The bad, the ugly and the good of curating children’s screen time

Dr. Stephanie Price talks screen time at the Wellness Week conference. photo by Michael Erskine

LITTLE CURRENT – The Mnaamodzawin Health Services Inc. Wellness Week 2020 conference held at the Manitoulin Hotel and Conference Centre was jam-packed through most of the three-day series of workshops and keynote speeches on offer. No exception was the ‘Kids and Screentime’ presentation by child psychologist Dr. Stephanie Price.

Dr. Price began her talk by canvassing those in the room on whether they had a smartphone, a tablet, a laptop or a personal computer. The response of raised hands was near-universal for each of those high-tech items.

“Everyone in this room has some form of technology,” concluded Dr. Price. “Technology is something that we can’t get away from. You can’t get a job without some technological knowledge on your resume.”

The statistics when it comes to children are startling.

Children as young as four months are being impacted by the screens of technology, she noted. Even though they may not know or be able to consciously interpret what they are seeing, there is still an instant gratification aspect to the lights and sounds. Stats show that even as young as four months, 93 percent use some form of technology. Some 51 percent of infants age six to 11 months use a touch screen daily, mobile use for two to four year olds is approximately 80 percent and children three to five years old spend an average of two hours a day on technology.

By age four, children are more likely to use technology for entertainment as opposed to education; children eight months to eight years are exposed to almost four hours of background television daily; 93 percent of individuals between 12 and 29 use the internet and early exposure to technology predicts later use.

Technology is nigh on to ubiquitous in our modern 24-hour connected world and is just about impossible to effectively avoid—so the question becomes how can parents harness the positive aspects of technology to use it effectively? The good news is that behavioural science indicates there is plenty of hope, as long as parents do not ignore the issue.

“Early experiences determine later use as adults,” said Dr. Price. “If we can shape behaviour early, before the age of five, then children are more likely to approach technology more meaningfully as an adult.”

The question of “is my child addicted” came up early in Dr. Price’s presentation, but she was quick to point out that, professionally, this question poses challenges.

“As a psychologist I don’t have a diagnosis to say that someone is addicted to technology,” she said, pointing out there is not yet a set group of indicators for that diagnosis.

A neurological response (aka rush of the happiness hormone dopamine) in the pleasure centre results in those feelings of pleasure and reward, the faster and more intense the rush of dopamine, that response is more likely to result in addiction and long term exposure results in structural and chemical changes in the prefrontal cortex—the executive decision making part of the brain. Over time the brain adapts, making whatever has delivered the pleasure response less effective.

The executive functions of the brain include self-regulation, organization, planning and finishing tasks, prioritizing information, losing or forgetting things, multi-tasking and inhibiting impulses—so just about all of the important social stuff we need to successfully get through life happens there.

Executive functioning skills include our relationships as adults, environmental factors, our safety and security, established routines, modeling of social behaviour, creative play, social connections, coping skills, exercise and increased independence (aka getting out of their parents’ basement and into the world on their own).

When it comes to environmental impacts, Dr. Price used an example. “We tell children to not to touch the stove,” she said. Should the child later touch a hot stove, the resulting pain reinforces the message.

“But, if we do something that makes us happy, we are more likely to do it again,” she said. While that does not mean we become addicted, it does increase the likelihood of becoming addicted.

The executive functions of the human brain do not fully develop until a person is in their 20s, noted Dr. Price, so there is a lot of time for technology to impact the brain, but don’t think screen time is the be all and end all for learning.

“Children learn things better through interaction than they do from screens,” she said. So don’t be caught up in the brain builder craze. “We are not born with executive skills, they are learned.” The best environment for building stable and well functioning adults is a stable and predictable environment while they are developing and growing.

This is especially true in those formative years before age four to five, but another key bump comes during the adolescent years.

“Executive skills are best learned through interaction and parental reactions play a very important role when it comes to that development,” said Dr. Price. “Mom asks us to do a chore and we respond ‘I’ll do it later;’ we need to see her reaction.”

This response interaction helps us to develop how we deal with things in life.

Routines are also very important to creating a good parenting style and the impact of creative play is “amazing.”

Since there is no fully recognized set of determinates to diagnose a gaming disorder, child psychologists tend to fall back on the characteristics of substance abuse disorder. Any two of the following symptoms within 12 months is cause for concern: consuming more than originally planned; worrying about stopping or consistently failed efforts to control use; spending a large amount of time using or doing whatever is needed to obtain them; use results in failure to full major role obligations such as home, work, or school; “craving;” continuing to use despite problems caused or worsened by it; continuing to use despite having negative effects on relationships with others; repeated use in a dangerous situation (such as driving a car); giving up or reducing activities because of use; building up a tolerance; and withdrawal symptoms after stopping use.

