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Journal Issue: Children and Electronic Media Volume 18 Number 1 Spring 2008

Media and Attention, Cognition, and School Achievement
Authors: Marie Evans Schmidt Elizabeth A. Vandewater

Electronic Media and Attention

One growing popular concern is whether electronic media use is associated with attention deficit hyperactivity disorder (ADHD). Children warrant diagnosis of ADHD if they exhibit inattention, hyperactivity, or impulsivity that significantly impairs social or academic functioning for at least six months.50 According to parents, television viewing captures the attention of children with ADHD for extended periods of time and is one of the few activities capable of doing so.51 Given the widespread speculation about links between electronic media use and ADHD, it is surprising how little researchers know about the subject.52 Correlational work suggests a possible link, albeit a small one; the work does not answer the question of whether children with ADHD simply use electronic media differently than children without ADHD. The evidence for a link between ADHD and electronic media use is thus, at this stage, inconsistent.

To date, only a few studies have compared media use in children with a confirmed clinical diagnosis of ADHD and media use in children without ADHD. Richard Milich and Elizabeth Lorch found no significant differences in time spent watching television or in types of TV content viewed among boys, aged seven to twelve, with and without ADHD.53

More recently, Ignacio David Acevado-Polakovich and several colleagues, in a cross -sectional study, found greater TV viewing among school-aged children with a diagnosis of ADHD. But the link disappeared when the authors specifically controlled for the mother's education level (lower in children with ADHD) and whether the child had a TV in his or her bedroom. School-aged children with ADHD were two times more likely to have a TV in their bedroom; thus, they potentially had greater access to TV, which could account for their heavier TV use. However, children with ADHD who did not have television sets in their bedrooms did watch more TV than children without ADHD who had no television in their bedrooms. Children with ADHD also were significantly more involved with TV, as measured by parental report.54

Acevado-Polakovich and colleagues conclude that any link that may exist between television viewing and ADHD is complex. School-aged children with ADHD may be more involved with TV because it may serve as a substitute for social interaction, and children with ADHD are more likely to experience peer rejection. Further, the authors found that children with ADHD are more likely to watch TV with an adult, perhaps in part because, by parental report, TV viewing is a comparatively low- conflict, low-stress activity for them to do with their children. All these factors could account for increased TV viewing among children with ADHD.55

Analysts have also conducted research on attention problems, as distinct from clinical disorders. Jeffrey Johnson and several colleagues, in a prospective longitudinal study, found a weak to moderate association (odds ratio = 1.44) between television viewing at age fourteen and attention problems (as assessed by the Diagnostic Interview Schedule for Children) at age sixteen. This link remained when the authors controlled for relevant child and family variables, including parent income and education, presence of childhood neglect, and learning or attention difficulties at baseline. Youth who watched three or more hours of television a day were at greatest risk for subsequent attention problems. Notably, the authors did not find evidence that attention problems at age fourteen predicted subsequent television viewing at sixteen years of age.56

A few cross-sectional studies have also examined the link between attention problems and television viewing. One study found that TV viewing and attention problems, as assessed by the Child Behavior Checklist (CBCL), were related (r = .20) among second- and third-grade children in Turkey. Children who watched TV less than two hours a day scored lower on the attention problems subscale of the CBCL than children who watched TV two or more hours a day.57

Another study found a positive link between fourth- and fifth-grade students' television viewing and teacher ratings of attention problems and impulsivity, as assessed by the Attention and Hyperactivity subscales of the ADD-H Comprehensive Teachers Rating Scale (r = -.4). The study, however, found no link between TV viewing and parent ratings of attention problems or impulsivity, a laboratory measure of attention (the Stroop Color and Word Test), or classroom observation. Further, the type of program viewed was not differentially linked with attention outcomes. Television viewing predicted less classroom attention during independent work periods.58

Very few studies have examined links between electronic media other than TV and attention. One cross-sectional study surveyed seventy-two adolescents (time use) and their parents to assess ADHD, as indicated by the Conner's Parent Rating Scale (CPRS), and found a significant association between playing video games for more than one hour each day and an increase in scores on the inattention and ADHD portions of the CPRS. There was no association between time spent watching television or using the Internet and ADHD symptoms. Because the authors did not test for the direction of the link, it is plausible that adolescents with ADHD simply spend more time playing video games.59

Interestingly, video games may provide optimal learning conditions for children with ADHD. Some studies rely on computer game tasks for laboratory tests of children with ADHD, because they are thought to promote the best possible test performance in this population.60 Why is this so? In particular, video games offer immediate feedback, which is highly motivating for children with ADHD. External rewards are almost continuous during game play, but especially just before and contingent to any of the child's responses to the game.61 Also, video games increase activation and arousal, which may improve task performance. Matthias Koepp and several colleagues have demonstrated that video games effectively stimulate the neural reward system by causing the brain to release dopamine, which is associated with learning and positive reinforcement.62