CURRENT LITERATURE PRESENTS CONTROVERSIAL EVIDENCE ON THE USE OF TECHNOLOGY ON A YOUNG CHILD’S FINE MOTOR DEVELOPMENT. QUALITY INTERACTIONS BETWEEN CAREGIVER AND CHILD SHOULD BE THE KEY

Technology has been integral in our daily lives. Recognising the ubiquitous role of media and technology in children’s lives, the American Academy of Pediatrics (AAP) recommends parents and/or caregivers to prioritise creative, unplugged playtime for infants and toddlers.

These controversial evidence on the use of technology on young children’s development, particularly fine motor development, call for a need for further reviews.

Studies that support the use of technology in children’s fine motor development tend to focus on children who are 5 years old and older. A researcher reported fine motor skill benefits such as improving eye-hand coordination for children when they are playing active video games.

However, there are also several studies in the public domain on the negative effects, starting with risks of very young children’s exposure to digital technologies which can lead to major attention deficits around ages 7 to 8. Additionally, children may show the adverse effects such as aggressiveness of perverse effects of social media on personal identity and self-esteem.

There is scant literature for children from birth to 3, with studies presenting controversial evidence on the effects of media and technology on fine motor development. Researchers examined the association between toddlers’ touchscreen use and the attainment of developmental milestones and found significant association between toddler’s age (19 to 36 months) of first touchscreen use and fine motor skills (stacking blocks).

However, this is a survey research design, using an online questionnaire to collect data based on UK-based parents’ perceptions. Future longitudinal studies are required to clarify the chronological order and mechanisms of this association, and to examine the impact of touchscreen use on other, more fine-grained, measures of behavioural, cognitive, and neural development.

On the other hand, a few researchers found that children’s motor skills were inversely related to screen-time.

To examine the associations among preschoolers’ fundamental motor skills, screen-time, physical activity (PA), and sedentary behaviour (SB), 126 preschoolers were enrolled in a prospective observational trial of PA. Trained assessors conducted the Test of Gross Motor Development (3rd edition, TGMD-3), and the Movement Assessment Battery for Children (2nd edition), and parent-reported child screen-time and sociodemographic information. Children wore an accelerometer for seven days to examine SB and total PA (TPA). They found that children’s screen-time was inversely related to the Movement Assessment Battery for Children (2nd edition), manual dexterity skills percentile. Further inquiry into the implications of high exposure to screen-time in young children is needed.

From birth to 3 years old, the young child’s developing sensory and motor systems have not evolved biologically to accommodate the sedentary, yet frenzied and chaotic nature of today’s technology.

The AAP has advised zero screen time before the age of two years although the AAP are currently in the process of revising the guidelines.1 This guideline has been adopted by other government agencies around the world, such as Canada.

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9. Lipnowski, S., LeBlanc, C. M., Canadian Paediatric Society, & Healthy Active Living and Sports Medicine Committee. (2012). Healthy active living: Physical activity guidelines for children and adolescents. Pediatrics & child health, 17(4), 209-210.

In Singapore, the focus is on choosing healthy screen time and quality media choices for infants and toddlers from birth to 2 years old. Child development experts also recommend limiting children’s daily screen time as screen time limits can help lower the risks of screen time for the child, which include physical, developmental, safety and other risks.

Children’s course of development is significantly facilitated by appropriate, affective relationships with consistent caregivers as they relate to children through play.

Infants are fed, carried, cleaned, and comforted through touch and tender caregiving. Tactile sensation provided by parents and caregivers helps satisfy infants’ physical needs and affects emotional development. Reflexes have survival value which connects parents or caregivers to respond to baby’s needs for safety and security. Reflexes help parents and infants establish gratifying interaction. A baby who searches for and successfully finds the nipple, sucks easily during feedings. A baby who grasps when the hand is touched encourages parents to respond lovingly. Parents can also make use of reflexes to comfort babies.

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13. Berk, L. E. (2017). Exploring lifespan development. Pearson.

When babies did not receive adequate care during their first year, they retained newborn reflexes, which have effects on fine motor development. Researchers suggested that children with retained primary reflexes will have less efficacy in performing fine motor tasks such as doing up buttons.

This affects self-esteem and results in withdrawal from physical activities.

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15. Missiuna, C., Rivard, L., & Bartlett, D. (2003). Early identification and risk management of children with Developmental Coordination Disorder. Paediatric Physical Therapy, 15, 32–38.

At the extreme end of the spectrum these issues may have far-reaching implications for children’s learning and academic progress. One example of primitive reflex is the asymmetrical tonic neck reflex (ATNR) found in newborn humans that normally vanishes around six months of age. It is also known as the bow and arrow or "fencing reflex" because of the characteristic position of the infant's arms and head, which resembles that of a fencer. In Western Australia, research was conducted on non-Indigenous children of pre-primary age, concluding that children with retained ATNR perform at a lower level on motor skill tasks, particularly those involving manual dexterity, than do children without ATNR.

14 per cent of the tested population were found to have an ATNR in the moderate to high range.

Parents and caregivers need to bear in mind that the three critical factors for healthy development are movement, touch, and connection to other humans. Movement, touch, and connection are forms of essential sensory input that are integral for the eventual development of a child’s motor and attachment systems. When movement, touch and connection are deprived, devastating consequences occur.

The critical period for attachment development is from birth to seven months, where the infant-parent bond is best facilitated by close contact with the primary parent and by lots of eye contact.

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17. Insel, T. R., & Young, L. J. (2001). The neurobiology of attachment. Nature Reviews Neuroscience, 2, 129-136.

These types of sensory inputs ensure normal development of posture, bilateral coordination, optimal arousal states, which helps in development of fine motor skills.

The relationship between caregivers and infants plays an important part in fine motor development. In a study of babies between 6 and 24 months of age from 291 children centers in Peru, infants and toddlers with caregivers who demonstrated higher quality interactions had significantly better communication, problem-solving, and fine motor skills.

Researchers used developmental assessments to measure child development and quality of childcare (frequency and quality of interactions between babies and caregivers).

Young children with caregivers who exhibit higher quality interactions were found to have better developmental outcomes. Findings reveal that the association between the quality of care and child outcomes is significant throughout most of the distribution of child development.

By playfully interacting with infants, caregivers create opportunities for social communication with them. During these play times, caregivers can observe and track children’s development of their hands. With such awareness, caregivers can provide appropriate fine motor activities for children’s development.

Simple activities like helping children make “angels” helps them learn to control their muscles with graceful postures.

Simple inexpensive objects can also be used for supporting playful imitation and promoting fine motor skills, such as rattles, push toy cars, stuffed animals, child-sized teacups, hairbrushes, or blocks. Caregivers can use objects such as a wind-up toy, a favourite snack in a jar, a bubble blower, or a balloon to elicit communication about challenges and temptations that might require adult assistance.

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20. Wetherby, A., & Prizant, B. (2002). CSBS-DP manual: Communication and symbolic behaviour scales developmental profile. Baltimore, MD: Brookes.

Using a simple object would provide infants with an opportunity to focus on the object, make eye contact with the adult, and gesture or speak to the adult to ask for assistance while working with the object.

For older toddlers, cookery, threading, shaving cream activities and painting are highly encouraged.