Children may spend as many as seven hours a day using electronic media, such as television, computers, video games, tablets, and smartphones, the American Academy of Pediatrics (AAP) estimates. As a result, the AAP recommends limiting children's screen time to help avoid problems with attention, obesity, and academics (bit.ly/AAP-Media).
A recent study by Sophie E. Ambrose, MS, PhD, and colleagues examined the influence of electronic media use in the home on the language development of children who are hard of hearing (Ear Hear 2014;35:139-147).
Children who are hard of hearing may be more likely than their peers with normal hearing to have delays in communication development.
Any negative impact of electronic media on language learning would be particularly important to quantify in children with hearing loss. Providing them with consistent, high-quality language environments can help minimize the potential for delays in communication.
Linguistic Input, Electronic Media, and Communication Outcomes of Toddlers with Hearing Loss
Ambrose SE, VanDam M, Moeller MP
The study by Dr. Ambrose and colleagues examined audio recordings from the homes of 28 children with mild to severe hearing loss who were followed as part of a longitudinal study on child development.
Of the children, 27 wore bilateral air-conduction hearing aids, and one child wore a bone-conduction device. On average, the children were 2 years old at the time of the recordings.
The audio recordings were made using the Language Environment Analysis (LENA) device (LENA Research Foundation; Boulder, CO), a small recording device worn by the child in a chest pocket on an outer piece of specially designed clothing. The children wore the LENA devices in their homes for an average of 12 hours per day.
The recordings are automatically analyzed by software that classifies the acoustic environment into a number of different categories.
For the purposes of the study, Dr. Ambrose and her colleagues were most interested in the quantity of adult words on the recording, number of conversational turns (vocal interactions) between the child and adults, and percentage of each recording that was classified as electronic media.
The researchers examined the relationships between these measures of the acoustic environment and standardized language scores that were collected as part of the longitudinal study of development.
TAKING CONVERSATIONAL TURNS
One of the primary findings of the study was that children were exposed to an average of 1,400 adult words and about 60 conversational turns per hour during a recording day. These results compare favorably with those of other studies in children who have varying degrees of hearing loss or normal hearing.
On average, eight percent of the recording time was classified as electronic media by the LENA analysis, but that proportion ranged from one percent up to 20 percent across children in the sample.
The researchers examined the relationship between the proportion of the recording classified as electronic media and outcomes in receptive and expressive language.
Children with a higher percentage of electronic media in their LENA recordings had poorer receptive language abilities than peers with a lower proportion. Interestingly, these children with more exposure to electronic media also experienced fewer conversational turns than peers with less exposure.
When both conversational turns and electronic media were used to predict receptive language ability, number of conversational turns was the key factor. This finding led the researchers to conclude that the negative relationship between electronic media and language was mediated by the quantity of conversational turns.
In other words, the presence of electronic media in the listening environment reduced the number of conversational turns that the child experienced, which may have led to the weaker receptive language abilities observed in this study.
POWER OF PARENTS, CAREGIVERS
For clinicians who work with children who are hard of hearing, this study has two important findings:
* 1. Language input from parents and caregivers can have a positive effect on children's receptive language development. In an age with amazing technologies, there is still no substitute for real, high-quality communication with other people.
* 2. The use of electronic media in the home environment may reduce the frequency of conversational turns taken between parents and children. It is unclear if this reduction is because electronic media may be an additional source of background noise in the environment or if the presence of electronic media reduces communication in other ways.
The current study has several limitations that could be addressed by future research, the authors noted.
As in many other research studies, the children included here had a higher socioeconomic status relative to the general population of the United States. As a result, it is unclear if these results would be observed in a larger sample of children from a broader range of socioeconomic backgrounds.
Additionally, the LENA recordings that are used to estimate the presence of electronic media in the home do not differentiate among the sources of electronic media (e.g., computer versus television) in the home environment.
Overall, these findings support the recommendation of the American Academy of Pediatrics to limit electronic media in the home, particularly for infants and young children, who rely on parental input to support speech and language development.
Electronic media not only may increase the level of background noise but also may inhibit interaction between children and other people in their listening environment.
The key role of parents and caregivers as facilitators of speech and language skills for their children should be emphasized, supporting our goal to improve communication outcomes.