Screen time stress

Many parents may have experienced the challenges of getting kids to turn off electronic devices when time is up, and for some families it can even turn into a struggle with kids refusing to stop. Dr. Marcia Slattery, UW Health child and adolescent psychiatrist and director of the UW Anxiety and Stress Disorders Program, sees many families for whom screen time has become a "battle."

"It's not uncommon for kids to be reluctant to turn off the device when time is up," she says, "But it is important for parents to set limits and have discussions early on before the resistance and battles develop."

There has been a lot of debate about kids and screen time (e.g. TV, computers, tablets, smart phones) leaving many parents unsure of what's actually best for kids. It used to be the American Academy of Pediatrics (AAP) stated no screens before the age of 2. But recently, that guideline has been revised to include some exceptions.

From the most recent AAP guidelines, no screens at all are still best for babies younger than 18 months with the exception of live video chat. While there isn't much evidence to suggest infants benefit from the interaction in the same way they do live social interaction, there is some research indicating they can be emotionally engaged when a relative, for example, is on the other side of the video screen.

For infants 15 months to 2 years the guidelines have shifted from "no screen" to "no solo screen" — meaning any use of electronic media should be done with a parent or adult watching along with the child. The key is to interact the same way they would with a book - repeating words and drawing attention to what's on the screen. Several studies have shown that passive media consumption - when media replaces interactions with people - can cause language delays in children.

For children ages 2 to 5, quality is really key and no more than an hour a day. Even so, the AAP still recommends watching along with kids to help them understand what they are seeing and how it applies to the world around them.

According to Slattery, what remains key regardless of a child's age is that parents have to play an active role with their child's use of screens.

"Electronic media has tremendous educational potential, but like anything that is done overboard, too much time spent with screens/electronic devices can have a negative effect including negative impact on a child's developing brain," she explains. "Moderation and monitoring are crucial."

There are several studies that suggest kids who spend too much time using electronic devices experience sleep problems, decreased attention spans, irritability, depression and even problems at school. Many kids who spend too much time on devices also experience anxiety in social situations because they don't know what to do. "Some kids have spent so much time 'interacting' online through texting or instant messaging instead of in-person interactions that they haven't learned basic social skills and that contributes to increased anxiety and social avoidance in real-life situations that involve talking directly with people."

She notes the same is true for adults. Stand in line anywhere and you are apt to see a large number of people staring at their phones. Social interaction can be intimidating, even for adults, and so it can be tempting to "hide" behind a screen.

Many individuals don't realize that screens can even become a source of addictive behavior if used for longer periods of time. "Increasing studies are showing that excessive internet gaming, for example, can lead to changes in the brain that are similar to those found in people with addictions," Slattery explains.

She adds that excessive gaming has caused a lot of problems for kids by affecting their school work, interfering with activities and even causing some college-age kids to drop out as they spend time gaming instead of going to class. For adults a gaming addiction has contributed to marriage and home problems, job problems — just like any addiction.

So what's a parent to do?

Slattery stresses that the key is to set limits before problems develop.

"The use of screens has to be in balance with other activities, including in-person interactions," she says. "Electronic devices can play a very positive role in our daily lives, but moderation is really key."

To help, she offers the following tips:

• Talking with kids about household media rules so everyone is clear on expectations

• Set screen time limits for each day — designate times of day when screens will be allowed and when they are off limits (i.e. meal time, family time, etc.)

• Use electronics in open areas of home so you can see what kids are watching or doing; monitor internet use sites

• Model appropriate use of electronics — you can't tell kids no screens at dinner and then use them yourself

• Include physical activity each day

• Encourage activities with peers/family that doesn't center on screens

• No screens at bed time (the APA recommends no screens starting an hour before bed) and no electronic screens (TV and electronic devices) in the bedroom overnight

"Talking about screen time rules in the home is important for everyone," Slattery emphasizes.  The American Academy of Pediatrics has developed an easy to use Family Media Plan (www.HealthyChildren.org/MediaUsePlan) to develop media guidelines for each child in the home, appropriate for their age. Slattery encourages parents to review the plan together with their kids  and to post it somewhere in the home to remind kids and parents of their family guidelines. "Reviewing the plan together every few weeks can also help decrease arguments that occur in the moment of when, how much, and where kids can use their devices, and also reminds everyone of the responsible use of media".