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This year I’ve been introduced (thrown in the deep end, that is) to my delightful step nephew and niece as well as my partner’s 2 boys – all under 10 and all with seemingly boundless energy. Until then, much of my experience with children was purely professional as a doctor and GP. My suspicions of how hard it is to be a loving, supportive and positive influence on little ones was confirmed, but I was delighted at how enjoyable it is too.
2020 has also been a particularly tough year for all of us in light of COVID-19 and the lockdowns that people across the world have had to endure. Some states and countries have been hit harder than Queensland, but it has impacted all of us to a degree. Home schooling was a particular challenge and my observations about this brought up the above question – are tablet devices (and screen time generally) a good or a bad thing? The answer is more complicated than this black and white question, of course, but I wanted to summarise the guidelines and some of the evidence.
During the lockdown, and during every holiday, handing over a tablet or switching on the TV can seem an easy remedy for bored and whinging children. However, we know that too much screen time is associated with some concerning poor health outcomes.
Screen time is a term used to describe the amount of time spent looking at a TV, a computer, a smartphone, tablet or a video console. Screens are integral to our modern way of life and are used for work, education, communication as well as leisure. This makes it is a challenge to control the amount of time children spend using screens, and in some cases, children are avoiding participating in other important childhood activities in favour of more screen time.
In 2017 The Royal Children’s Hospital Melbourne conducted a National Child Health Poll and found that almost all Australian teenagers, two- thirds of primary school-aged children and one-third of pre-schoolers now own their own tablet or smartphone – I dare say this has only increased since the study was done.
“Is it really that harmful?”
Unfortunately, there are legitimate concerns. There is evidence that time spent in front of a screen, and the quality of the content on screen, is associated with a variety of health harms for children, with evidence strongest for overweight and obesity, unhealthy diet, depressive symptoms and quality of life.
Children who spend a lot of time using screens may not be getting enough physical activity, leading to weight gain. Current Australian guidelines recommend that children exercise for at least an hour each day.
Children using screens will often eat during their screen time and not be conscious of the amount of food they are eating. They may also be influenced by junk food advertisements and be more likely to seek out unhealthy food.
The light produced from screens has been shown to prevent sleep onset in children when used in the evening or just before sleep. This reduced sleep duration and quality and is linked to weight gain and to mood and behaviour problems. Australian guidelines recommend children sleep between 8 and 12 hours each night.
Screen use can isolate children from what is going on around them and evidence suggests that TV watched in the first 2 years of life may be connected with delays in language development. Families may miss out on the everyday interactions that build healthy relationships. Friendships may also be affected as children sit alongside each other on screens instead of interacting and communicating with each other. Children can also miss out on opportunities to develop language through play and interactions with others.
Although the link between violent video games and being violent in real life has not been shown in research, there is growing evidence that children who watch violent content are more likely to view the world as a scary, uncaring and/or? mean place – and this can negatively affect their quality of life.
The Internet and social media platforms can supply children with inappropriate and hurtful messages. Teach your children what is appropriate to share online and to think before posting messages and images. (Most social media platforms require users to be 13 years and over.)
Research has shown that children who spend more time outdoors are less likely to develop short sightedness and the more time a child is on a screen the less likely they are to be active outside.
When children stare at the screen for a long time, they may blink less than normal which can dry the eyes. This can lead to eye strain and fatigue.
“Please tell us it’s not all bad!”
Thankfully, it isn’t. Like any tool or new technology screens can be used in positive ways as well as harmful ones. Small amounts of screen time can be useful and enjoyable for children and families. They can offer time for children to connect with others, be creative and learn. Screen time can keep children entertained, or distracted, and are used in educational settings by teachers.
Although young children learn best from face-to-face, 2-way conversations and interactions, ‘’video chatting”, eg: using Skype or FaceTime, may be of some benefit for children to keep in touch with friends and family, especially in the current environment of social isolation and restricted interstate and international travel. Video chatting has allowed my nephew and niece to forge and maintain a loving relationship with their Grandparents in England all their life, since in person interactions are obviously much less frequent.
