Vanya D. Ivanova1, Silviya A. Mitsova1, Temenuzhka G. Petrova1, Violeta R. Manolova2 and Stoyan R. Vezenkov2
1Center for Social Rehabilitation and Integration for children with disabilities, BG-5000 Veliko Tarnovo
2Center for applied neuroscience Vezenkov, BG-1582 Sofia, e-mail: info@vezenkov.com
For citation: Ivanova V.D., Mitsova S.A., Petrova T.G., Manolova V.R. and Vezenkov S.R. (2025) Full Recovery of a 10-Year-Old Girl with Persistent Screen Addiction Since Age 2 and Autism Spectrum Disorder: Case Report. Nootism 1 (3), 17-26, ISSN 3033-1765 (print), ISSN 3033-1986 (online)
Abstract
This case report presents the full recovery of a 10-year-old girl diagnosed with Autism Spectrum Disorder (ASD) and a history of early-onset screen addiction and screen-induced trauma spanning eight years. The intervention was conducted over a four-month period and involved exclusively remote therapeutic work with the parents, due to the mother's advanced pregnancy and logistical limitations. The therapeutic model focused on complete screen detoxification, sensorimotor and emotional regulation, restoration of healthy attachment dynamics, and restructuring of family roles - particularly the father's engagement in caregiving. Although the parents had previously adhered to general screen-time guidelines, the case clearly illustrates that once screen addiction and trauma are established, standard recommendations are insufficient without targeted intervention. Significant improvements were observed across emotional, behavioral, social, and communicative domains, with complete remission of crisis behaviors and restoration of peer and academic functioning. The case also demonstrated that the Screen-Induced Pathological Vestibular Reflex (SIPVR) served as a sensitive marker for regression and recovery, with its resolution closely paralleling behavioral stabilization. This report highlights the possibility of rapid and complete recovery through intensive parental involvement and systemic support, and underscores the critical importance of addressing screen-related pathology with structured, family-centered therapeutic approaches. An independent institution - the Center for Social Rehabilitation and Integration (CSRI) - was therapeutically involved during the intervention and continued to monitor and document outcomes afterward, providing external validation of the child’s progress.
Keywords: Screen addiction; Autism Spectrum Disorder; Screen-induced trauma; Parental training; SIPVR; Remote therapy; Child recovery
Introduction
One of the primary research questions that concerns us is the successful recovery of children from early-onset screen addiction. If not treated promptly and adequately, this condition may evolve into autism spectrum disorder (ASD), manifesting in a wide range of functional impairments.
When screen addiction emerges extremely early - before the age of one - and persists for a prolonged period - exceeding ten years - what are the prospects for recovery? Which functions can be effectively restored, to what extent, and by what means?
The bioindicators and neurophysiological mechanisms underlying early screen addiction have been comprehensively outlined in previous studies (Vezenkov et al., 2025(1); 2025(2)) and continue to be refined and expanded. The effectiveness of therapeutic interventions is directly linked to the active participation of parents and caregivers in the treatment process (Manolova et al., 2025(1)).
A central component of the therapeutic approach at our Center is the implementation of neurotherapy for the parents themselves (Vezenkov et al., 2024; Pashina et al., 2025), particularly in cases where they exhibit some form of addiction, including screen addiction. Often, the hidden dynamics within the family system revealed during therapy are deeply unsettling (Petrov et al., 2025(1)). A cornerstone of our therapeutic model (Vezenkov et al., 2025(2)) is the restoration of a secure attachment style (Petkova et al., 2025).
Comorbidity with Attention Deficit Hyperactivity Disorder (ADHD) is observed in approximately 70% of cases, and the stages of recovery in such instances have also been documented (Stefanova et al., 2025). If the parents themselves are not therapeutically engaged, they may inadvertently - or deliberately - undermine the recovery process. One of the most straightforward forms of sabotage involves reintroducing screen exposure to the child, either overtly or covertly (Petrova et al., 2025). More complex forms include behavioral patterns driven by unconscious psychodynamic motives (Manolova et al., 2025(3)).
In this report, we present a case in which the parents actively and consistently supported the therapeutic process over a four-month period. The outcomes were remarkably positive for all involved: the child, parents, therapists, teachers, peers, and even members of the family’s social circle and neighborhood community. The case was independently documented by the external therapeutic institution - the Center for Social Rehabilitation and Integration for Children with Disabilities (CSRI) in Veliko Tarnovo - both before and after the completion of the intervention program conducted by the team at the Vezenkov Center for Applied Neuroscience, Sofia.
