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TV & ADHD: Can Early Television Exposure Be Linked to the Diagnosis of ADHD?
February 3, 2011
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders today and can continue through adulthood. There is little compelling evidence that gives us the pure causes of ADHD; however, there are many theories linking ADHD to neurobiology and genetics. Studies have found that environmental factors may have an effect on the increasingly widespread diagnosis of ADHD. New studies have shown tested possible links between the development of ADHD in children and television. Television has both benefits and disadvantages from the exposure of television to children at an early age. Although children can learn from the educational aspects of television, excessive television and certain programming at an early age can be detrimental to a childŐs development. Researchers have observed correlational studies focusing on the effect of early exposure of television to behavioral issues. Furthermore, watching television at an early age could potentially lead to a diagnosis of ADHD in the future.
History of ADHD
In 1902, a British doctor, Dr. Still, recognized ADHD as a disorder; its initial name was ŇDefect of Moral ControlÓ. He believed that the disorder was definitely a medical problem. In 1937, stimulants were first used to treat children who exhibited signs of ADHD. Ritalin became available in 1956 to treat children that were considered ŇhyperactiveÓ. During the 1970s, more symptoms were recognized to be related to hyperactivity, including impulsiveness, lack of focus, daydreaming, and other lack of focus type symptoms. It wasnŐt until 1987 that the name was revised to ŇAttention Deficit Hyperactive Disorder.Ó In 1988, the American Medical Association (AMA) stated that ADHD was one of the most researched disorders. Today, the cause of ADHD is still unknown, and there is no cure (HelloLife).
In 1985, it was estimated that 500,000 children were diagnosed with ADHD. Today, there are between 5-7 million children diagnosed. According to the National Institute of Mental Health, approximately 2-3% of all children have ADHD (ADHD - Child ADHD and ADD).
While there are no real known causes of ADHD, many scientists believe that genes may play a large role. Results from several international twin studies show that ADHD can often run in families. In 1990, Joseph Biederman and his colleagues studied families of children with ADHD. They found that over 25% of first degrees relatives of the families of ADHD children also had ADHD. Studies also suggest a potential link between cigarette smoking and alcohol use during pregnancy and ADHD in children. Furthermore, children who are exposed to high levels of lead in the first three years may have a higher risk of developing ADHD. There is a popular theory that sugar causes ADHD and/or makes symptoms worse; however, extensive research has falsified this hypothesis (MyADHD).
Symptoms & diagnosis of ADHD
Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. Although these behaviors are common in children, in children with ADHD, these behaviors occur more often and are more severe. Often these symptoms are paired with poor social skills and difficulties at school. ADHD has three subtypes: predominantly hyperactive-impulsive, predominantly inattentive, and combined hyperactive-impulsive and inattentive. Each subtype depends on the types of symptoms that the child expresses. The following data relates behavioral symptoms to inattention, hyperactivity, or impulsivity:
Symptoms of inattention
á Easily distracted, miss details, forget things, frequently switch activities
á Difficulty focusing on one thing
á Becoming bored with a task after a few minutes, unless enjoyable
á Difficulty focusing attention on organizing & completing task
á Difficulty completing/ turning in homework assignments
á DoesnŐt seem to listen when spoken to
á Daydream, become easily confused, & move slowly
á Difficulty processing information as quickly/ accurately as others
á Difficulty in following instructions
Symptoms of hyperactivity
á Fidget and squirm in seats
á Talk nonstop
á Dash around, touching/ playing with anything in sight
á Difficulty sitting still during dinner/ school/ story time
á Constantly in motion
á Difficulty doing quiet tasks/ activities
Symptoms of impulsivity
á Very impatient
á Blurt out inappropriate comments
á Show emotions without restraint
á Act without regard for consequences
á Difficulty waiting for things they want/ turns in games
á Often interrupt conversations/ othersŐ activities
In order to fulfill each subtype, a child must meet the following requirements:
á Most symptoms (6+) are in the hyperactivity-impulsivity categories
á Fewer than 6 symptoms of inattention are present
á Majority of symptoms (6+) are in the inattention category
á Fewer than 6 symptoms of hyperactivity-impulsivity
á Less likely to act or/ have difficulties getting along with other children
Combined hyperactive-impulsive and inattentive
á 6+ symptoms of inattention and 6+ symptoms of hyperactivity-impulsivity
á Most common type of ADHD
Neuroscience of ADHD
A study in 1990 discovered that brain activity was 8.1% lower in 30 of the 60 brains in adults who suffered from ADHD. This was measured by global glucose metabolism. The premotor cortex and the superior prefrontal cortex, regions that normally mediate impulse control, that showed the most significant decreases in activity. Currently, over 10 genes have been suspected to be involved in the diagnosis of ADHD. Many of these genes center around dopamine (important neurotransmitter in the brain) receptors or dopamine transporting molecules (Batts).
Benefits of Television
According to the Kaiser Family Foundation, two-thirds of children 6 months to 6 years old watch television daily. Furthermore, more than 43% of children under the age of 2 watch television daily (Gavin).
