17 The Immediate Impact of Different Types of Television On Young Children's Executive Function

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The Immediate Impact of Different Types of Television on Young Children's

Executive Function
Angeline S. Lillard and Jennifer Peterson
Pediatrics 2011;128;644; originally published online September 12, 2011;
DOI: 10.1542/peds.2010-1919

The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/128/4/644.full.html

PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly


publication, it has been published continuously since 1948. PEDIATRICS is owned,
published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point
Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2011 by the American Academy
of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.

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The Immediate Impact of Different Types of Television
on Young Children’s Executive Function
WHAT’S KNOWN ON THIS SUBJECT: Previous study results have AUTHORS: Angeline S. Lillard, PhD, and Jennifer
suggested a longitudinal association between entertainment Peterson, BA
television and later attention problems. Department of Psychology, University of Virginia, Charlottesville,
Virginia
WHAT THIS STUDY ADDS: Using a controlled experimental KEY WORDS
design, this study found that preschool-aged children were television, preschool, executive function
significantly impaired in executive function immediately after ABBREVIATIONS
watching just 9 minutes of a popular fast-paced television show EF—executive function
relative to after watching educational television or drawing. HTKS—head toes knees shoulders
Dr Lillard conceived of the essential study; Ms Peterson and Dr
Lillard developed the methods together; under Dr Lillard’s
guidance, Ms Peterson conducted the study and coded and
entered data; both authors contributed to data analysis; and Dr

abstract Lillard wrote the text, and Ms Peterson reviewed it.


www.pediatrics.org/cgi/doi/10.1542/peds.2010-1919
OBJECTIVE: The goal of this research was to study whether a fast- doi:10.1542/peds.2010-1919
paced television show immediately influences preschool-aged chil- Accepted for publication May 31, 2011
dren’s executive function (eg, self-regulation, working memory). Address correspondence to Angeline S. Lillard, PhD, Department
METHODS: Sixty 4-year-olds were randomly assigned to watch a fast- of Psychology, University of Virginia, PO Box 400400,
Charlottesville, VA 22904. E-mail: [email protected]
paced television cartoon or an educational cartoon or draw for 9 min-
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
utes. They were then given 4 tasks tapping executive function, including
Copyright © 2011 by the American Academy of Pediatrics
the classic delay-of-gratification and Tower of Hanoi tasks. Parents
completed surveys regarding television viewing and child’s attention. FINANCIAL DISCLOSURE: The authors have indicated they have
no financial relationships relevant to this article to disclose.
RESULTS: Children who watched the fast-paced television cartoon per- COMPANION PAPER: A companion to this article can be found on
formed significantly worse on the executive function tasks than chil- page 772, and online at www.pediatrics.org/cgi/doi/10.1542/
dren in the other 2 groups when controlling for child attention, age, peds.2011-2071.

and television exposure.


CONCLUSIONS: Just 9 minutes of viewing a fast-paced television car-
toon had immediate negative effects on 4-year-olds’ executive function.
Parents should be aware that fast-paced television shows could at
least temporarily impair young children’s executive function.
Pediatrics 2011;128:644–649

