Screens and teens with migraines: visually sensitive learners in contemporary digital classrooms

Abstract

Technology-rich school classrooms incorporate digital media in the form of computers and interactive whiteboards into the visual learning environment. Whilst evidence-based research shows use of technology improves academic outcomes for high school students in general, there are limited data available on the consequences of digital media use for high school students with migraine. This article highlights the historical issues with light-emitting media, the physical parameters that are changed by adoption of these digital media into the classroom and some of the adverse effects caused by visual light stimulation. The article concludes by calling for further social research to better understand adjustments needed by students with migraine in the digital media classroom, and the policies needed to support image parameter guidelines for schools. In this article, the term visual light sensitivity refers to any student’s abnormal sensitivity to optically sighted light leading to negative responses, including that of migraine.

Keywords:

• Digital media
• migraine
• classroom
• school
• light sensitive
• adolescent
• children

Reactions to light-emitting digital media

In 1997 a broadcast episode of Pokémon (fantasy, children’s cartoon) was attributed as the cause behind 685 children being hospitalised for neurological reactions to specific visual images. The reactions ranged from dizziness to seizure. Many of these children had no previous diagnosis of neurological disorders. It follows that with increasing use of digital media in schools, there is the potential for similar adverse reactions to classroom visual images. Yamashita et al. (1998) estimated that 6.25% of the young people watching the cartoon would have been affected neurologically. Although isolated incidences of screen-induced seizures were reported prior to 1997 (Harding and Harding 1999), the Pokémon incident prompted widespread investigation of the visual properties of the cartoon and the effects they have on developing and developed brains. The parameters investigated include alterations of wavelength and luminance (Parra, Kalitzin, and Lopes da Silva 2005), frequency (Ricci et al. 1998), amount of visual area stimulated (Wilkins, Emmett, and Harding 2005) and concentration during a programme (Furusho et al. 2002). In 2002, Binnie et al. demonstrated individualised reactions to broadcast flicker patterns. This could explain why the Pokémon cartoon did not elicit a negative response in its creators, but stimulated a range of reactions in the audience of children.

Digital media and school

Technology-rich classrooms have altered the way in which information is accessed by students. Visual communication has changed from light reflective to light emitting, so students perceive the information in a different way. Light reflective visual communication includes the blackboard, non-interactive whiteboard, books and pen/paper. Light-emitting visual communication includes interactive whiteboards (IAWs), tablets, computers and laptops. In general, light-emitting visual communication devices are categorised as digital media. There is evidence that use of an IAW in a classroom increases student engagement (Preston and Mowbray 2008). For light-sensitive students, however, this increase in engagement could be tempered by the negative reaction to the physical attributes of the images (Binnie et al. 2002; Wilkins, Emmett, and Harding 2005).

There have been many technological advances regarding digital media used in classrooms. These changes may increase or reduce the risk of an adverse reaction for students with visual light sensitivity, but all represent change in a student’s learning environment. For example, the change in viewing screens from cathode ray tubes to liquid crystal displays has reduced the risk of an adverse reaction due to the increased refresh rate or flash frequency. However, the increase in screen size from smaller television screens to larger IAWs and the use of laptops used closer to the user have greatly increased the percentage retinal area stimulated by the image, increasing the risk. Increased screen luminance from cathode ray tubes to IAWs has also increased the risk of an adverse reaction. In addition, more than half the school day can be spent with digital devices ‘on’ in the classroom, using a screen saver, even though they are not the immediate focus of the current learning experience. This peripheral stimulus for hours during the day can have an adverse effect on students with migraine due to lack of habituation (Boulloche et al. 2010).

Overall, the evolution of digital media in education has gradually increased student exposure to light-emitting digital media. The documented increase in the number of visual light sources, intensities and duration could create impairment for students who are light sensitive, including those students with migraine. To date the use of digital media in the classroom has not been recognised as a limiting factor for students with light sensitivity. Freund (2001) discusses the importance of spatio-temporal arrangements of material culture. Classroom IAWs demonstrate the effect of these arrangements. A visual light-sensitive student sitting at the front of a classroom would increase the risk of adverse reaction. However, the same student would decrease this risk by sitting further back. By acknowledging that specific cultural tools could create limiting factors for some students, individual accommodations could be created to enable these students to access the digital media with decreased risk.

Migraines and school

Students with migraine are already disadvantaged at school. Lipton et al. (2007) reported that 28% of people with migraine felt that their productivity at work or school was reduced by at least half. Because migraine impacts productivity, a student may be present in class but not be able to work at full capacity. For affected students this may have implications for curriculum knowledge, understanding, process development and assessments. Added to this is the high rate of school absence due to migraine. In the same research, Lipton et al. (2007) found that 25% of people with migraine reported an absence rate of greater than one day per week from work or school.

Educators have an important role in understanding and creating a supportive environment (Smagorinsky 2012). Teachers provide particular support for students with diagnosed conditions, but not all conditions attract the same level of assistance to access learning activities. For example, frequency and levels of adjustments allowed for students with migraine and Attention Deficit Hyperactivity Disorder (ADHD) are different despite the similar prevalence in adolescents. Both follow international guidelines that include neurological symptoms. ADHD may not be fully understood but it is well recognised in the compulsory educational community, and therefore reasonable adjustments can be made for the students both during and between episodes. However, migraine in children and adolescents is neither understood nor well known. It attracts few adjustments in the classroom to support student participation, other than in the ‘pain’ stage. Most individuals with migraine are noticeably sensitive to visual stimuli during an episode, and these can trigger an episode (Shepherd 2010), but they are also sensitive in between episodes (Martín et al. 2011). This ‘interictal’ response is not always observable in the classroom. It seems for students with migraine that there is already disadvantage due to regular absences from school with additional potential disadvantage from light sensitivity when at school. The challenge is to find a set of parameters for classroom digital media that is inclusive of students with migraine whilst not diminishing the learning activity.

As with many neurological disorders, reactions to stimuli (like light) are unique to each individual. There are specific physical properties of light and certain combinations that trigger adverse reactions in significant groups of the population. Some individuals are sensitive to changes in frequency (colour) whilst others are sensitive to changes in luminance. Using data collected from different demographic groups, theories were generated regarding the parameters causing the adverse reactions. These led to the revision of guidelines in use by developed countries. They include the Independent Television Commission guidelines, which are designed to increase equity of safe access to broadcast television. The World Wide Web Consortium (WC3) developed the Web Content Access Guidelines (WCAG) incorporating equitable access for light-sensitive individuals. This was followed in 2008 by WCAG 2.0 to incorporate additional technological developments.¹

Classroom application of safer viewing parameters as outlined in these policies would enable equity of access to information using digital media for visually light-sensitive individuals, including those with migraine. However, at this time, compulsory educational institutions are not required to adhere to these policies. This means that students with migraine are less protected from digital images in the classroom.

Future research

Given the altered parameters of screen type and use in the classroom, and the age of the students using them, it is imperative that classroom digital media guidelines be re-interpreted with a focus on neurological safety. The increase in digitalised classrooms also highlights the need for further social research regarding equity of access to learning activities including spatio-temporal arrangements. This would involve using contemporary classroom equipment, current digital media pedagogies and the inclusion of digital media in required schoolwork completed outside the classroom, especially for upper school students.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

Janene Sproul receives financial support through an Australian Government Research Training Program Scholarship.

Notes

1. See https://www.w3.org/TR/WCAG20/ (accessed February 3, 2017).