iScreen, you screen, we all scream for screen time!

In a world where technology is everywhere, how much screen time is too much?

 

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We all know too much TV is bad for us. Everyone remembers being scolded by their parents for watching too much television, hearing “it’s bad for your eyes,” or “you’re turning into a couch-potato.” But in the 21st century, the problem has expanded far beyond television – iphones, tablets, laptops, smart-watches, gaming systems…the list is endless. Nowadays, we are glued to our gadgets and the thought of giving up our phones for even a day seems as preposterous as parting with a limb. Having such an enormous wealth of information and entertainment at our fingertips 24 hours a day seems almost too good to be true…

Because it is.

There is a significant body of research on the harmful effects of television exposure and screen time, especially on children. In 2016, the American Academy of Pediatricians (AAP) published special guidelines on screen time for children of different ages. This post will review the AAP’s recommendations for each age group.

Toddler/Preschool (Age 0-5)

We’ve seen the adorable internet videos of toddlers swiping left on hardcopy magazines trying to turn the pages and babies in high chairs playing on tablets made especially for kids. Studies have shown that by age 2, children are already able to learn from touchscreens and video chat. It is true that good quality programs like those on PBS (such as Sesame Street) can actually help young children learn and have long term educational benefits. But too much television in early childhood has been associated with increased body mass index (BMI) and poorer sleep as well as cognitive, language, and social delays. This may be due to the replacement of parent-child time with solo media time, and as a result, toddlers miss significant bonding and social learning with their parents.

AAP Recommendations:

For children younger than 18 months, try to avoid all digital media use with the exception of video-chatting with friends or family members. Once the child is a little older (18 months to 2 years old) choose high quality educational programs and make it an activity that the parent and child do together. When children are between ages 2-5, screen time should be limited to 1 hour per day of high-quality programming, watched together with a parent or caregiver who can help the child understand what he or she is watching.

Young Children/Grade School (Age 5-12)

As childhood obesity has increased, so has media use. On average, children watch over 2 hours of television per day. In addition to the increased sedentary time while using screens, mindless snacking while watching TV has been shown to greatly increase the risk of obesity. The bombardment with food advertisements doesn’t help, either. In a recent study published in March 2017, increased screen time was shown to be associated with markers for diabetes in children. The Child Heart and Health Study in England (CHASE) was a survey of cardiovascular health in over 4,000 schoolchildren in the United Kingdom aged 9–10 years old. Children with daily screen time of over 3 hours had higher weight to height ratios and increased insulin resistance (marker for diabetes). Media use has also been shown to interfere with normal sleep patterns – studies have demonstrated that those who used social media more frequently or who slept with mobile devices in their rooms were at a greater risk of sleep problems.

AAP Recommendations:

For grade school aged children, the AAP does not offer specific recommendations for hours per day of media use, but encourages parents to choose a consistent limit. Emphasis should be placed on making sure the child has enough time for sleep, physical activity, homework, etc. and that media time does not replace those activities. Parents should also place limits on the content and age appropriateness of the media their children use.

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Teens/High School (13-18)

Perhaps the most difficult age group to separate from their media is teens. This generation of adolescents is deeply entrenched in social media; the majority use at least one of many apps like Facebook, Instagram, Snapchat, Twitter, Vine, and Tumblr. A 2012 study found that teenagers between 14 and 17 years of age send an average of 100 texts per day. A study on TV screen time found that the odds of being overweight were almost 5 times greater for adolescents who watched more than 5 hours of TV per day compared with those who watched 0 to 2 hours.

There are clearly a number of benefits of media use in this age group, such as collaborating on class projects, improving access to information, and improved social connectedness (especially for teens needing extra support, such as those with mental illness, LGBT youth , etc.). However, there are a number of issues parents need to be aware of in addition to the potential negative health and emotional effects of screen time. Through media use, adolescents are more easily exposed to alcohol, tobacco, and sexual behaviors, which are associated with earlier initiation into these behaviors. Cyber bullying, a problem consistently highlighted in the media, has led to consequences as drastic as children leaving school or committing suicide. Adolescents can develop internet or gaming addictions which have been shown to negatively impact relationships and school performance.

