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A Population-Based Study

Dimitri A. Christakis, MD, MPH; Jill Gilkerson, PhD; Jeffrey A. Richards, MA; Frederick J. Zimmerman, PhD; Michelle M. Garrison, PhD; Dongxin Xu, PhD; Sharmistha Gray, PhD; Umit Yapanel, PhD

Arch Pediatr Adolesc Med. 2009;163(6):554-558.

Objective  To test the hypothesis that audible television is associated with decreased parent and child interactions.

Design  Prospective, population-based observational study.

Setting  Community.

Participants  Three hundred twenty-nine 2- to 48-month-old children.

Main Exposures  Audible television. Children wore a digital recorder on random days for up to 24 months. A software program incorporating automatic speech-identification technology processed the recorded file to analyze the sounds the children were exposed to and the sounds they made. Conditional linear regression was used to determine the association between audible television and the outcomes of interest.

Outcome Measures  Adult word counts, child vocalizations, and child conversational turns.

Results  Each hour of audible television was associated with significant reductions in age-adjusted z scores for child vocalizations (linear regression coefficient, –0.26; 95% confidence interval [CI], –0.29 to –0.22), vocalization duration (linear regression coefficient, –0.24; 95% CI, –0.27 to –0.20), and conversational turns (linear regression coefficient, –0.22; 95% CI, –0.25 to –0.19). There were also significant reductions in adult female (linear regression coefficient, –636; 95% CI, –812 to –460) and adult male (linear regression coefficient, –134; 95% CI, –263 to –5) word count.

Conclusions  Audible television is associated with decreased exposure to discernible human adult speech and decreased child vocalizations. These results may explain the association between infant television exposure and delayed language development.

Author Affiliations: Center for Child Health, Behavior and Development; and Department of Health Services, University of Washington (Dr Christakis); Seattle Children's Research Institute (Drs Christakis, Zimmerman, and Garrison), Seattle, Washington; and LENA Foundation, Boulder, Colorado (Drs Gilkerson, Xu, Gray, and Yapanel, and Mr Richards).

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