Screen Time

Living Well in Myanmar

Watch out for kids who watch too much

Part of every ‘Well Child’ checkup in my clinics in Yangon and California is talking to kids and parents about healthy lifestyle. This of course includes eating well, getting lots of exercise, and using safety equipment like helmets and seat belts whenever possible. It also includes a discussion on screen time and how much of it is felt to be healthy for growing children.

Screen time refers to the total number of hours that a child spends per day looking at a TV, computer, tablet, telephone, etc. Doctors and pediatric counselors have become increasingly concerned over recent years with the amount of a kid’s day is taken up by staring at technological devices. The fear is that the more time spent with movies and games means less time spent engaging in physical activities and creative play. In their mental, physical, social, and emotional development kids need dedicated time for problem solving, communicating with others, developing/pursuing ideas, and using their bodies to promote neurological development (link to Healthy Children Need Time For Play, MMTimes, Health Supplement, Aug 4, 2013). All of these critical activities get compromised by excessive hours in front of TVs and computers.

So how much time is too much time? While medical research hasn’t arrived at definitive ‘safe’ number for hours in front of a screen, we are starting to benefit from an increasing number of studies that highlight poor health outcomes for kids that watch too much TV. In addition professional pediatric societies now feel comfortable taking an official stance on screen time and making parenting recommendations.

Although most of the research conducted to date shows an association – rather than causality – between screen time and poor outcomes later in life, the results are nevertheless startling. For example a 2014 study published in the Journal of the American Medical Association looked at 3600 European children at age 2 through 6 and found that children exposed to more media were twice as likely to have emotional problems and poor family functioning three years later. This supports an older study published in Pediatrics which found that for every hour of television watched by a child between the ages 1-3, there was a 9% increase in a diagnosis of ADHD at 7 years old. Furthermore an analysis of 9-10 year old girls performed in 2011 found screen time to be associated with poor self-esteem. Finally, a study from New Zealand in 2013 concluded that the more television we watch as children the more likely we are to have a criminal, a diagnosis of antisocial personality disorder, or more aggressive personality traits as an adult.  Ouch!

The American Academy of Pediatrics (AAP) has released guidelines suggesting that children under 2 years old not have any screen time and that older children older be limited to 2 hours per day. They arrived at this recommendation after reviewing evidence that shows TV watching leads to weight gain and thereby increases lifetime risk of diabetes, heart disease and cancer. Unfortunately the United States may have some work to do in achieving this goal as the average American spends 5 hours per day watching TV and 50pc of infants watch TV daily.

At the same time, the AAP concluded that young children who ate dinner with their families, got adequate sleep, and had limited screen time had a 40% lower occurrence of obesity. This reinforces the general message doctors should feel obligated to pass along to their patients during consultations: in addition to eating well and exercising children require sufficient time to explore their social and physical environments, which can’t be achieved in front of a screen.

gelsdorfMD@gmail.com  © Christoph Gelsdorf 2013