Communication Sciences and Disorders
Katie Martini

The Association among Media Exposure, Disruptive Behaviors, and Language Ability in Young Children.

  • Faculty Advisor

    Megan Roberts

Published On

July 2018

Originally Published

NURJ 2017-18
Honors Thesis

Abstract

Objective. In recent years, access and exposure to media, including television, tablet devices, phones, and radio, have grown exponentially. Research on the effects of media on child development has recently become a topic of exploration, but has proven to be complex. Much of the existing research is contradictory. The purpose of this study is to better understand how media impacts disruptive behaviors in young children, and to understand how language ability may moderate the relationship between media and disruptive behaviors.

Methods. Data were taken from the baseline time-point of a longitudinal language intervention study on 177 young children, 53 percent of whom received a language delay diagnosis. The remaining 47 percent were developing in a typical manner. Data on media use was collected using the Language Environment Analysis (LENA) device and software. The Infant Toddler Social Emotional Assessment (ITSEA) was used to measure disruptive behavior, specifically attention, hyperactivity and aggression. The Preschool Language Scale 4th Edition (PLS) was used to determine language ability. Separate regressions were run for each disruptive behavior.

Results.  Increased daily exposure to media was associated with higher levels of hyperactivity in children regardless of their language ability. Media exposure was not associated with attention skills or with aggressive behavior. However, attention skills were correlated with language ability.  

Conclusions. Findings in this study indicate that media exposure is related to hyperactivity, but more research is necessary to determine directionality. In general, more research that clearly defines and accurately measures each disruptive behavior or disorder is necessary in order to understand the complex relationship between disruptive behaviors and media use.

Introduction

In today’s world, technology and media are difficult to escape. Media, anything from phones, tablets, electronic gaming devices, to television and computers, has become a necessity in our culture. Research has shown that 35 percent of children live in a household where the television is always on in the background. One out of every five children has used a computer before two years old (Wartella, Vandewater, & Rideout, 2005). Because of this sudden increase in media exposure, there has been debate over the effects of media on child development. One such area of child development is exhibitions of disruptive behavior.

Disruptive behavior is a term that accounts for behaviors that interrupt or disrupt a child’s day-to-day life. Common examples of disruptive behaviors include: attention deficits, hyperactivity, impulsivity, temper tantrums, aggression and antisocial behavior. Studying these disruptive behaviors is important, as many are symptoms of behavior disorders, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). Although nearly every child exhibits these behaviors, research cited by the American Academy of Pediatrics has shown that it is possible to accurately assess which children are demonstrating disruptive behaviors at a level that qualifies for a diagnosis of Attention Deficit and Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder, or Conduct Disorder as early as preschool-age (Keenan & Wakschlag, 2002; Lahey, Pelham, Loney, Kipp, Ehrhardt, Lee, ... & Massetti, 2004). Because we can accurately identify atypical levels of disruptive behavior in young children, it is important to understand what may impact these behaviors to inform intervention strategies. Some evidence suggests that media use impacts disruptive behaviors, although the current research on the topic is often contradictory.  

Literature Review

The existing literature on media’s effect on child behavior is inconclusive. Several studies support the idea that media exposure is a predictor of disruptive behaviors, while other studies find it has no effect. Still, other studies suggest that media exposure is a predictor of disruptive behaviors, but often demonstrate that the relationship between media exposure and child behavior is complex, and dependent on other variables.  

Disruptive Behaviors and Amount of Media Exposure. Many studies took into consideration the effect that media exposure has on child behavior. One such study found that the number of hours of television a child watches per day at ages one and three was significantly associated with attention problems later in life, specifically at age seven. This suggests that viewing time is also an important factor when examining this relationship (Christakis, Zimmerman, DiGuiseppe, & McCarty, 2004). Researchers have also shown that high levels of television viewing in preschool children have been associated with higher ratings of inattention, hyperactivity, and impulsivity, as assessed by parents and teachers (Miller, Marks, Miller, Berwid, Kera, Santra, & Halperin, 2007). These studies demonstrate a negative relationship between early television viewing and disruptive behaviors. Still, some studies suggest that there is no relationship between media exposure and disruptive behaviors. Stevens & Mulsow (2006) found that in a sample of 2,500 kindergarteners, exposure to television, as reported by parents, was not a significant predictor of ADHD symptoms in children, later in first grade. These conflicting results suggest that the relationship between child behavior and media exposure is complex. Therefore, many variables should be considered when analyzing the relationship.