Things that make someone vulnerable to addictions include: genetic disposition; personality traits such as sensation-seeking, deficits in executive functioning; mental health issues (depression, anxiety and PTSD); exposure to trauma or abuse; substance abuse in the home or among peers and quality of infant and caregiver relationships.

So when it comes to what to look out for, remember that risks are associated with excessive screen time, emphasized Dr. Price. “I see some kids who are gaming 24 and 48 hours straight,” she said. “That’s a problem.”

Those include taking the place of other activities that children benefit or learn from. “As a working parent, between school and daycare, there is only a limited amount of time left in the day for me to interact with her,” said Dr. Price.

Watch out for reduced physical activity and/or increased weight gain and problems sleeping and/or increased fatigue during the day, acting out when taken away or restricted and complaining of being bored or unhappy if not using technology.

Possibly even more important is that parents need to monitor their own use. “Parental use can result in a reduced ability to interact in the moment with your own children,” said Dr. Price. Parental interaction with a child is the most important factor in their development, along with modelling (seeing what you as a parent does, not says). “Be aware of your own technology use,” she said. “If your child has a moment where they want to interact with you, make an effort to not be on your phone.” She will think it’s normal if you ignore her for your own small screen.

When it comes to technology and young children, it’s important to understand the progression.

“Newborns do not understand content from TV,” said Dr. Price. For them it is all about the bright lights and sounds. But imitation from screens begins around six to 14 months and by 18 months they can recall sequences, by age two they begin to understand content.

Still, at these ages children learn much better through face to face interaction, especially language and vocabulary as well as school readiness skills, particularly if the child is coming from a low socioeconomic status.

Be aware that there is a strong association between television exposure at age two and self-reported victimization, social isolation, aggression and anti-social behaviours. There is also an association (although mixed) between screen time and attention difficulties when exposure exceeds seven hours. Background television affects language development, attention and executive functioning in children under five. This may well be due to the reduction in the amount and quality of parent-child interactions and the distraction from play associated with excessive screen time.

Another constant among caregiver concerns when it comes to video games is the amount of violence children are exposed to—with some 85 percent of video games containing some form of violence. “The link between violent videogames and aggressive behaviour is well documented, especially for those over the age of 10,” said Dr. Price. “Increases in aggressive behaviour, affect cognition along with decreases in empathy and pro-social behaviours and morality.”

It is clear from the science that viewing violence increases desensitization and increases aggression. Put simply, children imitate what they see. The more exposure to aggression and violence the more likely a child is to show aggression and have poor outcomes. It is important to note that mental health status and family life can have a major moderating impact on how all this plays out in practice. “If you have a strong relationship with your child you can moderate these effects,” she said. “So as much as you might think getting your toddler to watch Baby Einsteins will help their development, there is no evidence to support this. Interaction with your child is really what is going to hit it home.” 

Dr. Price noted that is not clear if screen time changes a developing brain.

But in conclusion, technology is not all doom and gloom, noted Dr. Price. Although there are no proven benefits for infants and toddlers (children at this age learn more from hands-on exploration and social interactions), by age two quality (age-appropriate and educational) television can help with early language and literacy, positive racial attitudes and imaginative play, while e-books and apps can help with practicing letters, phonics and word recognition. But if you really want to help your child’s development with technology get down on the floor and watch it with them—have conversations about what is on the screen.

Even video games are not complete bugaboos. They can help develop a sense of competence, connection and autonomy. They can help children who are not comfortable with face to face interactions and who have social anxiety practice social skills. Executive functioning skills such as attention, planning, problem solving and organization. They can also develop increased visuospatial skills, reasoning and memory.

So like all things in life, moderation is  key.

The Canadian Pediatric Society recommends no screen time under the age of two and limiting two to five year olds to less than one hour a day (and not routine).

Instead, make more time for face-to-face interactions, combine technology with creative or actual play, maintain screen free times, especially at meals, and encourage book sharing. 

Possibly among the most important, and yet difficult, suggestions—avoid screens at least  one hour before bed.

So, if you want to mitigate the impact of technology on your child use it with your children, connect the content with real life, prioritize educational, interactive and age-appropriate content and teach self-regulation when it comes to its use.

“Your children should not have to compete with technology for your attention,” said Dr. Price. “Turn off technology when it is not in use.”

Set limits, she advises, but don’t overreact or over-restrict. “Remember, your children are not living in a vacuum, they can be the only ones in the conversation that do not know what Minecraft is.” Create regular tech-free time and household rules especially for young children. “Setting limits early is much easier than restricting later,” she said. 

Don’t let technology invade the bedroom and limit use before bed.

“Children don’t need technology to learn, especially young children,” said Dr. Price/ they need you. The key is moderation, supervision and modelling appropriate technology use.