Child's Play, The Citizen, July 2018 ADHD in Our Digital Age

Gregory K. Moffatt, Ph.D.

Digital media is here to stay.  I even see two- and three-year-olds toddling around with iPads.  For many years the American Academy of Pediatrics has encouraged children under six years of age to avoid video all together.  That is probably an unrealistic expectation, but limited exposure to digital media isn't out of reach.

In a recent study in the Journal of the American Medical Association, a potential link between ADHD symptoms and social media has been suggested.  2500 high school students in California were tracked over two years.  None of the subjects had ADHD symptoms at the start of the study.

Two years later, about 10% of those who reported high frequency use of social media demonstrated ADHD symptoms as compared to about 5% of those who reported no social media use.  That is a huge difference.

I'm not convinced that digital media is "causing" ADHD, but I am almost certain that it is causing the ADHD symptoms.  In order to understand what I mean, we have to look at the ADHD diagnosis itself.

In the diagnostic criteria for inattention and hyperactivity, there are nine criteria each.  Generally, individuals under 17 must meet six of these criteria for the diagnosis to be made.  Among them are difficulty maintaining focus, difficulty organizing tasks, inattention to detail, and forgetfulness, just to name a few.

Children with ADHD will exhibit these symptoms, no doubt.  But children grieving the loss of a loved one or experiencing trauma will exhibit some of the same behaviors and these symptoms can persist over many months or even years.  Therefore, the criteria for ADHD might be met, but the symptoms are due to another cause - grief or trauma.

So back to the digital media.  I suspect what we are seeing in this JAMA study is a development of ADHD symptoms rather than the development of ADHD.  Digital media - especially social media - is almost instantaneous.  Twitter, Facebook, Instagram and other social outlets allow an individual to get information with almost zero delay from the moment of posting to the moment of consumption.

This creates an expectation of instant gratification.  We are all molded by this.  Think about life 30 years ago.  If you wanted money from the bank, you had to go to the bank during banker's hours and withdraw money.  Now you can get it any time anywhere with ATMs.   

Or if you use an APP like Square Cash, you can send digital money across the country to a friend at any time. 

My college students almost go into withdrawal because I don't allow texting in class.  They are accustomed to talking to anyone they want at any time.  Many of them sleep with their phones just in case someone texts in the middle of the night.

This has changed our expectations in life.  Sometime in the mid-1980s I was with some friends in the north Georgia mountains.  We happened upon a small community festival.  It was, to use my friend's words, "rinky dink," but the young people there were having a blast.  My friend observed that it would be hard to get metro Atlanta youth excited about such small potatoes.

The current generation of young people doesn't know a time when a car ride meant looking out the window instead of watching movies on personal devices.  They haven't learned to experience the pleasure of silence and solitude that comes from being unreachable for short periods of time.  They expect constant stimulus.  That creates agitation and ADHD symptoms.

I'm not a curmudgeon and I enjoy my smart phone and laptop.  I'm not suggesting getting rid of social media.  As I've said many times in this column over the years, it is about moderation rather than all or nothing.  Ice cream is fine, but you shouldn't eat ice cream three meals a day.

There are lots of ways to moderate social media use, but here are a couple of ideas.  Have quiet zones for your family - the dinner table or in the car - where no digital devices are allowed.  Perhaps you could have a digital-free day each week or a digital free night once a week where everyone's devices go in a basket for a few hours while you enjoy an activity together.

Even if my assessment of this JAMA study is incorrect, moderating the use of digital media as I've suggested can't hurt.