AAP Recommendations:

Similar to the recommendations for grade school aged children, in adolescents, emphasis should be placed on prioritizing healthy activities, making sure the child has enough time for sleep and physical activity (about 1 hour per day), and that media time does not replace those activities.

Parents (Yes, you!)

Don’t think the negative effects of media use only apply to kids. Screen time in adults is associated just as strongly with obesity and social/emotional issues. In fact, parents’ excessive use of media can have negative impacts on their children, as well. Time spent engrossed in emails and smart phones can be better spent on child-parent bonding activities and improving the child’s social and emotional wellbeing. Healthy habits such as turning on the “do not disturb” phone option can help minimize interruptions.

Easier said than done…

Now that all the negative consequences of screen time have been explained, how do you actually wean your children from their screens?

The AAP has an excellent website called HealthyChildren.org where families can create custom Family Media Plans. The plan allows parents to block out time for necessary activities and fit in television and video games in the time left over. Parents can also try to create “unplugged” spaces or times in the home. It is good to enforce good sleep habits, like no screens 1 hour before bedtime, and not taking mobile devices to bed. Mealtimes and parent-child time should be kept screen free for both children and parents. Entertainment media should be turned off while children do homework, to minimize distractions. Again, emphasis is on not allowing media use to replace proper sleep, exercise, socializing, reading, and play.

Technology can be used in an endless number of beneficial ways, and can be enormously helpful in connecting people and making vast amounts of information accessible. While the above recommendations may seem overwhelming, even implementing a few small changes can drastically improve the wellbeing of both parents and children.

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May 2017. This blog post was written by Belinda Daniel, Medical Student at the University of Illinois at Chicago College of Medicine and edited by Dr. Susan Buchanan.

 

References

Photo source #1: DONALD IAIN SMITH/MOMENT/GETTY IMAGES http://health.howstuffworks.com/human-body/systems/eye/sitting-close-tv-bad-eyes.htm

Photo source #2: Calvin and Hobbes, Bill Waterman http://notsogentlereader.blogspot.com/2010/02/friday-featured-comic-calvin-and-hobbes.html

Photo source #3:  https://www.reddit.com/r/wholesomememes/comments/5ze7x5/proof_that_you_can_follow_the_rules_and_get_what/

 

AAP COUNCIL ON COMMUNICATIONS AND MEDIA. Media and Young Minds. Pediatrics. 2016;138(5):e20162591

AAP COUNCIL ON COMMUNICATIONS AND MEDIA. Media Use in School-Aged Children and Adolescents. Pediatrics. 2016;138(5):e20162592

Reid Chassiakos Y, Radesky J, Christakis D, et al., AAP COUNCIL ON COMMUNICATIONS AND MEDIA. Children and Adolescents and Digital Media. Pediatrics. 2016;138(5): e20162593

Nightingale CM, Rudnicka AR, Donin AS, et al Screen time is associated with adiposity and insulin resistance in children Archives of Disease in Childhood Published Online First: 13 March 2017. doi: 10.1136/archdischild-2016-312016

Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH. Television viewing as a cause of increasing obesity among children in the United States, 1986-1990. Arch Pediatr Adolesc Med. 1996;150(4):356–362pmid:8634729

Wen LM, Baur LA, Rissel C, Xu H, Simpson JM. Correlates of body mass index and overweight and obesity of children aged 2 years: findings from the healthy beginnings trial. Obesity (Silver Spring). 2014;22(7):1723–1730pmid:24415528

Links

Personalized Family Media Use Plan: www.HealthyChildren.org/MediaUsePlan

iPad Baby Can’t Work a Magazine http://gawker.com/5849593/ipad-baby-cant-work-a-magazine

 

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