• Collaborative

Screen misuse in children with Autism Spectrum Disorder and/or intellectual disability

Cecile Testud, Mathilde Canavesio (educators), Dr. Anna Maruani (child psychiatrist)

Center of Excellence for Neurodevelopmental Disorders in Ile de France, Robert Debré Hospital, Paris

What is screen time? Screen time refers to the time spent watching television or movies, playing games on portable devices, such as phones, computers, or game consoles. A distinction is generally made between the use of screens for entertainment and the use for educational purposes.

An increase in screen time is inevitable during confinement:

○ Do not feel guilty!

○ Remember that good habits will resume later

○ Screens can be an important reinforcer or a motivation to set up other activities

○ Television, videos can also provide parents and children with a common language (subject for discussion and exchange, work support)

★ How to rationalize the use of screens

○ Use them as a reinforce or a reward after activities that require more efforts

○ Suggest varied content (applications, cartoons, consoles, etc.)

○ Suggest educational applications promoting skills stimulation in a fun way

○ Limit their recurrence and duration visually with a timer

★ Tools that can be useful for better “managing” screen time:

Playing video games or using screens could be a source of conflicts and difficulty to maintain the framework. Here are some ideas to better manage screen time:

Timer: It may be useful to resort to a visual aid such as a timer to show how much screen time your child has left.

Define the “screen” slots with your child and set a reminder before the end of the allowed time (for example, five minutes to the left, one minute to the left).

Choice chart: Develop a list of alternative activities such as a visual list of activities to choose from, after spending time on the tablet out of play time (use this list to identify the rewards for an appropriate behavior).

Eye contact before the start of the game and after the start of the game.

Reward appropriate behavior (for example, turning off the TV when the timer goes off means playing cards with a parent, doing an activity that interests the child - but don't reward with more screen time right after, and don’t “punish” by deleting it, especially in a moment when it will be difficult for you to hold).

○ Decree a “truce” where everyone “withdraws into his territory” while the tension goes down. In the event of a larger escalation, you can refer to our practical sheets “How to manage oppositional behavior and anger outbursts during confinement?”, “COVID-19 and Autism Spectrum Disorder: What to do at home during confinement?”

Example of choice chart

Example of a visual planning

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©2020 by Dr. Benjamin Landman. Child Psychiatry, Robert Debre Hospital - Paris