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Autism and Screen Time by Dr David Zimmerman, Clinical Psychologist

Autism and Screen Time by Dr David Zimmerman, Clinical Psychologist

Research suggests that children and adolescents with Autism Spectrum Disorder (ASD) spend more time on video games and computers than their peers (Mazurek et al., 2012; 2013; Kuo et al., 2014). Although there are evidence-based benefits identified from the use of digital and social media, such as early learning opportunities, building knowledge and increasing opportunities for social contact and support, there are a number of risks that must be considered. These include: poor sleep hygiene, in-attention, addiction, a higher incidence of obesity and depression; exposure to inaccurate, inappropriate or unsafe content and contacts; and compromised privacy and confidentiality (Chassiakos et al., 2016).

It is believed that individuals with ASD are drawn to screens more so than their peers because there is a repetitive and predictable interface and is highly customisable to specific interests. Digital media produces visual and auditory engagement that stimulates neural pathways, and that for many children and adolescents with ASD, those neural pathways are not necessarily stimulated during face-to-face interactions. Often, these social interactions elicit anxiety for many young people, so it is understandable why digital media devices are preferred. However, the use of social media can also be a trigger for poor mental and physical health and has been associated with greater depression, increase in social anxiety and other lifestyle related diseases (Becker et al., 2016; Chassiakos et al., 2016; Sidani et al., 2013).

As screen time is so alluring, parents need to take concrete steps to create limits and structure. Below are strategies for managing screen time access for young people with ASD (these strategies are equally relevant to their neuro-typical peers).

1. Parents should set limits in hour increments during the weekday and weekend that is consistent throughout the year.
2. Parents need to role-model appropriate technology use, including usage of smart phones/tablets at the dinner table or at certain hours of the evening.
3. Parents need to add external structure to afternoons and evenings. Young people with ASD will need more external structure than their peers and will benefit greatly from increased real-time social interaction. Parents are encouraged to be arrange small playgroups, engage in creative/imaginative play, coordinate martial arts/sports groups or join specialist clubs (e.g., Lego Robotics). It’s important to replace screen time with appropriate alternatives that are interesting and compelling.
4. Parents should structure screen time in designated time slots. Computer access from 7 to 9 p.m. will work much better than simply saying “you have 2 hours of access each afternoon”. It prevents power struggles and means that parents won’t have to micro-manage.
5. Parents should monitor social media closely and should have access to account passwords. Young people with ASD are likely to learn social media later than their peers. They also may lack social nuance awareness that puts them at risk for problematic online interactions, including cyber-bullying.
6. Parents should give a warning (e.g., ten minutes) prior to ending screen time. At the point at which screen time access is over, parents should use clear and calm communication and should avoid negotiating over additional screen time. Positive reinforcement strategies should be implemented to reward desired behaviours.
7. Parents should avoid demonizing digital technology. With open conversation, parents can establish limits and boundaries for screen time, without creating an adversarial interaction. Digital media is very engaging, there is no denying it. As adults, we can respect digital media while still respecting our boundaries.

References:
• Mazurek, M. O., Shattuck, P. T., Wagner, M., & Cooper, B. P. (2012). Prevalence and correlates of screen-based media use among youths with autism spectrum disorders. Journal of autism and developmental disorders, 42(8), 1757-1767.
• Mazurek, M. O., & Wenstrup, C. (2013). Television, video game and social media use among children with ASD and typically developing siblings. Journal of autism and developmental disorders, 43(6), 1258-1271.
• Kuo, M. H., Orsmond, G. I., Coster, W. J., & Cohn, E. S. (2014). Media use among adolescents with autism spectrum disorder. Autism, 18(8), 914-923.
• Chassiakos, Y. L. R., Radesky, J., Christakis, D., Moreno, M. A., & Cross, C. (2016). Children and adolescents and digital media. Pediatrics, e20162593.
• Website: http://theautismblog.seattlechildrens.org/autism-and-screen-time/
• Sidani, J. E., Shensa, A., Radovic, A., Miller, E., Colditz, J. B., Hoffman, B. L., … & Primack, B. A. (2016). Association between social media use and depression among US young adults. Depression and anxiety, 33(4), 323-331.
• Becker, M. W., Alzahabi, R., & Hopwood, C. J. (2013). Media multitasking is associated with symptoms of depression and social anxiety. Cyberpsychology, Behavior, and Social Networki

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