Screen time: Do you have a love - hate relationship with it?

Screen time. Parents often have a love - hate relationship with it. We've all heard the warnings that it is bad for our kids, but we've experienced the benefits of it keeping our kids occupied while we get things done. And some programs and games have an educational component -- do we group those in the same category as purely entertaining ones?

Most parents by now have heard the recommendations that kids under 2 years should have no screen time. At all. And older kids should have no more than 10 hours / week total.

Most parents are also fully aware that their kids exceed those guidelines. Some by a little. Others by a  lot. There are all kinds of reasons parents have for allowing this. Some are good reasons, others are not.

To be honest, there is still a lot we don't know about screen time. Research continues. When I was a child, television and movies were just passive watching. Thankfully there wasn't much offered, and with a limited number of channels, we usually stuck to watching tv only on Saturday mornings. Other times we played outside. Shows were not as action packed and overstimulating as those of today. Compare Mr. Rogers to pretty much any show designed for kids today with quick scene changes, music in the background and motion everywhere. Now there are interactive games, many of which are educational, or at least they seem to be teaching letters, counting, or other skills. There's even Wii and Kinect that use whole body movements to get kids off the couch. One can get a good workout with some of the games, but Wii bowling is nothing compared to real bowling.

So how do you count educational and active game time? Should it be included in that 10 hours/ week, or should you allow extra time for it? Are e-readers a form of screen? They often allow interaction like a computer and many can show videos and offer games.

Short answer about counting total screen time: We don't know.  Experts can give thoughtful opinions, but really at this point it's all educated guesses.

Some studies show that kids learn better when things are presented on a computer or video format. Maybe it keeps their attention better than a paper workbook. I love the ability to hold my finger on a word in an electronic e-reader and have the pronunciation and definition pop up. How many times as a young reader did I simply skip over words I didn't know? My daughter likes to increase the font size so only a sentence or two are on the screen. She feels like she reads faster because she "turns the page" more often. Does this build her confidence reading? Does it actually slow her down? I don't know. But she's happier to read and it seems to work for her. (This does drive me nuts if I pick up the Kindle after she's changed the settings... but I can change it back to my preferences easily.) Are kids losing the ability to find things in alphabetical order, such as using an encyclopedia to look something up, since they just hit "search" and find the answers? Does it matter?

Parents must really pay attention to what kids are watching and playing as well as how much time they are spending on a screen. For every minute they are on a screen they aren't interacting with people to work on social skills, they aren't outside playing games and getting exercise. If the games they are playing help develop thinking skills, strategy, math, reading, and more, then some screen time every day can benefit. If the content has violence or other age inappropriate material, it can be very detrimental. If they are online playing against other people, dangers multiply. While I can see kids who hate to read actually not notice how much they must read to play a game on a computer or tablet, are there better ways to get them pumped into reading a book?

There's a time and place for everything. The dinner table and bedroom are never a good place for online/screen time. Watch and play with your kids. They will love the time with you and you can better supervise what they're exposure is and modify it as needed.

More information:
Media Resolutions Every Family Should Make in 2014 has some tips to help monitor and limit screen time.
For information on internet safety, check out YourSphere for Parents.
American Academy of Pediatrics Media page.

Screen time for under 2 years might be okay? What!!!???

I was initially confused by recent headlines such as this reporting that Dr. Dimitri Christakis now says some interactive time on tablets or computers might be okay at young ages. He is one of the authors of the 2011 American Academy of Pediatrics Guidelines that recommended no screen time under 2 years of age, so this seemed at first contradictory. He has previously been on record affirming that television for children under 3 years is very detrimental for their attention span, stating that it permanently damaged their brains. So naturally my first impression was the news must have the angle wrong.

photo source: Shutterstock

Then I was reminded that when those guidelines were written, the scope of screen time availability was much different. The guidelines relied on research done well before iPads or other tablets were readily available. It was a time of flip phones, not smart phones. We have little information on what interactive screen time does for development since it is such a new concept.

Toddlers in my office are often on their parent's smart phone or other device. They scroll through family pictures. They try to match puzzle pieces. They find the letter or count the objects. They watch a movie. Each of these is very different in what the child is exposed to and what they can potentially gain. There are lists of educational games for 2-4 year olds to teach various skills. I suspect if the under 2 year crowd playing e-games is sanctioned officially by the AAP, lists for that age group will develop too.

We really are in infancy stages of learning what kids of all ages can learn from these devices or all the negatives that could be attributed to them. Of course the types of interactions make a big difference in addition to the total amount of time spent on these activities. As Dr. Christakis explains in this TED talk, some screen time is too action packed and fast moving for healthy brain development, encouraging short attention spans and hyperactivity. Children under 3 years have an especially rapidly developing brain, so they are more sensitive to the interactions they have in real life or on a screen. (He starts talking about television at about 5 minutes into the video but I encourage watching all of it, it is that good.) It is still unclear if television actually causes increased risk of ADHD or if children with ADHD are simply more drawn to action-packed television. Interestingly, educational television programs aren't linked to increased risk of ADHD but action packed and violent shows are. In short, any experience we have during our developmental years changes us, we just don't know exactly how influential television and video games are.

