November 4, 2024

expert reaction to a study on the association of screen time before 2 years of age and risk of autism at 12 years of age

A study published in JAMA Pediatrics looks at the association between screen time and autism diagnosis in children.

Prof Chris Ferguson, Professor of Psychology, Stetson University, said:

“The problem with this study is both straightforward and common.  They report an effect size for screens and autism that is little different from zero.  However, because the sample size is large, this becomes “statistically significant”.  This is common for methodological noise in big sample studies.  This should not be interpreted as evidence supporting the hypothesis. If this study was taken as suggesting that screen time is linked with autism, the public could be misinformed or misled.  Put simply, there is no actual evidence here for a link between screen time and autism.

“Also, the authors claim previous research suggests an association between screen time and autism – this worries me as in my view the evidence base as a whole does not suggest this.”

Dr James L. Findon, Senior Lecturer in Psychology, King’s College London, said:

“While this study found an association between screentime before 2 years of age and being diagnosed with autism before 12, it does not suggest a causality. This is consistent with our understanding of the development of autism which is predominantly genetic. What the results show us is that autistic children are more likely to have higher screentime than their neurotypical peers. Screentime often gets bad press, but for many autistic children screentime can be beneficial. This might be because screentime helps them regulate their emotions and calms them during periods of sensory overload.”

Dr Rachel Moseley, Principal Academic in Psychology, Bournemouth University, said:

“While the authors have done a good job of controlling for variables which might explain the association, the study can in no way tell us anything about causation – that screentime causes a later autism diagnosis. The authors are actually appropriately tentative in their conclusions, where they highlight, rather, that behaviour related to screentime might instead be a useful indicator of differences in social-emotional development. Autism is a complex, heritable and brain-based difference which, categorically, cannot be caused by spending more or less time on screens.

Do the findings of this study address the reverse directionality of the association wherein autistic children may be more likely to spend time on screens rather than screentime leading to autism?

“No – the findings of this study cannot tell us anything about the direction of the relationship between being autistic and time spent on screens. Given my comment above, it is more likely that children who are already autistic but not yet diagnosed, and their parents, might be finding particular benefits of screen-time. Note that autism is quite rarely diagnosed before 2 years of age, but autistic children ARE still autistic and developing differently before that point. It might well be that within this different developmental trajectory, they find it easier to engage with screens, or find benefits from doing so. To warn parents away from screentime could actually be counterproductive, in this case – and there is certainly nothing which warrants scaring people that “screentime causing autism”. The authors come to a responsible and measured conclusion, which I hope will not be lost in the reporting.”

‘Screen Time Before 2 Years of Age and Risk of Autism at 12 Years of Age’ by Lin et al., 2024 was published in JAMA Pediatrics at 18:00 UK time on Monday 4^th of November.

DOI: 10.1001/jamapediatrics.2024.4432

Declared interests

Prof Chris Ferguson No conflicts to declare

Dr James L. Findon No conflicts to declare

Dr Rachel Moseley No conflicts to declare