Case History of the Child (Name Changed): Eva
Eva is a 10-year-old beautiful girl who was brought for evaluation at the Vezenkov Center for Applied Neuroscience by her parents. An initial attempt to place sensors and an EEG cap on the child was unsuccessful - even with the promise that she could watch her favorite cartoon during the procedure. Negotiations and offers of future rewards were also ineffective. In response, Eva began cursing in English and displayed irritated, defiant behavior.
Her mother was five months pregnant and radiated a profound sense of hopelessness and fear - fear not only about Eva’s unmanageable behavior, but also about the upcoming birth of her next child. Her eyes reflected a silent cry for help, a final plea before total collapse. Her anxiety stemmed in part from the loss of a previous pregnancy. She accompanies Eva almost everywhere, serving as her personal assistant - except during therapeutic sessions.
On the verge of exhaustion, her desperate expression also carried a spark of determination - as though she still believed a solution was possible. This was not only due to her name, Nadezhda (Hope), but also because she was, by nature, a fighter.
Developmental and Medical History
Eva was born and lived in Ireland until the age of six. According to medical records, she was diagnosed at age three with Autism Spectrum Disorder (ASD) accompanied by a language development disorder. Appropriate therapeutic interventions were initiated and administered while the family resided in Ireland.
Upon turning seven, the family returned to Veliko Tarnovo, Bulgaria, where Eva began attending the local Center for Social Rehabilitation and Integration. There, she received a multidisciplinary intervention program that included speech therapy, psychomotor activities, and psychological support.
Initial reports from specialists indicate that Eva was unable to enter therapy rooms, adhere to structured routines, engage in interaction or play, tolerate mirror-based speech exercises, or delay gratification. For extended periods, work with her was conducted in a psychomotor and sensory environment, aiming to help her engage with another person and follow basic rules. The core principle guiding the intervention was negotiation.
In the second phase, a speech-language pathologist was included in her therapeutic team. However, at the time of our assessment, every instance of unmet desire triggered behavioral crises and tantrums. Adults in her environment, in an attempt to avoid such episodes, frequently accommodated her demands and maintained a highly predictable routine. These patterns are the primary barrier preventing Eva from entering a structured learning environment and progressing developmentally.
Behavioral crises and tantrums are observed across all settings: therapy sessions, the home, and school - often escalating to aggression. In this context, Eva’s psychological age appears to align with that of a 3–4-year-old child. As therapists, we often observe a strong correlation between screen addiction and infantilization of emotional functioning (Alexandrov et al., 2025).
Before therapy, Eva attended school for up to two hours per day, accompanied by a support aide and receiving special educational resources.
Screen Addiction History
Throughout Eva’s development up to the age of 10, screen-based devices have served as the primary tool for behavioral regulation - used to soothe, manage transitions, or facilitate participation in activities, though only on her terms. According to her mother, Nadezhda, screens were introduced at the age of two through selective exposure to children’s videos, though passive exposure to television had begun even earlier.
Screen devices were used for multiple purposes: during feeding, to induce sleep, to calm emotional states, to support transitions between activities, and to ensure task completion. Eva began speaking in English, influenced by the content of the videos she watched. English became the primary language at home as a means of maintaining basic communication.
In Ireland, Eva’s therapy focused on developing core self-care skills. Nadezhda made efforts in every possible direction, seeking both conventional and alternative solutions to support her daughter. However, over time, Eva’s behavioral crises became more severe and increasingly resistant to intervention.
At the time of the initial assessment, Eva’s screen time had been limited to two hours per day, as regulated and consistently maintained by her parents. Standardized measures - SIPVR (Screen-Induced Pathological Vestibular Reflex) and SIPECR (Screen-Induced Pathological Eyes Covering Reflex) - were both positive.
Communication during the assessment ceased abruptly following a mild provocation by the examiner. Eva disengaged and began to repeat several phrases in an automatic loop, exhibiting oppositional and provocative behavior. Her father removed her from the session, after which a private consultation was conducted with Nadezhda to discuss potential options for therapeutic support and intervention.
Methods
Due to Nadezhda’s advanced pregnancy (fifth month), a different therapeutic approach had to be adopted, tailored to the specific circumstances and available resources. We had exactly four months to prepare Eva for the arrival of a new family member - preparation that would allow Nadezhda to experience a calm and fulfilling postpartum period, without the disruptions of Eva's crises, tantrums, and aggressive outbursts.
In-person therapy sessions involving both Eva and her mother were not feasible, as this would have required weekly travel to Sofia, which was not possible under the circumstances. We undertook a high-risk intervention that diverged from our standard effectiveness criteria: the process began with weekly remote consultations conducted solely with Nadezhda.
Behavioral probes were administered, and based on Eva’s responses, tailored exercises were assigned. With each subsequent session, a structured sequence of tasks, activities, and exercises was introduced - for Eva, as well as for her mother and father.
