Left to Their Own Devices – Child-development Experts Worry About the Effects of Screen Time

“In our clinical practice, we definitely see an overrepresentation of children who have difficulty with handling limits on screen time, especially when parents aren’t enforcing them,” said Dr. Jack Fanton, medical director of the Child Partial Hospital Program at Baystate Medical Center.

“We see children who have too much screen time, or devices are being brought into their rooms and are at the bedside and interfere with sleep continuity,” he added. “And lots of anecdotal evidence and research suggests this increased screen time is coming at the expense of real-world social skills.”

He cited a study at UCLA, published recently in the journal Computers in Human Behavior, suggesting that sixth-graders who went five days without exposure to technology were significantly better at reading human emotions than kids who had regular access to phones, televisions, and computers.

The researchers studied two groups of California sixth-graders, sending one group to an outdoor education camp, where they had no access to electronic devices, and making no changes to the media diet of the other group.

At the beginning and end of the study period, both groups were shown images of 50 faces and asked to identify the feelings being modeled. The researchers found that the students who went to camp were significantly better at reading facial emotions and non-verbal cues than the students who had access to their devices.

“Even after just five days, there was a measurable decline in their ability to recognize the emotions expressed on the faces, compared to a group of kids without any screen time,” Fanton said.

The study’s senior author conceded that the camp experience itself, fostering personal connections with other people, probably boosted that group’s scores as much as ditching technology, and she would like to expand the study to retest the camp group again, after they went home and spent five days with their smartphones and tablets. But the implication is clear that there is a measurable difference between human interaction and screen time.

And that worries pediatric experts who worry that a generation of kids may be growing up lacking sufficient empathy or emotional maturity.

“We’re acutely aware of how important it is to promote healthy social skills, and that emotional intelligence predicts more favorable outcomes than academic or intellectual intelligence,” Fanton told HCN. “With cultural trends toward decreasing recess, music, and art, and then increasing screen time, neuroscientists worry that children are not exercising the circuits in the brain that are involved in emotional regulation. When kids are not involved in independent play and creative activities, when they’re not responding to social nuances, cues, and direct feedback, they’re not exercising the circuits involved in helping them nurture emotion and self-esteem.”

The American Academy of Pediatrics (AAP) has long advocated that young people up to age 18 restrict their screen time — including TV viewing, Internet use, video games, tablets, and smartphones — to no more than two hours per day, and that children 2 and under have no screen time at all.

“It’s not that media itself is bad, evil, or a pox on society,” Fanton said. “It’s that it’s coming at the expense of social needs and developmental processes critical to later success.”

The AAP cites studies that connect excessive media use with obesity, lack of sleep, school problems, aggression, and other behavioral issues, although Fanton stressed that any one of these correlations does not prove causation. Still, pediatricians fret over statistics showing that the average 8- to 10-year-old spends nearly eight hours a day with different media, and older children and teens spend more than 11 hours per day — much more than the recommended two hours.

Meanwhile, children and teens who have a TV in their bedroom spend even more time with media, and about 75{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of 12- to 17-year-olds own cell phones, with nearly all teenagers adept in text messaging. The key, according to the AAP, is not banning all this activity, but directing it into a considered strategy.

“A healthy approach to children’s media use should both minimize potential health risks and foster appropriate and positive media use. In other words, it should promote a healthy ‘media diet,’” said Dr. Marjorie Hogan, co-author of the AAP policy (see sidebar, page 15). “Parents, educators, and pediatricians should participate in media education, which means teaching children and adolescents how to make good choices in their media consumption.”

Dr. Robert Leavitt, a Longmeadow pediatrician, tells parents that it is not a good idea to put a TV in a child’s bedroom, and advises them to set limits on cell-phone use before they give the child their own device. If they don’t do this initially, he explained, it may become difficult to enforce rules later on, and their teen may become sleep-deprived as they respond to non-stop text messages from peers.

Some parents will no doubt argue that familiarizing their kids with the latest technology is only preparing them for the world they will inhabit as adults, but Fanton said this philosophy ignores more critical needs.

“I would remind parents that kids are not little adults. Kids are still developing, and it’s not automatic they will develop these social skills as adults; they acquire these skills through innumerable hours and exchanges with other people.”

And there are societal consequences to raising a generation of young people who lack the ability to empathize and relate emotionally to their peers — skills that come in handy when dealing with bullying, for example.

“No one’s saying that not spending time with devices will help kids treat each other better,” he told HCN, “but we want to promote a culture of tolerance and respect, where kids spend time with each other, and screen time interferes with that.”