Media and Language Ability. The effect of media exposure on child language development is another controversial topic, with conflicting research findings. Some suggest that it is beneficial to language development when parent-child interactions occur during media exposure, in order to supplement the information that the child is receiving from the media (Mendelsohn, Brockmeyer, Dreyer, Berkule-Silberman, & Tomopoulos, 2010). Other studies suggest that there is no relationship between language development and media exposure in toddlers between 17 and 24 months (Zimmerman, Christakis,&  Meltzoff, 2007). Other studies have found that media exposure at six months was associated with lower language and cognitive skills at 14 months (Tomopoulos, Dreyer, Berkule, Fierman, Brockmeyer, & Mendelsohn, 2010). Much like the relationship between disruptive behaviors and media, the relationship between language ability and media is complex and findings are controversial.

Disruptive Behaviors and Language Ability. Research has also shown that children with language delay watch more television, and begin to watch television at an earlier age than their typically developing peers (Chonchaiya, & Pruksananonda, 2008). It is important to consider how media may affect children both with language delay, as well as other those with language difficulties. Research has shown that diagnoses such as language delay and specific language impairment are associated with higher levels of disruptive behavior (Qi & Kaiser, 2004; McCabe, 2005). The aim of this study is to begin to understand how media exposure affects these behaviors in children when considering language ability.

Measuring Media. Existing research on the effects of media exposure on disruptive behavior is not yet extensive enough to gather a complete picture. More research that utilizes better strategies to gather a more accurate understanding of the relationship is necessary. Nearly all existing studies about media and child development rely on parent reporting to measure children’s exposure to media. Today, new technology, and new ways to engage with media present themselves regularly. Because of this, it has become increasingly difficult to fully capture a child’s exposure to media. Thus, parent reports that have been validated with the use of video-taped observational data are likely inaccurate in representing full media exposure. Recent studies have therefore focused primarily on television, while ignoring other types of media that may very well influence disruptive behavior in children as well. Future studies should incorporate a more objective measure of media in their analyses.

The existing literature on the effect of media exposure on disruptive behaviors is not conclusive, but has laid a solid foundation for future research. The first aim of this study is to better understand how the amount of media exposure relates to disruptive behavior, specifically hyperactivity, attention and aggression. The second aim of this study is to understand whether language ability moderates the relationships between media and hyperactivity, attention and aggression, if these relationships do exist.

Methods

Sampling. Existing data on a sample of 177 children, consisting of both typically developing children and children with language delay, were used to investigate the relationship between disruptive behaviors and media exposure. The sample consisted mostly of males. This is likely because language delays are more common in males than in females. The typically developing group of children was matched to the language delay population based on age and gender. Detailed information on the demographics of the participants can be found in Table 1.

Measures:

ITSEA: Infant Toddler Social Emotional Assessment.  At baseline, parents filled out the Infant Toddler Social Emotional Assessment (ITSEA), a parent questionnaire that measures social-emotional development, providing subscale scores that align with symptoms of behavior disorder diagnoses used in the Diagnostic and Statistical Manual for Mental Disorders 5th Edition (DSM-5). Scores on each subscale range from zero to two, and represent the average endorsement of items by parents in that subscale. To measure hyperactivity, the “Activity/Impulsivity Subscale” was used. In this subscale, a high score indicates that the child exhibits more hyperactive behaviors, while a low score indicates that the child exhibits less hyperactive behaviors. The subscale consists of six items, such as if the child is restless, and if the child is “wound up,” or silly, when playing. To measure attention, the “Attention Subscale” was used. On this scale, a high score indicates exceptional attention skills, while a low score indicates poor attention skills. The subscale consists of five items, such as measuring if the child pays attention for a long time, and if the child can sit for five minutes, while the parent reads a story. To measure aggression, the “Aggression/Defiance Subscale” was used. On this scale, a high score indicates more aggressive behavior, while a low score indicates less aggressive behavior. The subscale consists of 12 measurement items, such as if the child is destructive, and  if the child is disobedient or defiant.

LENA: Language Environment Analysis. At baseline, children were asked to wear a LENA Pro recorder for a full day during the weekend. Parents were instructed to leave the LENA in the child’s shirt for the entire day, taking it off when the child went to bed. The LENA Pro device records up to 16 hours of natural audio environment, and automatically analyzes the data, providing an estimate of the presence of linguistic variables, such as the number of adult words and conversational turns, as well as an estimate of media clips present in the recording.  Data were processed using the LENA software. The percentage of media exposure in the child’s day was used as a measure of daily media exposure.

