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A Pediatric Perspective

Is Smart Technology Changing Developmental Milestones?

Published February 26, 2012 11:12 AM by Cecilia Cruse

I was most intrigued by a recent study which states that up to 40% of 2-4 year olds and even 10% of babies under age one have used some type of smart phone or tablet already. The news clip included a toddler who could access and move pages on an iPad, but given a magazine the continued using the swipe method of hand movement and was unable to motor plan how to turn the pages. See the video here.  The child in this clip is stated to be a one year old so may be a tad young, but as peds therapists we all know that turning pages of a book or magazine are indicative of developmental milestones (roughly by age 2 years turning the pages 2-3 at a time, while by age 3 the toddler should be able to turn pages one at a time) and have long been used on developmental screening tests.  Certainly smart phones and tablets are great for building cognitive concepts and as part of universal design for learning, but is the point and swipe going to replace the development of good pincer grasp? What about eye muscle development and/or fatigue from doing such focused vision tasks at such an early age?  Do you think Smart Technology is going to change developmental milestones and how we evaluate them?  Let me know what you are finding in your assessments!


Such thought provoking comments from all of you! Thanks for your input. Yes as OT's I think most of know not to rely totally  on assessments, but rather what is occurring with the child's skill level in the natural environment. Also as the ever adaptive therapists that we are, I think it is smart and practical to be using some apps as part of our intervention solutions, but to still incorporate plenty of movement, deep touch pressure/heavy work and creative mediums to engage the child fully. These are interesting times to be pediatric therapists for sure!

Cecilia Cruse, MS, OTR/L March 2, 2012 4:20 PM

In response to your query: Do you think Smart Technology is going to change developmental milestones…?

Somewhat related to this question is that I have been finding an increase in referrals to screen children who are exhibiting poor writing skills. I am an OT working in a school district in a large city. I am referring to a group of children in the general school program demonstrating grade appropriate levels in reading and math. Referrals are being made by teachers and/or parents. What I have found is that a percentage of these children do indeed produce letters, numbers and shapes poorly in relation to many of their peers although they have been demonstrating adequate fine motor manipulation skills. Upon further inquiry I have found that these children in question have spent (and are spending) an inordinate amount of time and are quite skilled on computers, using  tablet devices, playing video games, etc. I find myself questioning the parents on whether the children engage or have engaged in other activities such as coloring (particularly use of a coloring book requiring staying within the lines), dot to dot, free hand drawing, etc. Not surprisingly the answer has always been “no”.  The parents often state that the children have no interest in doing that sort of thing.

I agree with the sentiments expressed in the video link you provided – that there are some truly wonderful benefits that children have growing up with today’s technology but it really needs to be balanced with other experiences.

Cecilia Manser February 27, 2012 9:06 PM

I use a mini stylus pen (about the size of a flip crayon) and have my 4 and 5 year olds do letter tracing and mazes, etc, it saves paper and in some cases is a huge motivater for kids to interact with a writing utensil and correctly form letters. There are also good games requiring quick reaction times and occular motor control. It cant replace good old fashion manipultives but i find it to be a great additional tool in my arsenal! Also kiddos on the spectrum seem to understand writing concepts on an IPAD much easier than paper based trials.

Jenny Bridges February 27, 2012 7:31 PM

I had noticed that new developmental norms were already being established before the i-pad etc.  Prior to the i-pad, I believe the combination of electronic toys, lack of unstructured outdoor play, and possibly the decrease in tummy time for infants had all combined to create different developmental norms.  I used to lament the fact that children appeared to be developing more slowly but now I realize that I am probably missing increased skills in other areas.  All in all, I believe that new developmental norms are developing.  I caught myself thinking that these new norms should be gathered but then I realized that norms actually serve to exclude people.  Maybe occupational therapists need to stop assessing children by comparing them to norms.  Instead let's challenge ourselves to ask them and their families, what they need. How can I assist you to get and do and be what you want and need to get, do, and be? A participation and occupation focus can help us to do this but I don't claim that it is easy.  We are surrounded by pressures to conform to the norm.  Please comment or e-mail me if you have a different (or similiar) perspective and want to talk more.

Sheila Hamilton February 27, 2012 10:47 AM

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