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The world has drastically changed with the advent of technology, which has had an immense impact on the field of medicine. Changes in the fields of medicine and surgery are moving at a fast pace and pediatrics is catching up.
The world has drastically changed with the advent of technology, which has had an immense impact on the field of medicine. Changes in the fields of medicine and surgery are moving at a fast pace, and pediatrics is catching up. [For example,] there have been increased survival rates of extremely premature babies with high mortality conditions.1 However, every coin has 2 faces, and technology is no exception.
We see a rising trend of obesity, type 2 diabetes, depression, and behavioral issues with more sedentary lifestyles and poor physical activities. Something that has caught my eye in the recent past [has been] the increasing incidence of attention-deficit/hyperactivity disorder (ADHD). We have seen increasing numbers of parent-reported ADHD cases after the changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria 2
Attention-deficit/hyperactivity disorder is predominately because of decreased activity in the frontal lobe.3 Treatment includes pharmacologic and nonpharmacologic [therapies such as] coaching, providing structure, and academic accommodation, and we see that the last is least tried, although the success is better with a combination. Comorbidities such as specific learning disabilities, anxiety disorders, and oppositional defiant disorders are commonly associated with ADHD, and education of parents and teachers, behavioral therapy, and medication are the main components of management.4 If only teachers and parents could team up, the results would be more favorable.5
Parents walk in with electronic devices, and most of the time we examine their children with the electronic devices in their hands. For parents, [these devices] work like pacifiers.6 Parents use them to put their children at ease, to keep them from disturbing others, and while driving. Even when we are discussing our plan, the electronic device is given to the toddler and he is expected to be good while we continue with the exam.
Kids are no longer given an opportunity to explore and learn to behave. Behavior is automatically expected from them. They seem to lack interest in living things and are more inclined toward electronic devices. Parents feel that it is difficulty to place limits on the kids unless they have their mobile electronic devices.6
The American Academy of Pediatrics recommends no television or other electronic devices until 2 years of age, and yet we see our parents give in so easily way before 2 years of life. Is it because we do not let kids be kids anymore? Do we expect too much from them at such a young age? Does the use of electronics have anything to do with the growing incidence of ADHD? [Do electronic devices] alter the chemical balance in the frontal lobe that deals with focus and organizational skills?
Studies have shown that early television exposure is associated with attention problems later in life,7 but a direct causal relationship is yet to be proven. So far we have no data on this, but I would encourage clinicians to conduct such research and provide their valuable guidance.
Until then, I will continue to discourage the use of electronic devices, instead recommending the use of age-appropriate books. I advise all parents at our clinic to read to their children every day. It’s never too early to start.
1. Hall NJ, Curry J, Drake DP, Spitz L, Kiely EM, Pierro A. Resection and primary anastomosis is a valid surgical option for infants with necrotizing enterocolitis who weigh less than 1000 g. Arch Surg. 2005; 140(12):1149-1151.
2. Centers for Disease Control and Prevention (CDC). Increasing prevalence of parent-reported attention-deficit/hyperactivity disorder among children-United States, 2003 and 2007. MMWR Morb Mortal Wkly Rep. 2010;59(44):1439-1443.
3. Bokor G, Anderson PD. Attention-deficit/hyperactivity disorder. J Pharm Pract. 2014;27(4):336-349.
4. Kulkarni M. Attention deficit hyperactivity disorder. Indian J Pediatr. September 4, 2014. Epub ahead of print.
5. Karande S. Attention deficit hyperactivity disorder-a review for family physicians. Indian J Med Sci. 2005;59(12):546-555.
6. Brown S, Scharf MA, Bustos C, Chavira D, Stein MT. “Media addiction” in a 10-year-old boy. J Dev Behav Pediatr. 2013;34(5):375-378.
7. Landhuis CE, Poulton R, Welch D, Hancox RJ. Does childhood television viewing lead to attention problems in adolescence? Results from a prospective longitudinal study. Pediatrics. 2007;120(3):532-537.
Dr Kola is an assistant professor at Texas Tech University Health Sciences Center, Odessa. She has nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.