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Symptoms of ADHD in teens linked to heavy screen time

Teens who spend a lot of time using digital media show an uptick in symptoms of attention-deficit/hyperactivity disorder (ADHD), a new study reports. That doesn’t mean parents should panic about teens texting at the dinner table; it just means that if your kid is a heavy media user, maybe you should have a conversation about why they like it so much.

Today’s study monitored ADHD symptoms in a group of nearly 2,600 high school teenagers. Students who used multiple types of digital media multiple times a day were roughly twice as likely to report new symptoms of ADHD over a two-year period than their less digitally active classmates, according to the study published today in the Journal of the American Medical Association.

Studies have linked digital media like social networks to changes in mental health before; Facebook use, for instance, has been linked to drops in well-being, but it’s hard to say what the cause is.

In depression studies, one possibility is that depressed people who find it difficult to socialize are substituting online interaction for real-world interaction, which means the internet isn’t causing the depression at all. In today’s study, it’s possible that the emerging symptoms of ADHD are driving kids to the instant gratification of digital media. It could also mean that the constant distractions of the internet make it harder for adolescents to learn patience, impulse control, and focus, and lacking those things are hallmarks of ADHD.

This study didn’t say if more frequent digital media usage caused the ADHD symptoms or how those symptoms affected the teens’ lives.

But it does make the case that these kids were using digital media before their symptoms started. “It’s not a doomsday scenario. It shouldn’t add to the moral panic about technology,” says Jenny Radesky, an assistant professor of pediatrics at the University of Michigan who was not involved in the study. But it is a reason for parents to talk to their kids about their motivations for and reactions to using technology.

Michael Rich, the director of the Center on Media and Child Health at Boston Children’s Hospital who also did not participate in the study, agrees. “We want to do more than just wring our hands and say, ‘Oh me, oh my.

This is not the ’50s anymore,'” he says. “Is this how we are evolving as a species? And is this a bad thing to do, or is this actually going to be helpful for the future?”

The study is the first to take a long-term look at ADHD in the modern media environment, where smartphones provide ready distractions whether we want them to or not. Researchers led by Adam Leventhal, a professor of preventive medicine at the University of Southern California, surveyed high school sophomores at 10 different schools in Los Angeles County.

More than 2,800 teens completed one questionnaire about ADHD symptoms and another about their digital media use.

The ADHD survey asked students to evaluate whether statements like “I’m easily distracted” or “I don’t listen when spoken to directly” applied to them. The students also filled out a survey ranking how often they used 14 different types of digital media — like checking social media sites, texting their friends, streaming TV or movies, or playing games.

Students who already had significant ADHD symptoms in the first survey were eliminated from the study because the researchers wanted to figure out which came first: the ADHD symptoms or the digital media use. The nearly 2,600 students who didn’t have significant ADHD symptoms continued on and retook the same surveys periodically over the next two years.

The team found that nearly 81 percent of the students reported using at least one form of digital media multiple times a day (often social media or texting).

With each additional digital media platform the students reported using frequently — like streaming TV or playing games — their odds of experiencing ADHD symptoms climbed.

The 495 teens who reported infrequently using digital media had a 4.6 percent chance of reporting ADHD symptoms in the follow-up surveys. That likelihood almost doubled to 9.5 percent for the 114 students who reported using seven of the 14 digital media platforms frequently. And it climbed to 10.5 percent for the 51 students who said they used all 14 platforms multiple times a day.

There are some clear limitations to the study: for one thing, the digital media use and the ADHD symptoms were entirely self-reported.

And people can be forgetful or reluctant to admit to symptoms and behavior that are stigmatized. The study also didn’t investigate what could be behind the increased symptoms. But Leventhal and his colleagues have a few theories.

For example, it could be that phone notifications could divide kids’ focus and make it even harder for them to develop the skills they need to concentrate, causing an upswing in ADHD symptoms. It’s also possible that having entertainment and social stimulation just a few clicks away could habituate kids to instant gratification, making it harder to learn patience.

