March 28, 2000 (Atlanta) -- Television may turn out to be a useful tool for assessing development in young children, according to an observational study published in the March 25 issue of the British Medical Journal. Some British researchers say it may help pediatricians determine if a child who is not yet talking at 18 to 24 months has a learning problem. But other pediatricians are not convinced of its value.
"One thing [we] are concerned about is learning difficulties because they are not going to go away," lead author Ben Lloyd, MD, tells WebMD. "That is an important diagnosis. But trying to assess the abilities of a child who is not talking is quite difficult, so you need some good questions [to ask the parents]." Lloyd is a consultant pediatrician at the Royal Free Hospital in London.
One of the questions Lloyd and his colleagues have started using is, "Does your child recognize the picture of a cat, dog, or baby on the television screen?"
"In order to [recognize a cat, dog, or baby on TV], I think you have got to be of reasonable intelligence and you have got to want to communicate," he says, adding that they chose cats, dogs, and babies because those appear to be the first things young children recognize.
To determine at what age most developmentally normal children recognize those images, Lloyd questioned the parents of almost 800 children between the ages of 8 and 23 months old, as well as the parents of 26 18-month-old children with Down's syndrome.
If a parent responded that their child did indeed recognize the television image of a cat, dog, or baby, they were asked, "How do you know?" The researchers concluded that a child recognized the image if he or she named, imitated, or pointed at the image. Becoming excited or patting the screen was not considered sufficient evidence.
"We identified that by 18 months, 96% of the children are reported to recognize a cat, dog, or baby on the television screen," says Lloyd. By contrast, only 19% of children with Down's syndrome were reported to identify those images at 18 months.
Lloyd asks parents if their child recognizes these TV images as one of several questions asked to evaluate a child's development when there is a developmental concern. "I ask other questions, like, 'Does she help around the house? Does she follow simple instructions?'" he says.
One advantage of the TV image recognition question is that parents understand it and "they can answer it clearly." Whereas, Lloyd finds that other developmental questions asked of parents, like "Does he follow instructions?" are not always easy for them to answer.
"As a technique, [recognition of TV images] is not a particularly sophisticated one," Renee Wachtel, MD, tells WebMD in an interview about the study. "They asked parents at what age they thought their child could recognize these different things on television, which is really quite different than actually testing the children to see what they could, in fact, recognize. So it is very second hand in that regard." Wachtel is a professor of pediatrics and director of developmental and behavior pediatrics at the University of Maryland School of Medicine.
"Then obviously, you get into the other set of issues: whether children who are very young should be watching television at all," she says. "While the [American] Academy of Pediatrics and many pediatricians do not feel that young children should be watching TV, I think there are much better ways to be determining how well your child is doing developmentally. We are much bigger proponents of reading books to your children and having your children identify pictures rather than things on TV as a better way of teaching your child and knowing whether your child is learning what you are teaching."
Lloyd says he is aware that promoting the use of television as a diagnostic tool is controversial, especially in light of the American Academy of Pediatrics' recent recommendation that children under the age of 2 watch no television at all.
"Other pediatricians have said to me, 'You are sending the wrong message with this test,'" says Lloyd. "On a bad day you could imagine that some mother will hear about this, spot that her 16-month-old child isn't doing it, and then sit the child in front of the television for four hours as therapy. This is my nightmare scenario."
"Of course whether the child has normal development or not, they are better off not plopped in front of the television," says Lloyd. "In fact, as a result of this, I talk about the dangers of excessive television more."
- New research shows that by 18 months of age, 96% of children can recognize a cat, dog, or baby on a television screen, but only 19% of Down's syndrome children can do this.
- Researchers say this diagnostic tool can help determine whether a young child has a learning problem, but other experts question the validity of this measurement.
- One problem with this tool is that children under the age of 2 should not even be watching television, according to guidelines from the American Academy of Pediatrics.