For More Info:

https://www.virtualautism.org

To see the documentary:

https://watch.showandtell.film/watch/stoneunturned

Instagram:

@understandingvirtualautism

Hillary Wilkinson: (00:00)

My guests today worked from 2021 to 2025 to produce the award-winning documentary, A Stone Unturned, which explores how screen time shapes early childhood and the potential for behaviors that parallel autism. So much so that the term virtual autism has been used to describe these behaviors. Super compelling topic one that I know that has so much discussion welcome to Healthy Screen Habits, Wilder, Nicholson and Lori Frome.

I don't know much about the documentary process, so, but I'm interested in like, how the seed of a documentary gets planted and real life observation and your professional experience. So, could you both share how you kind of came first to this topic of screen overuse syndrome / virtual autism, and what led you to create a stone unturned?

Lori Frome: (02:46)

I came to this topic quite by accident, it was 2013 that I was working with a, uh, young child with red flags for autism. I was working with a family that I was put in for, to monitor the red flags for autism in their child for the first six weeks of therapeutic services. We were basically working, uh, with the child and the family to see if we could rectify some of the symptoms that were the red flags of autism. This child had no language, um, to speak except echo, which was the phrase, shut the door, um, but not functional, something he had heard the family say repeatedly. Um,

Hillary Wilkinson: (04:07)

And did you tell how old he was? I can't remember. 

Lori Frome: (04:09)

Yeah, he was two and a half at the time. Okay.

Hillary Wilkinson: (04:12)

Okay. Just so we're mm-hmm . Aware.

Lori Frome: (04:15)

Yes. And, um, he also was showing red flags, uh, for autism due to behaviors that, um, were very restrictive and repetitive. So he played with toys by spinning wheels. He was down on the floor looking at things at angles that were odd, uh, no functional play skills, not using gestures at the time, using hands of other people to have his needs met. So, um, these red flags were all documented on his intake paperwork. And I, um, you know, had talked to the parents about his daily routine, because that was documented on the paperwork as well. The family was from an area, um, in, uh, the Arabic countries, um, where they said that autism just didn't exist when we came in the house.

Lori Frome: (05:29)

So they didn't really know much about autism at the time, and of course, we know it exists in that area. Um, but the, maybe the family just wasn't exposed, so they didn't have a lot of background knowledge. This was also their first child. Um, so it was a very new term and new concept, new symptomology for them. And, um, in some ways, because they came here as refugees, um, I think that they were not even sure what exactly was happening. I know the pediatrician had recommended the family for services. So the mom came and was expecting another child, and she was learning English from the television. She had not known any English before coming over and knew that in order to feel safe going outside in the community, uh, navigating, you know, our local environment, she needed to learn English. So she was very tuned into television shows that, uh, that spoke in English, that she could understand and that was her way of learning language.

Lori Frome: (06:41)

Mm-hmm . So in her parenting mind, um, she thought, well, my child can learn language from his favorite cartoons as well. And I won't mention the name of any of the cartoons, but a lot of them were the same cartoons, the same episode. And we often see this, uh, as a frequent theme with a lot of the children that we see with virtual autism. It's a lot of the same programming, um, which we have also found just in our own circle, to probably be more detrimental than programming that's different every day. And we believe that it wires the neuroplasticity in a way that, um, you know, the neurons that fire together wire together in a way like our brains have never been able to do before. The same stimuli again, and again and again. Exactly the same.

Hillary Wilkinson: (07:39)

the same clip going again and again that the child wants to see, will run back on the tablet, rewind, watch the same, you know, maybe one minute clip, maybe 30 mi 32nd clip. 

Hillary Wilkinson: (08:22)

So it's not, oh, I'm sorry. I was gonna say, so it's not, it's not the same as a parent who say is being requested to read night after night, you know, Goodnight Moon, or, I mean, 'cause I know, I know there's a, at some point there is a lot of repetition in toddlerhood. 

