Differences in Performance on Developmental Tasks in Young Children Across Digital and Paper-Based Modalities: A Feasibility Trial
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Updated: Feb 2, 2026

Measuring Statistical Learning Across Modalities and Domains in School-Aged Children Via an Online Platform and Neuroimaging Techniques
Published on: June 30, 2020
Allison G Dempsey1, Amy K Barton2, Andrea F Duncan3
1Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO.
Insights
Young children engage similarly with developmental tasks presented digitally versus on paper. However, very young children (under 2 years) may benefit from hands-on manipulatives for accurate developmental screening.
Area of Science:
- Pediatric developmental assessment
- Human-computer interaction in early childhood
- Digital health technology
Background:
- Assessing child development is crucial for early intervention.
- Digital screening tools offer potential for efficient monitoring.
- Understanding children's interaction with digital interfaces is key to feasibility.
Purpose of the Study:
- To evaluate the feasibility of digital-based screening for child development.
- To compare young children's performance on developmental tasks presented digitally versus on paper.
- To investigate the influence of home touchscreen exposure on digital task performance.
Main Methods:
- Randomized experimental design involving 80 children aged 18-48 months.
- Developmental tasks administered across 7 domains (language, literacy, numeracy, social-emotional, cognition, fine motor).
- Comparison of task performance between digital (tablet) and paper-based formats; parent-reported technology use collected.
Main Results:
- No significant differences in raw scores were found between digital and paper presentation modalities across all domains.
- Weekly hours of home touchscreen use did not correlate with performance in the digital condition.
- Performance limitations were noted for children aged 2 years and younger in both formats.
Conclusions:
- Digital screening is a feasible approach for assessing child development in young children.
- Young children's performance on developmental tasks is comparable across digital and paper formats.
- Manipulatives may be necessary for developmental assessments of children under two years old.
Objective:
To determine whether use of digital-based screening is a feasible approach to monitoring child development, it is necessary to assess young children's abilities to interface with touch screen technology. The primary objectives of this exploratory feasibility study with a randomized experimental design were to determine (1) whether young children respond differently to developmental tasks on paper versus tablet device and (2) whether responses to items presented digitally differed according to hours of weekly exposure to touch screen technology in the home.
Methods:
Eighty children attending 18-, 24-, 36-, or 48-month pediatrician well-child checks were randomly assigned to complete a series of 70 examiner-facilitated, developmental tasks across 7 domains (receptive language, expressive language, early literacy, early numeracy, social emotional, cognition, and fine motor) presented either digitally or on paper. Parents provided information about use of technology in the home. A series of t tests assessed for main effects of presentation modality (digital vs paper) on each of the domains.
Results:
Raw scores across the 7 domains did not differ by presentation modality. Hours of technology use per week was not related to raw scores among children in the digital condition.
Conclusion:
Young children do not respond differentially to items when presented in a digital format in comparison to a paper-based format. Use of manipulatives for assessing developmental skills may be needed for children 2 years and younger, as they displayed a limited range of responses to items in both conditions at these age groups.
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