I first heard about the study linking TV watching to attention-deficit (hyperactivity) disorder while, fittingly enough, watching TV. "Very scary," Katie Couric called it on NBC's "Today." Indeed. Something sank in my chest as Couric and a psychologist (not one involved in the research) discussed the implication that television can "rewire" the brains of young children and cause them to develop ADHD.
My first thought was, "Oh my God, I bet I've wrecked my kids."
My second thought was, "Oh my God, I bet they're confusing correlation with causation again."
Or so I assumed.
The study itself, reported last month in the journal Pediatrics, hardly offers smoking-gun evidence that television causes brain damage. Researchers at the Children's Hospital and Regional Medical Center in Seattle examined massive, government-sponsored health surveys of more than a thousand children, conducted over the past 25 years, which asked parents (among other things) about their children's TV-viewing habits at ages 1 and 3, and then, four years later, whether their children were impulsive, obsessive, restless, easily confused or had difficulty concentrating. Turned out the more TV the kids reportedly watched as preschoolers, the more often they were described as having those behavioral problems at 7.
It's a finding worth looking into, no doubt, though it offers little reason to fear that a child who can sing the "Barney" song in nursery school will be on Ritalin by second grade. But that's the impression you might get from the newspapers and broadcasts. The media were not content to announce merely that an activity enjoyed in 98 percent of American homes, according to the Census Bureau, has been associated with a neurobiological disorder. Instead, when they reported on the study during the first week of April, they took the concept an alarming step further.
"Frequent TV-watching shortens kids' attention spans," blared a USA Today headline. "Researchers have found that every hour preschoolers watch television each day boosts their chances -- by about 10 percent -- of developing attention-deficit problems later in life," an Associated Press story warned. Boston Globe columnist Derrick Z. Jackson compared television to crack cocaine and equated its use with criminal child neglect, "now that we know that the passive babysitter we let into the house turned out to be a drug dealer, altering the brain perhaps even more permanently than a bag of dope."
Actually, we don't know that at all.
Even the study's authors, led by head researcher Dimitri A. Christakis, caution against drawing firm conclusions, though they do hypothesize along those lines. (And a press release issued by Children's Hospital and Regional Medical Center sounded decisive: "The study adds inattention to the list of harmful consequences of excessive television viewing ...") ADHD experts I contacted agreed that the media blew the findings out of proportion. Some also questioned details of the study's design, though they differed on how much responsibility for the hyperbole belongs to its authors.
"I would say, based on the results of this study, that it would be worthwhile to look at this further. But I don't think this study can allow one to say, for example, that there's no safe level of TV viewing," said Linda Pfiffner, who directs a clinic for hyperactivity, attention and learning problems at the Langley Porter Psychiatric Hospital in San Francisco. "What parents need to understand is that most kids watch TV and most of them do not develop attention problems."
"It's easy to take a simplistic view of this study and draw some causal conclusion," said Jeff Epstein, director of Duke University Medical Center's ADHD program. "There are a lot of variables that could account for the relationship."
Much of the media confusion seems to stem from a common error of logic: the faulty assumption that a correlation (in which levels of one thing, like TV, rise and fall in proportion to levels of another thing, like attention problems) means that the first thing causes the second.
Research on children is particularly vulnerable to this sort of misreading, said David B. Cohen, a psychologist and author of "Stranger in the Nest: Do Parents Really Shape Their Child's Personality, Intelligence or Character?" partly because the interaction of genes and environment is so complicated. According to Cohen (based on research on twins and adopted children), correlations between kids' traits and their home environment are often not the result of their parents' behavior -- contrary to conventional wisdom and the parenting-advice industry -- but of inherited traits and other factors. In efforts to explain the connection between TV watching and attention problems, Cohen said, these other potential influences shouldn't be overlooked.
The Seattle researchers' method was valuable, ADHD experts noted, because it involved lots of kids observed over a long time. But because they were working with completed surveys, the researchers themselves acknowledged, they couldn't control what information was gathered. They didn't know, for example, whether the kids in the study spent their time watching "Sesame Street" or "Celebrities Uncensored." They had to take parents' word on both the children's behavior and their viewing habits (would a 1-year-old really sit still for five hours, Pfiffner wondered, riveted by a screen?). They didn't even know how many of the children actually had ADHD (the handful of behavioral problems they measured, Epstein pointed out, falls far short of an ADHD diagnosis). And although they attempted to adjust the figures to account for various aspects of the kids' home environments (emotional support, maternal self-esteem, etc.) they were limited to the available data and could not eliminate all other factors that might have affected the results.
To do that, you'd have to take a random bunch of kids, randomly assign them to watch TV or not, and see what happens. That's a complicated and expensive experiment -- though one that, in light of these findings, might now attract funding, said lead researcher Christakis.
Christakis and his colleagues' results are "by no means definitive," he acknowledged in an interview. "But one has to keep in mind that it's a very important finding, particularly because it does have some biological plausibility."
He's referring to experiments done on rats in the 1980s, indicating that unusual types of visual stimulation can alter the physical structure of young animals' brains. Christakis and his fellow researchers hypothesized that early exposure to fast-moving television images might do something similar to children. If so, they speculated, those structural changes might contribute to attention problems.
