How Much Screen Time is Too Much for Children with Autism?

Hopebridge SLP and BCBAs Offer Tips and Tools for Balancing Digital Media Use

Tablets, smart phones, smart watches, TVs and computers – screens follow us everywhere. It’s easy to let these devices consume our time. Caregivers often rely on screen time for their children as they cook dinner, clean the house, or work from home.

However, some families worry about their child’s digital media use. Research suggests that 1-year-old infants with one to four hours of daily screen time were more likely to experience developmental delays by ages 2 and 4 years.** These delays often affected problem-solving and communication skills. 

How much is too much? And how can caregivers work with their children to cut back on screen time when saying “no” to it becomes a struggle?

To help caregivers with screen time, we talked to Ashley Marshall, the Speech Language Pathology Clinical Specialist Ashley Marshall at Hopebridge. We also consulted our team of Board Certified Behavior Analysts (BCBA). They shared advice on how to manage screen time in an effective, compassionate manner that benefits children and families. They also considered those with autism spectrum disorder (ASD) or other developmental delays.

Hopebridge SLP answers, “How do I know if my child is participating in too much screen time?”

The American Academy of Pediatrics (AAP) offers specific recommendations for screen time. According to the AAP, infants and toddlers younger than 18 months old should not have exposure to screens, except for video chatting. While it’s not perfect, the AAP considers having human interaction on the other side of the screen acceptable. As children grow into the key developmental years of ages 2 and 5, the AAP recommends no more than one hour of screen time each weekday.

If your children are not meeting these recommendations, you are not alone. Managing screen time can be tough. As a caregiver, it is important to understand why these guidelines exist. This knowledge helps you make informed decisions for your family.

Research suggests that too much screen time can contribute to developmental delays and changes in brain composition. Some studies show that digital media usage can affect gray matter volume Gray matter is the brain tissue we need for daily tasks. It also affects neural pathways, which help our brains send signals to process information. Additionally, white matter of the brain is impacted – white matter is responsible for connecting the gray matter together and sending signals across the brain. With increased screen time, white matter is more disorganized, which makes sending signals through the brain more difficult.

“We’re also seeing an increase in behavior dysregulation as a result of too much or certain types of screen time. The music, bright colors and repetitive images create a constant feel-good chemical that can be addictive. When this visual input is gone, children may not know how to regulate themselves,” said Ashley.

Children, especially those with autism or speech disorders, may show new or increased high-intensity behaviors as a sign of “too much” screen time. Reactions can vary each child. Some warning signs include crying and tantrums when they are not given access to a screen.

Children may obsess over their devices; choosing not to engage in any other activities or play with any other toys besides interacting with a screen. They may “have to have it now” and constantly ask for it. Others may feel the need to touch a phone or tablet every few seconds so it doesn’t “go dark,” or have a desire to view someone else’s phone. Some may elope to an area where they last saw the device, which can lead to safety hazards.

These instances typically occur with tablets and smart phones, though television or computer usage can pose similar challenges.

Tablet Takeaways for Caregivers

“It’s common for parents to ask, ‘Is the damage already done?’ Yes, it can turn into an addiction that is the only thing that pacifies them, but their young brains are “plastic” and can be re-molded! You can help them work through it with involvement in more functional, interactive and play-based tasks,” said Ashley.

The best way to regulate screen time is to take a proactive stance, though we understand that is not always an option. At Hopebridge, this means engaging our children in a more active manner. We play games of tag and participate in various circle time activities to provide fun alternatives to the tablet.

Here are eight tips, tools and tactics caregivers can utilize to help make the process smoother:

