Pediatric experts: Beware of excessive screen exposure affecting children's language development!, The reason why 2-year-old Xiaobao speaks less is actually due to this

Screen exposure has become a global public health issue and a research hotspot in the field of children's health. Screen exposure refers to the activity of using electronic products with screens. Early excessive screen exposure can have adverse effects on children's language, sleep, vision, attention, social skills, and other psychological behaviors. Domestic and foreign studies have shown that long-term screen exposure is negatively correlated with early cognitive and language development in children. In clinical work, we often encounter a series of growth and development problems in children aged 2-5 who suffer from delayed language development and low communication interest due to excessive screen exposure.

Delayed speech and language development

Xiaojia is 2 years old and 8 months old this year, and she is seeking medical attention due to her lack of speech. At the age of 1 year and 3 months, Xiaojia started actively calling herself "dad, mom", but more than a year later, Xiaojia had almost no other language besides that. Xiaojia will say "ah, ah" to things she is interested in or express her needs, accompanied by gestures. When asked, she will answer "um", and while playing games, she will say things that parents cannot understand. After investigation, it was found that when Xiaojia was one year old, his family often played nursery rhymes for him to do rhythm together, with half an hour each morning and half an hour in the afternoon. After a period of time, Xiaojianeng opened his electronic device to watch videos, often for one hour at a time. After the age of 2, Xiaojia spends at least 4 hours a day in contact with the screen and reading pen. During the visit, Xiaojia was very cooperative, had good interaction, and had normal hearing. However, a comprehensive neuropsychological and language assessment showed that Xiaojia's oral expression ability was significantly lagging behind, and her gesture language was slightly behind. Her language comprehension, social communication, and gaming abilities were within the normal range.

In clinical practice, it is not uncommon for children like Xiaojia to develop delayed language expression abilities due to excessive screen exposure. The development of language ability requires an interactive communication environment, and focusing on the screen for too long can reduce the frequency of dialogue and interaction between children and their caregivers. Infant and toddler language learning cannot be separated from environmental stimuli, such as the speaker's lip movements, body movements, and auditory information, which can stimulate children's active cognitive language processing. However, when the screen is exposed, children's auditory and visual stimuli are passively processed and lack interactivity, which may lead to incomplete brain network development related to cognitive language control, thereby affecting language development.

Our suggestion for Xiaojia's visit is to control the usage time of the screen and reading pen to about half an hour per day. When playing games with Xiaojia, family members should use language related to the situation in a timely manner. Effectively communicate with children in family upbringing, become playmates with them, and choose interactive games and activities that children enjoy, such as hide and seek, playing house, etc. Parents should provide their children with timely and appropriate responses and sufficient language input in daily life. Two months later, Xiaojianeng's actively expressed vocabulary significantly increased, able to speak more than 30 words, and able to imitate and speak phrases with three different structures. It can be seen that the screen time has been controlled while providing reasonable guidance, and the child's language ability has improved rapidly.

Low interest in social communication

Yanyan is 2 years old, but she doesn't say anything and doesn't like to play with children. She sometimes responds to what her family says to her and asks her for help, sometimes ignoring it. Everyone thinks she is a "cold and aloof person". Her family took her for hearing and oral examinations, and the results were all normal. We have learned that although Yanyan's parents usually work from home, they are very busy and have fewer opportunities to talk to their children. Since Yanyan was 6 months old, she has been playing various music, cartoons, or children's programs at home for a long time. Yanyan enjoys watching and listening to TV programs very much. As she watches TV, she hardly disturbs her family's work and often twists her body to follow the rhythm of the music. When she sees funny scenes, she also laughs out loud. She also learned about colors, numbers, and shapes from it. When parents are not busy with work, they will play games with her, but she always has low interest and sometimes ignores them. During the visit, we guided her to participate with various toys and games, but she only occasionally glanced at the doctor. After a comprehensive neuropsychological assessment, Yanyan's language development, social communication, and gaming abilities are significantly lagging behind.

In the pre language stage, children complete communication and interaction through eye contact, collective attention, rotational activities, emotional sharing, and gestures. This ability is the foundation of later oral development. Excessive and premature screen use can have a negative impact on children's communication and self expression abilities. The sound emitted by electronic products is mechanical and cannot be interacted with by humans. Children can only passively listen and cannot actively communicate with them, which affects the development of their communication skills. When exposed to electronic products, children who watch with their parents have better language abilities than those who watch alone. Timely and effective responses, oral expression, and parent-child interaction from parents can help stimulate the establishment of connections between neurons in the child's brain, obtaining cognitive stimulation, emotional regulation, and social participation. Parents can establish emotional connections with infants and young children through interactive play, providing an environment that stimulates language development.

Our suggestion for Yanyan is to control the screen time and have her parents accompany her when touching the screen. At the same time, observing children face-to-face in the family upbringing environment to understand their interests and increase visual communication; Provide children with timely and appropriate responses, as well as sufficient language input related to their thoughts and actions; Patiently wait for the child to express themselves, follow their rhythm, and give appropriate encouragement; Create more communication opportunities, such as providing choices, intentionally making mistakes, and not rushing to complete games all at once. Two months later, when Yanyan came for a follow-up visit, she took the initiative to give us cookies and started calling us "dad, mom". When she left, she would wave her hand to say "goodbye" and so on.

Suggested screen usage time

The habit of screen exposure during infancy and young children not only affects language and social development, but can also extend to school age and even adulthood, and have a profound impact on their growth, development, and lifestyle. In recent years, children's screen exposure has been listed as an important goal in children's health management. The Outline for the Development of Children in China lists the popularization of healthy lifestyles, promotion of healthy behavior habits among children, and control of electronic product use as key areas of children's health management. The "Action Plan for Prevention and Control of Myopia in Children and Adolescents" points out that it is necessary to strengthen the management of the use of electronic products such as children's mobile phones and computers, strictly control screen time, and eliminate "electronic nannies". The Ten Core Knowledge for Preventing and Controlling Myopia in Children and Adolescents states that infants and young children aged 0-3 should not use video electronic products such as mobile phones, tablets, and computers; Try to avoid contact and use of video electronic products such as mobile phones, tablets, and computers for children aged 3-6; The duration of using electronic screens for non learning purposes by primary and secondary school students should not exceed 15 minutes per session, and the cumulative duration per day should not exceed 1 hour.

Parents should become guides for children's screen usage and strictly monitor the duration of screen exposure. It is recommended that parents choose high-quality programs to watch with their children within a reasonable screen time, actively provide responsive care, stimulate children's potential, and cultivate children's self-control in using screens reasonably, in order to better benefit from them.