By Maude Le Roux, OTR/L, SIPT, RCTC, DIR® Expert Trainer at A Total Approach

Ever since our response to the COVID-19 pandemic began, we’ve been spending much more time using our smartphones, tablets and computers. We rely on our devices as well as social media and digital content as primary ways to stay informed, entertained and connected.

While the use of tech devices immediately replaced in-person meetings and classroom learning, it is likely to continue this way for some time. That’s why we are all at increased risk for technology addiction during the COVID-19 pandemic—especially adolescents, who have already accounted for one-third of internet users before the coronavirus outbreak.

John K. Kriger, MSM, LCADC, CPS, sees a correlation between dependent device use and substance use disorder as defined by the American Psychiatric Association’s fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), especially with regard to the cycle of obtaining, using and recovering from device use.

John educates therapists and parents about tech dependence and the ways to manage it. He’s been studying tech dependence for 12 years, and he has found evidence that both children and parents may develop a tech addiction due to their dependence on devices.

Especially in a physical-distancing household during the COVID-19 pandemic, children and adults could be developing a technology addiction if they:

• Are increasing their use of devices, which creates a desire for more use.
• Have a constant need to check email or text messages.
• Get anxious and irritable without their devices.
• Lose their sense of time and underestimate how long they’re on their devices.
• Spend excessive amounts of money on their devices.
• Are limiting their social and personal interactions because of their devices.
• Stop taking care of themselves because of their devices.
• Fail to fulfill major obligations like work and homework because of device use.
• Are critically distracted by their devices in physically hazardous situations like driving, walking.

Technology Addiction: A Mental Illness?

Considered a mental illness by scientists, addiction is defined as a chronic and complex brain disorder characterized by compulsive substance seeking, continued use despite harmful consequences and long-lasting changes in the brain. The National Institute on Drug Abuse (NIDA) “Preventing Drug Use Among Children and Adolescents: A Research-Based Guide” identifies indicators of future substance abuse, including:

• Social isolation.
• Poor social skills.
• Early antisocial behavior.
• Inability to bond with positive peer groups.
• Low commitment to school and community.
• Positive attitude toward substance abuse.
• Lacking a positive peer group.
• Having an older sibling who is involved.

All these signs are evident in a person’s behavior when they’re dependent on devices.

Impact of Tech Addiction on Child Development

The negative impact of technology dependence, abuse or addiction and digital media on child development can be far-reaching. A 2011 study from the American Academy of Pediatrics finds that, after watching just nine minutes of the popular Nickelodeon cartoon “SpongeBob SquarePants,” 4-year-old children tested poorly on executive function activities that challenged abstract thinking, short-term memory, impulse control and the ability to delay gratification.

Researchers believe the overstimulated experience of watching hyper-fast-paced, fantastical cartoons like “SpongeBob” can also distract younger children and decrease their attention spans, which can lead to autistic-like behavior, such as:

• Losing the ability to have healthy interpersonal relationships.
• Preoccupation with a narrow topic of interest.
• Repetitive body movements like rocking or flapping hands.
• Upset over changes in their routine or environment.
• Obsessive attachment to devices or unusual objects like light switches or rubber bands.
• Clumsiness, atypical posture or odd ways of moving.
• Hyper- or hypo-reactivity to sensory input.

Science Is Studying Screen Time

In 2018, the National Institutes of Health embarked on a 10-year study of children’s brains to see if and how time on phones, tablets and other screens impacts young brain development. It’s called the Adolescent Brain Cognitive Development Project at the National Institute on Drug Abuse and is directed by Dr. Gaya Dowling.

Two years into the study, the data from MRI brain scans of 9- and 10-year-old kids is showing “significant differences” in the brains of those who use smartphones, tablets and video games more than seven hours a day, such as premature thinning of the cortex, typically related to malnutrition.

The researchers are also finding that kids who spend more than two hours a day on screens of any kind are making lower scores on thinking and language tests.

The results of this groundbreaking study will be complete after 2028—and will likely incorporate the influence of tech dependency in the time of COVID-19.

To learn with depth, focused attention is required to increase the brain’s capacity to process information. A Better Communications Research Programme (BCRP) study suggests a recent increase of 70 percent in children’s speech delays in the U.K. is due to tech devices, indicating that too much time on devices is affecting children’s speech and language skills.

In 2019, Rutgers-New Brunswick conducted the first classroom study that finds cell phone distraction in the classroom can lead to lower grades. When students are allowed to use their devices for non-academic purposes during classroom lectures, they perform worse in end-of-term exams.

Other studies show students can’t resist multitasking when a device is near, and it’s impairing their memory. Continual distraction impairs the ability to focus and learn, which leads to “partial focused attention.”

The underdeveloped adolescent brain lacks restraint and self-control. Parents need to help their children learn moderation when it comes to the use of tech devices.

Screen Time Guidelines

In 2016, the American Academy of Pediatrics (AAP) announced the most recent recommendations for digital media immersion to help families maintain “a healthy media diet.” The guidelines include creating a personalized Family Media Use Plan and these key recommendations:

Children 18 to 24 months: No digital media use except video chatting. When their children are old enough, parents should introduce digital media with high-quality programming and watch it with their children.

Children ages 2 to 5 years: Limit screen time to one hour per day of high-quality programs, and watch it with the children.

Children ages 6 and older: Place consistent limits on screen time and types of media and “make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.”

Designate media-free times together, such as during dinner or while driving, and media-free locations in the home, such as bedrooms.

Have ongoing communication about online citizenship and safety, including treating others with respect online and offline.

