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Virtual Autism: A New Threat to Toddlers

Dr. Anne-Lise Ducanda manipulates toy ball

Don’t miss the interview with a mom who helped her 14-month-old son overcome screen-induced syndrome, a condition also termed “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 a syndrome of marked behavioral changes that appear similar to autistic-like symptoms. The good news: the changes often disappear when the children stop all screen exposure and switch to face-to-face contact, reading, and play with parents, caregivers, other children, and non-electronic toys.

Two doctors in France are leading an awareness campaign, 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 and speaking words, began avoiding eye contact, and had become indifferent to the world around them. Many children lagged behind developmentally for their age and were language delayed. 

Pediatrician holds up drawings by two 4-year-olds. The drawing by the child who is on screens a lot is much less detailed than the one drawn by a child who doesn't spend much time on screens.

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 families stopped the child’s screen exposure and greatly increased social interaction and play with the child, most if not all aspects of the condition eventually disappeared.

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 (Autism Spectrum Disorder).”

Because this phenomenon has been so often observed in Romania, screen withdrawal there is now a therapeutic protocol for early ASD and a campaign is underway informing parents about the problem.

Romanian psychologist Marius Zamfir coined the term “Virtual Autism” to describe the screen-induced syndrome. 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 were “marked improvements in developmental trajectories.” 

Australian research also shows that babies with early signs of autism may avoid an autism diagnosis if parents are taught communication skills through video feedback

LEARN ABOUT THE LATEST TODDLERS AND SCREENS RESEARCH HERE FROM DR. KAREN HEFFLER  

Researcher has Firsthand Experience with Screen-Induced Syndrome 

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 young patients who had been diagnosed with ASD 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 months with no screens but 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 video explaining the phenomenon of Virtual Autism, with great suggestions on how to limit children’s screen viewing.

In this TEDx talk, I discuss the importance of parent-child Attachment and how digital devices can interfere with early relational health. 

Avoiding Screen-Induced Syndrome

So, what’s a parent to do? For one thing: respect the child’s basic developmental needs. For babies and toddlers 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.

Screen time duration drops in Journal of Asian Psychiatry Study from Iran

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.

The American Academy of Pediatrics agrees that babies and toddlers should never use screens alone. Any interaction with screens should be limited to video calls with loved ones, with a caregiver standing by.  

Preschoolers should not have more than one hour of screen time a day in order “to allow children ample time to engage in other activities important to their health and development,” says the AAP.

The World Health Organization agrees that, for the sake of their health and proper brain formation, children under age one should have no exposure to screens.

Life Balance Guidelines for Infants from the World Health Organization

World Health Organization Infant Guidelines (Under Age One)

Early Childhood is a Once in a Lifetime Opportunity

When you look through Today’s lens, early childhood has become a rarified, once-in-a-lifetime pre-digital opportunity. As I write in The Durable Human Manifesto: Practical Wisdom for Living and Parenting in the Digital Age, each child begins life as a “wild human”—as free and unplugged as any other animal.

“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.”

Boy playing outside with toy trucks

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 empty plastic food containers and lids, stacking cups, 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 your young child
  • Not hand a phone to your baby or young child (and keep the screen locked, just in case they grab it)
  • Keep the TV off around kids under age four, even if it’s TV on in the background and 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

Great grandfather plays on floor with great grandson

Dr. Heffler points out in her research that characteristics that may resemble those associated with autism in very young children can have a variety of causes. 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, ASD-like problems in many children may “miraculously disappear or diminish considerably.”

Conversely, if a child has a full, well-balanced life with very minimal screen exposure, these types of symptoms may never emerge.

Parent Resources

Watch an interview of an American mother who came forward after discovering information on this post to tell the story of how her 14-month-old son developed and overcame screen-induced syndrome. 

This site has links to research and researchers.  

Watch webinars with Lori Frome M. Ed. who explains how to detect, treat, and avoid screen-induced syndrome: 

See the latest webinar on YouTube:

Webinar Welcome Page "Virtual Autism. What to Look For. What to Do."

