Many families will be buying their children new tablets or maybe their first cellphones this holiday season. The kids will love it, but there is growing concern among health experts on the impact that screens and online activity has on young, developing minds.
There’s also a growing body of advice on how to encourage healthy use of electronics. The Hill spoke with child psychiatry expert Dr. Erin Belfort about the issue and rounded up guidance from across government and academia for a holiday guide to one of parent’s most vexing challenges.
Here’s what we know:
Quantity and quality both matter
The surgeon general this year issued an advisory on social media use and the risk it poses to youth mental health. The advisory noted studies linking prolonged social media use — more than 3 hours a day — to worsening mental health outcomes. And surveys suggest teens spend significantly more than that online, eight-and-a-half hours a day on average.
Guidance from groups such as the American Academy of Child and Adolescent Psychiatry (AACAP) has recommended limiting screen time to a set number of hours, especially for young children, but the quality of what they’re consuming during that time should also be considered.
“The American Academy of Pediatrics used to have a sort of magical number. It was like two hours a day of screen time, and I think they and all of us have realized that that number is a little bit arbitrary,” said Belfort, who is chair of the AACAP’s Media Committee.
“The emphasis has, I think, really shifted away from quantity and more about quality of screen time.”
When counseling families, Belfort says she advises parents to strongly consider what they feel is developmentally appropriate for their children.
The AACAP’s guidance on screen time recommends limiting what type of content children can view based on their age. For children less than 18 months old, the group recommends limiting their screen time to video chats with an adult. For children younger than 5 years old, the AACAP encourages an emphasis on education content over non-education screen time.
Their first cellphone shouldn’t be a surprise
Nowadays, most children can expect to receive their first cellphone sometime in middle school or earlier. And while parents may feel pressured to give their children the same products their friends have, peer pressure shouldn’t be a factor in making that decision.
“The kid needs to be able to have thoughtful, reasonable conversations about, you know, who owns the device. Who pays for it?” Belfort said. “Where is it allowed to be in the house and at what time? What is the child allowed to be doing on the phone? You know, all of those kinds of agreements really need to happen before the phone is purchased.”
In AACAP guidance published last month and co-written by Belfort, it’s recommended that parents consider a simpler device without access to the internet for their child’s first cellphone, noting smartphone use in elementary schools has been linked to increased involvement in bullying and cyberbullying.
The guidance further notes there is no evidence that waiting to get a phone is harmful to children.
“If your child cannot discuss the rules calmly and maturely, then they are probably not ready for their own cell phone,” the guidance states.
Yes, kids should occasionally put the phone down
In 2020, the World Health Organization (WHO) issued a set of guidelines for healthy development among children and adolescents in regard to physical and sedentary activity.
“Evidence indicates that greater time spent in sedentary behavior, especially recreational screen time, is related to poorer health outcomes,” the guidelines stated. “For example, higher duration of screen time (including television viewing) is associated with poorer fitness and cardiometabolic health in children and adolescents.”
For children aged between 5 and 17 years old, the WHO recommends they engage in at least an hour of some type of physical activity of ”moderate- to vigorous-intensity” daily.
The WHO also recommends that children and adolescents limit their amount of “recreational screen time,” with the organization citing research indicating a possible link between screen time and poorer mental health outcomes, negative impacts on pro-social behavior and shorter durations of sleep.
The group acknowledged, however, that the evidence is of low-certainty and there isn’t currently enough information to provide a specific time limit on this type of sedentary behavior.
It’s not all bad
Screen time and cellphone use have been observed to have some benefits as well. The advent of smartphones has been correlated with a reduction in risk behaviors among adolescents.
“Since the iPhone was released … various kinds of risk behaviors among youth have actually declined,” Belfort noted. “So, kids are driving less, they’re less sexually active, overall less kind of substance use. Some of the kind of like ‘bad things’ we worried about like teenage pregnancy, motor vehicle accidents, drunk driving — some of those things have actually declined quite a lot.”
According to Belfort, the theory behind this phenomenon is that kids are simply devoting more of their time to online activities instead of risky behaviors that were more common in the past. However, she is quick to note that correlation is not causation.
Apart from a possible link to reducing risky behaviors, being online provides kids an opportunity to connect with communities kids might not otherwise have access to.
“There’s some nice data for LGBTQ kids and for racial and ethnic minority kids that finding community, finding people who look like them and have shared or lived experiences is really a powerful source of community for kids who can otherwise feel isolated,” Belfort said.
Sins of the father (or mother)
If parents are concerned by what their children are seeing online or how much time they spend glued to a screen, it’s important that they model the behavior they want to see.
“What I hear from kids a lot is, ‘You know, my parents tell me to get off my phone, but they’re always on their own phone, even at the dinner table,” Belfort said. “So, I think all of us need to just reexamine our relationship with tech and social media.”
The American Academy of Pediatrics puts out an annual Family Media Plan guide that applies to all members of the family. The plan allows families to track how much time they spend online as well as establish what their media priorities are.
The interactive plan also emphasizes screen-free times and screen-free zones, with tips and explanations that parents can use when establishing these boundaries.