42-15672052Guest Writer: Ben Wahl, MSW, is the program director of Aspiring Youth Program, www.aspiringyouth.net

Do children and adolescents with Autism Spectrum Disorder (ASD) spend more time on video games and computers than their peers? According to researcher Dr. Paul Shattuck, the answer is ‘yes’.

Dr. Shattuck, of Washington University in St. Louis, sampled 1,000 study participants who had ASD and found that 41% indicated a level of screen time that would qualify as ‘high user’. The results of the study are telling: “Given that only 18 percent of youths in the general population are considered to be high users of video games, it seems reasonable to infer based on the current results, that kids with ASDs are at significantly greater risk of high use of this media than are youths without ASDs” (Shattuck, 2012).

We can certainly infer why children with ASD would have a higher proclivity towards video games and TV than their peers. There is a repetitive and predictable interface. It is also highly customizable to interest; if a young person has an interest in historical trains, there are thousands of You Tube clips to peruse. Again and again and again. In addition, digital media produces visual and auditory engagement and stimulates neural pathways. For many children and adolescents with ASD, those neural pathways are not always stimulated by face-to-face interaction. In fact, face-to-face interaction can often produce anxiety for these young people. Digital media is therefore a safe and predictable place to engage. Many of my adolescent clients have indicated to me that while they do not have any friends in their school, they do have a lot of online friends.

As a community of professionals and providers, what is our response? Many have speculated that digital media should be embraced as a treatment tool or a behavior incentive for those with ASD. The thinking is that if it engages young people in this population so well, we should use it. This approach makes sense for those who are more profoundly impacted by Autism. Electronic devices have given voice to countless individuals who otherwise would experience verbal isolation.

For others on the spectrum, the embrace of digital media as a treatment tool is misguided. Simply stated, screen time should never be used as a behavior incentive. It is an approach that does not work for neuro-typical peers, why would it work for our client population? I have spoken to my colleagues about this issue for years and there is widespread agreement that screen time should be consistent and should not be tied to behavior. It is very easy to incentivize behavior with screen time access, but unfortunately it creates a false reward system. The intrinsic pride of achieving a good academic grade is more important than any concrete reward (i.e., screen time) a student might earn. This client population will need more assistance in building internal motivation than their peers. The use of digital media as a treatment tool or behavior incentive is a hindrance to their growth and maturation.

As screen time is so alluring, parents need to take concrete steps to create limits and structure. Below are some strategies for managing screen time access for young people with ASD (these strategies are equally relevant to their neuro-typical peers). 

  1.  Parents should set a weekday hour limit and a weekend hour limit. There should not be more than 3 hours per day of screen time exposure. Sadly, families will be swimming upstream by setting limits, as the national average of screen time exposure for children ages 8-18 is 7.5 hours per day according to a 2010 Kasier Family Foundation study.
  2. Parents need to role-model appropriate technology use. We have seen parents create home rules that prohibit cell phone use at the dinner table or at certain hours of the evening. Children and teens watch us and we have to demonstrate appropriate limits on our own use. By being good role models, we may even find that it creates a healthier digital balance in our own lives.
  3. Parents need to add external structure to afternoons and evenings. Young people with ASD will need more external structure than their peers. They will also benefit greatly from increased real-time social interaction. Parents have been very creative, from building small playgroups to signing up for Akido to Lego Robotics clubs. It is about replacing screen time with something else that is compelling.
  4. Parents should set consistent screen time limits and not change access privileges regularly. One parent I know increases screen time access once per year. If access fluctuates with grades and behavior, it becomes too difficult to track and it becomes the constant source of conversation between parent and child.
  5. Parents should structure computer time in designated time slots. Computer access from 7 to 9 p.m. will work much better than simply saying “you have 2 hours of access each afternoon”. It prevents power struggles and means that parents won’t have to micro-manage.
  6. Parents should monitor social media closely and should have access to account passwords. Young people with ASD are likely to learn social media later than their peers. They also may lack social nuance awareness that puts them at risk for problematic online interactions, including cyber-bullying.
  7. Parents should give a ten minute warning prior to ending screen time. At the point at which screen time access is over, parents should use clear and calm communication and should avoid negotiating over additional screen time.
  8. Parents should avoid demonizing digital technology. With open conversation, parents can establish limits and boundaries for screen time, without creating an adversarial interaction. Digital media is very engaging, there is no denying it. As adults, we can respect digital media while still respecting our boundaries.

Digital media is compelling and very pervasive, but it demands our respect and a concrete approach. As a new dad, I am certain that I will fail to heed some of my own strategies. But that doesn’t mean I shouldn’t try.