Lori Frome: (08:46)

Right. But that's good. That's how toddlers learn mm-hmm . And that's how they increase their attention span. Mm-hmm . So with each subsequent reading, usually you'll find that if the child is interested in the theme of the book, or, um, what the book is about, or characters in the book, that every subsequent reading from the first the child has more interest due to the predictability. And yet there's a difference. 'cause we can never recreate to a T the real world. Yeah. Like the screen is able to replay Yeah, exactly. In the same time, same voice, same situation, you know, that just doesn't happen in real life. The research shows that in early childhood, with the first video viewing and, uh, cohort of 18 months old with parents, the first video viewing the parents had the most attention to the video. It was novel. Their attention held. The children at 18 months had the least, um, attention to the video. It was new. Their mind constantly seeks different stimuli. And so they didn't, weren't able to attend that long. There was no, you know, prediction pattern, anything after the subsequent viewings. Then the second viewing the adult's attention started fading with every subsequent viewing and every subsequent viewing. After that, the child's attention started getting stronger and more tuned in. 

Lori Frome: (12:44)

So anyway, this, this child was watching, reportedly by his parents, 10 hours of screen time a day, mostly on a tablet, mostly repetitive viewing of cartoons and very strong signs of autism. Uh, going to the back of me, hitting me with his hand, um, coming because he wanted to communicate, um, that he wanted me like to communicate to mm-hmm . But this child had so few, uh, understanding of communication, so little understanding of communication that he didn't even know to come to the front of my face to communicate.

Hillary Wilkinson: (13:44)

so how did you know to link that specifically to screens?

Lori Frome: (13:58)

So I had no clue. It started with the mom and me talking to the mom after six weeks and saying, look like he just hasn't made the progress that we need in our country, in our, um, state. Um, and we know that best development comes with, uh, the more resources the earlier with this type of situation. And so the mom said, well, you know, we really don't know anything about it. Let us think about it for a weekend. We'll get back to you next week.

Lori Frome: (14:49)

So I always would see them on a Friday, a weekly visit for an hour. And I came that next Friday. And, um, the child had had a little bit better of a visit. He actually came to the front of me to be swung, uh, onto the couch with his mom. I was swinging his hands. His mom was swinging his feet, and he came to the front and kind of, you know, put his arms up a little bit. At the end of the session, the mom didn't speak English well. I asked her, oh, he had a little bit better of a session today, anything new. And she said, well, when we talked to you on Friday, we decided to, uh, that he was more attentive without the screens on, meaning the tablet or the television. So for a period of 30 days, they were going to try removing all screen media. They also took away all LightUp toys, considering them as attention grabbers for him, and replaced it with like a tricycle, a ball jumping pit. Um, some train tracks like, uh, Thomas the train kind of thing. Like

Hillary Wilkinson: (15:57)

Analog toys.

Lori Frome: (15:58)

Yeah. Yep. Yeah. Just like very boring toys, Mr. Potato Head. And when I say boring, I mean develop developmentally amazing toys, but old school. Yes. We had to cancel the next three sessions due to weather and a personal conflict. So three weeks went by and when I came back, I came back to a completely different child. And yet I forgot what had been happening because it was three weeks before and he just had a good visit. But I've seen good visits many times throughout my career. Uhhuh . So I didn't really think too much of it. So this child who normally took my hand, you know, to lead me through this hallway, has the gesture of come, then that's like developmental milestones times a year ahead of pulling me just in

Hillary Wilkinson: (16:50)

Three weeks.

Lori Frome: (16:51)

Just in three weeks. Amazing. Comes up to my face and says, Mo and signs for more when he wants to be swung again, he used to stare off a lot with a blank look and just kind of look through you. Mm-hmm . There was more eye contact that was present, shared enjoyment with his tricycle. I was honking the horn on one side. He imitated, honking the horn on the other side. That was reciprocal for two turns. Um, that,

Hillary Wilkinson: (17:26)

That's like indicative of that serve and return relationship. Yes. That's so critical for speech development. Yes.

