November 29, 2017

Screen time and electronic device use in children

By Dr Megan Yap - Paediatrician

Helloooooooo there parents and carers!

Electronic screens and “smart” devices.  Smart phones/iPhones, iPads, tablet android computers… These days they are EVERYWHERE.  It seems even the youngest of children know how to use them and they are so readily available.  They seem innocent enough, these little colourful, hand held devices that kids are often mesmerised by, and that do so well to keep them quiet!

But are they GOOD?   Are they BAD?  Or are they BOTH?

I credit my highly esteemed colleague “Uncle Ian”  (ie Dr Ian Shellshear) with the majority of content in this blog.  He was generous enough to share his wisdom with me and reducing the screen time our kids have is a real passion of his – for good reason.

[Before you ask, he is called “Uncle Ian” by most of the Ipswich Paediatricians because he is an actual uncle of one of my best mates, Deb (who herself is a Dr Shellshear – and a Paediatric emergency physician).  Deb has called Uncle Ian just that (or the variation – “Unclean”) for as long as I remember, so when I started work as part of the Ippy consultant team, I just could not transition to “Ian” or “Dr Shellshear.”  So “Uncle Ian” it remained, and the rest of the team followed suit 🙂 ]

So back to the devices.  As with everything, there are always going to be pro’s and con’s, risks and benefits – and these differ, depending on your child’s age.

The Colleges of Paediatrics in Australia, New Zealand, United Kingdom, and the United States have ALL recommended that children under 2 ideally have NO exposure, and that children over 2 years of age have a maximum of 2 hours of all forms of electronics on any day, including that within teaching at school or in homework.

Now, it is not uncommon that parents will bring their children to their appointments and use their electronic device to keep their child occupied whilst they give the history or attend to the interview.  I have no problem with this, however I DO have a problem with when the history is consistent with

  • the child being on the device ALL day (like, 5-16 hours of the day)
  • the child has no involvement or interest in other activities (eg sports, going outside – riding their bike/scooter; jumping on a trampoline, arts and crafts, imaginative play with other toys)
  • parents do not supervise or LIMIT what their child can access on the device (and the child subsequently ends up watching inappropriate content)
  • usage of the device associated with aggressive, oppositional/defiant behaviour or mood changes
  • the child is using the device right up until (or often well past) bedtime – often resulting in a vast array of problems including (but not limited to) insomnia/prolonged sleep onset, sleep deprivation, mood swings, irritability and daytime drowsiness, poor attention and concentration at school and hence learning difficulties, restlessness and hyperactivity, behavioural outbursts and poor emotional regulation.

There is good reason for why the Paediatric Colleges suggest NO exposure in toddlers and very limited time in older children.

I am not saying that use of electronic devices is ALL bad.  It isn’t.  There are definitely benefits to be had.


Possible BENEFITS to screen time:

  1. Improved fine motor coordination (but only for these devices; tap/tap-and-drag etc)
  2. Increased general knowledge (depending on what content is accessed, and how it is accessed)
  3. Helps some analytical skills
  4. There are apps to help with self regulation (eg Smiling Mind), brain training, and specific learning skills including maths and literacy (eg Counting Caterpillar; Reading Eggs)
  5. Exposure improves understanding of electronic devices, now a routine part of the school and eventually the workplace – so arguably, improving and developing workplace skills
  6. Parents know where their child is; the child often remains relatively contained and calm whilst engaged with the device
  7. It is enjoyable and entertaining for the child


But let’s also talk about why it is important to LIMIT screen time.  In children under 2 years, it has been shown that ANY screen time (including television) has a DETRIMENTAL effect on developing social skills.  This is because the child sits and stares at a flashing screen that does not require them to socially interact with it to get a response; hence the child learns nothing about social interaction.  This effect can be mitigated by a parent or guardian who makes the experience interactive and who watches with, and continually interacts with the child whilst they are using the device.  In real terms though, how many of us do this?

