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Mobile Media Device Use is Associated with Expressive Language Delay in 18-Month-Old Children

van den Heuvel, Meta, MD, PhD*,†; Ma, Julia, MPH; Borkhoff, Cornelia M., PhD*,†,§; Koroshegyi, Christine, MA*,§; Dai, David W. H., MSc; Parkin, Patricia C., MD*,†,‡,§; Maguire, Jonathon L., MD, MSc*,†,‖,¶; Birken, Catherine S., MD, MSc*,†,‡,§ on behalf of the TARGet Kids! Collaboration

Journal of Developmental & Behavioral Pediatrics: November 13, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/DBP.0000000000000630
Original Article: PDF Only

Objective: The objective was to examine the association between mobile media device use and communication delays in 18-month-old children.

Methods: A cross-sectional study was conducted from September 2011 and December 2015 within the TARGet Kids! primary care research network. Children were included if parents reported their child's mobile media device use and completed a validated questionnaire for communication delay at the 18-month well child visit. Mobile media device use was measured using a parent-reported survey instrument. Daily mobile media device use was calculated as a weighted average of typical weekday and weekend day mobile media device use. Two communication outcomes were investigated: (1) expressive speech delay and (2) other communication delays, as measured by the Infant Toddler Checklist.

Results: The study sample included 893 children (mean age 18.7 months, 54.1% male). Most parents reported 0 minutes per day of mobile media device use in their children (n = 693, 77.6%). Among children whose parents reported any mobile media device use (n = 200, 22.4%), the median daily mobile media device use was 15.7 minutes (range 1.4–300). The prevalence of parent-reported expressive speech delay was 6.6%, and the prevalence of other parent-reported communication delays was 8.8%. For children who used a mobile media device, each additional 30-minute increase in daily mobile media device use was associated with increased odds of parent-reported expressive speech delay (ORa = 2.33, 95% confidence interval, 1.25–4.82). No relationship was observed between mobile media device use and other parent-reported communication delays.

Conclusion: Our study demonstrated a significant association between mobile media device use and parent-reported expressive speech delay in 18-month-old children.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

*Pediatric Outcomes Research Team, Division of Pediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada;

Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;

Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada;

§Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada;

The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada; and

Department of Pediatrics, St. Michael's Hospital, Toronto, Canada.

Address for reprints: Meta van den Heuvel, MD, PhD, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada; e-mail:

Supported by Canadian Institute of Health Research (CIHR), SickKids Foundation, St. Michael's Hospital Foundation, and Physician Services Incorporated.

Disclosure: The authors declare no conflict of interest.

Received March 04, 2018

Accepted October 27, 2018

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.