PLS-4: Preschool Language Scale Fourth Edition. At baseline, clinicians administered the Preschool Language Scale, 4th Edition (PLS-4), to measure each child’s language skills. The total language score, reflecting both expressive and receptive language skills, was used as a measure of language ability in this study.

Analysis:

A regression analysis was run to investigate the association between daily media exposure, as measured by the LENA media output code, and disruptive behaviors, as measured by the ITSEA subscales, including an interaction term to assess whether the association between media exposure and disruptive behaviors differs by language ability. The resulting regression equation is given below:

DisruptiveBehavior = β0 + β1Age + β2MediaExposure + β3LanguageAbility + β4MediaExposure*LanguageAbility.

Separate regressions were run for each disruptive behavior.

Results

Results from each regression are given below, including the standardized regression coefficient (β).

Hyperactivity.  Higher percentages of daily media exposure were significantly associated with more hyperactive behaviors, β = 0.327, t(177) = 3.45, p <0.001, a moderate effect size illustrated in Figure 1.  Language ability was not associated with hyperactive behavior, β = 0.143, t(177)=1.466, p = 0.145. There was no interaction between language ability and daily media exposure on hyperactivity levels, β = 0.098, t(177) = 1.070, p = 0.286, demonstrating that the association between media exposure and hyperactivity did not vary by language ability.

Attention. Daily media exposure was not associated with attention skills, β = -0.091, t(177) = -1.017, p = 0.311. Higher scores on the PLS-4, indicating a higher level of language ability, were associated with better attention skills, β = 0.419, t(177) = 4.862, p < 0.001, a moderate effect size illustrated in Figure 2.

Aggression. There was no significant association between either daily media exposure, β = 0.164, t(177) = 1.669, p = 0.098, or language ability, β = 0.050, t(177) = 0.339, p = 0.596, with aggressive behaviors.

A Bonferroni correction for multiple comparisons was run. Both the associations between media exposure and hyperactivity and between language ability and attention remained significant.

Conclusions

Hyperactivity. For children in this sample, the percentage of daily media exposure was significantly associated with higher levels of hyperactivity. This suggests that children who engage with more media have a higher likelihood of exhibiting hyperactive behaviors. There was no significant interaction between language ability and daily media exposure on hyperactive scores. This suggests that the relationship between daily media exposure and hyperactivity is independent of language ability. Therefore, the relationship holds true for both children who are typically developing, and children with language delay.  

Attention. There was no association between daily media exposure and attention skills. However, there is an association between language ability and attention skills. The data suggest that children with higher overall language skills are better at focusing on stimuli in their environment for longer. However, the amount of media with which a child engages in a day has no effect on his or her attention skills.

Aggression. Neither daily media exposure nor language ability were associated with aggressive behaviors in the sample. This suggests that the amount of media exposure does not impact aggressive behaviors. There is no difference in aggressive behaviors in children who interact with media for several hours as compared to children who only minimally interact with media.

Discussion

Media, Hyperactivity, and Attention. For children aged about 30 months, the amount of daily media exposure appears to be associated with hyperactive behaviors, but not with attention skills or aggression. The fact that there is no association between media exposure and attention, but there is between media exposure and hyperactivity, may shed light on the discrepancy in the literature. It is often difficult to gather information on attention that remains independent from information on hyperactivity, and vice versa. Therefore, it is crucial to consider how each study measured these disruptive behaviors.  

Studies that look at the effect of media on symptoms of ADHD as a whole may miss this distinction. Future research must focus on each individual behavior, rather than grouping several together. Christakis et al. (2004) found that the number of hours of television-viewing at ages one and three was predictive of attention deficits at age seven. However, to measure attention, they used the hyperactive scale of the Behavior Problems Index (BPI), which includes measuring whether the child is impulsive or restless. These items measure hyperactive behaviors more so than attention, so they lump together information about attention and hyperactivity. This conflation inhibits the items’ ability to conclusively demonstrate an exclusive relationship between television exposure and attention.  

