Girl Planting seeds

Screen Time and Keeping Kids Healthy

Child_on_tablet_shutterstock_453157573By Ben Kligler MD, 8-27-2018
The impact of the growth in the amount of time our kids spend staring at electronic screens has been a subject of concern for parents and pediatricians for over a decade. Recently the “Fortnite” craze sweeping the country—and the world—has led to renewed alarm about the potential impacts of excessive screen time on mental, emotional, and even physical health. Too much screen time has been associated with sleep problems, obesity,aggressive behavior and school problems. In fact, in June of this year the World Health Organization proposed adding a new diagnosis—“gaming disorder”—to the next version of the International Classification of Disease, ICD-11.[1]

If we are honest with ourselves, we all know the addictive power of these screens—particularly now that smart phones are so ubiquitous and seen as such a necessity. We recognize that tweak of anxiety when we’ve accidentally left our phones at home while out for a walk, or the challenge of not checking our phones every few minutes (or seconds!) when we don’t really need to. We know this is not just a problem for our kids, but really something we all need to grapple with. But clearly screens are now a huge part of our life—so the question is not how to get rid of them in our kids’ lives, but rather how to integrate screen time in a healthy way into our families lives and relationships.

To help us with this challenge, the American Academy of Pediatrics recently released a set of new guidelines for parents to use in addressing these issues.[2]  Here are a few of their specific suggestions, tailored to children of different ages.

  • For children younger than 18 months, avoid use of screen media other than video-chatting. Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they're seeing. 
  • For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
  • For children ages 6 and older, place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.  
  • Designate media-free times together, such as dinner or driving, as well as media-free locations at home, such as bedrooms. 
  • Have ongoing communication about online citizenship and safety, including treating others with respect online and offline. 

These are very sensible suggestions—and the AAP has also developed a toolkit for parents to help them build a “Family Media Plan” they and their kids can live with[3]—recognizing that all families are different and that people need to make a specific plan that will work for their family. The most important aspects of this planning are really common sense.boy_looking_at_phone_screenshutterstock_51928348 Don’t have young kids watching screens alone—watch with them, interact, help them understand what they are seeing. Don’t let excessive screen time eat up time for healthy activities like playing outside, sleeping, and socializing. Keep screens out of the bedroom if possible, and set a “media curfew” or a time after which no screen time is allowed. Obvious, but not so easy to do unless we really commit ourselves. And most important, according to the recent science, is how we ourselves model the healthy use of screen time for our children. Do we interrupt mealtime to answer a text? Do we take time at bedtime to read a story or sing a few songs rather than go straight from screens to sleep?

This is not an all or nothing, black and white issue, any more than is the question of what we feed our kids. We know what a healthy diet looks like—less processed foods, whole grains, lots of fruits and vegetables—but some days we do better than others at achieving it with ourselves and with our kids.  The challenge of managing screen time is the same: the important thing is not to expect perfection, but to maintain a high level of awareness of the pros and cons of digital media, and to do our best finding the right balance with our children.



Dr._KliglerDr. Kligler is the Medical Advisor for The Deirdre Imus Environmental Health Center®. He is also the National Director of the Integrative Health Coordinating Center for the Veterans Health Administration and Research Director for the Center Institute for Research and Education in Integrative Medicine. He is Co-Director of the Beth Israel Fellowship Program in Integrative Medicine, and teaches in the Beth Israel Residency Program in Urban Family Practice. Dr. Kligler is the author of Curriculum in Complementary Therapies: A Guide for the Medical Educator, and co-editor of Integrative Medicine: Principles for Practice, a textbook published by McGraw-Hill. He is also Co-Editor-in-Chief of the peer-reviewed journal Explore: The Journal of Science and Healing.

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