Don’t miss the interview with a mom who helped her 14-month-old son overcome screen-induced syndrome: 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. 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.
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 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 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.
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.
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.”
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
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:
Also see this earlier webinar:
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 January 7, 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.
Hi again, I had a secondary question for anyone who might have some information.
Does anyone know if there is an association between early screen exposure (virtual autism) and Gestalt Language Processing (echolalia and scripting)?
I’m wondering if virtual autism could also explain the echolalia and scripting we are seeing with my daughter who was exposed to television early in life but had the screens removed at 18 months before she started speaking. She’s now almost 3 and exhibits many traits of a gestalt language learner.
Thanks so much! I so appreciate all the time and effort it takes you all to answer these questions!
Hi, I have a few questions for Robin who shared her story about her son Walter. I apologize in advance for the length of this post.
Robin, I recently watched your video and was shocked by the similarities between your story and mine. I have a daughter, also born September 2020, who was also hooked on the show Cocomelon and developed many of the autism red flags that you noticed with your son. She started watching about 2-3 hours a day around the age of 9 months and finally at 18 months we realized that she had lost some skills such as pointing, she wasn’t responding well to her name and she was exhibiting some repetitive behaviours like tiptoe walking. Like you, we went to Google for answers, found The Durable Human blog and decided to remove the television completely. She initially scored a 13/20 on the MCHAT and so we started to work on those skills where she was “failing” as well as her language development. It took some time and a lot of work but she eventually started talking, making much better eye contact, engaging in imaginative play, initiating joint attention, and using gestures. Her recovery was nothing short of miraculous and we were convinced that this was a case of virtual autism and not true ASD.
However, after 15 months waiting for an autism evaluation, she was recently seen by a delvepmental pediatrician and unfortunately she did end up receiving an autism diagnosis. As she has continued to develop, a few other “markers” for autism have become apparent, mainly with her speech. Her speech has progressed to the point of speaking in short sentences however she uses a lot of echolalia and scripting when she talks. The way she says things (the intonation in her voice) is also very repatative and almost cartoonish. She struggles with with answering yes and no questions (usually just repeats the question back to us) and also mixes up pronouns like I and you. As she’s gotten older we’ve also noticed that she has some rigidity around routines (although maybe that’s just a toddler thing) and she is still very shy around other children (she watches them but doesn’t engage very much with them–the exception to this is her younger sister who she plays with regularly).
I was hoping to get an update on how Walter has been doing? Did you ever end up getting him evaluated for autism? Have you noticed any echolalia or scripting come up in his speech as he’s been progressing with language? Did Walter fully stop the repetitive behaviours you described in your video (tiptoe walking, hand flapping, spinning etc.)? Now that he’s older, does he struggle at all with making transitions and is he strict about following routines? And have you ever reintroduced the television or do you plan to in the future?
Thanks so much for taking the time to read and respond. I look forward to hearing back from you!
Hello Audrey, I am so glad you reached out here.
We did not end up having Walter evaluated for autism, the wait list was so long and his improvement, much like you saw with your daughter, was miraculous and had my husband and I convinced there was no need to seek a diagnosis. Walter did stop his repetitive behaviors except he does hand flap when something is VERY exciting or upsetting to him. (Though this can also be seen in neurotypical toddlers) He does sometimes struggle with transitions, but I don’t feel that it’s a hold over from screen induced symptoms–just normal toddler behavior. I would not say he is more rigid in sticking to a routine than the average sensitive but neurotypical toddler. We let Walter occasionally watch live action very slow TV. Things like tractors plowing fields or footage of trains chugging along. It’s always supervised, not every day, and we try to make it very social where everyone talks about what we are seeing or we ask questions like “where do you think the train is going? What kind of seeds is the tractor planting?” Etc. We also have a 10 month old now who we don’t turn the TV on at all around.
About speech, is that the only things the other markers for autism that have emerged with your daughter would fall under? Can I ask what the other markers are, if any?
At the time of my interview with Jenifer Madden that you watched, Walter was just starting to speak. He did go on to speak with a lot of echolalia and struggle with pronouns and yes\no questions exactly like you are describing with your daughter. These issues are largely resolved now, but not completely. (I will outline how we tackled them later in this post)I do feel that the speech hiccups were related to the screen induced symptoms. It doesn’t surprise me that there were more minor issues that came up as Walter learned to talk, after all, as most parents describe the process, it was a miraculous thing and very complex and grueling for the small child’s brain to rewire itself… So why wouldn’t there be a handful of loose ends or rough edges still needing attention? So that’s how I take it. Walter is out of the woods, but still has a few twigs and thorns leftover to be plucked out of his clothes. And it also didn’t surprise me that the language hiccups presented themselves in a very autistic-seeming way…how else could they present? I think of these small issues in language similar to the way a baby born prematurely gets their milestones measured for an adjusted age not the actual amount of months or days since they exited the womb. Our children have lost some valuable developmental time during their days when they were still using screens. You and I have closed the major gaps but it is understandable that as some deficits are corrected, other deficits that couldn’t be seen before the more major ones were rectified will make themselves shown.