The therapeutic methods we employ are conceptually described in prior work (Vezenkov et al., 2025(2)) and were adapted in this case to include a comprehensive screen detoxification protocol, a sensori-motor reset, and the processing of screen-induced pathological primitive reflexes. The program also addressed sleep quality restoration, deactivation of control- and dominance-based behavioral patterns, continuous cortical awakening, and the transition from addictive functioning to learning- and orientation-based behavior, through the gradual introduction of real-world activities.
All of these components had to be delivered remotely, through parental training and structured instructional support. Simultaneously, individual therapeutic work with Nadezhda had to be maintained, and the father had to be actively engaged in the process, as he had not been directly involved up to that point.
The father participated in three one-hour remote sessions, while Nadezhda underwent thirteen weekly remote sessions. No direct meetings or sessions were conducted with Eva during this period.
Throughout the intervention, Eva continued to attend the Center for Social Rehabilitation and Integration in Veliko Tarnovo, where she received regular speech and psychological therapy. In addition, Nadezhda participated in weekly psychological consultations at the same center.
Results
The first month of therapy proved to be the most challenging, as it required the strict implementation of a complete screen detox protocol alongside intensive sensorimotor work focused on processing screen-induced pathological reflexes. Simultaneously, abstinence-related behavioral crises and tantrums had to be managed and contained.
The father, Simeon (name changed), was gradually involved in the therapeutic process from day one. He was expected to become a central figure in Eva’s daily life, in order to relieve Nadezhda of the constant need to accompany Eva and manage her daily routines.
According to Nadezhda, Eva had previously run away twice in the past two years - incidents that required police intervention. Surprisingly, Eva navigated the initial abstinence phase with relative ease. While severe reactions had been anticipated, they did not materialize to the expected degree. An exception occurred when other family members - during social visits - reintroduced screen exposure, despite prior warnings.
In one instance, an uncle with a history of alcohol dependency turned on the television and handed Eva a phone, ignoring all prior instructions. Simeon chose not to confront his relative, while Nadezhda refrained from escalating the situation, instead observing to gauge Simeon’s response and its impact on Eva. Following this brief reintroduction of screens, Eva's behavioral crises re-emerged with full intensity, even though the exposure was isolated. When Nadezhda raised the issue with Simeon, he dismissed her concerns and went to sleep, avoiding the confrontation.
Following the screen relapse episode and the resurgence of behavioral crises, three consecutive sessions were held with Eva’s father. Fortunately, he demonstrated motivation to become involved across several domains. As a result of these sessions, the following roles and responsibilities were gradually assigned to him:
- To engage in daily exercises and structured activities with Eva;
- To protect the family from external influences - particularly from relatives whose actions might undermine therapeutic progress;
- To act as a representative of Eva and the family in interactions with institutions, including school and social services.
Prior to this intervention, Simeon had never attended a parent-teacher meeting, nor had he interacted with school administrators, teachers, or therapists.
After a multi-day crisis - during which, as previously described (Vezenkov et al., 2025(3)), the SIPVR (Screen-Induced Pathological Vestibular Reflex) again tested positive - the symptom was once more nearly stabilized within a few days. The intensity of Eva’s response correlated with her level of fatigue: the more tired she was, the stronger the reflex activation.
Changes Observed During the First Month of Therapy
During the first month of therapy, several notable changes were observed. Eva gained 3 kilograms in weight. Each night, she began cuddling with her mother before falling asleep, and engaged in extended evening play wrestling sessions with her father - often lasting over thirty minutes.
For the first time, Eva entered a store without negotiating for access to a phone. At the Center for Social Rehabilitation and Integration, the therapists expressed surprise that Eva no longer exhibited behavioral crises. They were instructed on the screen detox protocol and, with great enthusiasm, began more intensive speech therapy, as Eva had started using her native language, Bulgarian, more frequently than English. At home, only Bulgarian was spoken from that point onward.
A swimming coach was found, and in the fourth week, Eva attended her first lesson - a new experience that quickly became her favorite activity. She enjoyed swimming so much that she willingly wore a swim cap, despite never having tolerated one before.
Changes Observed During the Second Month of Therapy
In the fifth week of therapy, Nadezhda took the initiative to change her mobile phone in order to avoid triggering screen-related associations in Eva. The family began taking trips to more distant towns, and during car rides, phones were not used - Eva no longer mentioned or requested them.
On weekends, when Simeon was not working, he spent full days with Eva, allowing Nadezhda uninterrupted personal time, free from anxiety about leaving Eva in someone else’s care. Eva began eating fish and drinking herbal teas, experimenting with various flavors such as linden, chamomile, and lavender. She also resumed trying all foods placed in front of her - including broccoli, which she once loved but had not eaten in years.
