sensory experiences that build their brain. So, understanding and providing information go a long way in, as you said, a nonjudgmental way. And that's why you guys started gaining, right? So, and you're getting momentum, too. It's, um, it's amazing because you're sounding the alarm in 30 countries, and it's—it's addressing all these problems that we're seeing in infant—k—children, uh, young adolescent children, and basically—what is the ultimate goal in raising awareness through this movement, and how can everyday parents be a part of it?
Well, I would say that everyday parents—once they get—they understand about basic brain development and how—why their babies need them and their natural—and the natural exploration of the environment—and that's what makes the baby's brain bushiest—that they need to advocate for themselves. So we have three alerts. One is for parents, one's for healthcare providers, one's for governments. And the parents can make sure they can help and suggest to the the pediatricians, please, I really would like a screen-free waiting room, and the the pediatrician can have everything screen-free, um, to support the parents. The the advice worldwide is no screens under age two. That means no screens in the waiting rooms and also no screens in preschools or daycare centers. So the parents themselves could start to be advocates for that and to be unafraid and not embarrassed because they're looking out for their own child's brain development—for goodness sake. There isn't anything more basic than that. So I'm encouraging parents to have guts and to just stand up for yourself.
Any last words you want to empower parents with? You know, um, any messages that you want to share personally, uh, or professionally that that would empower parents to make a difference in their kids' lives? There's, um, speech-language pathologist—her name is Alyssa Leberti—and I interviewed her, and she had—was brilliant in this concept that we began to call bubbles and balls. So balls are—remember you're playing ball with your child sort of throughout life. If they throw out a bid for your attention, you're paying attention. You accept it, and you respond back. And that starts way back when—when they are firstborn—to be watchful for their bids for attention. Keep an eye on how they're feeling. Don't have this blocking. So you don't see it. They're looking at you. They're pleading. They don't see it. You don't see it because you're blocked by the phone. So that's—remember the concept of playing ball with with your child. And the other one is bubbles, which I really love, is that if you see three kids on a couch and a dad, you know, watching a screen on the wall, each of the kids are on their own devices. They're in their own bubbles. None of them is communicating. None of them has a shared experience about what they're seeing on their screens. So, as a parent, just if you remember anything at all, can we be in the same bubble? You know, even if you—if you watch a two-hour movie on Friday night and the baby's sitting there, at least you can say, you know, oh, that's Winnie the Pooh or, you know, you're—you're interpreting it. Um, and so try to be watchful for people in their own individual bubbles. It's a family. The family needs to be together and be united. And so watch out for individual bubbles. I would just say information is powerful because parents have decisions that they can make in how their babies and toddlers spend their time and understanding how the experiences build their developing brain, uh, and how those experiences can be negatively impacted by technology is very—I hope—very helpful for parents because it's a decision—how and when to introduce technology. Nobody forces them to do it. So, uh, having this information can provide—or better, uh—providing an environment that may be more prosperous for their young child's brain.
That's awesome. We developed a card, um, called a Care Card, and it's—it's a two-sided printed document, and it has the babies' kind of what they want from the mom and dad—like, um, you know, take me outside so we can play and you know, involve me in your routines—and on the back is some support information for parents because we think parents do need more information. So we do have that available on the Gaining website if people would like to go and download that. Yeah, that's awesome. And I'll put the Gaining website address here as well as links to all your important websites, the Durable Human and your books and publications. It was only one in a 100 kids like more than 10 years ago, but now it's 1 in 31—at the rate it's doubling every 5 years—'cause it was one in 54 in 2020. So if it's doubling almost in—in 5 years, that means that 1 in 31 will be 1 in 15 or so or in the teens. And then finally, we're going to get to one in 10. If—if truly the screens or what you're describing as being this like significant inhibitor of brain development, it's going to be a huge problem for the world and our society. And every decade we lose a generation because it's permanent. If you don't act by the age of 18, I mean, I'm just throwing the number. What do you got? What do you think in terms of your knowledge of brain development? I think it's 18. What do you think, Jennifer? What do you think, Dr. Hefler? At what age is it too late to really make a difference?
