Screen Time for Children Under Three: A Trigger for Virtual Autism?

In 2017, if you googled the term “virtual autism,” you would get exactly two hits. One was my blog on Mad in America and the other was a paper (2017) by Romanian psychologist Dr. Marius Zamfir. Zamfir found that a high percentage of young children diagnosed with autism at a Romanian hospital had more than four hours per day of screen time before the age of two and a half. He found that removing screens reversed the symptoms of autism. Zamfir then coined the term virtual autism. Two child psychiatrists in France, Dr. Isabelle Terrasse and Dr. Anne-Lise Ducanda, replicated Zamfir’s findings. While European psychiatrists began to research the topic of virtual autism, it was a different story in the United Sates. In 2017, other sites on which I blog refused to publish anything I wrote on the topic of virtual autism. The subject was too controversial. Not enough research had been done.

Today, googling “virtual autism” yields thousands of hits. These include the web pages of highly respected institutions like the National Institutes of Health and the Children’s Hospital of Los Angeles. On the website of NIH you can find meta-analyses of several research studies on virtual autism from Japan, China, India, Canada, Thailand and other countries around the globe. Some researchers, alarmed at climbing autism rates among children as screen usage surged, have come around to viewing virtual autism as a real syndrome that is reversable. Google even presents an AI overview: “Virtual autism is a term used to describe a set of behaviors and symptoms that resemble autism spectrum disorder (ASD) but are caused by excessive screen time and limited real-world interactions in young children.” Virtual autism is not yet a medical diagnosis, but today doctors seem to know what it is and how to treat and even prevent it. What a difference eight years makes.

A 2019 study in The Asian Journal of Psychiatry looked at 158 children: 101 children diagnosed with ASD and 57 typically developing children. The researchers analyzed the correlation between the amount of screen exposure of the two groups and ASD-rating scores. The study listed its main findings as twofold: 1) The screen time of children with ASD was longer than that of typically developing children. 2) The screen time was correlated with the autistic symptoms and Developmental Quotients (DQ’s) of the children with ASD. In the words of the authors, their results demonstrate that “the longer the screen time the more obvious the autism-like symptoms.”

A 2022 study of 84,000 children in Japan found that boys were three times more likely to have been diagnosed with autism spectrum disorder than were girls. “Among boys, longer screen time at 1 year of age was significantly associated with autism spectrum disorder at 3 years of age. With the rapid increase in device usage, it is necessary to review the health effects of screen time on infants and to control excessive screen time.”

Research on virtual autism in the United States is sadly lacking. In the United States today, the CDC reports that 1 in 36 children are diagnosed with autism or autism spectrum disorder (ASD). We don’t know how many of those cases are classic autism or virtual autism. Mainstream child psychiatrists and pediatricians generally don’t distinguish between them. This can have tragic consequences, since virtual autism can be reversed simply by removing electronic screens from the child’s environment and increasing parent interaction with the child. The American Academy of Pediatrics previously had recommended that children under age two and a half should not be exposed to screens at all. Today, however, the AAC merely recommends that children from 0 to 18 months avoid “lots of screen time.” They feel that there is not enough research to know whether media use has contributed to the rise in ASD diagnosis rates.

One parent of a child diagnosed with autism at age two and a half wondered why his son, who had been developing normally, should suddenly have symptoms of such a grave disorder. This father was Michael Waldman, a professor of economics at Cornell University. He figured out for himself that excessive screen time had caused his son’s symptoms. He eliminated screen time from his son’s life and increased parent interaction. By age six, his son showed no symptoms of autism.

Waldman and his colleagues went on to study autism rates and precipitation rates. His research showed that children under the age of three watched more TV on days with high precipitation, and in areas with higher precipitation rates the rate of autism was also higher. Waldman’s studies concluded that their results were “consistent with the existence of an environmental trigger for autism among genetically vulnerable children that is positively associated with precipitation.”

Professor Waldman’s story and his research on screen-induced symptoms of autism were met with skepticism by the medical community, which relies heavily on the belief that autism is mainly determined by genetics and is a lifelong ailment. From his own experience as a researcher and a parent, Waldman felt that no stone should remain unturned in searching for environmental triggers of ASD. In 2022, he set in motion the production of a documentary film called A Stone Unturned. The film weaves together the threads of virtual autism research around the globe and individual stories of children whose autism symptoms were reversed by removing screens and adding more parent engagement.

In collaboration with Mad in America, the film’s premiere is set for June 7.

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Editor’s note: The film will be available for viewing on June 5 – 8. On June 7, Mad in America will host a panel on the film. The panel will feature film’s director, Wilder Nicholson, Marilyn Wedge, researchers and parents, and will be moderated by Robert Whitaker. You can register here to stream the film and sign up for the MIA panel.

References

American Academy of Pediatrics, 2024, “Early Childhood Screen Time, Brain Development, and Autism,” AAP website

Garg et al, 2024, Virtual autism among children: A leading hazard of gadget exposure and preventive measures, J Educ Health Promot. 

Han-Yu Dong et al, 2021, “Correlation Between Screen Time and Autistic Symptoms as Well as Development Quotients in Children with Autism Spectrum Disorder,” Front. Psychiatry, vol 12.

Kushima et al, “Association Between Screen Time Exposure in Children at 1 Year of Age and Autism Spectrum Disorder at 3 Years of Age: The Japan Environment and Children’s Study,” JAMA Pediatrics.

Sadeghi et al, 2019, “Behavioral and electrophysiological evidence for parent training in young children with autism symptoms and excessive screen-time,” Asian Journal of Psychiatry

Waldman et al. 2008, “Autism Prevalence and Precipitation Rates in California, Oregon, and Washington Counties,” JAMA Pediatrics.