A significant shift occurred in her emotional expressiveness: Eva began to share her feelings, unlike before when she would withdraw and go silent. Nadezhda noticed that she exhibited the same emotional withdrawal pattern, and together they began to work through it by consciously sharing their emotions with each other.
For the first time, Eva recounted a social interaction at school - specifically, an incident in which a classmate took her ball. She also began actively participating in the assigned exercises in the psychomotor and sensory therapy rooms at the Center.
Evening play wrestling with her father continued, now accompanied by laughter and playful cries of: “Mom, save me!” as her father “pretended to bite” or “eat” her.
In the sixth week, the family was assigned a new set of tasks for Eva: to begin riding a bicycle (despite her fear), as well as to draw, sing, and play musical instruments, in addition to her beloved swimming activities. These goals were successfully met - Eva allowed herself to be drawn into a variety of new activities.
By the seventh week, the SIPVR (Screen-Induced Pathological Vestibular Reflex) tested fully negative, and Eva began to fully relax in her father’s presence. Daily walks with her father became a routine, with Eva completing her first 8-kilometer walk without complaints or sulking.
For the first time, they visited the countryside and entered an old family house - previously, Eva had only stayed in the yard, refusing to enter due to the “bad smell” and only doing so when given a phone. This time, not only did she enter willingly, but she also found ways to occupy herself without demanding her father's attention.
According to Simeon, approximately 80% of her use of inappropriate language had ceased, now occurring only in rare moments of surprise. Following our therapeutic guidelines, the parents discontinued all negotiation-based communication, as well as the practice of informing Eva in advance about activities or locations.
Nadezhda, though physically and emotionally depleted, sometimes shouted at Eva under stress. In school, Eva still occasionally walked around during lessons, but no longer exhibited crises or outbursts. Her classmates had begun to express genuine joy in her presence and showed reciprocal interest in her.
Simeon reported that he no longer feared Eva might run away, as she now verbalizes her intentions and desires openly and clearly.
Intensive work with the speech-language therapist has been ongoing. While Eva’s Bulgarian remains agrammatical, significant progress has been observed compared to the previous six-month period. Her speech now includes a wider vocabulary, and she constructs increasingly complex sentences. She participates in joint activities and games with the speech therapist, something she was previously unable to do.
For the first time, Eva has begun to use prepositions, although she still confuses them at times. While she uses word roots correctly, she frequently misuses prefixes and suffixes. A dialogical question-based game has been introduced, which has quickly become one of her favorite activities. When asked the same question in different sessions, she strives to include new information and enrich her responses each time.
However, retelling a text read aloud by the therapist remains an unattainable task for now. Her receptive vocabulary - including unfamiliar words, abstract concepts, and polysemous terms - is still underdeveloped.
Nonetheless, Eva now engages actively in dialogue, asks increasingly complex questions, and shows a growing sense of curiosity.
The eighth week marked another series of remarkable changes. During a visit to a hospital to see ill relatives, Eva remained calm, composed, and reserved. At one point, she quietly approached her mother and whispered in her ear: "I want to leave this place."
She waited for 30 minutes in front of her general practitioner’s office without once asking for a phone - an unprecedented change compared to all previous visits.
Because of her swimming routine, her hair is now consistently tied back in braids, which she accepts without resistance. This marks a significant change, as she previously could not tolerate even being brushed. On one occasion, she took a phone and snapped a photo of herself but did not request or engage in any further use of the device.
Eva continues to share stories from school and now even speaks about her classmates. In the evenings, she jokingly asks her father, "Are you hungry? Do you want to eat me for dinner?" - a playful echo of their bonding ritual.
She has also begun retelling what she reads from books - her newfound passion. That week, her topic of interest was the Solar System, and she shared facts about the planets with her mother. At school, she has started reading extracurricular literature during class hours without disrupting the lesson. Her love of books, as her mother notes, is "inherited" from Nadezhda’s own father.
For the past three years - following Nadezhda’s miscarriage - Eva had displayed strong aversion toward children. Now, for the first time, she began to show interest, asking her mother about the baby and expressing her intention to become a big sister. Together, they began cooking from a recipe book they had picked out and purchased together at the store.
Eva continued to expand her diet, recently adding mackerel, and one day spontaneously said, "I want strawberries!"
She also began to differentiate her emotional behavior toward her parents - seeking tenderness from her mother and continuing her playful wrestling and "biting" games with her father. For the first time, she started reaching out and holding her mother’s hand on her own initiative.
During this period, a significant crisis emerged between Nadezhda and her husband. Nadezhda began asserting herself more openly, expressing what she wanted and what she felt needed to change - no longer suppressing her voice within the family dynamic.
