Abstract
OBJECTIVES: In some studies, parents and toddlers verbalize less when engaging with a tablet versus a print book. More needs to be known regarding child contributions to specific parent verbalizations. We examined parent-toddler contingent interactions with tablet applications versus print books, as well as moderators of these associations. METHODS: We conducted a laboratory-based, within-subjects counterbalanced study of 72 parent-toddler dyads engaging with a nursery rhyme application (with enhanced + autonarration [E+A] and enhanced formats) and print book. We coded parent verbalizations (eg, dialogic, nondialogic) and proportions of child responses to these in 5-second epochs. Poisson regressions were used to analyze within-subjects variance by tablet or print format. We tested effect modification by child emotion regulation and home media practices. RESULTS: Children responded more to parent overall (print 0.38; E+A 0.31, P = .04; enhanced 0.11, P = .01), dialogic (print 0.21; E+A 0.13, P = .04; enhanced 0.1, P = .02), and nondialogic (print 0.45; E+A 0.27, P < .001; enhanced 0.32, P < .001) verbalizations during print book versus tablet. Stronger child emotion regulation, greater frequency of co-viewing, and instructive practices moderated associations such that differences between conditions were no longer significant for some parent verbalizations and child responses. CONCLUSIONS: Parent-toddler reciprocal verbal interactions occurred less frequently with tablet versus print book use. Child emotion regulation and parent home media practices moderated some of these associations. Pediatricians may wish to promote co-viewing and instructive media practices but may also consider that child emotion regulation may determine response to interactive tablet design.