Video Games Join TV in Link to Attention Problems

Playing video games may join television viewing as an activity that can cause attention problems in children and young adults, according to recent research.

A study in the July 5 online edition of Pediatrics examined potential associations between television and video-game exposure in children and development of attention problems. The research, which aimed to build on previous studies that have found associations between television viewing and subsequent attention problems, concluded that a similar association between video games and attention problems exists in late adolescence and early adulthood.

The longitudinal study of 1,323 adolescent subjects paired parent- and child-reported television and video-game use over a 13-month period with attention problems reported by teachers. In addition, another sample of 210 late-adolescent and young-adult participants provided self-reports of television exposure, video-game use, and attention problems.

The study authors, led by Edward Swing, a psychology doctoral student at Iowa State University, found that exposure to either television or video games was associated with greater attention problems, especially when the adolescents engaged in more than the maximum two hours of daily television viewing or video-game playing recommended by the American Academy of Pediatrics. The link between exposure to the entertainment systems and attention problems in the adolescents remained even when researchers statistically controlled for earlier attention problems and gender. The link was similar for both video games and television use, regardless of whether the subject was an adolescent or a young adult.

The attention problems were assessed using a three-question, five-point scale in the children and the Adult ADHD Self-Report Scale—an ADHD screening tool—in the young adults. The authors defended the validity of the measuring tool used in the children based on its findings mirroring the outcomes among the adults measured with the established screening tool. No patients were examined for an ADHD diagnosis.

The findings led the researchers to urge that future attention-deficit studies include video-game use in addition to television exposure, which has been the more commonly studied factor.

Critics Find Fault With Study

The Iowa State study was challenged, however, by at least two other researchers, T. Atilla Ceranoglu, M.D., a psychiatrist at Harvard Medical School, and Christopher Ferguson, Ph.D., an associate professor at Texas A&M International University.

In a letter to Pediatrics, Ceranoglu and Ferguson criticized the “limitations and omissions in the methodology and conclusions” of the Iowa State study. Specifically, they criticized the lack of clinically validated tools to measure attention problems in the adolescents, such as the Child Behavior Checklist or the Conners Rating Scale. Instead, the Iowa State researchers developed a three-item scale that their critics said had “no known validity.”

“Better tools are available,” said Ceranoglu in an interview with Psychiatric News.

Ceranoglu and Ferguson also questioned why the study authors relied solely on attention problems reported by teachers and not ones identified by parents, who would have the greatest familiarity with the children's behavior.

Swing, the lead study author, told Psychiatric News that teachers were selected to observe the children because they were seen as more likely to have the children perform tasks that required “sustained attention.”

Ceranoglu also said that the study failed to control for other commonly measured variables that may influence attention such as home environment, school quality, parent education, poverty, and genetic risk.

“The conclusions in the study reached far beyond what the findings were,” Ceranoglu said.

Contradictory Findings?

Additionally, Ceranoglu criticized the Iowa State study for overlooking studies that suggested that some video-game use was more likely to increase, not decrease, attention and cognition.

“It's not necessarily a one-way relationship,” Ceranoglu said. “Other studies have found cognitive improvements over time” among children playing video games.

Swing described the study as “early evidence that [video-game use] may be causal” for attention problems. But he acknowledged that further research is needed to prove any causation between video-game exposure and attention problems in children.

“Television and Video Game Exposure and the Development of Attention Problems” is posted at <http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-1508v1>. The critics' letter is posted at <http://pediatrics.aappublications.org/cgi/eletters/peds.2009-1508v1#50502>.