The relationship could work the other way: maybe early ADHD drove some of the teens to distraction online. But the students who reported stronger ADHD symptoms didn’t wind up using media more, the study says, which is a blow to that theory.

It’s also possible that something else is driving the teens to digital media and interfering with their ability to concentrate. “The biggest ones are poverty or psychosocial stress or family dysfunction. All of those correlate with heavy media use, and all of them correlate with attention problems,” says Radesky, who wrote an editorial accompanying the study.

So, as a parent, it might make sense to just talk to your kid if you’re worried. That will give you more direct information about how much time they’re spending on digital media (and why).

Radesky suggested that parents who want to figure out how to have that conversation should check out Common Sense Media. She’s used it to give advice about how to talk to teenagers about healthy social media use. That might include limiting the amount of time teens can spend on social media apps by using a tool like Apple’s recently released App Limits.

The research is still early, Leventhal says.

But with digital media continuing to advance, he says, “I just think it’s something for health professionals, scientists, and the overall community to keep their eye on.” Radesky says it’s key not to feel overwhelmed by the results, “not to feel like it’s ruining kids futures or fundamentally changing their abilities to succeed in school.” Her recommendation?

Just talk. “There are so many teachable moments in technology use because no one knows the best way to do this.

We’re all just trying it out, every day.”

Making Alto’s Adventure free on Android helped it reach a whole new audience

When it came time to port serene snowboarding game Alto’s Adventure to Android, Ryan Cash, from developer Snowman, was a bit worried. He’d heard plenty of stories about how hard it was to make money on Android and the challenges of supporting so many different devices. Eventually, the studio partnered with mobile developer Noodlecake for the Android version, and the two decided to make the game free to better suit the platform.

And while it’s true that the Android version of Alto’s Adventure hasn’t been as lucrative as its iOS counterpart, that doesn’t mean it wasn’t a success.

In fact, it helped the small studio reach entirely new audiences in countries where the iPhone doesn’t have much penetration. “Our top countries for Android are so different from our top countries for iOS,” says Cash.

Next week, will see the Android debut of the game’s sequel, Alto’s Odyssey, and it comes at a time when Alto’s Adventure is doing particularly well on Android. According to Cash, the game has been downloaded more than 36 million times on Android and has slowly evolved into a healthy business for the studio. One of the reasons for the game’s success is that it’s been regularly tweaked based on player feedback.

Initially, Alto’s Adventure on Android was supported by in-game ads and a single in-app purchase of a coin doubler. But as time went on, players actually requested more ways to spend money.

“We didn’t sell any coin packs for the longest time, and people were emailing all of the time asking for them,” says Cash. “It was a shock to me, people asking for monetization. We adapted as we went and retroactively tweaked some of the monetization.

By doing that, we were able to better service our players and also increase revenue. It seems odd that you could make more money but also make your customers happier. You’d think if you add more monetization, you’re actually going to piss people off.

It was the exact opposite.”

Cash admits that, even with these changes, the free version of Alto’s Adventure still doesn’t monetize as well as a lot of other free-to-play games. But for a studio of just seven people, it does well enough. And, more importantly, it has allowed the team to reach new players it otherwise couldn’t.

According to Cash, while Adventure‘s number two country for Android downloads is the US, the rest of the top five consists of countries where the paid iOS version has few sales. That includes Russia, India, Brazil, and Mexico. “We don’t really sell any copies of our iOS game in India,” says Cash.

Over the past few months, the free version of Adventure has been updated with a few paid features, including the aforementioned coin packs as well as unlockable characters. Part of this was to test the waters before the impending launch of Odyssey on Android. “We wanted to do it before Odyssey came out to see if would actually monetize and make sure people were happy,” Cash explains. “So we ran that test with Adventure, and it worked.”

Alto’s Odyssey is coming to Android on July 26th, and that date represents another accomplishment for the studio.

It took Alto’s Adventure a full year to move from iPhone to Android, but with Odyssey, that number was cut in half.

Closing that window between platform releases is an area the studio hopes to continue to improve. “Our goal is to keep getting better at that,” says Cash.

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