If you haven’t heard the buzz about screen-time lately, you may have been hiding under a rock, or maybe behind a screen. Recent studies and compelling reports have been implicating excessive screen time in poor mental and physical health. Collin Kartchner has been crusading throughout Utah against smartphones and social media with his #savethekids Parent Awareness Nights at many local schools. However, another recent study contradicted the findings that screen time is harmful.
How is a parent to respond to all this? Are screens really all that bad?
With these questions in mind and as a father and a pediatrician, I set out to learn more. I perused many journal articles and studies which I will link throughout this post. I also devoured a couple of books, the best of which was “Glow Kids” by Nicholas Kardaras, Ph.D.
Despite my research, I still have an appreciation of how technology can improve our lives and make us more connected when used healthfully. But I also have a deepened respect for how it can isolate and harm us by negatively shaping the thinking, emotions and behaviors of its users. This shaping is the phenomenon some, myself included, have come to call “brain hacking.” And it can happen to both kids and parents who use their devices unhealthfully.
I’ve seen “brain hacking” in my clinic. Parents have told me how screen time affects their children’s behavior. I’ve seen it cause developmental delays in toddlers. I have teens who are addicted to gaming or the internet. Phones, social media and cyberbullying have played a role in my teen’s suicidal thoughts and attempts. I’ve seen parents tuned out from their kids and so distracted by their screens they have a hard time putting it away for their child’s doctors appointment, while their kids meaninglessly check their phone every 5 minutes. I can’t help but notice the similarities between some teens and their phones with toddlers and their “lovies”.
I’ve experienced “brain hacking” in my personal life. My preschool-aged son had a drastic improvement in behavior when my wife and I banned YouTube Kids and smartphone games, and significant deterioration in his behavior when we reintroduced them. (We took them away again). Personally, I took the step of deleting Facebook and Instagram from my phone and, when I wasn’t on call, I put my phone away in a drawer and didn’t look at it all evening with my family. I fasted from social media. (Though I obviously started using it again, but with stricter limits for myself.) Within a few days of starting the fast, I found I had a greater desire to connect with my friends, neighbors, and relatives. I was more present when I was with my kids and wife and enjoyed their company more. And my mood and outlook improved.
I don’t believe these were coincidences. They are “brain hacking.”
But, realizing all these observations are anecdotal, is there actually scientific evidence that our kids’ brains and mental and physical health (and parents’ as well) are really being manipulated by our electronic culture?
First, there is real evidence that video games and internet use can be addicting. Scientists have actually documented structural brain changes in teens observed to be internet addicted. Similarly, social media addiction has been demonstrated in studies similar to substance addiction. Social media developers have admitted to consulting with gambling experts in order to design their apps and user interfaces in a way that makes their platforms as addicting as possible to keep users coming back for more.
Have you felt the thrill of getting a lot of ‘likes’ on your post? Do you feel the need to check your phone for texts or calls every 15 minutes just in case you missed something? This can be explained by neuroscience. Getting comments or likes on posts, kills in a game, wins on a slot machine, or the thrill of mastering a difficult puzzle or game, all activate the pleasure center of the brain by increasing the release of the pleasure neurotransmitter dopamine. Dopamine = pleasure. Any potentially addictive activity (drugs, gambling, sex, binge-eating, spending sprees) comes from the hijacking of this natural pleasure/reward system. A surge in dopamine release leads to down-regulation of dopamine receptors in the brain’s efforts to maintain the status quo.
The problem comes when the brain is no longer getting likes, kills, texts, wins or other stimulation and there is less dopamine flowing. With fewer dopamine receptors, there is less pleasure. The brain becomes less sensitive to the subtle natural pleasures of life like human interaction, reading a book, practicing a skill, enjoying nature or doing hobbies. In the case of screen addiction, these old-fashioned activities just can’t compete with the ‘digital morphine’, and as a result, everything else becomes boring.
The adolescent brain is especially vulnerable to this effect. This is when kids tell me gaming is the only thing that makes them happy. Have you had a teen that just doesn’t feel like doing anything besides play video games? Chances are they may be addicted.
But even for those who are not truly addicted, excessive screen time negatively affects mental health.