One thing I have noticed from spending time around diagnosed autistic people of varying severities and ages (child to adult) their echolalia seems to hold very little understanding or intention behind the words or act of repetition. But with Walter, there was a definite tenacity and intention behind these statements he would repeat back to us, a strong desire to communicate. Does your daughter seem to want to be answering your questions when she repeats them back to you? Does she make eye contact and seem frustrated, as If she wants to answer but doesn’t know how?
Walter had trouble answering yes and no questions for quite awhile. He would repeat the question back to us in a happy voice for “yes” and a mad voice for “no.”
What my husband and I did was to model yes and no questions repeatedly for him. We would ask each other questions in front of him with obvious answers. I would say to my husband: “Dad, are you wearing a red shirt?” Husband: “yes!” He would ask me a similar one, then we would ask one of Walter. At first we would have to answer the question for him, after giving a pause to give him a chance to answer. Eventually he hesitantly started saying yes and no, and we would have a big fun celebratory reaction which he loved. We made it into a daily game we would all play together. He now answers yes\no questions reliably ~95% of the time and will even purposely lie to avoid a diaper change or to try to be funny.
The echolalia in general has faded a lot after he has learned to answer yes\no questions, that is where I recommend you start with your daughter. Walter does still do some echolalia, but again, it seems to have a lot of intention behind it. It’s not a robotic, flat, automatic type of response but almost like he is testing out the way the new phrase feels coming out of his mouth. He usually has a big grin, eye contact, and even tries our a few different intonations.
I also recommend you attempt to teach your daughter how to answer some other types of questions too like “what color is dad’s shirt?” In the same exact way I described teaching the yes\no questions.
I noticed that to combat echolalia (which can be completely normal with neurotypical toddlers too, by the way) I noticed that I was able to help Walter lessen the habit by methodically analyzing our conversations and seeing what scenarios were triggering the echolalia, like yes\no questions, and then working specifically to give him the tools to and skills to answer correctly. This technique cut down a lot on the echolalia. I am inclined to say your daughter’s echolalia and issues with answering questions might be more intertwined than they are separate issues.
I think there are a lot of subtle holdovers from the screen induced behaviors that our kids need special attention from us to overcome, subtleties in development that would not be an issue with a child that didn’t have problems with screens in the past. It is my instinct that these subtleties can present as red flags for autism, but can be remedied by a continuation of the special attention by parents used during the major parts of the screen removal protocol, perhaps evolving in technique and intensity as severity of the child’s condition lessens.
We are still working on pronouns with Walter. He is constantly using “you” to mean himself, and “i\me” to refer to others. It makes sense. He hears me call myself “I\me” and him “you” all day long. He is at a point where we correct him after a misuse with a statement like: “say *I* want some milk ” and he will repeat the phrase correctly. We also have been grabbing his hand and making him pat his own chest on the “I” part of the sentence, a tip learned from a speech pathologist for helping toddlers learn pronouns. It is slow going but there is improvement. I am not worried by this because many “normal” toddlers have issues with pronouns and eventually figure it out as they age.
Again we are so glad to hear from you, please write as often as you want. Congratulations to you and your family, I am proud of you!
Robin
Robin, thank you so much for getting back to me and telling me more about Walter! I’m honestly so relieved to hear that he has had some of the same patterns of speech that we have seen with our daughter and that he’s made such great progress as you’ve continued to teach him. We saw so much improvement with our daughter (her name is Aspen) in the months following screen removal (and replacing it with high quality interaction) that we naively thought there would be no further complications related to her development and so when the echolalia started and we noticed these difficulties with answering questions and pronoun reversals, our confidence was shaken. I initially thought, since so much time had passed without her watching TV, that the early screen exposure could not explain the autism-like patterns that later emerged in her speech, but hearing you describe the exact same experiences with Walter has me rethinking that maybe the two are still connected.
You asked if Aspen has any other markers for autism besides her speech–unfortunately the answer is not entirely clear to us. There are some minor things that could be interpreted as “inflexible/rigid behavior” for example, when we’re reading a book, we can’t skip any pages or she’ll catch it and make us go back and read the part we skipped, same with the verses in a song. But in my personal opinion, things like that could also just be typical toddler behaviours.
Probably the most noticeable and troubling thing besides her speech is that she doesn’t show a lot of concern when someone else is obviously sad or angry. My husband and I have had moments of trying to discipline her or even just telling her to stop doing a particular undesirable behaviour and she doesn’t seem to pick up on the seriousness in our voices or facial expressions–she will often just look at us then continue what she’s doing and sometimes she even laughs and thinks we’re being funny. Something else that happens frequently is that she will get in a power struggle over a toy with her 14 month old sister and Aspen will grab or shove her sister, which of course results in crying, and Aspen can now identify and tell us that her sister is sad but she doesn’t seem to connect it to her actions of grabbing and shoving and she doesn’t seem very concerned about it. I guess you could say a lack of empathy and remorse.