Also see this earlier webinar: 

Welcome screen Virtual Autism webinar "Learn More About Virtual Autism"

Download Lori Frome’s specially-curated Parent Resource List from the box on this page.

Finally, in this simple online course, I teach parents why and how to create loving bonds with their babies and toddlers as well as to maximize their brain development and language learning.

Note: This post was last updated on December 14, 2023

About the author:

The mom of three practicing durable humans, DurableHuman.com founder Jenifer Joy Madden is a certified digital wellness instructor, health journalist, digital media adjunct professor, and author of How To Be a Durable Human: Revive and Thrive in the Digital Age Through the Power of Self-Design and The Durable Human Manifesto.

Her work has informed millions on ABC News and Discovery Health Channel, in The Washington Post, Readers Digest and other news outlets.

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Fatima

Hi Robin, Jennifer, and Lori,

I am very much depressed about what has happened to my son. My son was put on TV from 9 to 23 months. Though I realized that he was not responding to his name and not making eye contact pretty early (13 months old), it took so long to know that the screen was causing the problem. After learning that, we stopped screen time immediately, and he started showing improvement. He started getting interested in us, playing with toys; we went to the park every day, where he snatched the football from other children and began to play with it (alone). After two months of our recovery journey (25 months old), he started responding to his name and making good eye contact, and we followed our routine. Also, he started babbling for two weeks and then said proper words, like mama and baba. Then he got ill after 15 days (25 months and 15 days old), lost interest in toys, and did not want to play with toys anymore. He was still interacting with us, and then I bought some new toys, for instance, a tricycle, a bike, and a horse. He showed interest in them but did not play with other toys. So, we were satisfied that he was making eye contact, responding to his name, and interacting with us. On command, he would stop, turn the light on and off, wear his slippers, and take off his jacket. Soon, he started expressing his feelings, pointing to the jar to take the cookie. When he is hungry, he will begin to cry, then I ask, do you want milk, then he smiles at me; in this way, I know that he wants milk. When we were in the 6th month of our recovery journey, he got sick again; this time, he was very ill. After that, he stopped making eye contact and responding to his name but was still doing other things. After a couple of weeks, he started making eye contact. We are now in 7th month of recovery; he is still not responding to his name. I am very much depressed. Besides, he has new stimming behaviors like clapping, shaking his hand, or anything he holds. He wants to do them all the time, and I do not know how to stop him; please suggest me 🙁 But his interaction with us and eye contact are improving day by day. One more thing: I would like to say that, instead of pointing, he reaches for things (is that normal?). His babbling is still there, but he hums or grunts while listening to music. He is saying “aga” nowadays. Please let me know what improvements are still needed or what routine I should make to improve him. I am very worried and need advice.
Thanks in advance.

Robin

Hi Fatima,

The apparent regression around times of stress or illness is very common. Seeming to “lose” a skill or gain new stims is the Hallmark of these regressive behaviors. What kind of illness was his last one? It might be worth getting him checked at a doctor to see if he developed an ear infection from the last illness just in case that could be affecting his response to his name.

When your son reaches instead of points, you should model pointing for him. Point at the object he wants while saying the objects name before you give it to him. After a few days of this, if he will let you, when he reaches take his hand and make it into a pointing position for him. It is good however that he understands the power of a gesture for communicating, so take the reaching as a good sign!

Keep up what you are doing, it’s a long hard process. It does come with snags and setbacks along the way. Just know that it is normal and to be expected!

Robin

Fatima

Dear Robin,

Thanks for your prompt response!

He had stomach flu last time. I am so stressed that I want to die; I cannot forget my self 🙁

Please let me know why he is not playing with toys. He knows how to play but simply does not want 🙁

Regards,
Fatima

Robin

PS- I forgot to mention the regressions are temporary. Give it time and he should come around. Illnesses really throw off the kids when they’re in their recovery process.