644 LILLARD and PETERSON


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ARTICLES

Preschool-aged children watch ⬎90 engaging in a self-paced activity such abilities,28 theoretically because it taps
minutes of television daily,1 and corre- as drawing. “hot” or emotional decision-making.29
lational studies link early television There is a limited amount of literature In this study, one-half of the subjects
viewing with deficits in executive func- on the immediate impact of television were tested by experimenters blind to
tion (EF),2–7 a collection of prefrontal8 show pacing on children’s attention or the subject’s study group. It is unusual
skills underlying goal-directed behav- other aspects of EF. One study found to use blind experimenters in basic
ior, including attention, working mem- that a fast-paced show led to less task cognitive development research, but
ory, inhibitory control, problem solv- persistence than a slow-paced one.22 we did so out of concern that exper-
ing, self-regulation, and delay of However, posttesting was conducted imenters might intuitively expect
gratification.9–12 EF is increasingly rec- in a large group setting in which the fast-paced television to influence
ognized as key to positive social13 and behavior of a few individuals might children’s performance. Studies of
cognitive 14 functioning and is strongly have affected others. Another study the impact of pretend play, generally
associated with success in school.15–17 suggested fast pacing is not problem- presumed to be positive,30,31 on chil-
atic: watching fast- versus slow-paced dren’s cognitive functioning show ex-
If television has long-term effects on
episodes of Sesame Street had no im- perimenter bias influences results in
EF, then one might see small short-
pact on task persistence or impulsivity that domain: when experimenters
term effects; even adults report feeling
in later free play.23 It should be noted were blinded, positive results went
less alert immediately after watching
that Sesame Street is even faster- away.32–34 As a precaution and to exam-
television.18 Most research on televi- paced today than it was 30 years ago24 ine whether blind experimenters are
sion has focused on attention, one when that study was conducted; it is important in this domain, we tested
of many EF processes. Entertainment possible that even the fast-paced clip one-half of the children with a blind ex-
television is particularly associated created for the 1977 study was not as perimenter and compared results un-
with long-term attention problems19; fast-paced as today’s television shows. der the 2 conditions.
thus, its viewing might be most likely to
Task persistence is only one outcome
have negative short-term impacts. METHODS
of high EF. Young children’s EF has
Within the realm of entertainment tele- been assessed by many tasks tapping Sixty 4-year-olds (Table 1) were re-
vision, fast-paced shows seem particu- its various aspects. Performance on cruited from a database of families
larly likely to have a negative impact on these tasks is often found to be inter- willing to participate in research. Most
attention, one reason for this being correlated,14,25 and it is also correlated of the children were white and from
that rapidly presented events capture with parent and teacher assessments middle- to upper-middle-class fami-
attention in a bottom-up fashion, in- of children’s self-regulated behav- lies. Parents were telephoned and told
volving the sensory rather than pre- ior.26,27 EF was assessed here by using about the study; willing parents made
frontal cortices.20 Thus, fast-paced 4 well-known tasks: Tower of Hanoi, an appointment to come to the labora-
television would do nothing to train in- backward digit span, delay of gratifica- tory, where the study was described
ternally controlled (prefrontal) atten- tion, and head toes knees shoulders again, and parents signed a consent
tion over the long-term. In the short- (HTKS). Although delay of gratification form approved by the University of Vir-
term, the effort to encode rapidly is considered a measure of EF, espe- ginia institutional review board.
presented events could tax children’s cially of inhibitory control, it tends to Children were randomly assigned (by
executive resources. When adults are be less well correlated with the other the experimenter drawing a number
presented with televised events in
more rapid succession, more re-
sources are allocated to encoding TABLE 1 Study Factors According to Intervention Experience
those events,21 presumably depleting Characteristic Fast-Paced Television Educational Television Drawing
resources that could otherwise be Mean (SD) age, y 55.10 (3.61) 54.84 (3.72) 53.95 (3.66)
Boys, n (of 20) 12 10 10
available for other aspects of atten-
Attention baseline, mean (SD)a 1.83 (2.31) 2.16 (1.57) 2.00 (1.75)
tion. Thus, we hypothesized that watch- Television time, mean (SD), min/wk 338 (66.73) 278 (66.72) 381 (66.73)
ing a fast-paced cartoon would have an Tower of Hanoi, mean (SD) 0.15 (0.37) 0.35 (0.49) 0.70 (0.47)
HTKS, mean (SD) 19.70 (13.29) 33.20 (28.02) 30.58 (17.71)
immediate negative impact on chil- Delay of gratification, mean (SD) 146.15 (151.29) 257.20 (132.16) 242.00 (142.10)
dren’s EF relative to watching a slower- Backward digit span, mean (SD) 3.85 (2.58) 4.21 (3.19) 3.90 (4.11)
paced, realistic educational cartoon or a Assessed by using a scale of 1 to 10 (10 indicates more attention problems).