The other thing that concerns us is that she doesn’t interact much with other children. She will say hi and bye if we prompt her, but she’s otherwise pretty quiet and shy. She’s still in the parallel play phase where she’ll play next to another child but not with them (except her sister). She does some imaginative play that usually revolves around making her toy dolls and stuffed animals do things but it is not very elaborate yet. She might put her doll to bed, for example, but she wouldn’t take the doll though an entire night-time routine of a pretend bath and brushing teeth and reading a story and then bed unless we prompted her to do each step. She’s also not very good at pretend scenarios yet, like pretending she’s on a boat or pretending she’s a horse–she can engage in those games if we initiate them but she isn’t initiating yet.
Other than that, I still occasionally catch her toe-walking, usually when she’s bored, and it’s only for a couple steps. She can still become pretty engrossed in what she’s doing and it can be a bit hard to get her attention when she’s really focused on a toy or a book–but that just happens occasionally. As her parents we really struggle to know how many of these things are actually signs of autism and how many of them are just part of being a toddler. Both my husband and I are pretty reserved and introverted people so it’s not a stretch to think that she would have those personality traits as well.
What the doctors reported following the autism assessment was that Aspen showed eye contact and joint attention and imaginative play but it wasn’t to the level that they expected (mind you, they only observed her for 35 minutes in the clinic–if they had witnessed her at home with us, I believe they would have seen more eye contact and better joint attention).
The doctors also felt that her play skills and her speech were too repetative. The speech pathologist present at the assessment said that Aspen was “failing to make language her own” and that too much of her speech seemed to be “borrowed” from others. This applied to both what Aspen said and how she said it (her intonation). They also noted that she failed to have a proper “conversation” with me because she didn’t reciprocate when I made comments such as, “The crackers are yummy.” or “I like the park!” That kind of back-and-forth exchange is definitely something we need to continue working on.
I’m sorry for how long this message is getting. It’s hard to give you a full picture without going into all the details. But I think that pretty much covers everything that we’ve noticed (both as parents and what the clinicians have told us) that could possibly be autism. I’d welcome your feedback on any of it–have you noticed any of these things with Walter? What are his play skills like? How does he interact with other children?
About speech, I found it very interesting and encouraging to read what you described about Walter’s echolalia and how it was communicative. I do think the same is true about my daughter, at least most of the time. When she repeats a question or a statement it often seems like she’s doing it to help herself process what she heard. Sometimes she will repeat a question we’ve asked then go on to answer it, so it was just that she needed an extra second to process and think of the answer. Other times, in the case of yes/no questions, she repeats the last part of the question instead of answering “Yes” (she can answer “No” pretty reliably but she’s struggling a lot with “Yes”).
Often times she repeats a question just because she doesn’t know the answer, and she usually does do it with eye contact–it’s almost like she’s asking the question back at us, so then we answer it for her. I wouldn’t say that she gets frustrated that she can’t answer but she does understand that she’s expected to respond so then she echoes. Other times I think she just wants to practice her speaking, and so she’ll repeat what she hears being said around her.
We also see some delayed echolalia (or scripting) such as saying, “Are you okay?” after she falls down–because of course she’s heard us say that to her every time she falls. I’ll also add that she’s a big self-talker so she talks all the time about what she’s doing and what she’s seeing even if she’s playing by herself and a lot of that self-talk is a reproduction of what she’s heard other people say to her.
Thank you for your tips on teaching yes and no! We have been doing some of that with Aspen so we will continue with it and be more intentional about modelling it daily. And thanks also for describing how you helped Walter by analyzing the echolalia triggers and working to give him the appropriate language to respond to questions. I was wondering if Walter also echoed statements/comments (not just questions) and how did you get him to reciprocate with his own unique comment? For example, if I say to Aspen, “I see an airplane!” she will usually look at the airplane and repeat what I’ve said instead of coming up with an original comment like, “The airplane is flying.” or something like that. I hope that makes sense.
It sounds like our kiddos are in the same place with mixing up I and you. Aspen will often say, “Do you want ___?” when she’s requesting something and when we correct her with, “I want ___.” she will copy it. I like the tip about making them pat their chest or point to themselves when saying “I.” Sometimes I also try to model different ways of requesting, like saying, “Can I have ___?” instead of always, “I want ___.” because I find Aspen can get very stuck on a particular carrier phrase that she then uses the same way every time.
Again I apologize for the the length of this message, I’m just so thankful to have found another Mom who has had the same experiences with their child. When I’ve tried to tell other parents about the danger of screens (Cocomelon in particular, I think there’s something especially harmful about that show), I usually get looked at like I’m nuts. But our kids are proof that it doesn’t take a lot of exposure to cause significant problems, a couple hours in front of the TV every day was enough to really disrupt their development. I look forward to hearing back from you! Thanks again for sharing as much as you have and for taking the time to respond. I truly appreciate it so much.