1. Use a visual schedule.
   Visual schedules can be as simple or as detailed as you like, dependent upon the child’s functional level. It can include pictures, written words or both. This tool provides children with a clear mental picture of the day and prepares them for what’s to come. The more preparation we can provide prior to the child moving through each transition, the better off we’re going to be. Using antecedent strategies like this decreases the need to be reactive.
2. Give them a visual timer.
   This is a great way to help your child visualize how much total time they have with the device, as well as show how much time is left on the clock once it begins counting down the minutes. Place the timer somewhere that is within their eyesight, but not close enough for them to touch it.
3. Break up screen time in smaller chunks of time.
   Keep screen time short and sweet, rather than watching for hours or one long period of time. This will give your child’s mind and eyes a break. If this is not an option due to virtual learning or your own deadlines, create boundaries with set specific time frames each day for device usage. Outside of this time, focus on other activities that do not involve a screen.
4. Utilize guided access.
   Guided access is simple to set up, but not many parents realize the function is available to them. Within the device’s settings, users can place time limits on its usage. When the time is up, the user must enter a passcode before continuing. If regulating screen time is a goal for our kids, our speech-language pathologists or behavior analysts may recommend this route during Hopebridge’s family guidance, and we can aid in setting it up.
5. Use a first-then board.
   A first-then board or book provides children with a visual picture of what is expected of them. It helps them understand that first they can use their tablet, then they will play outside with you, for example. First-then statements can be especially effective when paired with a visual timer. This way, they can hear and see that they can use the tablet for three minutes before moving onto something else.
6. Opt for educational programming.
   This may be tough to hear, but our clinicians recommend staying away from “bright and shiny” cartoons with a quick refresh rate like “Cocomelon” and “Sponge Bob.” Children’s brains can’t comprehend information presented this quickly. Instead, choose shows and channels like “Sesame Street,” “Baby Einstein,” and “Ms. Rachel,” which prioritize slow, intentional communication. Options that incorporate pauses like this give kids a chance to interact, but the main point behind them is to slow things down so children can process what they’re seeing on the screen.
7. Make screen time active.
   When your child is engaging in screen time, use it to your advantage. If they are really interested in it, you may as well make it functional! There are plenty of apps and websites available to make the time productive such as the GoNoodle app and Jack Hartmann Kids Music Channel on YouTube, which are wonderful resources to get kids up and moving. They will still get the tablet time they desire without simply staring at a screen.
8. Watch with your kids.
   Whenever possible, sit alongside your child during screentime to engage in the content with them. Encourage them to sing along or count objects. This can be difficult if you are working from home or need to get chores done around the house, but try to carve out some time for interaction. You want to become the “fun thing” for them, versus solely the tablet. The device should never be more fun than you, so pair yourself with it!

Watching TV or the tablet with your child will also help you notice if there are any concerns, such as a limited response, lack of understanding or limited speech overall. If you think your child may not be engaging in the content in a way that is typical for their age (check our developmental milestones here), you can then choose to discuss it with their physician and possibly seek a speech evaluation or autism testing.

How ABA Therapy Can Benefit the Goal of Reducing Screen Time

Participating in applied behavior analysis (ABA therapy) is an effective way to combat the screen-time challenge for kids with autism. Here are some steps to reduce screen time with ABA principles:

1. Leverage your child’s interests.
   Identify what excites and engages your child while they’re on the tablet, then find hands-on alternatives. For interest, if your child is really interested in letter games, try singing an alphabet song or crafting letters with Play-Doh.
2. Increase reinforcers.
   Many children come to us with the tablet as a primary source of reinforcement. ABA therapy helps expand the range of items or activities that can serve as reinforcers for your child, moving beyond screen-based rewards. We conduct “preference assessments” in our centers, but you can create your own version at home, too. Place a variety of toys in one area while keeping the tablet out of sight. Observe what your child gravitates toward and what holds their attention the longest.
3. Introduce new toys and activities.
   As part of your at-home preference assessment, rotate in new items or reintroduce toys your child hasn’t played with in a while to spark fresh interest. For example, if blocks capture their attention today, let them play longer with the blocks. Over time, give them a choice between the blocks and the tablet to encourage non-screen alternatives.
4. Gradually build tolerance.
   Use a gradual approach to reduce screen dependence. Pair the tablet with another activity that keeps their hands and mind busy while keeping the tablet playing in the background. Slowly shift the focus to the non-screen activity while the tablet remains nearby, eventually reducing screen time over several play sessions.

Get Screen Time Support at Hopebridge

We want to emphasize that some screen time is acceptable and does not have to be cut out completely, but it should not be limitless nor take away from other more important activities and skills.

Do you want more assistance on this goal and others? Our therapy team at Hopebridge has experience in this area and beyond to help your child get the most out of what life has to offer. If your family is struggling with screen time and your child experiences other behaviors that may need support, fill out the form on our website to find out more about our autism testing, ABA therapy and other outpatient service options like speech therapy and occupational therapy. 

** Takahashi I, Obara T, Ishikuro M, et al. Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years. JAMA Pediatr. Published online August 21, 2023. doi:10.1001/jamapediatrics.2023.3057

*Informed consent was obtained from the participants in this article. This information should not be captured and reused without express permission from Hopebridge, LLC.