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Brains on Books, and Screens

These days, Hutton is a pediatrician and director of the Reading and Literacy Discovery Center at Cincinnati Children’s Hospital, which combines clinical services for children with reading difficulties and research. A major strength is neuroimaging, and Hutton and his team have published the first studies in the world (12 to date) using MRI to show how parent-child reading and screen time influence the developing brain prior to kindergarten. Their work made international headlines in 2015 and again five years later.

The first study, published in Pediatrics, used functional MRI images showing “your child’s brain on books,” Hutton says. The findings, focused in areas supporting language and imagery, reinforced that reading with a child in the preschool years is not only a nice thing to do if there’s time, but it directly influences how a child’s brain develops to learn how to read.

A more recent study, published in JAMA Pediatrics in the fall of 2019, is the first to use a different type of MRI (Diffusion Tensor Imaging; DTI) to show how different aspects of screen time—access, frequency, content and co-viewing—may impact the development of brain white matter tracts (the brain’s “wiring”) prior to kindergarten.

“This study completely blew up,” Hutton says. “I was out of town at a reading conference when it was released, and I got something like 80 requests for interviews in three days. It was really intense—including CNN, The New York Times, FOX, German Radio Network, even the MIT Technology Review.”

That’s because, Hutton says, as screens become a bigger part of how children spend their time at ever-younger ages, parents are nervous—the media response reflects this parental anxiety.

“Several journalists asked, almost with a cringe, if our study showed that screen time causes brain damage,” Hutton says. “But that’s not what it showed. However, the findings were definitely concerning.”

What the study did show is that: 1) It is possible to get 49 preschoolers to sit still for an MRI (they are never sedated for these studies); 2) those that had less screen time had better-developed white matter tracts throughout their brains, especially tracts involved with language and executive functions, and 3) those with less screen time also had higher language, executive and composite early literacy skills. While direct effects of screen time such as age-inappropriate content were possible contributors, the most likely explanation for the findings cited in the paper was displacement of nurturing experiences by screens.

For instance, children that use more screens tend to interact less with parents and other caregivers (through activities such as reading books together), and also with the real world. They don’t engage in imaginative play or go outside as often as kids who use screens less. This was reinforced by a follow-up MRI study published in the European journal Acta Paediatrica this year that found better-developed brain white matter and higher language and early literacy skills for preschool-age children with more exposure to reading at home.

“Our brains are essentially analog organs that evolved over millennia to process the real world, including people and feelings and language and all of our senses,” Hutton cautions. “What we’re doing with screens is we’re taking all of these experiences and we’re collapsing them into audiovisual experiences, and then we’re expecting that the brain’s going to develop normally. In some ways, it probably does, but in others such as expressive language and social cognition, there are real concerns: digital media just isn’t optimized for what a child’s brain needs.”

Hutton recommends a measured approach. Keep screens out of bedrooms. Limit screen time each day—for children AND for grownups when they are with the child. Avoid violent or hyper-stimulating content. Be wary of apps and videos that are marketed as “educational”—these claims are extremely common and rarely tested. Resist the temptation to soothe or distract children with screens, especially in short-term situations like meals or errands; in other words, allow children to experience good old-fashioned boredom.

“The point isn’t for parents to be screen police or to feel guilty, but to be selective with the age of the child in mind,” Hutton says. “A six-month screen time binge for an adult is arguably no big deal, but for an infant or toddler whose brain is growing rapidly may blunt critical skills and set them up for long-term overuse.”

New Chapter

As Hutton’s work with the ramped up, along with leadership roles (he’s “Spokes-Doctor” for the Read Aloud 15 Minutes national campaign, co-leads the Early Childhood workgroup for the Children and Screens Institute, advises Reach Out and Read and Dolly Parton’s Imagination Library, and presents on reading and screen time widely), he had to re-evaluate his obligations.

After nearly 20 years at the helm of blue manatee, Hutton faced a fork in the reading road—whether to pass the crayon and sign the bookstore over to a new owner.

Instead of a “for sale” sign, though, he posted a challenge on Facebook. The bookstore would be given to the person with the most convincing proposal…sort of like Willie Wonka’s Golden Ticket in the beloved book Charlie and the Chocolate Factory.

More than 120 queries flooded in, ranging from earnest college students to venture capitalists. The most intriguing one came from a software developer who’d just sold his business and was moved by his experience as a literacy volunteer in an underserved school. He suggested the bookstore become a non-profit—an idea Hutton and his wife had entertained.

And so, in 2019, blue manatee became , a 501c-3 non-profit that provides books and literacy experiences to underserved children: “You buy a book, we give a book.” Hutton remains an advisor, or Manatee Emeritus.

“It wasn’t exactly a golden ticket, though,” Hutton says. “The book business is definitely no path to riches. At least not gold for the wallet. It’s gold for the heart.”