Lori Frome: (17:32)

Yes. So by the time the session's over, I'm like, he has made more progress in three weeks than 28 months of me seeing any other child that had a similar, uh, predisposition of skills, like a similar disposition of skills, uh, or presentation of, uh, red flags for autism. So I kind of, um, I asked the mom, I said, I need to go out to my car for a minute, like, be excused, . And I just actually, my eyes started watering. 'cause I felt like I had seen a miracle occur in my mind.

Lori Frome: (18:23)

And I didn't know where to start with the mom, mom, um, only because of her capacity to understand English and my capacity to communicate what I wanted to. So I needed to get myself together and just find a way to ask her, what in the heck has been happening the past three weeks? Right. And so when I did say to this mom, wow, like, what is happening? He's made so much progress. She basically told me, like, remember we had said we were removing screens for 30 days. This is what he's doing now. We're on day 29. Do you think we should continue it? We think we should . I'm like, oh my gosh. Yes. But like, I don't think because of her lack of knowledge with autism and how it looked in young children to begin with, that she understood the amount of progress and that this was not normal 

Hillary Wilkinson: (19:19)

Well, if it's, if it's your first child and you, and you haven't worked with children mm-hmm . How would you know? You know, and I mean, clearly they were undergoing a lot of change, a lot of stress mm-hmm . And Yeah. No, that's what I think it's important that we just come from a place of understanding and teaching. We don't come from a place of, you know, judging Yeah. Of where people are in their life. It's like the more you know, the better you can do mm-hmm . So Yes.

Lori Frome: (19:50)

Right.

Hillary Wilkinson: (19:51)

Yes. Yes.

Lori Frome: (19:52)

So, so then I, um, you know, was just like, please, whatever you're doing, continue what you're doing. I will be here next week. I need to go home and learn everything I can on autism and screen time, because that's all I could connect it to. Everything else she was doing was normal stuff that any other parent would've done play with their kid would good toys, like, you know, and she removed the LightUp toys. It wasn't like, in my opinion, a huge, you know, huge deal. But that this screen time that was normally 10 and a half hours a day per the evaluation report had come down to zero mm-hmm . And was replaced with a huge amount of interaction in the meantime because this child constantly wanted her attention. That was the function of a lot of that behavior was attention and, uh, coming to communicate so that she was playing with him a lot and involving him in all these routines.

Lori Frome: (20:54)

 So I started looking up screen time and autism, television and autism, and not really anything's coming up except one paper that was published back in 2006. And that was by, uh, Dr. Michael Waldman and Dr. Sean Nicholson, uh, entitled, does television cause autism? It was like my exact search words, basically. Yeah. So I was like, oh my gosh, like, you know, this, this paper is like exactly the title I'm looking for. Let me read it. And as I was going and reading it, it was talking about precipitation data and cable integration in areas of Pennsylvania and California that close by each other as far as, um, weather patterns.

Lori Frome: (22:05)

Mm-hmm . But the, the cable television went into the homes at a different rate. One had access to free cable or very discounted cable early. The other did not have access to cable till later. Mm-hmm . And then when it rained a certain amount in the area, the children watched a certain amount more television. They were able to decipher this data. And basically it looked at these two counties and where the cable television went in earlier, it would be an assumption that there was more time to watch screen time when it rained than when the cable television didn't go in. There was only three channels at the time. Adult programming most likely wouldn't hold a toddler's attention mm-hmm . And so they would be doing other things. Yeah. And the correlation showed that it was highly correlative with, um, the autism rate at that time in that county.

Hillary Wilkinson: (23:08)

Yeah. I found that fascinating in the little preview of the documentary that I was able to see. Which leads me to ask Wilder, how did you come into this subject and decide, Hey, this, this deserves a full documentary? Like Yeah. I feel like this is a good segue into your side of the, the story.