But other factors also could explain the correlation they found -- genes, for example. Scientists already know that ADHD is highly heritable. Parents who have it pass it on to their children; suppose those parents also are more likely to keep the TV turned on. The Seattle researchers couldn't rule that out.
"That was my first reaction when I was hearing about this study: They didn't measure ADHD in the parents," Pfiffner said.
Another possibility is that the cause and effect might work in the other direction. Maybe ADHD "causes" TV viewing -- that is, maybe small children with attention or hyperactivity problems are inclined (or allowed) to watch more television.
"ADHD kids can't sit quietly ... maybe the parents just give in and say, 'OK, here's the TV, do what you want,'" Cohen said.
The study's authors wave away this interpretation, arguing that 1- and 3-year-olds are too young to display symptoms. But other experts weren't as quick to dismiss the idea that toddlers with ADHD could be more active and restless than their peers, even before their encounter with the rigid expectations of a classroom leads to a formal diagnosis.
"I don't find the rationale compelling that they're capturing kids before their risk has been established," Pfiffner said.
Neither do I. My own two sons, now 8 and 9, do not have ADHD. But from their earliest years, the boys have been so extraordinarily rambunctious that life sometimes resembles one giant Halloween party. Early on, I developed a grudging appreciation for that smarmy purple dinosaur -- or for any screen character who would keep them occupied long enough for me to get dinner prepared, the newspaper skimmed or a phone call made without having to wonder if the living-room curtains were being yanked off their rods.
Not that I was thrilled about relying on the dreaded "electronic babysitter." I once read a column by a mom who banned TV and boasted about her nonviolent, imaginative, nonmaterialistic kids. Her words echoed accusingly in my skull whenever one of my sons would grab a handful of the other's cheek and twist, or when they'd beg in the store for some new toy or candy they mysteriously knew all about. Exhausted, I would wonder how to turn them into the sort of kids who like to sit peacefully playing with blocks.
Eventually, I realized that I might as well have wished to change the color of their eyes (and, still later, understood that I didn't really want to fundamentally alter their personalities, anyway). Not long ago, author Daphne de Marneffe mentioned in a Salon interview that her children were so naturally easygoing that she could read whole novels while they played quietly at her feet. "A lot of how children are is temperament, a built-in thing," explained de Marneffe, a psychologist.
While my family's story doesn't prove anything, the experiences of other parents I spoke with don't necessarily support the research findings, either.
"My child was so hyperactive, he couldn't even watch TV until he went on medication," said Adrienne Nelson, who leads an ADHD support group in Chicago and whose son is now 17. She said she didn't believe what she heard about the study - especially because Nelson, 59, has the disorder herself. "For the first few years of my life, we didn't have a TV. And I was hyper and distracted. How do you explain that?"
Karran Harper Royal, 40, is skeptical about the study, too. Her 17-year-old was diagnosed with ADHD years ago, and her 8-year-old has shown signs of it and is being evaluated. But neither boy has ever watched much television. The New Orleans mother sharply restricted their viewing for reasons of her own.
"TV makes them relate too much to the television world instead of the real world," she said. "And I wanted my kids to be in the real world."
But some parents have trouble shrugging off what people in lab coats say. Having heard about the study, they may be morosely shouldering responsibility for their children's attention disorders. Like the "refrigerator mothers" who were blamed for their children's autism 50 years ago (incorrectly, it later developed), parents of children with developmental problems have often found themselves on the accusing end of psychologists' collective pointing finger.
"The media puts us, parents with ADHD children, in a very negative light," read a posting on a message board for parents of kids with learning problems. "I am sure we'll be asked how much TV our kids watch, once someone knows that they have ADHD." A parent on another site moans, "I have grandparents now yelling at me saying I caused the (ADHD)."
Even parents whose kids don't have attention disorders may wonder whether there's reason for concern. Rewiring brains sounds awfully scary -- what if all of the effects aren't immediately obvious? Some mothers and fathers might begin to question whether every C might, without TV, have been a B or an A. But Alison Gopnik, a psychologist and coauthor of "The Scientist in the Crib: What Early Learning Tells Us About the Mind," warns that child development is way too complicated to reduce to a checklist of practices that determine whether a baby will "turn out fine ... or be messed up."
Still, Gopnik doesn't see much harm in a little parental guilt. "Being a parent is the most profound moral responsibility anybody has. If you didn't feel guilty 90 percent of the time, you wouldn't be a moral person."
These days, though, few parents complain of a shortage of things to worry about. Peter N. Stearns, author of "Anxious Parents: A History of Modern Childrearing in America," says decades of alarming news stories and overblown research findings have sapped some of the joy out of family life.
"The experts are undoubtedly well-meaning -- and also trying to get attention and funding," said Stearns, provost of George Mason University. "But the accumulation makes it very hard for parents to feel confident about what they're doing."
My questions about the new study's findings are not intended as a defense of television, or an argument that it's good for kids: For all I know, the idiot box is justly nicknamed. One can certainly imagine healthier pastimes for small children, activities that engage them in the three-dimensional world of human interaction and physical activity and all five senses. And sure, it's worth asking just what effect that flickering blue screen is having on malleable young minds. After all, that obnoxious purple dinosaur wasn't around during the millennia in which humankind did most of its evolving.
On the other hand, the record doesn't indicate how many of those Pleistocene-era parents emerged with their sanity -- and their living-room curtains -- intact.
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