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from a bag) to 1 of 3 conditions (20 could be moved at a time, the monkeys bell or ate the snack, or after 330 sec-
children each): fast-paced television, always needed to stay on the trees onds when the experimenter returned.
educational television, or drawing. The (pegs), and the Daddy monkey (the big- The children then participated in a cre-
fast-paced television group watched a ger disk) could never go on top of the ativity task (not discussed here) be-
truncated episode of a very popular Mommy monkey (the smaller disk). fore completing the backward digit
fantastical cartoon about an animated The children were given a score of 1 if span subtest of working memory ca-
sponge that lives under the sea. The they moved the disks from the first peg pacity from the Woodcock-Johnson
educational television group watched to the third peg following all the rules. tests of cognitive abilities.37 The exper-
a truncated episode of a realistic Pub- Children who broke a rule or failed to imenter told the child, “I am going to
lic Broadcasting Service cartoon about complete the task were given a score say some numbers and I want you to
a typical US preschool-aged boy. Free of 0. say them backwards; for example if
drawing with markers and crayons Next children were given the HTKS I say 3,4 then you say 4,3. Now you say
was the control condition. All children task,27 in which the experimenter told the numbers backwards.” The experi-
completed the study. children, “When I say touch your head, menter then gave practice items with
To quantify pacing, the 2 television ep- I want you to touch your toes, but when feedback; once children got 1 correct
isodes were viewed for the number of I say touch your toes, I want you to or after 4 practice items maximum,
times a complete scene change oc- touch your head.” After brief training, they moved on to 15 test items until
curred (eg, from swimming pool to 10 test items were presented. Children they got 3 consecutive items wrong.
bedroom). For the fast-paced show, received 2 points for every correct re- Children received 1 point for each cor-
the scene completely changed on aver- sponse, 1 point for every response that rect answer and could receive up to 15
age every 11 seconds; even within the was initially wrong but corrected (eg, points. A Sony Camcorder (Sony Elec-
scene, characters were almost con- they touched their head then touched tronics, San Diego, CA) was used to
stantly rapidly moving through space. their toes), and 0 points for an incor- record children throughout the
The educational television show had a rect response. If children received at procedure.
complete scene change every 34 sec- least 10 points on the first 10 items, a While children were being tested, par-
onds on average. shoulders-knees rule was added and ents completed a media survey on
The experiment was conducted with 10 more items were given. Children which they indicated the number of
each child individually in a small room who received at least 14 additional minutes the child watched television
in a university laboratory. Nine-minute points on part 2 went on to part 3, and DVDs each week. They also filled
clips of the fast-paced or educational where the rules switched (eg, “Now out the Strengths and Difficulties Ques-
shows were played on an Acer note- when I say touch your head I want you tionnaire,38,39 a 25-item personality
book computer (Acer American Corpo- to touch your shoulders”). survey with 5 items related to atten-
ration, San Jose, CA) to children in the After the HTKS task, children com- tion. Items were scored 0, 1, or 2 char-
television groups. Children in the pleted a delay-of-gratification16 task. acterizing how true the statement was
drawing condition were given some First, they were shown a bag of minia- of the child. The attention-related
crayons, markers, and paper and al- ture marshmallows and a bag of Gold- items were: “restless, overactive; can-
lowed to draw for 9 minutes. Next chil- fish crackers and asked which they not stay still for long,” “easily dis-
dren were administered the EF tasks in would like to have as a snack. The ex- tracted, concentration wanders,”
a fixed order using a Latin squares perimenter put 10 pieces of the chosen “constantly fidgeting or squirming,”
design. snack on 1 plate and 2 pieces on an- “sees tasks through to the end; good
The Tower of Hanoi task35 used a base other, and placed the bell between the attention span,” and “thinks things out
with 3 long pegs and a larger and a 2 plates. Children were told that they before acting” (the latter 2 were
smaller disk that fit on the pegs, as could eat the 10 pieces if they waited reverse-scored).
well as a picture depicting a goal state. for the experimenter to return, or they
The disks were described as monkeys could ring a bell at any time to get the RESULTS
playing on a tree (the left peg), but they experimenter to come back immedi- Results (mean [SD]) of the study as-
were tired and needed to move to their ately, in which case they could only sessments are shown in Table 1.
sleeping tree (the right peg). The child have the 2 pieces. The experimenter re- Groups did not differ in attention prob-
was asked to help move the monkeys corded the time from when she left the lems at the outset, as indicated by par-
according to 3 rules36: only 1 monkey room until the child either rang the ent responses on the Strengths and

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ARTICLES

and intervention condition at the sec-


ond step, setting the drawing and ed-
ucational television conditions as
baseline. Again, the first 3 variables
made no significant contribution but
condition did (P ⫽ .006).

