Tuesday, March 5, 2019

By Kate Cook, MD, Medical Director of Pediatric Hospital Medicine and School Telehealth Norman Regional Health System

There is an invader in your home that can lead to many adverse health outcomes in children, including unhealthy weight gain, irregular sleep, and poor nutrition. It has detrimental effects on social behaviors, such as spending time with parents and siblings, doing homework, or engaging in creative play, and is linked with getting lower grades, getting into trouble, and feeling sadness and boredom. What is this uninvited guest? Screen time!

This is certainly a case of “do as I say and not as I do.” As a parent of elementary-aged kids, I know the struggles of limiting access to the games, videos and movies that they are begging for. Several studies have come out recently demonstrating the adverse effects of excessive screen time, such as elevated body mass index (BMI), poor sleep and delays in cognitive, language and social/emotional development. Heavy users of video games are at risk of Internet gaming disorder. Its symptoms can include a preoccupation with the activity, decreased interest in offline or “real life” relationships, unsuccessful attempts to decrease use, and withdrawal symptoms. Up to 8.5 percent of U.S. youth 8 to 18 years of age meet criteria for Internet gaming disorder.

The American Academy of Pediatrics has listed the following guidelines for screen time in children:

  • Avoid digital media use (except video-chatting) in children younger than 18 to 24 months.
  • For children ages 18 to 24 months of age, if you want to introduce digital media, choose high-quality programming and use media together with your child.
  • For children 2 to 5 years of age, limit screen use to 1 hour per day of high-quality programming (such as PBS), coview with your children, help children understand what they are seeing, and help them apply what they learn to the world around them.
  • Turn off televisions and other devices when not in use.
  • Monitor children’s media content and what apps are used or downloaded. Test apps before the child uses them, play together, and ask the child what he or she thinks about the app.
  • Keep bedrooms, mealtimes, and parent–child playtimes screen free for children and parents. Parents can set a “do not disturb” option on their phones during these times.
  • No screens 1 hour before bedtime, and remove devices from bedrooms before bed.
  • Promote that children and adolescents get the recommended amount of daily physical activity (1 hour) and adequate sleep (8–12 hours, depending on age).
  • Discourage entertainment media while doing homework.
  • Have ongoing communication with children about online citizenship and safety, including treating others with respect online and offline, avoiding cyberbullying and sexting, being wary of online solicitation, and avoiding communications that can compromise personal privacy and safety.
  • Consult the American Academy of Pediatrics Family Media Use Plan, available at: www.healthychildren.org/MediaUsePlan.