I know I don’t.  My 4 year old is limited to 10 minutes of smart-device screen time a day.  She is limited to children’s apps and games, and she loves it… however, when initially she hated (and would tantrum) at “time’s up.” She has now learnt that if she doesn’t give it up willingly, then she will have another privilege revoked AND she misses out on further screen time the next day. When she DOES go on the iPad, I use the opportunity to have a quick shower, quickly clean the kitchen, do an online grocery shop etc etc.  It is a chance for us to get things done!  I certainly do not sit there and use the iPad with her.  It is tempting to allow them longer than the agreed time, but to stop this from happening, we set the kitchen timer to alarm at 10 minutes.  My 2 year old isn’t allowed ANY time on the iPad, although his grandad does occasionally let him watch nursery rhyme clips on his phone.  This is always supervised and directed by said grandad and is pretty much always short lived.


The other CONS to electronic devices:

  1. They take the place of play with others, learning how to lose, learning to control and regulate feelings and for shared creativity develop.
  2. Screens do not provide an interactive adult view of the relevance of the materials (unless deliberately encouraged) to differentiate between ‘good’ vs ‘bad’ information.
  3. They restrict the development of social skills and skills in negotiation, and (with many GAMES) replace it with disrespectful and violent solutions
  4. It is often difficult to “police” the content of what our children are watching online (even with parental locks/restrictions) and inappropriate content can still slip through best laid strategies to prevent it
  5. They restrict outside play where gross and fine motor skills develop across a range of activities.  Children (especially boys) who are naturally active in the preschool period, need these busy outdoor activities to develop awareness of their body position, balance, awareness of objects to avoid and to develop motor planning skills. This need is delayed if the child is indoors, and then when it surfaces (when the child is somewhat older) the child is at risk of being labelled ‘hyperactive’.
  6. Screens are addictive – the brain does not get a rest and this creates irritability, conflict and resistance for other duties (including homework, and the development of responsibility within the family).  I see this SO commonly!  Parents who report their children are MORE badly behaved when given even limited screen time, as opposed to NONE AT ALL.  Many “successful” games target the “reward centre” in the brain – the same area that is affected in compulsive gamblers; causing a true physiological addiction
  7. Excessive screen time restricts developing a range of interests and activities necessary for flexible thinking.  These interests might include inside and outside play, as well as rest periods. It might include reading, construction, craft, music, figurines, superheroes (and imaginative play), card and board games, relaxation training, ball games, trampolines, bikes, walking, pets, and ‘free’ play where there are no rules.
  8. Screen time can promote hyperactivity (and decrease patience). Flashing imagery and immediate gratification with just a tap of a finger, with no time to digest information before moving on (eg YouTube)
  9. It denies opportunity for “free play” where creativity develops by inventing something out of nothing(electronics are highly organised).  We all did this as kids – building bed sheet forts, creating whole cities in a sandpit, building a nest of fallen leaves and twigs, imagining a castle turret by climbing a tree…
  10. There is no opportunity to develop ‘inferential” knowledge. This is the ability to “read between the lines” about what someone means, depending on how they say it, and the body language they use to accompany it
  11. Parental addiction, including social media, denies children shared play with parents
  12. Screen time interferes with sleep, with rapidly changing visual imagery and “blue light” blocking the release of the “sleep hormone” melatonin
  13. It does not AT ALL teach self control in daily life.
  14. Encourages obesity because of lack of physical activity, and because eating is uncontrolled when concentrating on electronic media.
  15. Vitamin D levels require regular outside exposure so arguably, unless you are playing your device in the sun, usage increases the risk of vitamin D deficiency!
  16. Lastly but by no means least importantly, there is an increased risk of depression in teens by 70%if  exposed to 5 hours of screen time daily or more)


So like pretty much everything, there ARE BENEFITS to electronic device use in children (over 2 years of age) when EXPOSURE IS MODERATED.

In contrast, there are many drawbacks to the use of smart devices in kids, especially when use is

  • not supervised
  • not limited
  • for prolonged periods of time

So take home messages are:

  1.  Don’t give your kids under age 2 years any screen time
  2. Supervise your kids and limit what they can access
  3. Place strict limitations to duration of time allowed on electronic devices – a maximum of 2 hours per day INCLUDING school work/study
  4. Interact and play with your kids, and get them outside and doing other things!!!


I hope you have found this post useful,

Till next time, stay well,

xxDr Megs

For more articles from Dr Megan Yap visit her blog – “Dr Megs – Paeds & Feeds” at

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