Strategies to Offset Tech Addiction

• Parents’ behavior should model what they want from their children’s behavior.
• Parents should retain total access to all mobile phones, tablets and computers in the home and monitor device use of anyone less than 18 years of age.
• For special-needs children, limit handheld games to “rewards” of no more than 15 to 20 minutes.
• Log scheduled time on apps, checking and responding to email and texting.
• When reducing tech use, offer opportunities for increased interpersonal interaction and engage in reading, board games and other non-electronic activities.
• Consider introducing your children to meditation, prayer or other periods of introspection.

Three Ideas for Practical Application

When your kids are likely going to be in front of the computer multiple hours during the day for school—and they’ll still want to use screen time for fun—here are a few ideas for parents to incorporate during COVID-19:

1. Have your child take sensory breaks.
2. Keep ice water next to your child.
3. Rather than always being seated directly in front of the computer, have your child view the screen from different positions such as standing or on laying on the floor.

It is a well known observation that children struggling with a developmental delay and / or corresponding diagnosis, tend to find technology to be a strong outlet for their superior cognitive skills, making them more prone to tech addiction, leading to a decrease in much needed social and problem-solving exposure. 

Call us now at 484-840-1529 for a free initial phone consultation.

By Maude Le Roux, OTR/L, SIPT, RCTC, DIR® Expert Trainer at A Total Approach

            A call to reflect on what “social behavior” means in Autism Spectrum Disorder (ASD)

“My daughter is really struggling with attaining social skills. Sometimes I notice that she looks interested, but she does not want to venture forward. If I prompt her, she would go towards the person or group and she knows to greet, but it stops right there and her facial expression is almost “blank”. We have spent many years to get as far as we have come and she has worked hard, but we seem to be stuck now and it is going to impact on her ability to function in a social group at school. I do not know how she is feeling much of the time, not sure if she is happy or unhappy. Her preferred state still seems to be in her own world.”

I can feel the frustration of this parent, as she has dedicated many years to attain the level of skill required to attain what has been achieved. This plea is not from a parent who wishes her child to be “fixed”, simply happier, better understood and anxious over her future – to be the best version of herself she can be. I try to find ways of broaching my different responses over the years, though really it boils down to 3 aspects to consider.

Firstly, in order to consider social skill, we need to consider communication first. It starts with having the intent to communicate and understand the reciprocity of this turn taking process. In fact, this starts in utero already and continues to develop very strongly in the early bonding process. We are hard wired in our brain to connect with others, to act contingently to others’ overtures toward us. The typically developing baby responds to the overtures of their caregiver and the warm, secure bond of safety drives the intrinsic motivation within the baby to want communication and risk asking for more. This communicative intent with intrinsic motivation for initiation frequently occur as a key difficulty in autistic children and adults. They do not seem to be intrinsically motivated; they appear more motivated to avoid or use fight and flight. Connection with others can be overwhelming as so much needs to be considered. Instead of their sense of self driving toward communication, they frequently feel compelled to self-protect by retreating into their own world, where they feel so much more in control.

The second aspect to consider is that social communication depends on verbal and non-verbal skill. It is not just that we have the capability to use speech and language, but also that we can pair our verbal and non-verbal communication in order to assess a conversational turn-take and follow up on someone else’s contribution. The baby learns to use gestures and sounds before speech and it is really only when we start understanding full sentences with verbs that we can use speech in a social situation with continuous verbal flow. Yet, the baby learns from birth to about 2 to 3 years to first:

1. Enact on the environment
2. Form relationships in their lives
3. Get a grip on the emotional self
4. Get needs met with certain cries and pleas to the parent

The developing child learns emotions (dealing with self), praxis (pairing verbal with non-verbal gestures), as well as developing a physical sense of self (being separate from others). In order to consider others socially, they first learn to deal with themselves physically and emotionally. Verbal speech is built upon this sense of self as a way to express our thoughts, needs and wants and later becomes the principal player in having a debate, or a discourse, becoming a fluid stream of two-way communication from one person to another in a social situation.

As I am writing I can think of so much more to say, but will focus on only one more consideration. Erik Erikson discusses a sense of autonomy that comes with a sense of purposefulness. This is driven by the first two considerations already noted, which acts as building blocks for using working memory while simultaneously building Theory of Mind (ToM). This ability involves being able to use cognitive flexibility to assess how someone else is responding to my social overture, and within split second timing adjusting my next thought to suit the situation in an acceptable manner. This is quite complex and involves much integration of the different senses including our executive and emotional pathways.

Yet, in the light of all this complexity, we have spent the earlier parts of the child’s life focusing on speech, learning skills, “catching up on development”, in a behavioral context, using task analysis and drills to attain access to functionality in learning and language. All of the families coming my way are loving, caring and want the best for their child. Because behavioral therapy is the only therapy provided for through insurance, because all the doctors recommends it and everyone else seems to be doing it, families chose to do this therapy in these crucial early developmental years. Yet behavioral therapy has minimal to no research on contingent conversational turn taking, Theory of Mind, social perspective taking, to name only a few of the aforementioned considerations. In order to be a social partaker in our communities, these are skills honed in from birth and throughout all the drills of behavior therapy, albeit playful, the essence of social skill and the naturalness of co-reciprocity, does not feature. Social communication requires spontaneity, initiation and is not delivered through prompting. Now the families come to my office at ages 5, 6, 9, 13….. and we have to start from the very beginning. This also means we have to un-learn the habit of waiting to be prompted, which has now become a pattern of being.

What are we thinking? Are autistic children seen as walking bodies within which we must enforce what is “acceptable”? Acceptable to whom? They are babies, kids, adolescents, adults with thoughts, ideas, minds, emotions and if we do not harness their social being from the very beginning, we lose precious time that is going to be very hard to make up later.

Please think about this, too many kids are getting lost. And the excuse then? They are not developing social-emotional skill because they have a diagnosis.

Maude Le Roux, OTR/L

484 840 1529 for a free phone consultation