Is There an App for That?

Written by Sarah Midgett, Speech-Language Pathologist, Mecklenburg County CDSA

Technology.  It is all around us.  Our world is rapidly becoming pixilated and industrialized, online and plugged in.  School systems are issuing iPads and tablets to help children learn and have access to information.  Nowadays, technology is evolving faster than we could have ever dreamed.  “Smart” phones are now the norm, making the old flip phones seem antiquated by comparison.  And our children are becoming increasingly tech-savvy.  They learn to navigate a tablet or smartphone interface often before they learn to talk.  But is that a good thing, really?  Disclaimer: I do own an iPhone.  And my husband would say that I’m “in it” way too much.  But what happens when our children (and I’m talking about tiny little people, less than three years old) are “in it” too much?  When is a good time to use the iPad, and when is it potentially destructive?

The American Academy of Pediatrics (AAP) has released several position statements on the use of screens, or “screen time,” with children.  Two years ago, the position was that children should have NO screen time prior to age two.  And after that, screen time should be limited to 1-2 hours a day.  Numerous studies have shown that too much screen time can increase the risk for obesity, cause disruptions in sleep, and increase the chance for attention problems, hyperactivity or depression.  On October 28, 2013, the AAP revised its position to recommend a “balanced” media diet, rather than blanket bans on all technology.  They still cautioned, however, that plunking a baby in front of an iPad loaded with “educational” apps is no substitute for true face-to-face interaction.

I’m a Speech-Language Pathologist.  My job is centered around face-to-face interaction and communication, so I’ve watched this rise of cyber communication with a certain amount of bemusement.  I appreciate what technology has done and continues to do for us as a society.  We are able to find answers to questions at lightning-fast speed.  We can connect with people we haven’t seen in years.  We can see our family from across the country as we Skype with them.  These are all great things.  But when is technology not such a great thing?  Any minute that a young child spends navigating an iPad app is a minute NOT spent….

• playing a tickle game and laughing with caregivers;
• sharing a book, pointing to and naming pictures together;
• playing with cars, crashing them, making sounds, driving them to pretend gas stations and stores;
• playing dress up, practicing putting on hats and sunglasses, talking with funny voices;
• playing with baby dolls, putting the baby to bed, feeding it, dressing it;
• pretending to be animals, robots, dinosaurs;
• decorating a cardboard box and turning it into a play house; or
• going outside, running, playing, yelling.

If a family is asking about the use of an iPad with their child, early interventionists can take this opportunity to help families understand that these “no-tech” activities mentioned above are all wonderful, language-rich activities that engage young children and encourage them to talk, learn vocabulary, and follow directions.  When children interact with a real live human being, they are challenged in different ways than they are with iPad apps.  Sure, maybe the iPad apps help them work on shapes, colors, visual motor skills, etc., but they don’t provide ways to practice functional communication with another human being.  iPads may be able to talk back to them, but can they really listen?

Everybody with me so far?  Good.  Now, I’m about to say something that may be controversial:  If using the iPad is a mostly solitary act, involving one person (or child) interacting with a screen, how is this activity appropriate in a speech therapy session with young children?  Children with language delays, PARTICULARLY children on the autism spectrum, need help learning to communicate.  They need to learn to tell others what they want or need.  They need to learn the nuances of conversation, reading body language and non-verbal cues, and responding appropriately to others.  What better way to work on that than with real life experiences?  Even if there are great apps out there, and I’m sure there are, the iPad is effectively cutting out a real person as a communicative partner and putting a child in front of a screen.   Children with autism love a screen and respond well to it, but that doesn’t help them address the areas that are challenging for them.

Setting aside all the arguments about how screen time is no substitute for face-to-face communication, what if you are working with a family who does not own an iPad?  Does it make sense to bring out an iPad during a visit, use it with the child for an hour, and then leave with your iPad?  There’s not a great chance that the family will be able to carry over anything into their routines if an iPad isn’t part of their routines to begin with, and I think you’ll find the answer is “no.”  What if you have a family who does own an iPad and wants to incorporate it into their daily routines?  That’s a little different, but I still caution you and your families to use the iPad sparingly, maybe as a special activity and for a limited time.  It’s still a screen after all, and an app is not greater than interactions with Mommy, Daddy, or other family members and caregivers.

But what if your family is insistent?  What if they swear the iPad is truly the greatest thing since sliced bread and the magic cure-all for their child’s speech and social interaction issues?  How can we gently lead them to unplug?  It can be a tricky thing, indeed.  Here are some tips:

• Active questioning about iPad use is extremely beneficial.  Have parents talk out loud about what benefits and drawbacks they see, and really guide them to come up with conclusions on their own about the screens in their lives and whether those screens are really helping their child develop conversational skills and reciprocal interaction.
• Find out what is important to the family.  Is it important to them that their child be able to navigate an iPad, find the kid-friendly apps, and entertain himself while adults prepare dinner or complete other chores, or is it important for their child to call them “Mama” or “Daddy?”  Is it important that their child can use a touch screen to match shapes or put together virtual puzzles, or is important for their child to sit at the table and tell them about their day?  With a little perspective, parents may come to a very different conclusion about the iPad’s benefits. 
• Have them do little experiments.  If a child’s attention is good for an iPad, it should also be good for a book, right?  If it’s not, then what’s wrong here?  What is so much more interesting about iPads, and why is attention so much worse for story time?  Getting a child’s attention with an iPad is a false sense of attention.  It’s not real.  We need to coach our parents to help children listen, regulate and be happy, all while not using a device.

We can win the battle of man vs. machine.  It is possible, and it is necessary.  It just requires a little work, a little honest conversation, and a true attempt to get back to the basics…face-to-face communication!  We want to hear from you – what do you think about this?