Wilder Nicholson: (23:31)

 I've been making films about, uh, like early education and outdoors, uh, nature based education. and, and so I guess like, uh, back in 2021, um, a family member, Sean Nicholson mentioned this research that, that he did at, with, at Cornell University and the authors published and were hoping that this, like a lot of attention would be there, and that like awareness could happen. Well fast forward to 2021, that's when we started to talk, oh, maybe we can make a documentary to help raise awareness and, and reach people. But I really became interested in this topic when I spoke with, uh, Dr from France, uh, Dr. Ducanda, yeah. Mm-hmm . Uh, and, uh, so we, we did an interview and I had read a little bit about, um, the, like the research she had done and, and work she was doing with, with kids and, and recommending removing screen time as a way to help help kids with development delays and, and how, um, kids would, would lose a diagnosis like with, within a month or so of, of, of just going screen free and having more social interaction. Talking with Dr. Ducanda, it was just clear like this, this was like a, a worldwide phenomenon that was happening.

Hillary Wilkinson: (26:04)

Well, and I, I love that this is the place where research meets the road, right? Where it's like, here we've got Lori, who is so, so on the road, , that she's looking for literally like, like I'm not, I, I, I think I'm seeing what I'm seeing. Am I right in seeing this? You know? Mm-hmm . And then you've got other people who have done the research and they're going, we would love to share this, but we don't know how, and that's why we need people like you Wilder. So thank you for recognizing that this is a story that needed to be produced and published and is now winning awards. And so that's, that's very exciting. When we come back, let's talk more about the documentary, A Stone Unturned, and we're gonna get into some more of this like, specific definitions of virtual autism. 

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HSH Presentations

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Hillary Wilkinson: (27:15)

Wilder Nicholson and Lori Frome are here today talking about the first feature documentary that I have seen that is specifically on screen time and autism related symptoms. A Stone Unturned introduces three families who try a digital screen fast to help their children with autism, and they discover remarkable changes like Lori was talking about within their children. So we certainly have research studies showing how screen time is influencing early brain development. This documentary shows how the absence of screens can help with remediation and even reversal of autistic type behaviors. So before we start digging into the documentary, I want to kind of get into some definitions. And when we say screen overuse syndrome or virtual autism, these are terms that get used in your film and in your work. But I'd like to unpack them specifically for the listeners today.

Lori Frome: (28:37)

We define virtual autism as a term that, uh, Dr. Marius Zamfir of Romania coined. Um, it is excessive screen time in early childhood, usually before the age of two, but I have seen some of it occur later and still, you know, cause a problem. But the excessive screen time usually tends to be over two hours, but, uh, sometimes even over four hours. So it would just depend as of the sensitivity of the child, um, a day for obviously a routine long exposure of time, not just one time for four hours a day, but it can cause problems with the child's brain development, um, leading to behaviors and symptomology that just mimic classical autism, you know, that would not have that precursor, um, in the environment of the high screen exposure. So things such as cognition, delay, speech delay, um, aASD like behaviors, repetitive restrictive behaviors.

Hillary Wilkinson: (29:47)

ASD stands for autism spectrum disorder.

Lori Frome: (29:53)

So with repetitive restrictive behaviors, wanting things just the same, some sensory issues, not wanting to put certain textures on their body, not wanting to eat certain things. Um, and so it just a lot of the same, and basically all of the same manifestation that we would think of in, uh, language ability, in social interaction ability, and repetitive restricted behaviors, um, we are seeing can be present in children with that history. And obviously, we're assuming and working on research that has used genetic testing as well.

and this condition of virtual autism will test as autism on standardized assessments the same as classical autism without this exposure would test. So tests like the -A-D-O-S will have positive results the same as if the child had classical autism, the cars, the mchat, there's a lot of tests that are used to determine, um, autism, these testing tools will test just like typical autism will.