Developments in the Third Month of Therapy
In the tenth week of therapy, the entire family faced a major emotional test. The father’s ill uncle was taken in to be cared for at home. On the third day, his condition deteriorated, and he was hospitalized - shortly thereafter, he passed away. This was the third death in the father's extended family within a span of three weeks.
These encounters with death, along with Nadezhda’s evolving assertiveness, appeared to have a sobering effect on the father. For the first time, he began asserting himself clearly in interactions with relatives. Previously, he had kept his head down and avoided conflict in the name of maintaining peace.
During this period, Eva accessed a computer at home without her parents’ knowledge. Approximately one hour later, she experienced a crisis episode lasting 90 minutes, marked by prolonged screaming. However, afterward, she appeared contrite and affectionate - an emotional pattern not previously observed.
At the hospital, Eva asked for a phone, but for the first time, her father responded with a firm “No.” Up until this point, only Nadezhda had been enforcing screen restrictions. Eva also exhibited angry verbal outbursts - shouting “I hate you!” - directed not only at her mother but, for the first time, also at her father.
In school, a friend raised her voice at Eva. Remarkably, Eva did not respond with a hysterical episode, which had been her typical reaction in similar situations.
In the eleventh week, Nadezhda began experiencing contractions and was hospitalized for several days to prevent premature labor. During the trip to the hospital, Eva commented: "Mom isn’t well - we need to take her to the hospital!" For the first time, she expressed happiness about staying alone with her father, saying she was looking forward to it.
In critical situations, Eva still occasionally resorts to bargaining - for example, requesting ice cream or juice as a condition for going somewhere she doesn’t want to go. On one occasion, when she refused to leave the house, her father responded by saying he would cancel her swimming session. She immediately agreed to go and, for the first time, packed her swimming bag by herself.
However, she forgot to include underwear, and after swimming, she was unable to put her pants back on in the changing room - this triggered a panic episode. That evening, as she was going to bed, she shared: "This was the worst day of my life!"
Her father later reported that he had again attempted to motivate her to clean and organize her room by offering a small monetary reward - an attempt to replace previous screen-based reinforcement. This strategy was immediately discontinued. Before our intervention, negotiation-based behavior management - including screens, sweets, juices, and other preferred items - had been a primary method of behavioral modulation.
This approach was identified and eliminated as harmful, and Eva’s response has shown that the authority of her parents’ word is now sufficient; there is no longer a need to return to outdated methods. People have become more important to Eva than objects - another major developmental threshold has been crossed.
Another symbolic milestone occurred that week: Eva decorated her door with football players and learned that Hristo Stoichkov had won the Ballon d'Or in 1994, becoming the first and only Bulgarian to date to win the award. Her father now spends three hours each evening with her after work, and most weekends are also fully dedicated to time together. The redistribution of responsibilities between the parents proceeded smoothly and without conflict.
Upon Nadezhda’s return home in the twelfth week, Eva jokingly said: “You broke my heart, Mom, by not being here!” followed by, “You’ve swallowed a bomb, and it’s going to explode soon!” A new addition to her diet this week was yogurt in all its forms - including ayran.
For the first time, Eva shared a wafer with both her mother and father - an act that even surprised Nadezhda herself. Every evening, Eva would approach her mother to perform a "belly check," asking: “How are you?” and “Are you feeling okay?”
Developments in the Fourth Month of Therapy
In the thirteenth week, Eva proudly shared news of the upcoming baby with everyone. Nadezhda reported, for the first time, leaving Eva’s school feeling calm and reassured - no complaints, only praise from teachers. Many began asking what had changed and how such a remarkable transformation had taken place in such a short period.
Eva received a new two-wheeled scooter, which delighted her - transitioning from a three-wheeled one. One morning, when Nadezhda overslept and they were in a rush to leave for school, Eva surprised her mother by getting up and packing her school materials independently. From that day forward, Eva began preparing her backpack each morning on her own, organizing her notebooks and textbooks with care.
Even more significant, she started to take pride in her growing independence and in her ability to manage things by herself.
At school, teachers observed that Eva had begun engaging in cooperative play with her peers. She started inventing games and assigning roles to classmates. On one occasion, she took a phone, opened the calculator app to solve a math problem, and returned the device without requesting further use. Beyond taking photographs and using the calculator, she did not express interest in any other screen functions.
Her teacher shared with Nadezhda that Eva had begun apologizing to classmates - another first in her social development. As a result of her progress, her school schedule was expanded to include additional class hours.
During park outings, Eva began expressing a strong preference to go where other children were present, saying out loud: “I want to go there - there are kids there!”
Her eating behavior also evolved significantly. She now tries all types of food and, on one occasion, even took a meatball from her mother’s plate and ate it. When trying new foods, she clearly states her opinion, saying either: “I don’t like it!” or “Mmm, that’s delicious!”
