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Objective: To determine whether duration and con- (124.5) min/d. In unadjusted and adjusted analyses, du-
tent of media exposure in 6-month-old infants are asso- ration of media exposure at age 6 months was associated
ciated with development at age 14 months. with lower cognitive development at age 14 months (un-
adjusted: r=−0.17, P⬍.01; adjusted: =−0.15, P=.02) and
Design: Longitudinal analysis of 259 mother-infant dy- lower language development (r=−0.16, P⬍.01; =−0.16,
ads participating in a long-term study related to early child P⬍.01). Of 3 types of content assessed, only 1 (older child/
development, from November 23, 2005, through January adult–oriented) was associated with lower cognitive and
14, 2008. language development at age 14 months. No significant as-
sociations were seen with exposure to young child–
Setting: An urban public hospital.
oriented educational or noneducational content.
Participants: Mothers with low socioeconomic status
and their infants. Conclusions: This study is the first, to our knowledge,
to have longitudinally assessed associations between me-
Main Exposure: Duration and content of media expo- dia exposure in infancy and subsequent developmental
sure at age 6 months. outcomes in children from families with low socioeco-
nomic status in the United States. Findings provide strong
Main Outcome Measures: Cognitive and language de- evidence in support of the American Academy of Pedi-
velopment at age 14 months. atrics recommendations of no media exposure prior to
age 2 years, although further research is needed.
Results: Of 259 infants, 249 (96.1%) were exposed to me-
dia at age 6 months, with mean (SD) total exposure of 152.7 Arch Pediatr Adolesc Med. 2010;164(12):1105-1111
M
EDIA EXPOSURE PLAYS aged children on later outcomes, includ-
an increasing role in ing cognition, achievement, and behavior.
the lives of infants and Emerging research strongly suggests the
toddlers,1-3 despite the potential for adverse effects of media be-
American Academy of ginning in infancy.10,15 However, many of
Pediatrics recommendation that children the studies have been performed with fami-
younger than 2 years should have no me- lies that are not economically disadvan-
dia exposure.4,5 In part, the increasing ex- taged; also, these studies have not been
posure of infants and toddlers to various prospective or have not included de-
types of media has resulted from the emer- tailed information regarding content. In
gence of media content specifically geared particular, to our knowledge, there has
toward infants and toddlers and mar- been no prior longitudinal study per-
keted as educational.6,7 Children from fami- formed in the United States concerning the
lies with low socioeconomic status (SES) effect of media exposure on the develop-
are likely to be most vulnerable to any ad- ment of infants from families with low SES.
Author Affiliations: verse effects of media exposure on early In this study, we sought to assess
Department of Pediatrics, New child development because they have been whether duration and content of media ex-
York University School of documented to have the greatest expo- posure at age 6 months were related to later
Medicine–Bellevue Hospital sure to media8-10 and are at increased risk developmental outcomes at age 14 months.
Center (Drs Tomopoulos, in general for disparities in early develop- We had 2 hypotheses: first, that total du-
Dreyer, Berkule, Fierman,
Brockmeyer, and Mendelsohn),
ment, school readiness, and educational ration of media exposure in infancy would
and Department of Psychology, achievement.11 be adversely related to developmental out-
Manhattanville College, A substantial body of literature12-14 has comes, and second, that associations be-
Purchase (Dr Berkule), documented adverse effects of noneduca- tween media exposure and developmen-
New York. tional media in preschool and school- tal outcomes would vary depending on
(REPRINTED) ARCH PEDIATR ADOLESC MED/ VOL 164 (NO. 12), DEC 2010 WWW.ARCHPEDIATRICS.COM
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P P 99
Measure r Value  Value B (95% CI)
97
Bayley-III Cognitive b −.17 .008 −.15 .02 −1.5 (−2.7 to −0.3)
PLS-4 95
Total Language c −.16 .009 −.16 .005 −1.2 (−2.0 to −0.4)
Auditory −.16 .01 −.14 .02 −1.1 (−2.0 to −0.2) 93
comprehension
91
Expressive −.12 .06 −.13 .02 −1.0 (−1.9 to −0.1) 0 30 60 120 180 240 360
communication Media Exposure, min/d
(REPRINTED) ARCH PEDIATR ADOLESC MED/ VOL 164 (NO. 12), DEC 2010 WWW.ARCHPEDIATRICS.COM
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