Screen Time!

The I-Generation

Being able to work a computer tablet should probably be recognised as a developmental milestone nowadays with thousands of children under the age of 5 having IT skills far surpassing those of their grandparents. A cultural shift from ‘rough and tumble’ explorative outside play to viewing the world through a TV or computer screen means many children now consider Peppa Pig and Dora the Explorer amongst their closet friends, or spend their evenings living in virtual environments.

Progression is vital to human kind and technological advances have undoubtedly led to improvements in clinical care and increased access to education across the world. Having embraced the world of social media and increasingly led my life as per my google calendar, I still find myself lamenting back to the old days of reading good old fashioned books or splashing in puddles in the rain. There are days when I want to throw my smart phone out the window or sit my nephew down and emphasise how there is more to life than C-Beebies.

In view of this, I thought I’d take a step back and look at generation ‘Screentime’; trying my best to maintain a neutral perspective and elicit both the positives and the negatives of being a child in our increasingly technology driven society.

On average, by the age of 7 a child born in the UK will have spent an entire year, 8760 hours, looking at screens. Indeed by the age of 10, it is estimated that a UK child will have regular access to at least 5 different types of screen at home.Whether it’s a nintendo DS, a smart phone or a laptop, that’s a lot of hours which could be spent doing something else. This brings me onto my first point;

Screen time, inactivity and obesity

Screen time is generally regarded as a sedentary activity. Evidence has shown that there are significant links between increasing screen time, sedentary activity and obesity. Increasing screen time has also been found to correlate with other metabolic risk factors such as raised blood pressure and insulin resistance.

Viner and Cole released a study in 2005 which revealed that an additional hour of TV watched on weekends at age 5 years equated to a 7% increase in risk of obesity at 30 yrs. This is frequently presumed to be secondary to inactivity but interestingly further studies have shown that children who meet activity level guidelines but not screen time guidelines are over 30% more likely to be overweight than children who meet both targets suggesting other factors may also be at play.

A review by Aric Sigman in Archives of Paediatrics in 2012 highlighted studies noting increases in blood pressure in those playing computer games, and an increase in unhealthy eating behaviours associated with increased TV time. The latter was hypothesised to be secondary to an increase in exposure to junk food adverts as well as difficulties in regulating food intake whilst eating in front of a screen.

Our Department of Health has released guidelines for activity levels in children of different ages (see here). Pre-school children in particular are recommended to spend at least 180 minutes of each day being physically active.

Although screen time is generally viewed as a sedentary behaviour, can it ever be useful in promoting physical activity? The use of Wii-fits and the latest Pokemon go phase spring to mind. ‘Exergaming’ refers to screen-based activities which combine video game play with exercise and require participants to use bodily movements to control and play the games. Although most ‘exergames’ are equivalent to only light-moderate physical activity, they have been shown to increase overall energy expenditure and raise participants heart rates. Although few home-based studies have been performed looking at Exergaming and BMI, laboratory studies suggest they could play a role. The British Heart Foundation have published a paper looking at the evidence (see here).

wired.com

Exergaming can also have a role in the management of children with movement and balance disorders. Evidence suggests that the Wii Fit in particular can play a role in improving the motor and balance function of children with cerebral palsy and stroke8 and there is emerging evidence for its use in developmental co-ordination disorder.

The developmental argument

For many years, the American Academy of Paediatrics has recommended that children under the age of 2 have absolutely zero screen time and that for those older, screen time is limited to less than 2 hours a day. This is based on previous evidence suggesting that increased screen time could lead to developmental and behavioural problems particularly in the early years as screen time replaces the normal interaction that children have with their environment.

A study published in Paediatrics in 2003 suggested an association between number of hours of television watched in a day and attentional problems at age 7. Excess television has also been associated with irregular sleep patterns and sleep disorders in all age groups

Although much evidence is available in relation to television time and early childhood, less research has been done with regards to new devices such as I-Pads and mobile phones. However it is increasingly recognised that appropriately designed mobile phone apps can be beneficial in helping children to acquire early literacy and numeracy skills.

Russell Viner on behalf of the RCPCH recently made the following statement.

“There is evidence that suggests excessive time spent in front of any screen – whether that’s a television, iPad or mobile phone – promotes obesity and interferes with normal sleep patterns in children. However our children are digital natives in a way no previous generation has been before, so it’s unclear whether the use of these new devices improves cognition and coordination for children under the age of two. Therefore more research is needed on the benefits and harms of different types of screen use. Only then can we really be sure what screen time recommendations we should put in place for young children.”

The American Academy have also revised their recent guidance on screen time allowing for a more flexible, up to date approach to this every changing world (see here).

I’ve recently discovered the ‘Good App Guide’ on fundamentallychildren.com which is a useful resource for parents looking for a bit of guidance in choosing appropriate apps for their child. I guess the key messages are that more research is needed into the ever expanding spectrum of electronic devices aimed at children and care should be taken to ensure that any screen time is the ‘right’ kind of screen time. Also, the same rules still apply: Good parenting and engagement with a child regardless of whether through media is key to their social development.

Personally I’m feeling a bit ‘screened’ out now so I’ll leave the risks and benefits of social media for another day. Hope this article has been interesting and informative. Take time to have a look at some of the links and let us know your thoughts.

Further Reading

  1. https://www.theguardian.com/society/2012/oct/09/childrens-health-screen-time

  2. http://adc.bmj.com/content/early/2012/09/04/archdischild-2012-302196.extract

  3. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213745/dh_128225.pdf

  4. Viner RM, Cole TJ. Television viewing in early childhood predicts adult body mass index. Journal of Pediatrics. 2005;147(4):429-35

  5. American Academy of Pediatrics. Children, adolescents, and television. Pediatrics. 2001;107:423-6

  6. https://www.gov.uk/government/publications/uk-physical-activity-guidelines

  7. www.bhfactive.org.uk/files/558/Exergaming%20evidence%20briefing%20.pdf

  8. http://adc.bmj.com/content/98/Suppl_1/A97.1

  9.  http://www.bacdis.org.uk/membership/documents/Hammond%20&%20Jones.pdf

  10. http://pediatrics.aappublications.org/content/113/4/708?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

  11. http://pediatrics.aappublications.org/content/116/4/851.long?trendmd-shared=0

  12. http://www.forbes.com/sites/jordanshapiro/2015/09/30/the-american-academy-of-pediatrics-just-changed-their-guidelines-on-kids-and-screen-time/#191f5501137c

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