NICHD-NIMH Workshop: Impact of Technology and Digital Media on Child and Adolescent Development and Mental Health

April 4–5, 2024

Executive Summary

This public two-day workshop was convened in response to the Children and Media Research Advancement (CAMRA) Act, which was included in the Consolidated Appropriations Act of 2023 (P.L. 117-328) and directed the National Institutes of Health (NIH) to launch research on how technology and digital media (TDM) affect the cognitive development, physical health outcomes, and socioemotional development of infants, children, and adolescents. Specifically, the CAMRA Act directed the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute of Mental Health (NIMH) to examine how exposure to and use of TDM contribute to risk and resilience within this population. The invited workshop panelists reflected an array of scientific disciplines and research perspectives, with sessions featuring overviews of current TDM research findings and panel discussions addressing the need for greater diversity and inclusion in TDM studies as well as conceptual and measurement issues when assessing the short- and long-term effects of TDM. Over the course of the workshop, several common themes emerged regarding opportunities, gaps, challenges, and future directions in TDM research:

• A more balanced approach to understanding the positive, negative, and/or neutral impacts of TDM is needed.
  Much of the current research emphasizes the negative consequences of TDM use and exposure for infants, children, and adolescents (e.g., the promotion of risky behaviors, disrupted parent–child interactions). However, TDM use and exposure also have a wide variety of positive applications and effects (e.g., access to educational resources, building a sense of community) or even no effects at all. For example, youth with mental health concerns or from marginalized populations could experience either the negative effects of TDM exposure or the benefits of social support and information. A more balanced approach to TDM research will expand our understanding of the impacts of TDM use and exposure in youth and can help inform practices that maximize the benefits and decrease the risks of TDM.
• There is a tension between the time needed to conduct rigorous longitudinal research, the ever-changing technological landscape, and the community’s urgent need for answers and guidance.
  The need for both randomized controlled trials and observational longitudinal studies to describe real-world use patterns and determine the impact of TDM use over time, coupled with the rapid speed of technological change, presents both methodological and practical challenges. Given the increasing demand for timely and relevant findings to inform policy and practice guidelines and practical advice for parents and youth, the distinction between correlational and causal findings is often blurred. Some potential solutions include:  designing both observational and experimental studies with a complementary mix of cross-sectional and shorter-term longitudinal work; adapting proactively to technological developments when possible; focusing on the affordances of different technologies rather than specific platforms; and leveraging natural experiments and cohort data, and pragmatic randomized controlled trials as new technologies becomes more prevalent.
• To support the generalizability of findings, more consistent and ecologically valid measures of TDM use and exposure across multiple settings are needed.
  In order to compare results and make broader generalizations, measures need to be better aligned across studies. Further, measures of TDM use and exposure need to move beyond parent- and self-report and capture other important aspects of the user experience. For example, the impact of engaging for an hour with online educational content likely differs significantly from engaging with social media, which may include inappropriate or discriminatory content. Studies should draw on multiple disciplines (e.g., psychology, sociology, anthropology) and measure processes in both naturalistic and laboratory settings.
• Research should center on the needs, perspectives, and motivations of those who will be using or supervising the use of TDM, and a one-size-fits-all approach should be avoided.
  Individual, family, and community-level differences in terms of both motivations for TDM use and its impacts need to be considered. The manner of engagement with TDM and its effects on an individual vary, for example, by developmental stage, cultural identity, geography, and access to resources, among others. This person-centered approach requires a research workforce with diverse backgrounds and lived experiences and the ability to draw upon them to inform and facilitate collaborations across invested parties (e.g., institutional partners and study participants). It is important for researchers to remember that the digital world is the “real world” and interacts with users’ in-person experiences. Thus, understanding how use and exposure interacts with, and/or are integrated into, in-person experiences at the individual level is critical. Collaboration is integral to the design process, which might involve academic researchers, healthcare providers, school administrators, governmental organizations, and technology companies. Youth should be included as active participants in TDM research, as should parents or caregivers, teachers, and mental health professionals.
• Artificial intelligence (AI) can potentially enhance learning in the TDM environment, but it may also perpetuate bias if improperly designed.
  AI can stimulate dialogue and supplement human-to-human learning interactions when it is grounded in learning theory. However, computer algorithms, often trained on homogenous, adult datasets and driving content exposure across many platforms, may also perpetuate biases. This problem should be addressed at the design stage, incorporating both youth input, diverse perspectives, and non-English languages. In research design, computer scientists should be included as project leaders.
• Research in the field needs to address differential experiences for digital natives as compared to digital immigrants, as well as digital divides.
  There are important differences between digital natives (people who grew up with various technologies) and digital immigrants (those born to earlier generations who are accommodating novel technologies into their lives as older youth or adults). Within the United States, there are digital divides based on geography and access to resources, with greater opportunities for those with access to TDM resources. Research on TDM use among infants, children, and adolescents has focused primarily on the developed world, but some of the greatest potential impacts may be among the estimated 95% of the global population that has significantly less exposure and access to these technologies.
• Greater emphasis is needed on building digital literacy and encouraging digital citizenship.
  It is becoming increasingly important to understand how best to empower young TDM users, families, and the communities that support them to engage with TDM intentionally and responsibly. Research is needed to determine the types of tools that can be most effective in teaching youth of all ages how to be safe online, to mindfully participate online, and to balance time spent on and offline.