To the Editor I read with great interest the article by Heffler et al. 1 The authors reported that children with greater exposure to audiovisual media at age 12 months were more likely to have autism spectrum disorder (ASD)-like 1 symptoms at 2 years. The topic of screens, autism, and parenting is of tremendous importance, reflected in the accompanying editorial by Christakis. 2 However, it is important to draw attention to the study's limitations as well as problems with its stated implications.First, results are mixed and based on a small number of children with Modified Checklist for Autism in Toddlers (M-CHAT) scores meeting the threshold for positive screening, yet the conclusions drawn by Heffler et al 1 suggest a much stronger association than was found. In their data, only the autism symptom measure was significantly associated with screen time at age 12 months, not age 18 months. Moreover, autism diagnosis itself was not linked to screen media use at either age 12 or 18 months. Stating that media exposure is a modifiable risk for autism implies a causality that, while the authors might suspect, was not demonstrated.Second, important interactions between race/ethnicity and socioeconomic status, media use, and parenting were left underexplored. The authors briefly mention that young children on the autism spectrum may have a predisposition toward screens and that their parents might be more likely to turn toward media to soothe their child. Background and foreground uses of audiovisual media in households with young children on the spectrum, particularly those who are low income and non-White, may be less a cause than a symptom of complex social factors not measured by this study. Those factors include lack of affordable childcare, difficulty accessing culturally appropriate early intervention services, and single parents balancing caregiving responsibilities. 3 Lastly, Heffler et al 1 and Christakis 2 ultimately place the onus on individual parents to become more informed about media, but this fails to address deeper structural issues. Pediatric autism medical professionals report receiving minimal training to advise these caregivers about media use and having limited opportunity to counsel them because of clinic appointment time constraints, 4 while parents express feelings of stress, guilt, and confusion when speaking with clinicians on the topic. 3 In summary, the association between autism and young children's screen media exposure is overstated in this study, and more interdisciplinary, qualitative research is needed for medical professionals to best support diverse families of young children with and without an autism diagnosis in the digital age.