The usually ultra-cool marketing executive was over-the-top exasperated. “Every time we get together, the parents all talk about it. We don’t know what to do about Fortnite!” There’s much to learn about this wildly popular new pursuit and why it’s popping up at school, so let’s dig in.
What is Fortnite?
Fortnite: Battle Royale is a free-to-play, third-person-action online video game where players fight to the Continue reading →
Don’t miss the new interview “A Mother Speaks about Her Son and Virtual Autism”: Watch it here.
Pediatricians are alarmed that babies and toddlers who spend hours a day on phones, tablets, and around TVs can develop autistic-like symptoms, in a newly-identified condition termed Virtual Autism. The good news: the symptoms of Virtual Autism often disappear when the children stop all screen exposure and switch to face-to-face contact, reading, and play with caregivers, other children, and non-electronic toys.
Two doctors in France are leading an awareness campaign about Virtual Autism, which they explain in this video.
“Screen viewing several hours a day prevents the brain from developing and generates behavior problems and relationship problems,” reports Dr. Anne-Lise Ducanda, speaking also for colleague Dr. Isabelle Terrasse. “We decided to make this video to warn parents, professionals, and public bodies of the grave dangers of all screens for children between the ages of zero to four.”
The doctors had noticed more and more toddlers with unusual changes in behavior. Some had stopped responding to their names, they would avoid eye contact, and had become indifferent to the world around them—characteristics of Autistic Spectrum Disorder (ASD). Others were developmentally behind for their age.
Drawing on left by a 4-year-old who spends little time on screen media. Drawing on right by a slightly older 4-year-old who was highly screen-exposed..
After asking parents in detail about the kids’ media use and household exposure, the doctors discovered almost all the children had spent large amounts of time on and around screens—in some cases, ten hours a day. But when the doctors had families eliminate or greatly reduce the children’s screen exposure, the ASD symptoms would almost always disappear.
Various studies in Romania have come to similar conclusions, one stating “sensory-motor and socio-affective deprivation caused by the consumption of more than 4 hours/day of virtual environment can activate behaviours and elements similar to those found in children diagnosed with ASD.”
Romanian psychologist Marius Zamfir coined the term Virtual Autism. He worries about lack of motivation among children exposed to excessive screen content. “Children’s brains are used to getting pleasure without making any effort at all,” he says in this video made for the Romanian public information campaign.
Meanwhile, a study released in 2022 of more than 84,000 Japanese babies and their mothers found that “among boys, longer screen time at 1 year of age was significantly associated with autism spectrum disorder at 3 years of age.”
“With the rapid increase in device usage,” concluded the authors, “it is necessary to review the health effects of screen time on infants and to control excessive screen time.”
Study Proves Observable Brain Changes
A study of toddlers’ brains seems to bear out the behavioral indicators.
Cincinnati Children’s Hospital researchers show evidence in JAMA Pediatrics that young children who spend more than two hours a day on screens have less brain white matter. The brain’s white matter aids in thought processing and organization, as well as performing other vital functions.
“Think of white matter as cables, sort of like telephone lines that are connecting the various parts of the brain so they can talk to each other,” study author Dr. John Hutton told CNN.
“These are tracks that we know are involved with language and literacy,” he continued. “And these were the ones relatively underdeveloped in these kids with more screen time.”
47 healthy toddlers were studied. Screen exposure among them ranged from zero to about five hours a day.
In their report, the study authors did not make a connection to virtual autism nor did they specifically mention autistic-like symptoms.
Astronomical Rise in Autism Incidence
According to the U.S. Centers for Disease Control, in 1975—when VCRs first came on scene—only one in 5,000 children in the U.S. was reported to have ASD. But by 2016, video on demand had become ubiquitous and the incidence of ASD had risen to one child in 68. The CDC now estimates the rate is 1 child in every 44.
Until very recently, “AV (audio-visual) exposure in infancy has been overlooked” as a risk factor for autism, according to research ophthalmologist Karen Frankel Heffler of Drexel University College of Medicine. As she writes in the journal Medical Hypotheses, “There has been an explosion in viewing opportunities for infants over the past 25 years, which parallels the rise in autism.”
“Attention in the vulnerable infant is drawn away from healthy social interactions toward TV, computer screens, and electronic toys,” according to Heffler.
In early 2020, JAMA Pediatrics published an analysis that Heffler co-authored which found that babies who viewed TV and videos at age one had a slightly greater chance of displaying autistic-like symptoms than non-TV watching babies by the age of two. Conversely, the study found, “Less screen exposure and more parent-child play at 12 months of age were associated with fewer ASD-like symptoms at 2 years of age.”
In 2022, Heffler’s team published a pilot intervention involving 9 children between 1 1/2 and 3 1/2 years of age who were diagnosed with ASD and watched at least 2 hours of screen media a day.
As the study shows, when screen time was replaced by increased interaction with caregivers, “Children’s screen viewing decreased from an average of 5.6 hours/day prior to intervention to 5 min/day during the study. Significant improvements were observed in core autism symptoms and parent stress from pre- to post-intervention.”