Glazel

Hi Robin, Jennifer and Lori

First of all, I want to thank you all as you gave me hope for my daughter, she is 20 months old now, I do not exactly remember as to when she started watching TV but I’m pretty sure around when she was just few months old, with little interaction from us as me and my husband were busy working, my mother in law was the one who looked after her, she would put her in front of TV until she falls asleep for my mom in law to do some household chores. I did not realised she was delayed with her milestone until her 18th month vaccine and wellness check, she was too focused on what she was watching and would not bother looking at the doctor or to any of us, she was grabbing the dr’s finger to even press on the screen of the phone to change what she’s watching without looking. And trying to remember then, I did not noticed if she actually pointed her fingers to anything at all. She has a very good eye contact, she is playful and love being chased, she loves playing with her older sister (she’s 10yo). She was not talking much and only copies what she’s watching, she understands NO and would say No as well. She knows her alphabets, count 1-20, loves nursery rhymes but would not label any of us. When we went on holiday for a month(she was 19 months old), that’s when I realised how many red flags she was showing, she was not responding to her name at all (she used to when she was a baby) she would not look up to check who entered the room, she would play with toys but prefers to watch all the time, she does not know danger as she would just walk in front of a dog without realising that there’s a dog in front of her, she occasionally walk on tiptoes. I cried and cried everyday, every night blaming myself that we caused her this and that we did not even realised until now. We started 0 screen for 3 weeks now and have seen lots of improvements, I would read books to her, and interacted with her God knows how long whenever she is awake, her eye contact is still very good, started looking to people when when she hears them, she mimic some of the words we are saying (she understands shut the door, open door, go outside, milk), she started pointing to books and charts, her joint attention has improved as she will occasionally show me something and waits for my reaction, she still does not know how to play with building blocks as whenever I teach her she couldn’t wait to knock it down, we always go outside of the house, we go to park, to our friends house with kids, she interact well with kids however they are a little bit older than her so they play differently, and she likes to dismantle Lego’s which makes other kids frustrated as she would grab and destroy what they are building, the other day I was surprised as she looked up to me when I called her name, and my friend tried calling her and she looked up, but yesterday she did not respond much when called, I would still take it as improvement and will work on it even more. I am seeing light and I am very hopeful that we are on the right track of healing, we will see her dev paed this March and hoping that she will continue to improve and will only worry with her speech and not with actual autism diagnosis.

Robin

Glazel,

Welcome and congratulations! It sounds like your daughter is progressing on her recovery exactly how we would expect! This is great news! Don’t worry if she doesn’t do her new skills perfectly every time, like responding to her name. That is completely normal. Write here as much as you like to discuss questions, concerns, and joys with us!

Robin

Glazel

Hi Robin,

Is it normal for her to look at the mirror and interact with herself? She finds it amusing looking at the mirror and does some vocal stimming if it is called vocal stimming as she screams, laugh, and does head shoulders knees and toes in front of the mirror. She loves looking at the mirror and do silly things I wonder if she knows that that’s her reflection. Also she started saying byebye and blow a kiss and wave but gets really upset when she is saying it and she does not look at who she is waving to..

Carolina

Hello, my name is Carolina. I am from Venezuela but I live in Chile. I am a mother of a wonderful 20-month-old baby girl. I am a working mom. Since my baby was little, approx since she was 3 months old, I relied on screens so I could cook and clean while taking care of her, but we still interacted a lot. Then, when she was 6 months old, I went to work and left her in the care of a woman who leaned much more on the screens and interacted little with her because, due to her age, she doesn’t usually lie down on the floor to play. My daughter today says a few words (mom, dad, water, milk), and babbles frequently, but does not respond to her name, does not point, and has very poor eye contact. We are in the process of diagnosing ASD, applying the ADOS-2. However, I have always thought that the reason for his symptoms is the screens. Today we have had 0 screens on our part for 2 weeks, but I know that the caregiver has put them on when feeding her. Just today I told her that we were deciding to cut them for all and that she couldn’t use the phone while with her. We will also begin speech and behavioral therapy to improve the social skills of my daughter. Plus she will start going to kindergarten next week. There are many changes at the same time, I have a lot of hope (especially after reading the blog) but also a lot of fears. If anyone went through a similar journey and can tell me their testimony, it would help me a lot. In these two weeks with very little screen time, my daughter has improved her eye contact (although it is still similar to that of someone who is autistic), she babbles a lot more and seems to be starting to want to add new words. I have faith. Thanks for creating this community.