In this study, to measure hyperactivity and attention, the ITSEA was used. No relationship between attention and media was found. The ITSEA makes a distinction between attention and hyperactivity, using two separate subscales for each. This allows for distinct analyses of the relationships between media and attention, and media and hyperactivity. Researchers analyzed the relationship between television exposure and several disruptive behaviors. They found significant relationships between amount of television-viewing and externalizing problems, as measured by the CBCL. The CBCL defines the combination of aggression and attention subscales as externalizing problems (Chonchaiya, Sirachairat, Vijakkhana, Wilaisakditipakorn, & Pruksananonda, 2015). However, when looking only at the attention subscale –– which excludes hyperactive behaviors and therefore can better represent attention exclusively –– researchers found no relationship between the attention subscale and television exposure (Chonchaiya et al., 2015). It is important to distinguish between the relationship of media exposure and attention, and hyperactivity. This distinction may shed light on underlying reasons for the relationship’s existence.  

Media, Language Ability, and Attention. To begin investigating the causal relationship between media and disruptive behaviors, this study aimed at understanding whether language ability plays a role in the underlying cause. There was no significant interaction found between media and language ability on hyperactive behaviors. This finding suggests that the relationship between media exposure and hyperactivity is independent of language ability. This indicates that the relationship between media exposure and hyperactivity holds true for children, regardless of their language skills. Previous literature has demonstrated that there are relationships between language ability and disruptive behaviors (Qi & Kaiser, 2004; McCabe, 2005). The current study also demonstrates a significant positive relationship between language ability and attention skills.

Media and Aggression. No relationship between media exposure and aggression was found. This is inconsistent with previous research that demonstrated a relationship between media exposure and aggression (Verlinden, Tiemeier, Hudziak, Jaddoe, Raat, Guxens, ... & Jansen, 2012). The discrepancy in results could be due to the fact that the data analyzed by Verlinden et al. (2012) was longitudinal, while the data here focuses on children aged about 30 months. It is possible that 30-month-old children may demonstrate aggressive behaviors as a result of early media use later. The discrepancy between the finding in this study and that in Verlinden et al. (2012) may also have to do with the different methods of analyzing media. In this study, all media was considered. In the previous study, only television was considered. Media content and media type may be important in drawing conclusions on the relationship between aggression and media.

Limitations and Future Directions

It is clear there is a need for future research to more comprehensively look at media. The current study only considered the percentage of daily media exposure. Future studies should incorporate media type and content, as well as the amount of media exposure, for a more holistic understanding of media’s impact on behavior. The current study is not longitudinal, so conclusions can only be drawn for children at about 30 months. Future research should be longitudinal to provide a clear picture of effects over time.

There is also a need for studies that analyze individual disruptive behaviors, and provide clear definitions for each disruptive behavior or disorder. Research of this nature is limited in that many disruptive behaviors are manifested in similar manners. Therefore, it is difficult to define each behavior independently.

Overall, more research is necessary to fully understand how media impacts disruptive behaviors, while considering a more holistic view of media, providing clear definitions, accurate measures of each behavior, and exploring more reliable ways of measuring media exposure. The current study provides a foundational clarity in the distinction of the relationship between media exposure, hyperactivity and attention. However, future research is necessary to strengthen comprehension of this distinction. The current study also considered language ability’s relationship with media exposure and disruptive behaviors, illustrating that the relationship between hyperactivity and media exposure exists regardless of a child’s language skills. More research on language ability and other factors that may moderate the relationship between disruptive behaviors and media is necessary in order to understand the underlying reason behind relationships.  

ABOUT THE AUTHOR

Katie Martini studied Communication Sciences and Disorders and Psychology as an undergraduate.  She is interested in child language development and the factors that impact it. She is currently pursuing a Master’s degree in Speech Language Pathology at the University of Maryland, and upon graduation, she plans to work as a speech pathologist specializing in early intervention to gain clinical experience.  In the future, she hopes to pursue a PhD in Communication Sciences and Disorders where she can use her clinical knowledge to research intervention strategies for child language disorders.

ACKNOWLEDGEMENTS

I would like to thank Dr. Megan Roberts, my first reader and mentor, whose guidance was crucial to the completion of this work. I would also like to thank Dr. Alexis Lauricella, my second reader, whose expertise on media was key to the development of this thesis. Dr. Elizabeth Norton’s guidance during the year was essential in ensuring accurate and timely completion of the study activities. I am grateful to Philip Curtis, who provided crucial statistical knowledge and constant guidance throughout the process. Finally, I would like to thank my peer, Bridgett Riverol, whose support and feedback were paramount to this research.

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