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Comment & Response
November 9, 2020

Improving Research on Screen Media, Autism, and Families of Young Children—Reply

Author Affiliations
  • 1Drexel University College of Medicine, Philadelphia, Pennsylvania
  • 2Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania
  • 3Value Institute, Christianacare Health System, Wilmington, Delaware
JAMA Pediatr. 2020;174(12):1223-1224. doi:10.1001/jamapediatrics.2020.3022

In Reply In response to our article “Association of Early-Life Social and Digital Media Experiences With Development of Autism Spectrum Disorder–Like Symptoms,”1 we greatly appreciate the comments of Alper and encourage further discussion regarding the need to improve research on screen media and autism. In our study, we analyzed existing data from the National Children’s Study, finding a significant association between screen viewing at age 12 months and later autism spectrum disorder (ASD)–like symptoms. In addition, the 18 months’ screen viewing outcome of 4 hours a day or more vs 3 hours a day or less, while not statistically significant (P = .054), showed a point estimate of 10% higher ASD-like symptoms. We noted several limitations of our study based on the available data set and urged the need for further research that includes an ASD diagnosis and data on types and timing of screen exposure starting from birth. In addition, we provided E-values (eTable 3 in the Supplement) to estimate the minimum strength of association that an unmeasured confounder would need to have with each significant predictor to nullify its observed association with the ASD-related outcome.

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1 Comment for this article
Teach Students About Autism Spectrum Disorder
Frank Sterle |
There should be an inclusion in standard high school curriculum a child development course which in part would teach about autistic spectrum disorder.

It would explain to students how, among other aspects of the condition, how ASD people, including higher functioning autistics, are often deemed willfully ‘difficult’ and socially incongruent, when such behavior is really not a choice.

It might even spare some student, somewhere, from getting bullied.