Send to

Choose Destination
Pediatrics. 2019 Apr;143(4). pii: e20182012. doi: 10.1542/peds.2018-2012.

Differences in Parent-Toddler Interactions With Electronic Versus Print Books.

Author information

Department of Pediatrics, Medical School,
Departments of Health Behavior and Health Education.
Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.
Nutritional Sciences, and.
Biostatistics, School of Public Health, and.
Department of Pediatrics, Medical School.



Previous research has documented less dialogic interaction between parents and preschoolers during electronic-book reading versus print. Parent-toddler interactions around commercially available tablet-based books have not been described. We examined parent-toddler verbal and nonverbal interactions when reading electronic versus print books.


We conducted a videotaped, laboratory-based, counterbalanced study of 37 parent-toddler dyads reading on 3 book formats (enhanced electronic [sound effects and/or animation], basic electronic, and print). We coded verbalizations in 10-second intervals for parents (dialogic, nondialogic, text reading, format related, negative format-related directives, and off task) and children (book related, negative, and off task). Shared positive affect and collaborative book reading were coded on a scale of 1 to 5 (5 = high). Proc Genmod and Proc Mixed analyzed within-subjects variance by book format.


Parents showed significantly more dialogic (print 11.9; enhanced 6.2 [P < .001]; basic 8.3 [P < .001]), text-reading (print 14.3; enhanced 10.6 [P = .003]; basic 14.4 [P < .001]), off-task (print 2.3; enhanced 1.3 [P = .007]), and total (29.5; enhanced 28.1 [P = .003]; basic 29.3 [P = .005]) verbalizations with print books and fewer format-related verbalizations (print 1.9; enhanced 10.0 [P < .001]; basic 8.3 [P < .001]). Toddlers showed more book-related verbalizations (print 15.0; enhanced 11.5 [P < .001]; basic 12.5 [P = .005]), total verbalizations (print 18.8; enhanced 13.8 [P < .001]; basic 15.3 [P < .001]), and higher collaboration scores (print 3.1; enhanced 2.7 [P = .004]; basic 2.8 [P = .02]) with print-book reading.


Parents and toddlers verbalized less with electronic books, and collaboration was lower. Future studies should examine specific aspects of tablet-book design that support parent-child interaction. Pediatricians may wish to continue promoting shared reading of print books, particularly for toddlers and younger children.


Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Radesky is paid to write articles for PBS Parents and is on the board of directors and consults for Melissa and Doug; the other authors have indicated they have no potential conflicts of interest to disclose.

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center