I am not a doctor, only a mother, but yes, I do feel that Aspen’s speech issues that you are describing are directly related to her previous screen exposure and are not a regression as you originally thought. It’s almost as if these speech issues were always there and going to be there, but they couldn’t present until progress had been made in other areas. Think of all Aspen’s progress like an onion, and each new milestone or deficit that you correct is a layer. As you correct a deficit you peel away a layer. Again and again. These speech hiccups are the inside layers. They were always there but you could not see them until other issues had been removed.
Yes, talking with other parents, it is hard to decipher what is typical toddler behavior and what could be screen-induced. Walter can be uncompromising too in similar circumstances. But so is every other two year old that I’ve ever met.
On empathy: it is very normal for a two year old to only have a very small sense of empathy, exactly like what you described with her being able to identify that her sister is sad. Factor in the lost time from screens + the heavy mental workload of recovery that Aspen has been through (in other words she was too busy learning to make eye contact to learn about feelings), and this sounds very normal to me. Reading facial expressions and tones of voice is also something that takes years of practice for even neurotypical children to master. The smiling\laughing reaction sounds to me sounds like a normal nervous reaction possibly coupled with a slight deficit in understanding. Children, and even adults, can have a “nervous laughter” reaction when they’re feeling confronted or in an otherwise anxiety-inducing situation. It’s an instinctive reaction where the body is trying to regulate itself back into a parasympathetic (calm) state.
One thing that helped Walter to grow his sense of empathy was for us to 1) Label his own emotions consistently and 2) for us to be extra empathetic towards him, and very demonstrably so. I am not insinuating that you are not empathetic towards Aspen, but I have noticed with Walter (and this could be for toddlers in general) that he needs the dots connected for him in ways that seem obvious to adults but aren’t obvious to a toddler. So to do this, this demonstrative empathy, after Walter bumps his head and comes to me to be comforted, once he is calm or semi-calm, I will say “you are sad from bumping your head. It hurt. You’re crying because you’re sad. I am giving you hugs and kisses to help you feel better!” Same for every emotion. I’ll do it when he is scared, mad, happy, silly, etc. The more he has the capacity to recognize and label his own emotions and how to soothe\regulate\respond to them, the more he has the capacity to recognize and respond appropriately to the emotions of others. Another thought on rough or inappropriate behavior with others: Walter recently has started to be rough to our dog and chickens.
I was feeling exasperated when Walter threw yet another handful of dirt at the chickens… I knew he loved the chickens so why was he being “mean” to them? Then it clicked with me. He isn’t being mean, he loves the chickens and wants to interact with them, but he doesn’t know how. No one ever showed him. So the next time he threw dirt at the chickens, I picked him up, took him inside, and set him on a chair. I got down on my knees so I was eye level with him and I told him that it’s not okay to throw dirt at the chickens, that it scares and hurts them. Then I said I knew he loved the chickens and just wants to play with them, but he doesn’t know how, and that I was going to show him. I poured a bowl of Cheerios and we took it outside and sat down on the porch and the chickens gathered around us and took treats from Walter’s hand and he giggled and squealed the whole time. And since then, there hasn’t been a single dirt-throwing incident. We did similar interventions with how to play with the dog and even how to play with his baby brother. He wasn’t being cruel, he just didn’t know how to interact because he is only 2. I could see the strong-arming a toy away from her little sister also being a similar case of not knowing how to handle a situation. We have given Walter a few tools to use instead of brute force when it comes to toy disputes with his brother. Sometimes we say “oh Merle is awake, if you build your train tracks on the floor he might mess them up. Do you want me to help you put them together on the table instead?” And sometimes he doesn’t even need my warning anymore about putting special toys where the baby can’t reach. Other tools we have taught him are “oh Merle has that toy right now, it’s his turn. I know it’s hard to wait. Let’s find a different toy for you to play with while you wait!” And “let’s ask Merle if you can have a turn..” and then I try to ‘interpret’ for Merle “oh he said yes!” Or “oh he said he is still using it. Let’s find something else while we wait.” Another one we do when Merle starts trying to take the toy Walter has is to suggest to Walter to pick a different toy to offer to merle. This may or may not work with the 14 month old sister but it works great on a younger baby. I also do these same maneuvers to Merle, who is 10 months old and has no idea what I’m saying, but I say things like “oh sorry Merle, Walter is playing with that toy now, let’s find something else” for Walter’s benefit. These strategies are not perfect and don’t 100% always go smoothly, but they’re way better than physical altercations and do cut down on them. Sharing is a little beyond a typically developing 2 year old anyways, let alone ones that have had deficits like ours, but these practices are a good starting point for introducing the concept of sharing and turn taking. These tools we have taught Walter about sharing get used by him all the time now even without our prompting. He just needed explicit and repeated guidance and modeling to figure it out.