Heffler’s team also published a case study of two toddlers diagnosed with autism showed that when screen time was stopped and social time increased, there was “marked improvements in developmental trajectories.”
Researcher has Firsthand Experience with Virtual Autism
At the first ever Children’s Screen Time Action Network conference, I happened to meet Dr. Heffler’s research associate, Lori Frome, M.Ed. Frome is an autism treatment specialist who discovered, also by chance, that the symptoms in one of her ASD patients disappeared after her screen exposure was curtailed.
Frome then tried the same treatment on her own young son, who also had an ASD diagnosis. Over the course of several screen-free months and intensive face-to-face interaction with herself and other loved ones, he had “a complete developmental trajectory change in the core deficits of ASD,” as Frome describes in this video. In other words, her son became developmentally normal for his age.
Screen media has a “very addictive power,” says Dr. Ducanda. “Little by little the child can no longer do without and demands it more and more. If the parents try and withdraw him, he can go into a real meltdown.”
Doctors Ducanda and Terrasse contend that heavy doses of screen time affect what would be, in pre-digital times, the natural wiring of a child’s brain.
Watching a ball move on a screen, for instance, does not register in a child’s mind the same way it does to manipulate and throw a ball. Says Dr. Ducanda: “The small child’s brain cannot develop without this sense of touch.”
Dr. Andrew Doan, an ophthalmologist and neuroscientist, produced this animated video to show how watching screen media can rewire a child’s brain. In this TEDx talk, I discuss the importance of parent-child Attachment and how digital devices can interfere.
Avoiding Virtual Autism
So, what’s a parent to do? For one thing, to respect a child’s basic developmental needs. For kids to learn to speak, reason, and develop crucial social skills, they need face-to-face interaction with loving people and to use all their senses as often as they can.
A study from Iran proves the power of parent interaction and play. Investigators selected 12 toddlers with autistic-like symptoms who had spent half their waking hours on screen devices. Their parents were then given 8 weeks of lessons in how to play with their children, with an emphasis on eye-to-eye contact, loving touch, and continuous communication. While the parents applied these lessons at home, objects that had absorbed the children’s attention were taken away, including digital devices.
At the end of the two-month period, the children’s screen time had shrunk to a bare minimum, their ASD-like repetitive behaviors were greatly reduced, and brain studies showed ASD-like readings had returned to nearly normal.
One of the study’s chief investigators told me consistency is the key. For the intervention to work, the parents had to stick with high-touch, high-talk interaction all day every day during the children’s waking hours. He says researchers can now confidently recommend that children under age three should spend their time playing and interacting face-to-face with caring adults and not using digital devices.
“When toddlers range around, freely using all of their senses to examine, taste and play with whatever they choose, they are making rich and lifelong neural connections.”
So kids can stay on a healthy developmental track, experts including Dr. Ducanda and Lori Frome recommend that you:
Talk, play, and read with your child every day as much as possible
Provide materials, toys, and games that require manipulation, such as a play dough, finger paints, and a play kitchen
Go outside at least once a day and make sure the child has time to play alone and with other children
Not use screens when you are with children
Not hand a phone to your baby or young child (and keep the screen locked, just in case)
Keep the TV off around kids under age four, even if the child doesn’t seem to be paying attention to what’s on the screen
Explain to family members and caregivers why these measures are essential to a child’s healthy development, durability, and well-being
As Dr. Heffler points out in her research, autism-like characteristics that develop in very young children can have a variety of causes. Still, if symptoms do arise, Dr. Ducanda and her colleagues recommend keeping the child away from all screens for at least a month, which will require the cooperation of every household member. If that can be accomplished, she claims, the child’s ASD-like problems will likely “miraculously disappear or diminish considerably.”
Conversely, if a child has a full, well-balanced life with minimal time on screens, the symptoms may never emerge.
Now that he has kids of his own, Tony Fadell is thinking about the unintended consequences of the tools he helped create. “We allow this stuff in our lives in a way that may not be working for us,” Fadell told co-host Anderson Cooper and the crowd at Mindfulness in America, the first Wisdom 2.0 tech-in-perspective summit held in New York.
Bear in mind that Fadell is not your average everyday person, but a true living legend who dreamed up some of the world’s most-used consumer products, including the iPod, Nest thermostat, and world-changing, beloved, attention-grubbing iPhone. But there he was, saying, “We need to pull control back to ourselves.”
Being online can be so useful and entertaining it’s easy to forget what screens don’t do to help kids grow up to be self-reliant, durable adults. In fact, many tech-savvy school kids are doing strange things like losing their balance on chairs, accidentally bumping into kids in the hallways, and being more prone to cry when frustrated. Occupational therapy researcher Angela Hanscom, author of Balanced and Barefoot: How Unrestricted Outdoor Play Makes for Strong, Confident, and Capable Children, also reports that core strength among children has plummeted. A big reason? They just don’t get enough rough and tumble.