Poster #111 - Screen time reduction with social engagement among young children with ASD: A pilot intervention study.

• In Event: Poster Session 13

Abstract

Background: Recent research has found associations between early screen media exposure (e.g., TV/tablet/smartphone use) and greater Autism Spectrum Disorder (ASD) symptoms (Heffler, Sienko, Subedi, McCann, & Bennett, 2020; Kushima, Kojima, Shinohara, et al., 2022). Given that children with ASD often spend many hours a day engaged with screen media (Slobodin, Heffler, & Davidovitch, 2019), limiting their exposure to important social, sensory, and motor experiences critical for brain development (Napier, 2014), there is growing concern regarding the impact of early screen media on children with ASD. The present study used an open-trial design to examine whether a manualized 6-month intervention aimed at reducing screen media exposure and increasing parents’ social engagement with their young child with ASD would predict improvements in ASD symptoms and parental stress at post-intervention. This is the first prospective study to our knowledge to examine the potential effects of reducing screen media exposure among children with ASD.

Methods: Participants were 9 children ages 18 to 40 months with an ASD diagnosis who watched screens at least 2 hours per day. Weekly screen viewing and parent-child social interaction were assessed. The intervention consisted of a parent education program followed by weekly one-hour in-home support visits aimed at replacing screen time with social engagement over a 6-month period. Child autism symptoms (Brief Observation of Social Communication Change; Grzadzinski, Carr, Colombi, et al., 2016), functional behavior (Vineland Adaptive Behavior Scales; VABS-3; Sparrow, Cichetti, & Saulnier, 2016), and development (Mullen Scales of Early Learning; Mullen, 1995) were assessed pre- and post-intervention; parents also completed questionnaires on parental stress (Autism Parenting Stress Index; Silva & Schalock, 2012) and their perceptions of the intervention.

Results: Children’s screen viewing decreased from an average of 5.6 hrs/day prior to intervention to 5 mins/day during the study. Significant improvements were observed in core autism symptoms and parental stress from pre- to post-intervention (see Table 1). Specifically, autism-related symptoms on the BOSCC (the sum of the social communication deficits and restricted/repetitive behaviors subscales) significantly decreased from 41.3 (SD=10.1) to 32.8 (SD=13.1; t(8)=3.49, p=.008), yielding a medium effect size (Hedges g=0.66). Adaptive function on the VABS-3 Adaptive Behavior Composite standard score improved from 59.3 (SD=10.8) to 69.3 (SD=15.5) at post-intervention, a non-significant trend (t(8)=2.22; p=.058; g=0.68). Significant changes were not found for language (g=0.48), fine motor (g=0.28), or visual reception skills (g=0.06). Of note, the number of hours of children’s ongoing participation in their community-based therapies was unrelated to changes in any outcome measures. Importantly, parental stress decreased significantly from 21.7 (SD=8.9) to 13.7, (SD=8.3; t(8)=3.19; p=.013; g=0.84). Parental ratings of treatment acceptability were positive, and qualitative data suggested that children tolerated the intervention well.

Conclusions: Parent education and training/support to minimize screen time and increase social interaction was well-accepted by parents and children. These promising preliminary results suggest that a randomized controlled trial targeting screen viewing reduction and increased social engagement is warranted for families of children with ASD who present with high levels of screen exposure.

Authors

• Karen Heffler

• Lori Frome

• Brigid Garvin

• Lindsay Bungert

• David Bennett, Drexel University
  Presenting Author