This week, she asked Nadezhda: “Who will take care of me when you go to the hospital to give birth?” She also spoke about the baby with joy and excitement.
During a session with her psychologist, she asked: “Why is your voice like that?” - referring to a slight change due to an allergy, demonstrating increased attunement to others.
In the family’s social circle, it has become common for friends and relatives, when in Eva’s presence, to remind each other: “Put that phone away!” - if someone forgets and reaches for their device.
Eva now shows no reactive behavior when exposed to television screens in public places such as restaurants and stores, or when she sees people using mobile phones. When she sees her mother’s phone, she does not touch it, explaining simply: “It’s not mine.”
She is currently reading a book about Great Bulgarians and has expressed a desire to study psychology. Nadezhda shared that the home environment has become unusually quiet for extended periods - because Eva is immersed in reading.
Another change that deeply moved Nadezhda is that Eva is becoming increasingly expressive in a way that reflects her femininity. One day she said, “I don’t like your shampoo,” not in an arrogant or defiant tone, as she might have in the past, but with a distinctly girlish sensitivity.
Whenever Nadezhda lies down to rest, Eva comes over and gently asks: “What’s wrong, Mom?”
A particularly meaningful milestone occurred during a recent community fair - a large outdoor gathering - where Eva danced alongside an older girl right next to a large loudspeaker. This was astonishing to Nadezhda, given that just months earlier, Eva experienced sensory crises triggered by loud noises.
The relationship between Nadezhda and her husband has also shifted significantly. Nadezhda is now pleased with the increasing responsibilities her husband is taking on, and they have begun to share more openly with one another.
In the fourteenth week, Eva expressed a desire to have a dog at home. One day, she told her mother: “Don’t call me ‘little mouse’ - call me ‘princess’!”
Nadezhda shared that the neighborhood children had also begun a screen detox after witnessing the dramatic changes in Eva over the past few months.
Eva's swimming coach reported that she now occasionally needs to be scolded for daydreaming or not paying attention - but her reactions are appropriate and no longer escalate into crises.
One day, Eva and her mother prepared pumpkin patties together, using a recipe from a cookbook that Eva had chosen herself. She also began preparing toys for the baby’s arrival.
During the 40-day memorial for her late uncle, Eva said to her mother: “Mom, you’re not angry - you’re sad.” Nadezhda burst into tears and later shared: “For the first time, she was my emotional support.”
Eva also began asserting her personal boundaries. She started reminding her mother to knock before entering her room. Her school hours were extended by two more hours, and she expressed a clear preference for attending class with her peers rather than in individualized sessions.
At the park, she told an elderly man: “That’s my bench - you can’t sit there.” She continues to share more stories and experiences from school and asks questions constantly. Her speech therapist has now been reclassified as a "friend" in her vocabulary.
At home, Eva is almost always seen with a book in hand. One day she remarked: “May is here, and it doesn’t have an R in it!” - an observation that thrilled her mother. Together, they made bacon and burgers, which they later enjoyed side by side. On one day, she ate six times, showing a noticeably increased appetite.
She also began to display coquettish behavior - after losing a pair of earrings, her mother gifted her a set of her own, along with a jewelry box. Eva removed the earrings before swimming and put them back on afterward.
On one occasion, seeing her mother on the phone, Eva asked: “Are you looking for a stroller for the baby?”English is no longer spoken at home.
In the fifteenth week, Eva showed genuine interest in the neighbor’s baby. Around the same time, her father purchased a synthesizer. Eva became fixated on the pre-programmed melodies and began playing them repeatedly for several hours without pause.
Recognizing the potential risk, her father intervened immediately - removing the synthesizer from the home. Despite the prompt response, a regression in Eva’s behavior was observed: several previously resolved behaviors reemerged, along with renewed crises, which lasted for two days following the sensory overstimulation.
What stood out most in this situation was the father’s swift and decisive reaction - something Nadezhda identified as another highly affirming indicator of his full engagement in family life and in the therapeutic process.
Following this overstimulation event, Eva temporarily refused to attend her swimming sessions - another sign of regression.
That week, Nadezhda had to impose several consequences on Eva’s behavior. These disciplinary moments were handled without bargaining or negotiation. Eva tolerated them well and ultimately sought her mother’s approval afterward - indicating emotional processing and a desire for connection.
Before the overstimulation incident, during a 200-meter run at school, Eva had returned home and said: “My heart broke!” - a metaphorical expression that, while intense, reflected her growing capacity for emotional language and self-awareness.
In the sixteenth week, Eva increasingly demonstrated the ability to express her emotions freely, including anger. However, she now shifts between emotional states quickly and fluidly, without entering crises or exhibiting explosive behavior.