On playing with other kids : Many kids who have spent the majority of their lives in the pandemic environment are behind socially. Add in the deficits and the time spent recovering from them, I am not surprised to hear that Aspen is still mostly interested in parallel play. I think it’s a GREAT sign that she plays with her sister! I would say to monitor this and keep giving her opportunities to be in environments where she can choose to either observe other children or to interact with them when she feels ready. A playground or children’s museum type place would be good for this. The fact that she is interested in observing them and even has reservations about them is a great sign. What would be concerning is if she wasn’t playing with them because she didn’t seem to notice they were there.
On pretend play: Similar to her behavior regarding other children, it’s a little behind but the foundations are still there, which is a good sign. I would keep nurturing this by joining in the pretend play that she does do, and adding in your own bits to model for her that anything you want can happen in pretend play. You could put the doll to bed and then make her wake up and say “I need a good night kiss! You forgot my kiss!” And make the doll jump up and kiss Aspen in a silly way. Walter has only recently started more elaborate pretend play. I would say the progression of his pretend play went something like 1) driving toy vehicles around 2) pretending a block was a toy car when there weren’t any toy cars around 3) pretending he was a vehicle 4) making up simple scenarios involving the toy vehicles that could happen in real life that he has witnessed before 5) making up scenarios that were semi or completely original. Maybe the last couple of months he has been saying things like his cars are driving to the “baby high chair store”, a place that doesn’t exist except in his imagination. Just keep joining in a modeling the potential of pretend play, and leaning into the games she is interested in.
Walter, right now, has some reservations about other kids. He used to be interested in them but he got knocked down by another kid and it has been a long road to get him from being terrified of other children to being willing to be in the same vicinity. This appears to be a different issue, but maybe it isnt…Walter does better on play dates with quiet and calm kids, usually girls. Sometimes I think the noise and chaos from exuberant kids is something Walter finds overstimulating. I could see that potentially being an issue for Aspen too if she likes order and routine. (He, like Aspen, does like playing with his younger sibling.)
Walter and Aspen were both born in September 2020, started screen use at similar ages, and we started screen removal with Walter about 4 months before you started with Aspen. I am not saying that the recovery times are going to be exactly the same from child to child, but when I do think back to Walter 4 months ago, he did every single thing you mentioned in this post. All of it. And what’s funny is even despite the echolalia, he was and has been registering as advanced in language in other areas. He makes lots of jokes, his vocabulary is through the roof…even though there were and are some disconnects in spots with his language, other areas are robustly developed. I have full confidence that our children will close their gaps. I don’t see them going off to kindergarten and still saying “do you want some milk?” To ask for a cup of milk.
Walter did echo statements too, not just questions. I believe what made him start realizing he could make his own comments was when we taught him to answer yes\no questions then branched out to very simple one word answer questions like “what color is dad’s shirt?” Once we got him answering with real answers instead of just repeating us, it seemed like he made the connection himself that he could say other things.
Don’t ever feel bad about a long message. It’s a good thing! Because one day your long message will be just what another parent needs to see!
I also want to say that the autism diagnosis could be a helpful thing. I don’t know if you’re in the US, but if you are, now your insurance is now obligated to pay for things like speech therapy and whatever other professionals you seek out for Aspen.
Something I’ve seen you mention is prompting Aspen to do or say things you think she should be doing, and she does them. This is interesting. It’s something we did with Walter too to get him in the habit of certain things. He really responded well to it. It’s like he liked the extra guidance and it made him feel comforted and more sure of what he was doing. This, with Aspen’s need for routine, could be a great tool. The way we employed this strategy is, we would tell him “say yes\no” sometimes when he was faltering while learning how to answer questions. And he would! But just telling him, and telling him enough, it almost made speech into kind of a beloved routine for him, where the uncertainty was removed for him and he felt more confident and could more easily predict what he should say because we guided him so many times… which sounds right up Aspen’s alley. It looked like:
mom: is dad’s shirt red?
Walter.: Pausing, uncertain
Mom: say yes! (In an encouraging voice)
Walter: yes!
Everyone: yay! (Big celebration)
Another thing. I think when we first start this screen removal journey with our children, the progress at first is so rapid and dramatic, and very concrete. And the improvement is also so incredibly obvious, it’s like night and day. As we go further into the journey, getting into the second year of it, naturally the progress has appeared to slow down when compared to the beginning. So it does make us worry. But it shouldn’t. Walter’s progress keeps up steadily, but it is subtle! Sometimes I don’t always notice the way his facial expressions have matured and become more intricate, or his pronunciation has gotten smoother, until I look back at a video from a few months ago and he sounds and looks completely different. I think you are on the right track. I think you are very brave and strong. I see by your time lines that you did the screen removal with Aspen while you had a tiny newborn to care for too. That is an incredible feat, I am so proud of you. Aspen and her sister are lucky to have you.
