Screen Time: Is It Really That Bad?

Dora the Explorer was my savior for several months of morning routine with my 2-year-old (before I even knew the challenge of more than one child). I personally cringe at the cliché that parents use TV as a babysitter. It’s so not that simple, and definitely not as cavalier as it sounds. Many of us have this nagging thought it’s not the optimal move for our child’s development to allow them some Princess Sofia while we cook dinner.

When I first discovered that my child would actually sit through at least 15 minutes of a show, I thought, “what have I been trying to prove?” Today’s “screen time,” though, has become complicated by so many types of screens and media, potentially available at every minute, that most parents feel a constant pull of guilt versus convenience.

There was an online article circulating at one point with the title referring to an iPad turning the author’s child into a “psychotic junkie.” I read the article posted by some very intelligent, well-educated parents I know, and the overstatement of science and radical conclusions represented to me the worst of what our open media without quality standards allows.

Soon after reading this, the iPad use in our family had slowly slipped into more and more usage, through a series of small steps, each inconsequential on its own, but resulting in more iPad time than I realized. One week near the end of her first grade year, my 7-year-old was having tantrums and meltdowns reminiscent of her 3-year-old self. My husband and I kept staring at each other in disbelief – she had grown out of this – what was happening? After several days of feeling like we were in the child development twilight zone, and reviewing several possible factors (Sleep? Friend stress? End-of-the year anxiety?), I had an epiphany: it’s the iPad. She had discovered two games that she couldn’t wait to play when she got home, and had swapped out her usual TV time to play once or twice a day. Our reasoning was screen time was screen time, so she could choose. Although those iPad games did not make our maturing oldest child “psychotic,” she did seem to systematically become an emotional disaster after playing.

My instinct was telling me that maybe all screen time is not created equally, and I should understand this better.

The Original Screen: Television         

I am guilty of having a shallow understanding of the AAP recommendations for screen time in young children. I had gathered that TV for under 2 was bad, and I remember hearing the statement that parents should be watching TV WITH their children. My first thought was, what is the point of that – their watching TV helps me be available to do all other parts of my life for a luxurious few minutes. One morning, however, while using a spider man cartoon on the iPad with our 2-year-old to ensure we could get out the door on time, I glanced down to notice spider man had a gun and was shooting at people running away from him. WHAT? I guess the AAP was right, darnit.

The AAP released their most recent recommendations in October, 2016, and very thoughtfully categorized these recommendations into two reports by age: infant/toddler/preschool and school age/adolescents. In studying the gently titled, “Media and Young Minds” report, several take-home points stood out through the academic language. First, they discuss the youngest age for “media use” at 15 months, as long as it is parent-led with developmentally appropriate content that the parent “re-teaches;” but the report’s bullet point at the end states the minimum as “18-24 months.” For ages 3-5, well-designed TV programs and apps (think of the Sesame Street educational variety) actually CAN have positive effects on thinking, reading skills, and even social behaviors. The report includes an important caveat, however, that many apps advertised as educational are not “vetted” and may not reach the standard required for these positive effects.

We are probably all aware of the idea that too much TV time in early childhood can result in delays  – this is what underlies our guilt about allowing our kids “too much” TV. However, the research shows that this actually depends on several factors, such as the content and the outcome. For example, a well-designed study cited by the AAP showed that violent content relates to behavior problems, especially for boys; but if that content switches to educational or prosocial, there is a significant (this means statistically significant in this case) improvement in these behaviors. These findings suggest that our instincts are probably right to prioritize Sid the Science Kid over Batman.

In full disclosure, my husband is a huge Batman fan. He developed a Saturday morning routine with our girls (during preschool ages) to watch old Batman TV shows together. It seemed innocent enough – I got to sleep in and the girls and Daddy loved this time together. Clearly, my husband was excited to continue this tradition with our son when he was old enough. Guess what? That child started running around pretending to shoot guns and actually hit his sisters in the name of playing superheroes. We cut out Batman; that play immediately stopped. My husband’s heart lost a little piece of his dream of father-son bonding, but at least our son was no longer a toddler vigilante.

This anecdote illustrates, however, the importance of individual differences in children. Research is all about general trends and conclusions when examining a large group, but we need to temper these findings with what we observe to be true in our children. I view these types of studies and recommendations as guideposts to set some parameters around my own experimentation with what seems to work for my family.

