It Began at the 2023 WAIMH World Congress in Dublin
The packed crowd listened closely as Karen Heffler, M.D., delivered her team’s findings. Among infants who had higher daily screen time, very concerning behavior had developed. Her slide read: “Association of Early-Life Social and Digital Media Experiences with Development of ASD-Like Symptoms” (Heffler, et al. 2020). Heffler, an ophthalmologist with Drexel College of Medicine’s Psychiatry Department in Philadelphia, USA, had reviewed the many global research papers which found an association between screen time and autistic-like symptoms in toddlers and preschool aged children. Heffler’s team had also worked with a small group of parents whose toddlers had an autism diagnosis and had viewed screens for an average of five hours per day (Heffler et al., 2022). Her good news: When parents had six months of training to decrease screen time and greatly increase the children’s social opportunities, their screen viewing had dropped to a weekly average of only five minutes a day. As Heffler reported in Dublin, “It was a remarkable reduction in the children’s screen use after the training program. And we found that the core symptoms of Autism decreased significantly, by 23%…and parents’ stress decreased significantly, by 37%.”
Teaming Up
Taking notes in the audience was WAIMH member, Jenifer Joy Madden. An adjunct professor of digital media for Syracuse University in the US, Madden had been following Heffler’s work for five years (Madden, 2018). The two had a mission. At the conference, they would seek out members who were also concerned about technology’s influence on infant mental health and development. After Heffler’s session, Madden handed out invitations to an informal meetup later that day. The cards had a cheery message: “We’re Dublin down on Baby and Toddler Well-Being.”
Effort Pays Off
That evening, WAIMH members from seven nations attended the meetup. One was Miriam McCaleb, PhD of the University of Canterbury in New Zealand. She had presented her research in the same session as Heffler. McCaleb found that new mothers’ smartphone use increased in the postpartum period, despite associated risks. Her subsequent research found postpartum screen use increased despite parent education (McCaleb, 2024). “In Dublin, I was struck by the truly global nature of this struggle with distracted caregiving. Delegates from all over the world responded to my findings in remarkably similar ways. The collaboration born of that conference is inspiring, and necessary,” McCaleb affirms.
On To Tampere
At the 2024 Tampere interim Congress Madden and German pediatrician/psychotherapist Barbara Kalckreuth again invited members to a meetup. Kalckreuth had organized a team at the German-speaking Association for Infant Mental Health to write the position paper, “Digital Media and Early Childhood: State of Research, Effects and Recommendations,” which they had presented in Dublin. “For parents and other caregivers, the use of all sorts of screens is normal. It is urgent to inform them about the impact on the complex development of their babies and toddlers. Research is increasing and shows significant harms. It is time to get the word out,” stresses Kalckreuth. In Tampere, WAIMH members from nations including Greenland, Ethiopia, Bangladesh, and Myanmar joined the effort. As of this writing, 35 countries in the global north and south are represented in what its members have named GAINING—the Global Alliance for Inspiring Non-tech Infant Nurturing and Growth. The alliance was conceived in the U.S., but is truly global in that it has participants from numerous organizations around the world, including members from WAIMH.
Stepping Into Action
Early on, GAINING decided more awareness is needed—and needed soon. The World Health Organization and numerous national pediatric groups recommend children under 24 months have no screen exposure. Children ages 2 through 5 are advised to have no more than an hour of screen viewing per day (WHO, 2019). Yet, a 2022 international meta-analysis shows that 3 out of 4 two-year-olds exceed the guidelines (McArthur et al., 2022).
GAINING has compiled new research from around the world revealing that infants and toddlers who have regular and prolonged screen exposure may display not only behavior changes (Hill, 2024), but also other developmental harms including disrupted attachment (Gutierrez, 2021), atypical brain white matter formation (Dudley, 2022), changes in sensory processing (Heffler, 2024), and language delay (van den Heuvel, 2019). One of the newest studies, published in 2025 by McCaleb’s colleague Megan Gath, M.D. and others at the University of Canterbury found that more than 1.5 hours of “daily direct screen time” at age two was associated with below average language ability and above average peer relationship problems at the age of 4.5. (Gath et al., 2025)
Time to Alert
Soon after their first online meeting, GAINING decided to go global. Members would write research-based “Awareness Alerts” warning that “extensive and growing global research has intensified earlier findings that frequent and prolonged screen exposure among children ages 0 to 3 can disrupt their cognitive, physical, and social-emotional development.” The one-page Alerts offer government agencies, healthcare professionals, and parents strategies for supporting infant development and reduced screen viewing in the early years. María de los Angeles Paúl, WAIMH member from Chile and practicing pediatrician, helped craft the Parents Alert, which is focused on managing screen use in the home and finding alternate activities, including helping with everyday routines and spending time outdoors. “To support parents and acknowledge how difficult life can be, we strived to be understanding in what we wrote,” says Paúl.
The Alert for health agencies suggests actions including providing screen-free early childcare settings and initiating public health education campaigns. The healthcare provider Alert recommends informing parents and other caregivers about screentime risks and offering screen management strategies starting at the first prenatal visit.
GAINING Early Progress
Even before the Alerts were finished, GAINING was assisting WAIMH members.