I—I think the earlier that a child's environment and experiences are considered, the better. I—I don't have—I mean, you can learn at any age, but the rate of learning is less than in the early years. Okay, that's a political answer. So Jennifer, what would you say? Okay, in my course, I say that 25 years—years old—is when a child's brain—an adult's brain—is solidified and it becomes hard. We know that we try to learn languages now. I've been playing at so many languages over these years. Nothing's sticking really. Um, we really have to like totally apply ourselves. Whereas babies, they don't have to apply themselves at all. They just—they just pick it up. They can pick up multiple languages. They can pick up any language. So, let me give a real—I'll give you a real clinical, uh, comparison. I had a 2-year-old that I mentioned earlier in the podcast here that was severely autistic; took it away, 6 months, dropped the diagnosis. So, in 6 months for a 2-year-old, another parent who happened to be a physician—family—had an 8-year-old severely autistic boy, very addicted to the—to his tablet—so much that when they take the tablet away, they would have to bear hug the boy for an hour as the boy is screaming bloody murder. But they stuck with it—with limited screen time. And then I saw them 10 years later, and they said, you know, we stuck with it, and you were right. Our boy is high-functioning autistic, and people—he just graduated from high school, and no one realizes that he was severely autistic and had that diagnosis at eight—but that—in an 8-year-old—took almost 10 years for rehab. So I'm just drawing that correlation out. That's why I pick 18 because I think at 18 they need probably lifelong rehab and coaching and help at that point. We see that in Dr. Hillary Cash's clinic as well as Dr. Cordaris—that these gaming addicts who come—who also have autistic symptoms, they literally need lifetime rehab and work and therapy. I have to tell you something good though about that—Dr. Cash's re—restart clinic up in Seattle. I read in the New York Times that she said—this was like in 2017—that she said these kids up here in our clinic are taking the dog out. They're cooking dinner. We check their beds every day to make sure they made their beds. I was moved to tears. I'm like, "Are you telling me these kids are learn?—They're using durable human skills to recover from these horrible addictions to gaming?" And she said, "Absolutely." I went there. I flew to Washington. I went there. I talked to a couple of her guys that are recovering. And lo and behold, you can see on my website. I wrote about it. And I was so excited and so encouraged that these simple, durable human skills are what could help these people recover. And if we start at age five to make sure that they throw their dirty laundry into the laundry basket and do those things, that takes time out of their life. In other words, those are a few minutes. They're not online. They're not on some game. And all those add up through the day. And so if we just, you know, throw those things in there—setting the table, sitting down with dinner—to dinner without a device—pretty soon there's hours in the day where they're not playing Fortnite. And so, um, it's not really that hard. It just does require some attention to monitor your own house—to—to keep this—the the technology down.
So in today's society, everything is like, you know, give me the research—I want data—and there's a bunch of fact-checkers out there, and actually in my—one of my videos—I just had somebody who wrote to me and saying, oh, you're so wrong because autism was, you know, not even known in 1970, so how can you claim it's one in 10,000, you know—so they want to know the…
Facts? So I wrote, yeah, I wrote the facts for them. So what are the facts? What are the research-based facts that are validating your gaining recommendations?
Well, I would tell you that we pride ourselves at Gaining as professionals in the field. I'm more of an advocate communicator, but most of the people are actually early interventionists and clinicians and researchers, and all they do is, is, is deal with hard scientific data. We have pulled together a research list of studies that are validated, strong, in very top-notch journals that support the claim that there are associations between screen time and developmental harms. So, it's not just autistic-like symptoms. That's actually down the list. It's language delay, um, motor skill problems, brain formation—actual how the brain forms, less white matter, for instance. We have other categories of harm. All of them have links to research, and we also have some documents at the end that talk about sometimes the made-for-babies TV have, um, persuasive design techniques within them to keep babies viewing. So we also have those supporting documents. So we really pride ourselves on being able to feel very comfortable that we have research to back up what we're saying.
In fact, when we started this—and it started from a group of researchers and clinicians at the World Association of Infant Mental Health meeting in 2023—we, we, at, at one of the conferences, we were presenting on various developmental and concerns related to screen time. And as a group, we decided that, hey, the world doesn't really have this information that's accessible. So we wanted to get the information out, not just you know how and why, but actually in our alerts, in the, uh, alert for governments and alert for healthcare providers, we provide direct links to the research so they can see the articles that we're basing the information on.
And one of the things that we, uh, stress for government agencies is that this idea of prevention, it's pretty exciting because if people can make the connection about how early brain development depends on human connection and play and physical play, then language delays, behavioral problems, all these things are preventable. Right now, some of the documents we have in the alerts show that governments are spending an inordinate amount of money. So much so that they're not going to, they're just, it's going to become unaffordable. You're talking about the exponential increases in autism rates. Yes, it's an exponential increase in therapy that's happening. Either the parents paying for it or society's paying for it, but it gets very expensive. And of course, it's expensive to people's mental health, too. They're sad and depressed and all that stuff. And so this is an opportunity for prevention like no other, which I think you said, Dr.
Do thanks again for your time. I think what you're, I actually, I know what you're, you're sharing is such an important thing that this is a, you know, there's a few times in medicine when we as physicians and clinicians get to see something that can make a dramatic difference in people's lives that are like groundbreaking. And this is it. Both of you ladies are working in a field that will make huge impacts, and I've seen that personally too with, with the kids I work with, and I just applaud you.
Thank you so much for, for your time for being here and your expertise and your dedication in this field.
Thank you very much for having us and for sharing the information so that governments, providers of care, healthcare, and parents can be afforded this research-based information. Andy, you're doing a terrific job for all your listeners.
Thank you. Thank you. Thank you for joining us today. If you like our video, please remember to like, comment, and share. And also hit the subscribe button so that you get all notifications about our future videos and podcasts. Thank you very much. Have a wonderful day. [Music]