Another important context is the consistent finding that children in lower income and/or single parent households are more likely to have more screen time. This is another complicated topic that needs a lot of unpacking rather than blaming or shaming, but it is an example of how research findings are also layered with specificity to certain populations, and caveats to generalizing findings too much.

Back to the question of how much TV, really?? The AAP’s report states no more than 1 hour a day of “high quality programming,” preferably shared with the parent present, for ages 2-5. I combed through the studies cited in the AAP report to figure out where this 1 hour a day number originated. One study’s title, “Clinical and psychological effects of excessive screen time on children,” seemed promising. However, many of the findings applied to school age children or adolescents instead of toddlers and preschoolers.

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The author does refer to a study showing that toddlers watching 2-3 hours of daily TV had almost three times the risk of language delay than those with less than one hour. In the section on socio-emotional and mental health, there are no data presented on number of hours qualifying as “too much” screen time.

Another study in Thailand compared the cognitive, language, and motor development of children under three with high daily TV viewing time (average=67.9 minutes for under 2; average=137.2 minutes for 24-35 months) to children who watched little or no TV. The TV-watching group had significantly more delays. This has important implications, but a huge limitation to this study is it is cross-sectional rather than longitudinal. This means that the results show an association between developmentally delayed children and more time watching TV, rather than that watching TV at this age CAUSED these delays. The authors duly note this limitation as well as their small “sample size” (number of children in the study). It may be that the delayed children’s types of developmental delays interfered with ways that a typically developing child would be exploring the world, and that these families were not receiving adequate supportive services for these delays; these points were not addressed in the study.

So, my digging for the reason behind the 1-hour recommendation for 2-5 year olds unearthed more caveats than explanation. This is an area where I think we can let ourselves off the hook of a hard and fast rule, and use our common sense based on our own children and lifestyles. 

Screens, Screens Everywhere

In addition to the number of hours recommendations, the AAP’s report encourages no screen time on any device the hour before bed (the blue light actually affects our brain’s sleep hormone, melatonin), and ensuring kids have plenty of time for hands-on, imaginative play to keep developing those other parts of their brains and bodies.

To top it off, the report reminds us of the ills of too much PARENT “media use” (I visualize many of us checking Facebook and email constantly on cell phones), so we have to look at the behavior we are modeling for our children.

So maybe this is the reason I hadn’t paid closer attention – I didn’t want to know and would rather live my blissfully ignorant truth because the above standards sound hard for many family situations.  Instead of running away from what I didn’t want to read, I looked more deeply into the articles cited by the AAP as the basis of these recommendations.

Several articles acknowledged there is not enough of an understanding of distinction between types of screen time, but it is likely these differences exist. Another handful of articles described rates of use by different ages in different parts of the world. The most consistent and robust finding across various articles was the harmful effects of screen time on sleep. This translates into the recommendations that children (and teenagers) do not have screens in their rooms, and do not engage in using devices or watching TV an hour before bedtime.

These findings intersect with my professional work, as I focus on healthy sleep behaviors as a pediatric health psychologist. Common sense dictates that if your child is a great sleeper regardless of screen use, you may be in the fortunate minority. However, if your child struggles with sleep (as many do), modifying this access to TV and screens might help if they happen are on these screens close to bedtime. In our family, the kids watch one or two shows between getting home from school and having dinner. After dinner and homework / play time, the older girls have time in their room for what was originally deemed “quiet time” but has turned into “just play together without bothering us or waking up your brother.” After a long day, this pre-bedtime play seems to serve them well.

Again, it is figuring out what works best for each family depending on so many unique factors, and observing and responding to problems, which we can do by considering what the science tells us. I have friends who have discovered that telling their child it is time to turn off the device (TV or iPad) causes such behavior problems, that it’s better to never present the option in the first place. From the child psychology perspective, children with certain neuro-developmental traits (like those common in ADHD and Autism) may respond differently to types of media like video games, becoming so immersed and fixated that it interferes with them engaging in other behaviors, and they truly struggle with transitioning to a different activity.

To wrap up, I wanted to share one quote validating I did not harm my child during those busy morning routines: “In one study, the viewing of ‘Dora the Explorer’ resulted in 13.30 more vocabulary words required at the age of 30 months compared with non-viewers.”

Thank you, science.