If you would like you can email me and I can show you some videos of Walter’s speech during different periods. robinniendick@gmail.com
You’re going to figure this out, it’s just like when you went backwards with the M-CHAT. Identify the deficits (which you have!)and then work with Aspen on them. I want to say again, Walter does or has done every single thing you said here. Even the non-issue ones like talking to himself constantly while he plays. I even forwarded this comment to my husband to read because it sounded so much like Walter (also I sometimes have him read things here in case he has any ideas or remembers things I’ve forgotten that we did or saw with Walter.) In any case, good luck from both of us, and come back with any more questions or concerns.
Thanks so much for your detailed response Robin! I’m so relieved to have found another Mom with such a similar experience to mine and I so appreciate all the information and kind words you’ve shared. I will send you an email when I have time to write more.
Respected Lori !
Its been total period of 18months since i first wrote to this thread about my son’s VA. Who was on screen from age 9months till he was 2.4.
At 2.4 we started all the therapies and screen off journey.
At that time he was wuth zero eye contact zero response and alot of sensory issues
No understanding of the world. Totally lost.
Today after almost 18months therapy his present condition is
His eye contact is very Good. Almost everytime he looks into your eyes . We can rate his eye contact 7to8 out of 10.
He just started to imitate few things like saying bye bye(waving).
He communicate through dragging ur hands towards wh he wants .
For food
For water
For going out of room with u
When mother tries to get ready n go somewhere he quickly comes near her and ask her to pick him up and take him out with her.
He understands verbal commands e.g
Lets go
Pick it up
Give it to me
Have your food
Lets play ringa ringa
Etc
He picks up things if he throws and you ask him to give it back to you.
Toe walking reduced on command if the therapist says No Full foot on floor
He walks toe down n normally
But in excitment which is often time he is toe walking .
If you try to engage him in activities like playing cricket with sibling , he tries to hold bat and hit the ball or he tries to throw ball towards bat.
Now comes to his speech progress
He still babbles no words yet.
Sometimes it seems he wants to speak but doesnt know.
He hums when u listen to music.
If u engage him to look at face n make different he looks closely as he is noticing but not repeating or cant repeat.
One thing he does alot which is tapping two things mostly sticks and spoons when he is roaming around in the house
And he takes his eyes in cornor or move his head with that . He looks from cornor of eye .which he does alot.
Here my question
He seems vigilant to me as eye contact has drastically improved he is a improved child now. Trying to connect with us
But taping two things
Eye corner
And mouthing everything which is like plastic he tries to bit.
Along with speech has not improved
Please guide me accordingly
Sometimes people says there is nothing liek VA and autism is not cure able which makes me disheart.
Coz i know its only environmental my son was born 101 %normal without autism
Another question is
The things i mention he does . Does such child could be called aloof or is he getting out of it??
Thanking you
Waiting for your response
Gull
Mother of Rohaan who is 4.2 years old now.
From Pakistan
Hi Gull,
I want to let you know I haven’t forgotten about you and know of your concerns. I will respond this Sunday but have you on my mind. Thank you for your patience. My three kids and I are embarking on a new school year, I have finished some summer coursework, and had an unexpectedly full summer. Keep up the amazing work! I will answer this with my best this Sunday!
Thank you so much lori . I have no words to thank you that you actually taking time tp write to me.
Let me eleborate his present condition ..
My son is 4.3 now
From 2.4 screen is off and work has been done on his behaviour and speech.
He was totally lost in sensory .
His eye contact is much much better now.
Toe walk he has learnt to stop on command when we say Dont walk on toes he stops but then start doing it
Eye corner is at its peak.
Which is worrisome for me
We went to hill station in vacation there he was doing less eye corner when he is outdoor. Indoor he does
Mouthing is under control
He keep taping two things while he is free doing nothing
He tap things to different things also lik3 bed n table to listen to sounds i guess
Covering his ears
Sometimes we r observing screaming out of excitment and jumping and throwing withnit. This behaviour just came
On the other hand his understanding improving and his play with sibling is started he just sometimes wants to play with them try to mingle with them
Drag them in his trampoline also.
His speech is not yet there
I assume his understanding is good but no vacabulary yet.
He hums poems but not with babbling just mouth little open short n long sounds only he produced
I am worried he is near 5 now why he is slow in language.
Plz guide me
As i am sure he is VA. His screen time was too much
I am afraid with age he doesnt convert into classic as he is still not verbal. Its my fear only
Plz guide me if 100% sure its VA and i hv been working from 2.4 age
Will my son recover all this in coming years?
Plz guide me Thank u so much
Hello all,
I want to share my story and I am asking for help and suggestions from Lori and the other parents.
I have a 7 month old baby which I assume has VA. She was heavily exposed to TV from 2 months old until 6 and half months (4.5 months total). She was watching Dave & Ava nursery rhymes on YT. I started to express breastmilk several times in a day because she wasn’t breastfeeding very much, and that took me several hours in a day in order to express the milk, storage in the freezer and sterilize the equipment.