Robin

Hi Carolina,

I want to reinforce what Jenifer is saying…your child will not improve even half as much as she has the potential to if all screens aren’t removed. It is so important. I hope the babysitter will listen to you. These years are crucial for recovery. I will be so bold as to say get a new babysitter if this one will not comply.

Erica

It JUST hit me. After watching the Durable Human Youtube videos and Robin’s story. I always wondered why my son only wanted me to do something and he didn’t reciprocate (I would push a toy car to him but he would walk it to me to do again instead of pushing it back). It’s because of the TV! He would watch the kids on the TV push cars around or do this & that and he would never do it back because there’s no interaction other than watching. Holy moly.

I did want to reach out and say that I’ve watched Robin & Lori’s videos so many times now and I’m hoping it’s not too late to help my kiddo. He will be 3 in April. I want nothing more for him than to have a normal, successful life. We’ve cut the screens (about a week) and I noticed he is imitating more (i.e. his dad dropped a cuss word in the Chik-fil-A drive through and didn’t he repeat it….). He’s never quite checked all of the “autism” boxes so when I accidentally stumbled upon VA I was like, this has gotta be a factor in his language delay (receptive and expressive) and other things. I put him in front of screens as a NEWBORN! I had horrible PPA and he was a fussier baby and sometimes I needed a breath. But the past is the past and I’m praying, PRAYING that going forward I can make a big difference in his life.

I guess this is a good place to write his progress for my own sake too! Will keep everyone posted. Wish us luck!

Robin

I’m so happy to hear from you, Erica.

My son’s recovery process was both the most humbling and most empowering thing I’ve experienced thus far in my life. You’re in for an adventure filled with highs and lows. Come here and post with any questions, joys, and concerns!

Robin

Lara H

Hi! Me again! We’ve been screenfree for a bit over 4 months. Some things are going great whilst others not as good. We are still in the beginning of our journey so that’s to be expected. I wanted to ask about this new behaviour we are experiencing and whether this happens at all with screen affected kids. My son has started to cover his ears when sat at a table (therapy at home) or when eating. There is no sound so I am unsure why he is doing it and whether it’s some new stim or self soothing behavior. Can children who are screen affected be sensitive to sound or is that more common in classical autism? . He has never had an issue with loud noises or crowded places and it seems like that’s still the case. Why he feels the need to block out sensory input in this way is unclear but worries me that I’m wrong about his autism symptoms being screen induced

Lara H

He’s 2 years and 7 months

Robin

Hi Lara,

Screen affected kids absolutely can be sensitive to noise. Is your son still doing it? Does he seem distressed when he does it, or more neutral? Developing new stims during the recovery process is also common. My son developed a few new ones during his recovery, but they eventually disappeared. Not always, but usually, the new stims aren’t as intense as the original stims from before screen removal. If he doesn’t look distressed while doing it, I would guess it’s a new stim. If he looks upset maybe some type of noise is bothering him.

Lara H

Hi Robin! Thank you for reply. I’ve noticed he only does it on two occasions;

Mainly during table time with me (he also hides his face here sometimes). I think it might be a way to escape the task or table time in general. It will be completely quiet but he’ll look upset and cover ears or eyes.

Or

When his baby sister cries or makes loud noises. Any sound from her seems to upset him. In fact her presence overall makes him jealous and uncomfortable 🙁 He is 2 years and 8 months and she is 8 months.

I’ve noticed he does not care at all if hearing loud noises besides from her. I’ve observed him in noisy situations such as walking past an orchestra on the street, construction work with loud drilling, using the blender at home etc.

Curious to hear your thoughts and again many thanks for sharing your experience with us

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