Hillary Wilkinson: (31:36)

So is it one of those things that it's up to a, um, a family to recognize the amount of screen exposure that's happening and then experiment with it? Or, I, I'm just wondering how to identify, you know, what?

Lori Frome: (31:57)

Oh, oh, okay. So when parents contact me or interested in, does their child have virtual autism or classical autism, I get that question a lot. We qualify children for studies that we do is that they had to have at least two or more hours before the age of two to be considered a candidate for the study. Um, or like, even some of our studies are taking children at 18 months, but it has had to be a history that the screen time was about two or more hours a day. Um, and that, um, they are having symptoms of autism or red flags for autism, and a lot of them have already been diagnosed with autism.

Hillary Wilkinson: (32:50)

Okay. Okay. Thank you for that. Yeah. So, Wilder while you were, um, making the film, did, did anything surprise you as you were creating it?

Wilder Nicholson: (33:02)

Um,

Wilder Nicholson: (33:09)

I was surprised by how, how much, uh, like how much dedication, love, and determination the parents like, were showing and, and wanted to share their story. Uh, so that I would, I, I really looked up to them and like, and I, and, and I guess a, a surprise was just how like this, this journey of going on a digital screen fast for, for these families, like it brought, it brought them so close together and it was just like, it was just fun to be around and, and to just see their, their, how they communicate and, and the good times that they were having. So, I mean, that was, that was kind of a surprise 'cause uh, getting to know these families and, and, and that that was wonderful. Yeah.

Hillary Wilkinson: (34:01)

Yeah. Yeah. And really, uh, brave of them to let you into their kind of, their intimate space of their home and family, and allow you to record them at times of vulnerability where they're going, we're not sure what's going on. We don't know if what if this is the right thing. We're just trying. Right. Um, and I really appreciate how you gave a very global view. These are very international families that are represented here. This is not, this is not a one country problem by any means. It's not even a one continent problem, it's a global problem. Mm-hmm. Mm-hmm . So, so I really appreciate, you know, the, the work you did in all of that. Um, I want to ask Lori, uh, you know, we talk about doing, uh, I, I feel like this is a, a tricky episode in that I wanna talk about the documentary , but I also want, I feel like maybe, maybe Lori maybe you'll come talk to us another time. Oh, I would love to. Oh, okay. Because I like, I feel like I would love to, I feel like you're such a resource. I, I can't help but ask if you had some critical takeaways, like is there anything that you want families most to hear? Like what else you, you mentioned like the light up toys you mentioned, like those things, what else should be removed? Is it only screens if we're worried about our kids? can you speak to that? So

Lori Frome: (35:33)

We just highly suggest and recommend that all screens be removed, tablet, television, smartphone, whatever people have, computer, you know, would be removed from the child's sight and hearing mm-hmm . Um, that is affected, that, that toys be traditional non LightUp toys without sounds, because those are attention hijackers as well, especially for kids with this predisposition that are wired differently, um, than a typical child. They really get stuck in the toy. And the research shows that with those toys, there's less interaction between the parent and, um, that a child has less opportunities to play creatively. It's kind of like, make the sound and the toy is done. Mm-hmm . Make the sound and the toy is done so there's less imagination needed. Um, and they create times where sometimes too kids go from thing to thing to thing, like different LightUp toy to different LightUp toy, to different LightUp toy so that they don't, uh, allow for as long of opportunities to play with, which the longer opportunities to play, um, becomes the longer the learning. But Hillary, it's not just what we're removing, it's also what we're adding mm-hmm . In that place. So that's super important and critical as well.

Hillary Wilkinson: (37:03)

Yeah. Yeah. And what you're talking about adding is all of that interaction and just all of that, you know, in the creative process, they talk about the incubationary period, where it's like, it's kind of that, that bridge between boredom and creation where you're mm-hmm . You know, you're kind of hatching an idea, but it's quite, it's quite important to foster mm-hmm . Those moments, Wilder, did you have any like aha moments or takeaways while producing the, while producing A Stone Unturned?

