Recent Social Media Advisory Is Important for Autistic Youth

U.S. Surgeon General Dr. Vivek Murthy has had a longstanding commitment to promoting mental health and well-being. He views the increasing prevalence of mental health problems as the most significant public health crisis of our time. Recently, he issued an advisory about the impact of social media on the mental health of children and adolescents. Noting that 95% of youth ages 13-17 report using social media, he described both the positive and negative effects of social media use and made recommendations for policymakers, parents, and researchers regarding the use of social media by youth. These recommendations may have even greater importance for children and adolescents on the autism spectrum.

On the positive side, autistic children and adolescents often struggle with making social connections, and social media can sometimes help autistic youth make those connections. Some evidence suggests that autistic people have a stronger preference for using social media to seek out social relationships compared to nonautistic people. Social media platforms can help autistic youth find a positive community of friends, including those that share their specific interests and hobbies. Such communities offer opportunities for self-expression and social support. Making connections with other autistic individuals can promote a positive sense of self-identity and access to autistic role models.

A recent systematic review that included over 3,000 autistic youth and adults found that the use of social media had both benefits and drawbacks. Benefits described by autistic people included the reduced range of social cues online and being able to regulate the amount of stimulation during social interactions. However, autistic people also reported that such online interactions did not reduce their feelings of loneliness and were not a substitute for in-person friendships. This review also found that the negative impacts of social media, including cyberbullying, trolling, and deception, were more severe for autistic people. Another review and meta-analysis of 17 studies found that autistic youth are at greater risk of victimization and verbal bullying compared to their nonautistic peers. Studies have shown that people who have experienced cyberbullying are especially vulnerable to the harmful effects of social media on mental health.

Another drawback is social media's negative portrayal of autism. One study found that social media content often was stigmatizing rather than empowering. So, searching social media to understand what autism is could have negative consequences for a child's self-esteem. This is particularly worrisome given the well-established effects of social media on mental health. Research has found that using social media for more than three hours per day doubles an adolescent’s chance of experiencing depression and anxiety. These statistics are particularly concerning for autistic youth who have been found to experience mental health conditions at higher rates than the population as a whole. More than 70% of autistic youth have mental health conditions, such as depression and anxiety. Excessive or problematic use of social media could trigger or exacerbate these vulnerabilities to mental health conditions in autistic children and adolescents.

Another concern discussed in the Surgeon General’s report is the potential impact of social media on the developing brain. The period from 10 to 18 years is one of rapid brain growth, especially for the brain areas involved in risk-taking, reward-seeking, and self-regulation. Social media may overstimulate the reward pathways in the brain, similar to what occurs in addiction. Research with nonautistic youth has shown that increased use of social media can alter the development of the amygdala and the prefrontal cortex, brain regions involved in emotional regulation and reward sensitivity. These brain areas have been shown to develop differently in autistic individuals, raising the possibility that the effects of social media use on these brain areas could be more significant in autistic youth.

Finally, research has established a link between the use of social media and sleep problems. Autistic youth are at increased risk for sleep problems, including having trouble falling asleep and waking frequently during the night. Such sleep problems are thought to stem from differences in the genes that control circadian rhythm. Disrupted sleep in autistic people might also be related to sensory sensitivities and the presence of medical conditions, such as GI problems, that cause discomfort. Other research suggests that autism is associated with differences in levels of melatonin, a hormone that regulates our sleep cycle. The use of social media can cause suppression of endogenous melatonin by the blue light emitted from screens. Sleep disruption can also result from arousing or disturbing content.

What can parents and caregivers do to enhance the benefits of social media while reducing its harms?

• Establish a media use plan. Autistic youth can benefit from clear, concrete guidelines about the use of social media, including how much online time is healthy and what types of content are beneficial versus harmful. Provide concrete examples and a written or pictorial set of guidelines for your family’s media use plan.

• Educate your child about the potential harms of social media, such as how to recognize negative and inappropriate content, including cyberbullying and deception, and the importance of never disclosing personal information online. Explain in simple terms what bullying is, using role-playing and concrete examples.

• Encourage your child to ask you whether specific content is appropriate and to report cyberbullying to you. Tell your child to refrain from liking, forwarding, or sharing negative messages. Report bullying to the school, online platform, or law enforcement.

• Minimize or eliminate the use of social media in the bedroom, especially during the hours before bedtime, to promote a good night’s sleep.

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• Encourage in-person social interactions with family members and friends involving activities your child enjoys.

These steps can help autistic youth take advantage of the benefits of social media while reducing its potential harms.