Paula Bleckmann chairs the Media Education Department at Alanus University of Arts and Social Sciences in Germany. “In Dublin, Barbara Kalckreuth and my colleagues presented the GAIMH Position Paper. New research has accumulated since, and the GAIMH team was able to publish a second edition of the GAIMH paper in 2024 (Bleckmann et al., 2024), which now includes research we were alerted to in GAINING meetings,” Bleckmann reports. GAINING resources also informed Ireland’s new screen time guidelines for children ages two and under. (HSE, 2024)
Joining the Movement
The Alerts will be released globally on 23 April 2025, which is World Infant, Child and Adolescent Mental Health Day. Since the need is worldwide, GAINING invites WAIMH members from all nations to join the awareness campaign. “Digital devices are present in every child’s life so there must be global understanding of what very young children need and do not need for best development. All caregivers should understand that interacting face-to-face with their infants is crucial and absolutely irreplaceable,” urges Madden. Read the Awareness Alerts and see GAINING member video messages, along with supporting research studies and caregiver resources on the project website, MyBabyGains.org.
If you have questions, please email info@mybabygains.org.
References
Bleckmann, P., Brauchli, V., Denzl, E., Hantiger, M., von Kalckreuth, B., Klein, A., Schneebeli, L., Simon-Stolz, L., Sticca, F., Uhler, C., Wolf, M., & von Wyl, A. (2024). Digital media and early childhood: Research, effects and recommendations (2nd ed.). German Speaking Association for Infant Mental Health (GAIMH). https://www.gaimh.org/aktuelles-reader/2-auflage-positionspapier-digitale-medien-und-fruehe-kindheit.html
Dudley, J., Hutton, J., Horowitz-Kraus, T., et al. (2022). Associations between digital media use and brain surface structural measures in preschool-aged children. Scientific Reports, 12, Article 19095. https://www.nature.com/articles/s41598-022-20922-0
Gath, M., Horwood, J., Gillon, G., McNeill, B., & Woodward, L. (2025). Longitudinal associations between screen time and children’s language, early educational skills, and peer social functioning. Developmental Psychology. https://doi.org/10.1037/dev0001907
Global Alliance for Inspiring Non-tech Infant Nurturing and Growth (GAINING). (2025). Deleterious associations with baby, toddler, and caregiver digital device use: Global research highlights (2019-2025). https://durablehuman.com/wp-content/uploads/2025/03/Research-List-Update-Ver-March-2025-Deleterious-Effects-Babies-Toddlers.pdf
Gutierrez, S. A., & Ventura, A. K. (2021). Associations between maternal technology use, perceptions of infant temperament, and indicators of mother-to-infant attachment quality. Infant Behavior and Development. https://doi.org/10.1016/j.infbeh.2021.101609
Health Service Executive (HSE). (2024). Screen time and young children. https://www2.hse.ie/babies-children/play/screen-time/
Heffler, K. F., Sienko, D. M., Subedi, K., & Bennett, D. S. (2020). Association of early-life social and digital media experiences with development of autism spectrum disorder–like symptoms. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2020.0230
Heffler, K. F., Frome, L., Garvin, B., Bungert, L. M., & Bennett, D. S. (2022). Screen time reduction and focus on social engagement in autism spectrum disorder: A pilot study. Pediatrics International. https://doi.org/10.1111/ped.15343
Heffler, K. F., Sienko, D. M., Acharya, B., Subedi, K., & Bennett, D. S. (2024). Early-life digital media experiences and development of atypical sensory processing. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-023-05872-9
Hill, M. M., Gangi, D. N., & Miller, M. (2024). Toddler screen time: Longitudinal associations with autism and ADHD symptoms and developmental outcomes. Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2024.01.001
Madden, J.J. Durable Human. (2018). Virtual autism: A new threat to toddlers. https://durablehuman.com/virtual-autism-new-threat-toddlers-too-much-screen-time/
McArthur, B. A., Volkova, V., Tomopoulos, S., & Madigan, S. (2022). Global prevalence of meeting screen time guidelines among children 5 years and younger: A systematic review and meta-analysis. JAMA Pediatrics, 176(4), 373-383. https://doi.org/10.1001/jamapediatrics.2021.6386
McCaleb, M.A. (2024) A new guilty thing you’re aware of but you don’t change: Seeking supportive smartphone habits for new mothers at the transition to parenthood, a mixed methods study. [Doctoral Dissertation, University of Canterbury] https://ir.canterbury.ac.nz/items/46902716-3488-4b93-aaaf-39e70079b9f2
van den Heuvel, M., Ma, J., Borkhoff, C. M., Koroshegyi, C., Dai, D. W. H., Parkin, P. C., Maguire, J. L., & TARGet Kids! Collaboration. (2019). Mobile device use is associated with expressive language delay in 18-month-old children. Journal of Developmental & Behavioral Pediatrics. https://doi.org/10.1097/DBP.0000000000000657
World Health Organization (WHO). (2019). Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. ISBN 978-92-4-155053-6. https://www.who.int/publications/i/item/9789241550536
Authors
Barbara von Kalckreuth,
Germany
Jenifer Joy Madden,
United States