Toddlers who interact with a screen are learning hand-eye coordination and cause and effect. Yes, that can be learned the old fashioned way with exploring their world around them, and I encourage that most of it should be learned from playing with real objects. They need human interaction to learn social skills. Screen time can over-stimulate them if the action is too fast-paced, too loud, done in excess, or done at the wrong time (such as bedtime). Most of us know how addictive screen time can be. We can lose track of time as adults and so can toddlers and kids. If kids get frustrated playing (or refuse to turn it off when asked) they might be getting inappropriate or too much screen time. If this happens, stop all screen time for awhile and slowly re-introduce it after screening the games/ shows to evaluate if they are appropriate for your child's stage of development. Just because an older sibling or friend enjoys a show or game doesn't mean your child is developmentally ready for it.

For most families children using screen time is a given, it's not something parents avoid until at least 2 years of age. Regardless of recommendations to have no screen time under 2 years and only up to 10 hours per week for older children, most kids have much more screen time than that. Parents know that screen time is a great behavior motivator. Parents use screen time as a token to get chores done or to behave well. It can afford a parent time to get a few things done while kids are not running around the house. It is an easy way to keep kids occupied when they must sit quietly for a long period.

We still should use screen time wisely and responsibly. It should be age appropriate. Especially for younger children, it should have a learning goal and should not be too fast paced. A great video from CommonSenseMedia.org, Not All Screens Are Created Equal, discusses quality as well as quantity of screen time. I regularly use that site to pre-screen media my children want to watch or play to be sure it is appropriate for my child. I encourage you to do the same.

Playing learning games on a computer or tablet has the potential to be beneficial for children, as long as it is balanced with active play to allow for plenty of exercise. Remember as parents we must put down our devices too! Kids need our attention. If we are hiding behind our smart phone or tablet, we are not focusing on them like we need to. Set aside time just for family and turn off all the electronics. Model the behaviors you want your kids to do. Help toddlers and kids use screen time wisely and appropriately.

Spring Forward... Lose sleep...

As we move our clocks forward to increase the number of daylight hours, we all lose one hour of sleep.  In the whole scheme of things, this isn't much. Most people (kids and adults) lose needed sleep every night.  Only 8% of teens get the recommended amount of sleep.  Eight percent!  No wonder they have increasing rates of so many problems.

Last night I watched "Race to Nowhere" a documentary of the pressures placed on our kids today.  Kids feel pressure to do well in school (many while taking an overload of AP classes), leading to many hours of homework each night.  They participate in sports, which takes up valuable time after school away from homework, but does help them exercise and do something they enjoy (until they burn out and don't like it anymore). They feel the need to do community service and join clubs to build their portfolio to get into a great college.

While I think the film was developed with an agenda and not every kid is suffering from overload, I certainly see enough teens (and preteens) who seem to suffer from sleep deprivation, depression, anxiety, stress, and more.  Are these kids simply not using time efficiently?  Even the documentary showed one of the troubled teens doing homework with her cell phone right there and texting interrupting her thought.

Maybe a quick break after school to play outside for 30 minutes will help release energy and allow the brain focus to study.  Then turn off the tv and put the phone in another room and get to work.  My question: Are these kids spending 6 hours doing 1 hour worth of work?  

Interesting point made in the film though: Studies show that as the amount of homework assigned decreases, test scores increase.

Are we setting our kids up for failure from the beginning? Research shows that kids under 3 years who watch tv have higher incidences of ADHD and aggression along with lower cognitive development.  Kids with ADHD take longer to do tasks because they do not focus and concentrate until the task is complete.  They often need to re-read or re-do work because they miss concepts.  They can suffer from poor self esteem and increased rates of depression because they feel like failures.  In the short video below Dr. Dimitri Christakis explains how researchers are learning about the influences of stimulations (too little and too much) on learning and development.  Take 16 minutes to watch it!

Past growth and development cannot be changed, but we can improve current growth and development.  Maximizing nutrition, healthy exercise, and sleep can help the body and brain be its best.

Kids and teens are staying up too late (sometimes all night) to finish homework.  They are tired during class so take caffeine or other stimulants (such as those used to treat ADHD without a prescription) to stay awake.  They are too tired to focus in class, so they perform below their knowledge on tests.  Between 7-12 years old, kids need 10-11 hours of sleep every night.  Teens need 8-9 hours, sometimes more during rapid growth spurts.

Kids who once enjoyed a favorite sport feel the pressure from coach to train more, but the demands of school put the kids in a quandry: they need to make grades to play, but they don't have time after practice to do the homework.  Often practice and game times are late in the evening, making it hard for kids to fall to sleep at a normal bedtime, since the body needs about 2 hours after exercise to fall to sleep.  I have blogged on this before here.

I see many kids and teens who have chronic headaches or other symptoms that are likely due to sleep deprivation, but they insist it is something else and they want the million dollar workup to find a cause and expensive medications to treat the symptoms.  Once symptoms have started, they might need more treatments, but beginning with healthy nutrition, exercise, and sleep might prevent many of these problems!

