COMMENTARY

Fidget Spinners: A Pediatrician's Take

Alok S. Patel, MD

Disclosures

June 05, 2017

Editor's Note: Fidget spinners are the latest craze to sweep the nation. Kids of all ages are playing with them. They are purported to help with everything from boredom to attention-deficit/hyperactivity disorder (ADHD). We asked Alok Patel, MD, an associate professor of clinical pediatrics at Columbia University College of Physicians and Surgeons and a critical care pediatrician at Morgan Stanley Children's Hospital of New York-Presbyterian in New York City, to try one out.

Physicians, we all know that it's important to understand what medical research or innovations your patients are interested in. Now, I'm a pediatrician and my patient population is a little different, but the recent medical breakthrough that they're all about is the fidget spinner. Unless you live on a deserted island, you've probably heard of them by now. Trust me, I also tried to ignore these things, but they're everywhere. Fidget spinners are touted as a breakthrough for children with ADHD, autism, anxiety, and stress, and manufacturers claim that they improve focus and concentration.

I don't know how to evaluate those claims so I went and got expert testimonials. I'm an inpatient pediatrician here in New York City, and when I went around one evening to ask about these things, I was surprised. Every child had one. Most of them even had them right there with them in the hospital, just spinning away. I mean, I admit that they are pretty addictive. They're a top-selling toy on Amazon, you can buy collector's versions, and there's even one shaped like the Batman logo. I bought mine for $8 at a 7-Eleven on my way to the studio today.

But do they actually work? More important, are there safety concerns? The Consumer Product Safety Commission is actually investigating them over concerns about choking incidents.[1] Schools are banning them. National experts are not endorsing them. In Ireland, they've recalled 200,000 for safety review.[2] Doesn't sound too safe to me.

In Texas, in a report you've probably heard by now, a 10-year-old girl was just sitting in the backseat of her car, hanging on to her fidget spinner, and she accidently dislodged one of the bearings, which got stuck in her esophagus.[3]

Physicians, if you want to give your residents a little lesson on x-rays during grand rounds, Google "fidget spinner x-ray." See what they come up with. A similar incident took place in Oregon with a 5-year-old boy.[4] I've seen toddlers playing with them, and anything that goes in a toddler's hand goes right in his or her mouth. These bearings are not that safe. This is also a special risk for children with developmental delays, who seem to be a population that is specifically targeted by advertising for this product.

I polled my pediatrics friends to see if they had stories. A pediatrician friend who works in an urgent care setting saw a child with a stress injury because the child spun it continuously for 8 hours. Another one of my pediatric provider friends saw a child with a chin laceration because he was spinning it and walked right off a curb. That doesn't sound like increased focus to me.

What does Amazon say? If you look at the reviews on Amazon, you'll read claims such as: "increased focus for those suffering from ADHD, anxiety, and autism"; "discreet fidgeting helps stop bad habits"; and "boost your creativity!" No research or evidence actually supports any of these claims. What is shown, though, is that some children with ADHD may benefit from a small amount of background activity. Two studies, one published in the Journal of Abnormal Child Psychology[5] and the other in Child Neuropsychology,[6] showed that some children with ADHD can have improved working memory or cognitive performance with slight gross motor activity.

The way I translate this information for my parents is simple: Things like walking while talking, squeezing a stress ball, even sitting on one of those exercise inflatable balls while doing homework [may be beneficial for kids with ADHD]. Not bringing one of these things to class!

They are so captivating and pretty, and are probably just a distraction. I wouldn't tell any parent who is struggling with a child who is hyperactive to let a fidget spinner preclude them from actually seeing a specialist.

I approach children with autism differently. When I talk to parents of autistic children about these colorful little devices in the inpatient setting, they all report very interesting uses for them. They are aware of the safety risk and they use the toy primarily as a way to bond with their children. One father used it as a way to reward his daughter for taking her medications on time or completing certain tasks. Another mom was laughing and said that she and her daughter put them on a table, spin them, and race. They see whose spinner outlasts the other one. As long as they know exactly what they're getting themselves into, I say do your thing.

In the end, what I tell parents is that the device is not a replacement for evidence-based occupational or behavioral therapy. Even though they are really cool and flashy, there are hidden safety risks. Those bearings are not delicious little donuts; they can get lodged in a child's throat. Parents need to be smart about these just as with any other toy.

And doctors, if you're annoyed by these, relax. They're just like Pogs, slap bracelets, or the Jonas Brothers—they're a fad, and they'll be gone soon.

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