DISCUSSION
This study provides empirical evidence
that watching a 9-minute episode of a
fast-paced television cartoon immedi-
ately impaired young children’s EF rel-
ative to watching an educational televi-
sion show or drawing. Children in the
FIGURE 1
z scores for each task. fast-paced television group scored sig-
nificantly worse than the others de-
spite being equal in attention at the
Difficulties Questionnaire (P ⫽ .88). did significantly worse on the EF outset, as indicated by parent report.
There were also no group differences composite than the drawing group (P This result is consistent with others
in the amount of television children ⫽ .004). The difference between the showing long-term negative associa-
watched per week (P ⫽ .55), with the fast-paced and the educational tele- tions between entertainment televi-
range being 278 (educational televi- vision groups approached signifi- sion and attention.19 Given the popular-
sion) to 381 (drawing) minutes per cance (P ⫽ .05) (Fig 1), and there was ity of some fast-paced television
week. no difference between educational cartoons among young children, it is
Cronbach’s ␣ for 3 of the EF tasks television and drawing. A regression important that parents are alert to the
(Tower of Hanoi, backward digit span, analysis was performed entering the possibility of lower levels of EF in young
and HTKS) was 0.69 but dropped to 0.51 amount of television watched per children at least immediately after
when delay of gratification was in- week, attention problems, and child’s watching such shows.
cluded. Therefore, z scores for the first age at the first step, and intervention In addition to the pacing, we speculate
3 EF tasks were summed for a compos- condition at the second step, setting that the onslaught of fantastical events
ite EF score, and delay of gratification the drawing and educational television that was also present in the fast-paced
was analyzed separately. conditions as baseline. The first 3 vari- show might have further exacerbated
A first analysis of covariance assess- ables made no significant contribution EF. Whereas familiar events are en-
ment examining whether experi- to the EF composite score but condi- coded by established neural cir-
menter blindness influenced results in tion did (P ⫽ .03). cuitry,40 there is no such circuitry for
any condition, controlling for chil- Delay of gratification was analyzed new and unexpected events, which fan-
dren’s age, revealed that blindness separately and showed similar re- tastical events often are. Encoding new
had no influence on condition scores sults, with a significant main effect of events is likely to be particularly de-
(P ⫽ .83 for composite EF and .62 for intervention condition on the number pleting of cognitive resources, as ori-
delay of gratification). Thus, we are of seconds waited (P ⫽ .03, p␩2 ⫽ .12), enting responses are repeatedly en-
confident that experimenter bias did and posthoc analyses revealed that gaged in response to novel events.41
not influence results for those sub- the fast-paced television group waited Because cognitive depletion taxes self-
jects whose assessments were not run significantly less long than either the regulation,42,43 we hypothesize that the
blind. drawing group (P ⫽ .03) or the educa- fantastical aspect of the fast-paced
Combining across these groups and tional television group (P ⫽ .02), which show could also be partly responsible
using age as a covariate, there was a did not differ from each other. Another for the EF effects seen here. This hy-
significant main effect of intervention regression analysis was performed pothesis will be tested in further
on the composite EF score (P ⫽ .01, entering the amount of television research.
p␩2 ⫽ .15). Posthoc analyses revealed watched per week, attention prob- This study has several limitations.
that the fast-paced television group lems, and child’s age at the first step First, we cannot tell exactly what fea-

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tures of the fast-paced television of viewing; many children’s cartoon ep- toon that is currently the most-
cartoon created the effects. We have isodes last 11 minutes, and typically 2 watched television program among
speculated that the combination of episodes are shown in a one-half hour 2- to 11-year-olds.45
fantastical events and fast pacing programming slot. Watching a full fast-
are responsible, but further re- paced cartoon program could be more CONCLUSIONS
search systematically varying those detrimental.
features is needed. A recent study Children watch a great deal of televi-
Some strengths of the study were the
has begun this effort by replicating sion, and it has been associated with
use of a blind posttester for half of
the effect with different fast-paced the children, with results suggesting long-term attention problems. How-
and fantastical episodes and shows.44 blindness is not crucial in this domain; ever, there is little research on the im-
Second, only 4-year-olds were tested; random assignment to conditions; and mediate impact of television on EF. The
older children might not be negatively groups of children who were similar present study found that 9 minutes of
influenced by fast-paced television. at the outset in terms of weekly tele- viewing a popular fast-paced fantasti-
Third, we do not know how long the vision exposure and parental ratings cal television show immediately im-
negative effects persist or what the of attention. The use of a range of EF paired 4-year-olds’ EF, a result about
long-term effects of habitual viewing tests was also an asset, as was the which parents of young children
include. Finally, we only used 9 minutes testing of a children’s television car- should be aware.
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The Immediate Impact of Different Types of Television on Young Children's
Executive Function
Angeline S. Lillard and Jennifer Peterson
Pediatrics 2011;128;644; originally published online September 12, 2011;
DOI: 10.1542/peds.2010-1919
Updated Information & including high resolution figures, can be found at:
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