She was getting the milestones for her age as it should be. I must say on 3 months old she was having a perfect eye contact, she was always smiling at me, I was gonna say even one word and she was cooing back at me, it looked like we are having a conversation. It was such a nice two way communication. She was tryingvto imitate me with sounds.
In the meantime, she was diagnosed with hip dysplasia and she is wearing an orthosis on her body in order for the legs to be apart. She wears the bracelet 24/7 for 2 months already.
She was very angry and was not accepting the orthosis, she was crying a lot, that’s why we were letting her find a solace in D&A on Youtube even more than before. That month she was watching a lot, maybe 10h a day, she was settling down every time she looked at them, she looked happy and was smiling at some of the songs.
After 4.5 months exposed on screens (she was 6.5 months at that time), I noticed some repetitive behaviour that she was doing with her feet simoultaneosly which was my red alarm. That moving was increasing day by day, I knew that shouldn’t be a normal thing.
I did a lot of research and stumbled upon this diagnosis. Now it became all clear to me.
I can’t even describe how am I feeling the last few weeks, regretting that with our actions we took something from our child. I can’t sleep, eat, I have no interest in anything. I am so dissapointed as her mother.
I am looking at old videos with her and see what I lost….how I couldn’t see that she was changing in the meantime… I was so focused on the expressing breastmilk and the hip diagnosis/orthosis/hip check controls, that I couldn’t see the changes in her.
She was most of the time nervous and was crying a lot, she had bad night sleep, she didn’t want to go outside in the stroller because she was crying, etc.
We didn’t know what damage the screens are doing to the developing baby’s brain.
We cut the Tv immediately and we are spending more time now with her. We are trying to talk more, read and sing. She is now 3 weeks tv free, but I have a lot of concerns.
Her symptoms are worse before the screen cut.
As I was reading most of the comments, almost everyone said that they saw a little improvement after several days.
She is avoiding eye contact, she doesn’t babble, she doesn’t respond to name (I know this is 9month milestone, but still…),
she is more nervous, hyperactive, she has sleep disturbances (wakes a lot of times during the night), she has less focus on the toys (that wasn’t the case before screen cut) and the repetitive foot movement is more often than before.
She refuses to eat solids also.
I am so desperate whether my baby will be the same again… I know that she is still young and that the brain is neuroplastic, but I am so worried whether we crossed a line from not getting back. I am confused why the synptoms are worse now after screen removal. At least they should be the same if not better at the beginning.
Please give me some encouragment that there is still hope…
When can I see some minor improvement?
Our situation is complicated, because she doesn’t crawl or sit because she’s wearing the hip orthosis the whole time and I know that improvements are more possible along with physical activity (which she doesn’t have).
She is lying on the bed or is in my arms. That’s why it is so difficult to entertain a baby who is in such a situation. Please give me some advice how could I get her attention and to improve eye contact.
I must say the previous week she was watching me more in the eyes while I was singing her the songs from Dave & Ava that she liked, but I am not singing her anymore those songs, I don’t want anything to remind her of what she watched. Now I am singing some songs in our native language, but she isn’t looking at me like before.
Is singing a good option for acquiring eye contact or talking is better?
Sorry for the long post. Please share some ideas and give me some hope.
Hello Ves,
I am a parent who has been through this, but not a doctor or professional. And though I am not a professional, your daughter’s case to me sounds very unique with her young age and hip orthotic causing her to be immobile. I don’t have any anecdotal stories I’ve heard from other parents of working with a child this young, but I DO think you’re on the right track.
Let’s talk about what we know about 7 month olds. They are still little babies and can get overstimulated easily, especially by social interaction. When I went through this screen removal + high social interaction protocol with my son (then 14 months) in the first couple of weeks I was in his face talking and smiling and ignoring his cues of wanting a break because I was trying to squeeze in the most possible interaction. Once I started doing the social interactions in shorter increments with breaks between, they became a lot more tolerable and eventually even enjoyable for my son.
One element of why a baby latches onto screens is sensory seeking behavior. Babies are designed to always be looking for interesting movement, sounds, colors, touches, taste, etc. It is how their brains have developed to take in information about the world. When not in front of a screen, babies’ eyes move around the room focusing on something new every 5 seconds or so. They will linger longer if they find something interesting like a smiling parent. TV shows for kids now make a new image flash on the screen every few seconds. This mimics a baby’s natural way of interacting with their world, but with much less effort on the baby’s part, so the baby is drawn to it. Eventually the baby finds the real world to not be as stimulating as the screen, or even finds it stimulating or overstimulating in the wrong ways.
With that knowledge, let’s think of some sensory activities your daughter could do to fill that void left by the high sensory input of the TV. It sounds like she might be a combination of overstimulated and bored at the same time from spending so much time in your arms or in bed as she cannot crawl around. I would suggest lots of water play. Baths just for playing, playing in a bowl or cup of water outside or inside, even just sticking her hands in. Holding her to reach into the sink faucet. Another sensory activity that would be good for a 7 month old is being outside. Even just short periods outside on a blanket in the shade. There will always be wind rustling leaves and birds calling, grass or dirt, bugs, many things for a baby to look at, hear, feel, touch, taste.