Screen time can also play an important role in keeping children connected when they are sick or in hospital, or as a means of distraction.
For children with a medical condition, social media platforms allow them to connect with others with similar conditions and provide opportunities for self-expression and for increasing awareness amongst peers about their condition.
Older children’s use of the Internet helps develop their skills and interests. Social platforms can be a useful way of forming friendships, in addition to cultivating empathy and activism.
“So, what are we meant to be doing?”
Department of Health Australia state:
Babies and young kids need plenty of time to move – to play, reach and touch time to practice new movements when learning to crawl and walk.
Children younger than 2 years of age should not spend any time watching television or using other electronic media (DVDs, computer and other electronic games).
When kids watch TV or DVDs or use other electronic media like computers, hand-held games and other electronic games, they miss out on active play. Kids will benefit more from talking, singing, reading, listening to music or playing with other kids.
If kids stay up at night watching TV and DVDs – they also miss out on sleep.
For children 2 to 5 years of age screen time should be limited to less than 1 hour per day.
No more than 2 hours per day.
“That’s all well and good, but how am I going to do this?”
This is best done by decided on some rules that the whole family can agree to and will usually include things such as;
Dr Anthea Rhodes, a paediatrician from the Royal Children’s Hospital in Melbourne, has some helpful and practical advice on this that I’ve adapted below.
This includes all parents, as well as older kids – you will be more likely to get your children to agree if you come up with rules together and let them see that everyone will follow them, even if they’re slightly different for different ages. The role of screen entertainment in each household will be different, depending on the needs of your family and the age of your kids. Some families find it helpful to create a ‘screen-free’ schedule.
Children absorb media, even if they aren’t specifically paying attention. Bad language and violence will affect them, even if they are not directly watching. Try using background music instead of the TV – my partner and I find relaxing playlists on Spotify work well and can introduce kids to genres of music they may not otherwise have heard.
Take all TV and computer screens out of kids’ bedrooms. Have a central place where everyone’s smart phones and screen-based devices can be kept at night. Screens can affect sleep onset and quality. Have your children turn off the screen at least one hour before bed.
Mealtimes are a great chance to engage and chat as a family. Turn the TV off and make a rule no smartphones or iPads at the table. That goes for parents and grandparents too!
Screen time is a habit and like any habit, it will be hard to break at first. You will need to plan lots of alternative entertainment for your kids. If you take away the screen, they will be looking for something else to do. It may take a while for them to get used to occupying themselves and younger kids will need more direction. As a parent you will need to engage and play with your child more when they put the screen away. Consider all the things people did for fun before the influx of screens; Art and craft, puzzles and playdough are great for younger kids. Board games, books and sporting activities for older children. Encourage your kids to play outside and plan some day trips or family activities.
Media and technology are a great source of entertainment for kids and the whole family. When your kids are spending time on the screen, try to choose high-quality and age appropriate programs or games. For tips on this visit the RCH poll website. When possible, watch and play with your kids, as co-viewing makes screen time a more social and positive experience for children.
Lead by example. As parent figures we are our children’s greatest role models. If they see us constantly looking at our smartphone or playing computer games, they will want to do the same. Try to limit your own screen use when spending time with your children. This is a challenge we all battle with!
Royal Children’s Hospital Melbourne. Blog: Top tips to manage your child’s screen time these holidays. Dr Anthea Rhodes
The Sydney’s Children’s Network: Screen time and children.
Queensland Health: Exercise, sleep, and screen time – what do kids need?
Department of Health: Inactivity and screen time
https://www1.health.gov.au/internet/publications/publishing.nsf/Content/gug-indig-hb~inactivitiy
Stiglic N, Viner RM. Effects of screen time on the health and well-being of children and adolescents: a systematic review of reviews. BMJ Open 2019;9:e023191. doi:10.1136/ bmjopen-2018-023191
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326346/pdf/bmjopen-2018-023191.pdf
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