Wilder Nicholson: (37:45)

I think one aha moment was, we organized an online screening, an online summit, and, and it was a moment where we had, there were speakers from France, we, we had, we showed parts of the film, um, with stories from Romania, uh, and then researchers from the US were there as well. And, and then parents from all over the world joined like many, many countries. So this was like, it was just to, to see, how researchers and doctors are, are all finding similar things, um, independently. And so that just made the story so strong and there was such a, such a positive feeling there of, of hope, of like, we can, there's, there's, um, there's a solution and we, like, we're, we're, we're kind of discovering this together. And, and, uh, so that was a wonderful, that yeah. That was, uh, an aha moment to, to see that it is not just a tiny story, but it's it's a shared story.

Hillary Wilkinson: (39:06)

Yeah. A ripple effect. So how can people watch A Stone Unturned?

Wilder Nicholson: (39:14)

Yes. So we are organizing a online screening and a virtual event this fall. And so if you're listening to the podcast before November 15, there's, um, uh, a, a simple registration you can watch and stream the film. Um, the documentary is about an hour.

Hillary Wilkinson: (39:47)

And yeah, and I will link all of that in the show notes. And I, I recommend it be viewed for really any caretaker of children, whether it's parents, teachers, grandparents. I feel like the more we can educate people about this critical time of early brain development, which we classically have called early childhood development, but the more we learn about the, the brain development of the very young, I think the, the more importance we need to place upon, you know, just hanging onto the, the humanity of it. ,

Lori Frome: (40:28)

.

Hillary Wilkinson: (40:29)

So we have to take another short break, but when we come back, I am going to ask Wilder and Lori for their healthy screen habits. 

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Thank you donors!

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I'm speaking with Wilder, Nicholson and Lori Frome, who have worked together to cast light on excessive screen overuse syndrome with the documentary, A Stone Unturned, a documentary about screen time and virtual autism. On every episode of the Healthy Screen Habits podcast, I ask for a healthy screen habit. And these are going to be tips or takeaways that listeners can put into practice in their own home, hopefully right away, what are yours?

Lori Frome: (41:29)

Um, mine is something that's pretty easy to remember. Um, it's just screen free and the age four, and then ASD, that acronym for Autism Spectrum Disorder. I think that if we as parents can focus and caregivers on being as screen-free as possible and as hands-on as possible, uh, playing with a kid involving them in everyday life and just being in close proximity as much as possible and having the screens reduced as much, uh, as possible to age four, that they are gonna see so much better developmental outcomes in every spectrum of development. And that includes cognition, speech, adaptive skills, or self-help skills. So, uh, screen-free 4 ASD just really is something that I always tell parents.

Hillary Wilkinson: (43:10)

Great. How about you Wilder?

Wilder Nicholson: (43:13)

Just thinking or hearing again, like how, how children learn. And one of those ways even we learn really well is, is by storytelling and stories that we hear from, you know, and so just that healthy screen habit that I've tried to make use of is, um, to keeping my phone away during meals so that I can en enjoy the company and listen to those stories, uh, with friends and family. Uh, and also just simply, um, making the, like the screens on my telephone, like gray scale or black and white. And so it, it just returns my attention to this vibrant three dimensional world, where those meaningful relationships are. Yeah.

Hillary Wilkinson: (44:11)

Yeah. I love that. Thank you. Well, as always, you can find a complete transcript of this show as well as the link to watch A Stone Unturned and that nonprofit website by visiting the show notes for this episode. You do this by going to healthy screen habits.org. Click the podcast button and find this episode. Thank you so very much, Lori Frome and Wilder, Nicholson, for your time, your insight, your passion, and for, um, turning over stones of all sorts. ,

Lori Frome: (44:48)

Thank you so much, Hillary. It was so nice to be a guest.

Wilder Nicholson: (44:58)

Thank you Hillary, for, for all you do and, um, best wishes.