Something else I think would help would be for you to set up pillows in such a way that your daughter can lay down in whichever room you are in in a position that she can see and hear you. Let her lay in the kitchen while you do dishes or cook, and you can sing and talk to her, etc.
Your daughter is a unique case in my non-professional but very dedicated-to-the-cause opinion. She may very well be feeling something similar to withdrawal. She also spent more than half her life in front of the screens, so even though it was a “short” time, it’s half a lifetime for her and recovery may be a longer or more intense. Or not! Once you are over this initial hurdle, she may improve more rapidly than before. Children are individuals. I also want to say that I have heard of symptoms getting worse initially when screens are removed before getting better. The repetitive movements you describe sound like stimming to me. Stimming is a self soothing behavior. She is stressed from the sudden loss of screens and new interactions and her symptoms are flaring up right now in an effort to soothe herself. It will happen many times over this journey. I’ve heard it many times from other parents or saw it with my own son. During times of stress, tiredness, or illness, the child appears to retreat somewhat back into the stimming behavior in an effort to calm themselves.
And also, some of her frustration might be from the orthotic as well! Do you know how much longer she has to wear it.
Check in often, I think you are doing the right thing! I am deeply impressed by you noticing the change in your daughter so early. You are a great mother. I also know how hard expressing breast milk is. I have a 9 month old that I exclusively pump for. I’m on the pumps right now while typing this!
Don’t let the guilt swallow you up. Only recently, after my son has been rehabilitated for nearly a year, I am starting to feel forgiveness and compassion for myself. In fact, with my first son, I also had to pump and that is initially what lead me to start the screen time. I leaned on screens because I was only trying to do the best I could for my child, and so did you. It’s okay. Check in often with us.
Hello Ves,
I have been thinking about you and your daughter the last few weeks and sometimes occured to me. When I very first started the screen removal + high social interaction protocol with my son, at this point, he did not want to be held or touched. He hated it. He did eventually ease back into physical contact on his own terms and grew to love it again. If you haven’t already, try some interactions with your daughter where you are not touching her. Stay strong!
Hello Ves, I wanted to check in and see how you and your family are doing. I would love to know how things are going and to offer you some support. I’ve been thinking about you and your daughter since you first commented.
Robin
Hi Ves, your baby is still very young and you have already stopped her showing screen , that’s really good.
Bring her outside and get her more atmospheric stimulation by meeting new people , hearing different sounds etc. give her age appropriate toys with bright colours. Sing different rhymes and encourage her to imitate new sounds ( cow says “moo moo” , cat says “meow “ etc)
Spend quality time with her by showing new things , and encourage her to make eye contact by narrating simple stories.
Your baby is going to be alright. The issues you noticed are because of lack of stimulation and of course due to screen time . Forget about that and start a new life with baby . She is going to shine and grow. All the best .
Hello, I am French I already apologize for my English my 19 month old son makes a lot of sounds, he maintains our gazes and comes spontaneously towards us. Raises his arms to be carried and understands a number of our requests…but he doesn’t talk, he doesn’t point and often plays alone even when my eldest tries to get him to participate in games…I did research because he started 1 month ago to block his ears, to turn on himself and to walk on tiptoe… I was told about autism but no diagnosis yet. To see him interact with us I am convinced that the screens have a lot to do with it… I’ve kept him at home since he was born but im work from home which makes management difficult… we’ve just started to turn off all screans and I’m already noticing some improvement he agrees to play with us but not long and withdraws afterwards to play alone or swings during games together… despite this he finally seems to be using mom by looking at me and coming towards me… I am a little lost with each progress I have the impression of noticing a new problem… do you have any advice?
Thank you
Hello @Brenda! How wonderful to see how you have sensed the problem, addressed it, and your son is already making great progress! One of the most challenging things at this point is to have patience. Improvements will come day by day, if you stick with a screen-free protocol and really increase his face-to-face interactions, reading, and play with you and others in your household and also to play outside and go for walks. Please also include him in your household routines. He will be delighted to help! For encouragement and guidance, please check out the videos at https://www.youtube.com/playlist?list=PLr_UmoT5Wz0qYm8eh6PQ7l70B9rz-2Fcy. Make sure especially to watch Robin in “A Mother Speaks about Virtual Autism.” Please read through the many comments on this post for lots of great advice. You may want to join the private WhatsApp parent support group. Here’s the link to the group: https://chat.whatsapp.com/Fz9FQggeuU0G2HBaMUyuck. Finally, please check out the group CoSE which is fighting to create awareness in France about screen harms to babies and toddlers: https://surexpositionecrans.fr/accueil-du-site-de-cose/. Bonne chance! We are here for you!