Performance Differences in Young Children across Digital & Paper Modalities

Dr. Allison Dempsey

University of Texas Health Science Center at Houston


Participants were 80 children attending 18, 24, 36, or 48-month well-child pediatrician visits in general or high-risk pediatric primary care clinics. Twenty children were recruited for each age grouping and were randomized to experimental condition (digital vs paper). Participants were then presented with a series of tasks to assess knowledge/performance across 7 developmental domains (receptive language, expressive language, fine motor skills, early literacy, early mathematics concepts, social-emotional skills, and cognitive/reasoning skills). Parent interviews provided information about demographic characteristics, developmental and educational background, and technology use. Performances on items were compared to parent reports of developmental delays on standardized screening measures used in the pediatric clinics.

A series of 2 x 4 (visit: 18, 24, 36, 48) ANOVAs were conducted to assess main effects of condition (digital vs. paper)  and visit on raw score and interaction effects of condition x visit age for each of the 7 developmental domains and total score. For all domains and total score, there were main effects for visit type.  There was only 1 main effect for condition, and that was for the Early Numeracy domain (F (1, 72) = 10.667; p<.05), for which the paper scores were higher than the digital scores.  There were no condition x visit interaction effects.  A linear regression analysis indicated that total weekly hours of access to a touchscreen device did not predict total score across domains for those in the digital condition (F (1,38) = .27; p=.60).

Results indicate that digital approaches to screening early learning and development skills may be appropriate for development as children did not display a differential response patter to paper versus a tablet across most tasks. However, children at ages 3 and 4 demonstrated more range in item responses, indicating that digital technology may not be appropriate for screening skills in children under 3 years.