One evening, she shared an experience from school: her teacher had given her a calculator to solve a math problem, while the other students used their “thoughts.” This remark reflected Eva’s growing awareness of her learning differences and her capacity for introspective comparison.
Nadezhda was deeply shocked to learn that the Center for Social Rehabilitation and Integration (CSRI) had discontinued both her and Eva’s psychological consultations. The center concluded that neither of them required further psychological support. Only speech therapy was continued, focusing on:
- Correcting residual grammatical errors;
- Improving Eva’s expressive (impressive) speech - especially in retelling orally presented texts, which remains a challenge;
- Addressing lingering issues with writing, particularly under dictation conditions.
Final Clinical Conclusion (from the CSRI Team)
In their final report following the completion of the four-month joint therapeutic intervention, the team at the Center for Social Rehabilitation and Integration (CSRI) concluded that Eva had developed a strong interest in interpersonal interactions and in exploring the world around her.
Emotional crises have been entirely resolved and are no longer observed. Eva is now able to identify her own emotional states as well as those of her conversation partners. She shows interest in the emotions of others and frequently asks questions related to their emotional experiences. She actively integrates new information related to emotional states, as provided by her therapist.
Eva is able to regulate her behavior in accordance with the emotions of others. When unsure how to respond, she has the internal resource to ask for guidance and can adjust her actions accordingly. These behaviors are consistently observed at home and, as confirmed in meetings between therapists and school staff, are equally present in the classroom environment.
Behavioral crises are no longer observed. Eva demonstrates competent communication skills, is capable of negotiation, adheres to rules, and follows instructions. She is able to express disagreement without escalating into crises or tantrums. When expressing disagreement, she is also able to accept the perspective of others.
She is motivated to engage with both adults and peers, exploring social interactions with curiosity. She asks insightful questions about the behaviors of others and shows a marked interest in her own body and internal sensations.
Clear indicators are present that Eva perceives herself as an autonomous, distinct individual, with a clear sense of gender identity. She shows an emerging interest in her personal history and origins.
Based on these findings, the CSRI specialists concluded that there are no longer any problematic areas in Eva’s emotional and behavioral development. As a result, psychological sessions for both Eva and Nadezhda were discontinued. Only speech therapy will be continued to address remaining linguistic challenges.
Closing Reflections
With this, our work with the family also came to an end. We extended our heartfelt wishes for a smooth delivery and joyful moments with the new member of the family. Nadezhda wept and found it difficult to believe that there would be no further therapy sessions for her and her eldest daughter. Just a few months earlier, she had resigned herself to the belief that they would be attending therapy for the rest of their lives - with uncertain outcomes.
Discussion
Parental training has consistently emerged as one of the most effective approaches for addressing autism-related symptoms in young children (Owen et al., 2019). According to Dawson’s model, early behavioral interventions promote more adaptive patterns of interaction between the child and their environment, which in turn leads to a reduction in autism-related symptoms (Dawson, 2008). The active involvement of parents in implementing intervention techniques - such as those used in Parent-Child Interaction Therapy - has been shown to be particularly beneficial during early development (McConachie & Diggle, 2007; McNeil et al., 2019).
Parent-child interaction not only plays a central role in these interventions but may also function as a mediating factor in the overall effectiveness of early behavioral strategies targeting autism traits (Dawson, 2008).
Recent studies further support the notion that parenting-focused programs can significantly impact screen-related behaviors. For instance, following participation in the Triple P (Positive Parenting Program), parents reported a substantial reduction in their children's screen time (Özyurt et al., 2018). Similarly, a responsive parenting intervention was found to decrease both screen exposure and television viewing time in infants (Adams et al., 2018).
Studies have identified a correlation between Autism Spectrum Disorder (ASD) and increased exposure to television and cable screens during infancy, suggesting that early audiovisual stimulation may contribute to the development of autism-related symptoms (Heffler et al., 2016).
More recent research has drawn growing attention to the developmental risks associated with early-life screen exposure. Heffler et al. (2022) reported that excessive screen media use in early childhood is linked to developmental delays and the emergence of autism-related features. In their case study, substituting screen time with socially engaging, real-world interactions resulted in significant improvements, while the reintroduction of screen exposure led to a recurrence of symptoms. These findings are consistent with earlier work by Heffler (2020), which found a strong association between increased early screen use, reduced caregiver-child play, and the subsequent appearance of ASD-like behaviors.
Together, these studies highlight the importance of limiting digital media exposure in infancy and prioritizing social, interactive experiences during critical developmental periods.