The fear of failure and pressure to succeed is leading to kids trying anything to succeed, not just staying up late and drinking too much caffeine.  Cheating in schools, such as copying homework, plagiarizing, or cheating on a test is becoming commonplace. The large majority of high school students admit to cheating.  What does this mean for our future society if kids learn to cheat the system to succeed?

Kids who are chronically sleep deprived are at risk of physically hurting themselves due to slowed reaction times, concentration and focus failures, and difficulty processing information (much like being under the influence of drugs or alcohol).  They are more likely to be injured while playing their sport. Drivers are more likely to be in a car accident.  Drivers 16-24 years of age are the most likely to report falling to sleep at the wheel in the past year according to a study by the AAA Foundation for Traffic Safety.  Also in this study, people who sleep 6-7 hours a night are twice as likely to be in an accident as those sleeping 8 hours or more.  People sleeping less than 5 hours increase their risk 4-5 times!

How can we all wake up rested and still get everything done each day?  What can we cut back on with our families?  There are initiatives to get schools to enforce less homework and to start later, but until then, what can YOU do to help your kids get the sleep they need?

Screen Free Week Reflections

I have been a fan of Screen Free Week since I heard about it.  Even before I heard of the official week, it was a popular negative consequence in our home.  

I used to enforce unofficial screen free weeks at our house regularly when I saw my kid's behaviors turn toward selfishness, fighting, and whininess.  Turning off the tv and video games help.  Maybe it's because the screen activities wind up their brains.  Maybe it's because it is "down" time and they need active time.  Maybe because I was guilty of using the tv as a babysitter so I could get my own things done, yet the kids needed time with me.  There are many more maybes, but all I know is that turning off the tv and video games seems to always help.  I get a bunch of complaints at the beginning of the week, but by the end of the week the kids are in a new habit of finding things to do without electronics.  It's fun. We all get along better.

This Screen Free Week I realized that it is harder than ever though.  Not for the kids, but for me.  I can never get off computers completely.  We use electronic records at my office.  I use the internet to search for information related to my job.  Those are allowable uses, since electronics for work and school are exceptions to turning off the screen.  Computers are simply a part of our life.

We are all relatively new to all the opportunities for wasting time on tv (remember when there were just a couple channels?) and internet offerings.  We are plugged in from our computers and our Smart Phones.  We get a lot of work done and learn information on these Screens.  When can we unplug? How do we learn to manage our time?

This week I was going to at least stay off Facebook, since that is mostly fun stuff that I share with patient families. Work related, yes.  Necessary, no.  I feel that by posting to Facebook it encourages others to look at Facebook.  Facebook is a huge time waster for many. (And yes, this is from someone who is totally addicted to facebook... I spend quite a bit of time searching around on it to scope great things to share!) A great reason to turn off the screen for a week!  

But then I need to reevaluate the "Necessary, no."  What is necessary?  I still had to look at Facebook to be sure the office page was not being abused with posts that were inappropriate.  Most things I post are not timely.  There are some recalls that are important, but not really imperative to share NOW.

But there were several things that happened in this one week that Social Media could really benefit.   Where do you draw the line of staying off Social Media and when does it become "work" so it is excluded?

We did post two things to our wall that did seem to meet the criteria of important and timely.  One was a request from the Health Department to spread the word about an outbreak.  Why is this important?  Because 8 people in Kansas have been sick and 2 have died.  Warn people: good.  But then to see it, people are checking their Facebook posts: bad.  Such a slippery slope!

The second post was about our own office's access.  We were not warned that our parking lot was to be resurfaced.  Staff arrived to work and found the whole thing blocked with no access to our main door (until we convinced them it was unacceptable during office hours).  Yikes!  How to spread the word quickly?  Yes, we can call the patients with appointments and tell them where to park, but what about walk ins?  Facebook is fast.  It can be helpful!  But we told people to stay away for the week.  Sigh.  Just can't win!

A third post that didn't end up getting posted because it is a bit hazier in importance and timeliness.  We have promised that when we open flu clinic appointments we will share on our website and Facebook page.  Of course we were able to secure a couple dates during this Free Week.  We posted to the website, since people always use that for health matters, not "fun".  We sent out an email to registered website users.  But we didn't post immediately to Facebook, again to encourage people to stay off Social Media for the week.  But Facebook isn't purely Social.  It is used to share information in a way that wasn't possible years ago.  (No worries for those of you who haven't signed up yet... there will be plenty of time to sign up!) 

Other posts that aren't timely were easy.  Save for later.  I am using a scheduling system that schedules posts, so I don't have to post daily.  That is helping manage my time on Facebook.  I still have to look daily to check on posts, but it does help with time management.


I think that is where the secret lies.
We all need to learn time management with the Screens.  What is important? What are time wasters?  Time wasters aren't always bad.  It can be great to vege in front of the tv after a long day and just relax without any bothers.  It is fun to catch up on what friends are up to on Social Media.  It can save time if you have exciting news and post once for all your friends and family to see (less personal than a phone call or visit, but faster!)


We need balance.
We need to make time for family, faith, exercise, healthy family meals, and sleep.  Cutting out those important things in life to waste more time in front of the screen simply is dangerous.