The amount of time spent with screens is one issue, but content is another. Positive media not educate children — not just hard facts, but teach them empathy, racial tolerance, and a wide range of interpersonal skills. But it can also desensitize them to sexuality, violence, and negative attitudes.

Fanton cited a study conducted by the Joan Ganz Cooney Center, claiming that less than half the time kids between 2 and 10 spend in front of media is spent on educational programming. “It’s still being used for entertainment.”

Dr. Victor Strasburger, co-author of the AAP policy on screen time, noted that, “for nearly three decades, the AAP has expressed concerns about the amount of time that children and teenagers spend with media, and about some of the content they are viewing. The digital age has only made these issues more pressing.”

Dr. Laura Koenigs, a Springfield pediatrician who specializes in adolescent medicine, notes that violent programs, including cartoons, create their own host of issues. “Children who are exposed to violence experience long-term effects from watching it, even if it is not real,” she said, adding it can lead to aggressive play.

Still, Fanton said, some parents willingly accept a heavy dose of media exposure to the negative influences just outside their door.

For children in urban neighborhoods, for example, “the parents figure, ‘they’re not out on the street, getting themselves into trouble, so what’s the harm?’ Parents see these devices as safe. We have lots of families here in Springfield in these urban settings, and they don’t want their children in the neighborhood after school. Yes, it’s tricky.”

On the other hand, social media has been a boon to families who have moved away from their extended social supports, and their devices become proxies for face-to-face interaction. That’s why parents need to set their own limits, Fanton said.

“The truth is, we’re all addicted. It’s not going away. Kids are modeling at a fundamental level what they see us doing,” he said, noting that singling out an obese child and cutting off unhealthy snacks is likely to be counterproductive if the whole family isn’t modeling good nutrition.

“The same is true for screen time,” he said. “On one hand, there has never been more content, more ease of access through all these different platforms. But it’s up to adults to say, ‘we’re modeling this for the kids, too.’ They’re not little adults; they have different developmental needs that parents need to monitor and police and promote.”

In other words, put down that smartphone and engage with your child. It’s never too late to make emotional development a priority.

While media consumption can contribute to health risks, kids can still take positive lessons from media. The key is to teach children to make healthy choices. To that end, the American Academy of Pediatrics recommends the following tips for creating a family plan for healthy media use.

• Take into account not only the quantity, but the quality and location of media use. Consider TVs, phones, tablets, and computers. The rules should be written down and agreed upon by all family members.

• Screens should be kept out of kids’ bedrooms.  Insitute a ‘media curfew’ at mealtime and bedtime, putting all devices away or plugging them into a charging station for the night.

• Excessive media use has been associated with obesity, lack of sleep, school problems, aggression, and other behavior issues. Limit entertainment screen time to no more than two hours per day.

• For children under 2, substitute unstructured play and human interaction for screen time. The opportunity to think creatively, problem solve, and develop reasoning and motor skills is more valuable for the developing brain than passive media intake.

• Take an active role in your children’s media education by co-viewing programs with them and discussing values.

• Look for media choices that are educational or teach good values, such as empathy and racial tolerance. Choose programming that models good interpersonal skills for children to emulate.

• Be firm about not viewing content that is not age-appropriate in terms of sex, drugs, violence, and language. Movie and TV ratings exist for a reason, and online movie reviews can also help parents to stick to their rules.

• The Internet can be a wonderful place for learning, but it also is a place where kids can run into trouble. Keep the computer in a public part of your home, so you can check on what your kids are doing online and how much time they are spending there.

• Discuss with your children that every place they go on the Internet may be ‘remembered,’ and comments they make will stay there indefinitely. Impress upon them that they are leaving behind a ‘digital footprint.’ They should not take actions online that they would not want to be on the record for a very long time.

• Become familiar with popular social-media sites like Facebook, Twitter, and Instagram. You may consider having your own profile on the social-media sites your children use. By ‘friending’ your kids, you can monitor their online presence. Preteens should not have accounts on social-media sites.

• Talk to them about being good ‘digital citizens,’ and discuss the serious consequences of online bullying. If your child is the victim of cyberbullying, it is important to take action with the other parents and the school if appropriate. Attend to children’s and teens’ mental-health needs promptly if they are being bullied online, and consider separating them from social-media platforms where bullying occurs.

• Make sure kids of all ages know that it is not appropriate or smart to send or receive pictures of people without clothing or sexy text messages, no matter whether they are texting friends or strangers.

• If you’re unsure of the quality of the media diet in your household, consult with your children’s pediatrician on what your kids are viewing, how much time they are spending with media, and privacy and safety issues associated with social media and Internet use.