The publication of case data indicating full recovery in children with screen addiction and a diagnosis of Autism Spectrum Disorder (ASD) is a relatively new development (Vezenkov et al., 2025). Eva’s case demonstrates that there is indeed a path toward full recovery and reintegration into a normative developmental trajectory for children with early-onset screen addiction and screen-induced trauma (Manolova et al., 2025(2)).
The therapeutic process involved several critical phases. The implementation of a full screen detox was not without difficulties and disruptions. Several incidents clearly illustrated that the reintroduction of screens triggered a powerful regression and a return to addictive behavioral functioning, characterized by entrenched patterns of control and dominance expressed through crises and tantrums, without regard for others (Petrova et al., 2025).
This case reinforces the observation that even partial or indirect re-stimulation - such as exposure to pre-programmed melodies on a synthesizer - can be sufficient to trigger screen-seeking and addiction-driven behaviors in Eva. Such reactivation by partial cues related to the original addictive stimulus is a hallmark feature across all types of addictions, whether substance-based or behavioral. These triggers are capable of reinstating the entire addiction profile and behavioral patterns, even during later phases of recovery, often leading to significant regression.
The cornerstone of successful recovery lies in the parents’ understanding of these associative links and their ability to respond appropriately - namely, to recognize and intervene decisively in such situations to prevent relapse.
The life challenges faced by Eva’s father - including the intense changes in his wife and daughter, the anticipation of a second child, and the loss of three family members within three weeks - served as a catalyst for his personal development and maturation into his role within the family dynamic. These circumstances contributed significantly to his growth as a representative of the family’s interests in interactions with institutions and third parties.
Over the course of the intervention, the father undertook a substantial journey of emotional maturity and assumed a pivotal role in Eva’s developmental progress.
At the outset of therapy, Nadezhda - Eva’s mother - was on the verge of emotional collapse and burnout. Gradually, however, she developed the capacity to assert herself, to articulate her needs and desires, to delegate responsibilities to her husband, and to trust him in their execution. Not only did she listen attentively to all therapeutic guidance provided, but she also implemented it with consistency and decisiveness.
Her transformation was profound: from a state of constant bargaining and negotiation - often followed by Eva’s crises, outbursts, and screaming - she progressed toward calm and constructive communication with both her daughter and her husband.
The professional team at the CSRI also played a vital role. After Eva overcame her screen addiction, the CSRI team worked diligently and with exceptional professionalism to support her within the emotional, cognitive, and behavioral developmental space that had been opened through our collaborative therapeutic efforts.
The full cooperation of Eva’s teachers deserves special recognition. They played an active role in her integration and successful adaptation to the educational environment and peer interactions following the resolution of her severe screen addiction. Their supportive engagement was instrumental in sustaining her progress.
Equally important was the tolerant and inclusive attitude of Eva’s classmates. Their acceptance directly contributed to her rapid social and emotional recovery. It can be said that all participants in the process - including teachers, therapists, peers, and even family friends - created an exceptionally favorable environment for Eva’s rehabilitation. Such comprehensive support is exceedingly rare in similar clinical cases.
A comparable study conducted in Iran (Sadeghi et al., 2019) showed that a two-month parental training program combined with reduced screen exposure resulted in a measurable decrease in autism-related traits in children with ASD. The dynamics observed in Eva’s case support the growing evidence that complete recovery is possible when screen detoxification is combined with structured parental training - a pattern we observe in nearly 50% of similar cases (Vezenkov, 2025(2)).
Although Eva’s parents had adhered to screen-time guidelines prior to their arrival at the Center, the case clearly demonstrates that in situations where screen addiction and screen-induced trauma have already developed - and have not been therapeutically addressed - general recommendations alone are ineffective (Petrov et al., 2025(2)).
Conclusion
The recovery of a ten-year-old girl with early-onset screen addiction, screen-induced trauma, an eight-year history of use, and a diagnosis of Autism Spectrum Disorder (ASD) is not only possible - it can be achieved within a remarkably short timeframe when the right therapeutic conditions are in place. In Eva’s case, this recovery occurred over just four months.
When therapeutic intervention targets both the child’s and the parents’ functioning, and is supported by a coordinated approach from all key figures in the child’s environment - including therapists, teachers, coaches, and the family’s social network - what may appear to be a miracle becomes a realistic outcome.
In this case, the mother’s extremely high motivation - driven in part by her advanced pregnancy - combined with a fortunate alignment of circumstances and the rapid transformation and maturation of the father, significantly accelerated the recovery process.
This case clearly illustrates that time is not the determining factor in recovery; rather, it is the depth and quality of dynamic change within each participant and the overall family system that create the conditions for healing.
Under extreme circumstances, when in-person therapy is not feasible, remote intervention for screen addiction can be effective. However, such success should be viewed as the exception - not a substitute - for the structured, integrative therapeutic model we have developed.
References
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