Television has its benefits in teaching young children. Some doctors believe that itŐs only the content that children are watching that matters. For example, BabyFirstTV is a network designed for children under the age of 3. It includes programs that allow parents to interact with their children. Other programs even teach sign language to infants. The network also encourages healthy eating habits and exercise. A designer of educational DVDs for parents and toddlers believes that if parents donŐt abuse television and select quality programming, television can be extremely beneficial. Other educational networks and programs include: Sesame Street, Mr. Rogers Neighborhood, PBSkids, Barney, and many others (Mann).
Repercussions of Television for infants/toddlers
Although there are benefits to educational television, it can sometimes be detrimental to a childŐs development. Neuroscientists have extensively studied the impact of television on a developing brain. Because of the plasticity of neuronal connectivity in child younger than 2, environmental experiences can greatly affect the brain. Therefore, repeated exposure to anything like television can impact mental and emotional growth. Researchers have found that higher levels of television viewing are linked to lower academic performance. They have also found that television may predispose some children to attention problems. This is because the features of childrenŐs programming, including flashing color, quick movements, and loud noises, engage the brainŐs attention involuntarily. A child is then deprived from using his/ her own brain independently. Immoderate television viewing can also lead to violent behaviors, obesity, and difficulty in social situations (Healy).
Because the first two years of life are critical for brain development, the American Academy of Pediatrics (AAP) recommends that kids under 2 years do not watch any television. The AAP also advises that children older than 2 years watch at most 1-2 of quality programming each day (Gavin).
Television linked to ADHD
Although the cause of ADHD is unknown and behaviors that may lead to ADHD are highly controversial, researchers have tested the possibility that television may be linked to ADHD. An AAPŐs study showed that watching videos as a toddler may lead to ADHD later in life. Dr. Christakis, lead researcher and director of the Child Health Institute in Seattle, Washington, studied a cohort of more than 2500 children in 2004 (Lotus).
Mothers were asked then number of hours of the television watched on a typical weekday and weekend. When the children were near age 7, their attentional problem status was configured. This was found through the hyperactivity subscale of the Behavioral Problems Index (BPI). The BPI consisted of questions focused on difficulty in concentrating, frequent confusion, impulsiveness, obsessions, and restlessness. Christakis concluded that for every hour of television watched at ages 1 and 3, the child had almost a 10% higher chance for developing attention problems that could be diagnosed as ADHD by age 7. The discussion of the study included concerns of the accuracy of the results. The determination of ADHD was based on established checklists of behavior and not a clinical diagnosis. Furthermore, the parents determined the amount of television viewed, rather than direct monitoring. Finally, the content of the programs watched was not recorded nor was it relevant to the study (Christakis). Christakis summed up his research by saying, ŇIn contrast to the pace with which real life unfolds and is experienced by young children, television portrays rapidly changing images and scenery. ItŐs unnaturally stimulatingÓ (Learning Disabilities Association of America).
A study in 2010 from Iowa State University by Swing, Gentile, Anderson, and Walsh focused on television and video game exposure and the development of attention problems within a 13-month period. Parents and teachers observed attention problems in more than 1300 middle childhood participants. This study found that exposure to television and video games was associated with greater attention problems (Swing).
In 2010, a study was done in Japan that looked at early television exposure and childrenŐs behavioral and social outcomes at 30 months of age. Television exposure was observed by the mothers of infants ages 18 and 30 months. The results of this study showed that hyperactivity-inattention at age 30 months was directly associated with exposure to television at 18 months. Social behavior of the infants was not affected in this study (Meek).
A study was conducted at the Johns Hopkins Bloomberg School of Public Health in 2007. The study observed over 2500 children at age 2.5 and age 5.5. Sustained exposure was defined as watching two or more hours of television daily at both ages. This type of exposure was found to be associated with behavioral problems. However, reduced exposure at an early age seemed to have no effect on a childŐs behavior (School of Public Health at Johns Hopkins).
An extensive study was done in India in 1992 involving 250 children ages 3-10 years old. The children were studied for a period of 9 months. The study observed changes in each childŐs eating habits, weight, physical activity, sleep pattern, interest in study, and general physical health. The average duration of exposure to television for each child was approximately 18.5 hours per week. While each behavior resulted in varied changes, the change in interest in study had a significant decrease. Overall, 20% of the children in the experiment had a decreased interest in study due to a greater exposure to television. Although the reason for this decrease was unknown, theories pointed it in the direction of difficulty paying attention and overall lack of interest. According to previous data and studies, if this specific study had continued, the researchers might have observed other symptoms that could have led to a diagnosis of ADHD (Gupta).
The diagnosis of attention deficit hyperactivity disorder has been increasing exponentially over the past decade. During this time, television has become a constant in childrenŐs lives. In the United States, 99% of all American households have at least on television and a majority has more than one. Children are automatically surrounded by television even as infants. It is necessary for parents to moderate their childŐs television exposure so they do not experience the negative effects in the future. Although it is not proven that television can cause or strengthen the symptoms of ADHD, there is significant research that shows negative effects caused by excessive amounts of television at an early age. With todayŐs society highly dependent on technology and the media, there are many risks associated with early television exposure that can be detrimental to a childŐs future.
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