Screens and Mental Health
Preliminary results of a currently ongoing study has showed thinning of the cortex or gray matter of the brain with excessive screen time. The cortex is the part of our brain we use for higher-order thinking. The prefrontal area of cortex regulates impulses and emotions that originate in other parts of the brain, including aggression, and when necessary, inhibits them. A study using functional MRI brain scans in young men done in the UK showed decreased activity in these areas after video gaming. These changes occurred after only 10 hours of playing time over one week.
Also, a 2010 study published in Pedatrics showed that school-aged children and teens who engage in excessive TV viewing OR video gaming had subsequent attention problems as rated by their teachers and parents. Excessive screen time has been shown to worsen attention and focus in kids who have already been diagnosed with ADHD.
A Case-Western School of Medicine study of screen use in teens reported that those who were highly engaged in texting and electronic social networking show higher rates of depression, stress and suicidal thoughts, and were more likely to use illicit drugs, tobacco and alcohol, have multiple sex partners, get in physical fights, as well as have poor sleep and poor academic achievement.
Teens and young adults have recently passed up the elderly as the loneliest generation of Americans, according to a recent survey. This is not likely due to screen time and social media alone, but these things are likely playing a significant role. Studies have reported that kids are making less eye contact today than kids did a decade ago, and that they are less aware of their environment, demonstrate decreased sensory thresholds, and have fewer opportunities to practice and refine their interpersonal skills. With poorer social skills, it is increasingly difficult for them to navigate real-life relationships.
Screens and Education
Screens are being pushed on kids at school as they are moving more and more to computer-based learning, but there is scant evidence that this is actually beneficial for educational outcomes and some evidence it may actually be harmful. Students were shown to perform worse in reading comprehension after reading a passage on computer compared to those that read the same passage in print. And students have been shown to have better memory recall after hand-writing old-fashioned paper notes compared to typing on a laptop.
What about the value of verbal discussion, debate and other human exchanges? Many educators feel they are being shortchanged by the investment of thousands of dollars by their school districts in smart-boards, iPads and other devices that actually distract rather than promote engagement. In contrast, some foreign countries have taken action against the invasion of electronics, going as far as to to ban electronic devices from school. I have talked to parents in my clinic whose children were exposed to pornography or cyber-bullying for the first time because of the devices and internet access provided as young as the 3rd grade.
I recognize that for some students who have severe anxiety or autism, completing some of their schooling remotely on-line may be helpful. However, if they allow students to opt out of interpersonal interaction completely, parents can enable and reinforce avoidance of anxiety-provoking triggers, preventing their children from learning social skills and coping strategies that help them to manage their anxiety.
Care must be taken to find a balance between allowing students to be challenged and accommodating their disability. For some students, a modified schedule which is part brick-and-mortar, part on-line can be helpful. Consultation with a mental health professional and school counselors can help craft an educational plan that’s an important part of the treatment of these conditions, allowing the child to be integrated with his or her classmates to the appropriate degree.
For the vast majority of students, however, screens add little or nothing to the value of their education, and may even detract.
Screens and Physical Health
We are learning more all the time about how mental and physical health are intimately connected. Obviously, the more screen time kids have, the less active they are. The American Heart Association recently released a statement calling on parents to limit their children’s screen time for the sake of their children’s heart health.
A review of media use in children showed that children between ages of 4 and 9 who watched TV more than 1.5 hours a day were more likely to be obese, as well as adolescents with heavy TV viewing. Having any media in a child’s bedroom was shown to increase risk of obesity. Additionally, those who sleep in the same room as a smartphone were shown to have disrupted sleep and altered natural melatonin secretion. Heavy social media use was also associated with poor sleep.
It is important to note that most of these studies are not randomized controlled studies, with the exception of the UK study showing brain changes after video gaming mentioned above. Correlation isn’t the same as causation. In other words, phones might make kids less active, more depressed or more distracted, but it could also be true that Kids that are already less active, depressed or distracted could be drawn more to their phones than their peers.
While this is true, the relationship probably goes both ways, creating a chicken-and-egg cycle that spirals down toward poorer health. Phones reinforce kids’ aversion to activity. Depressed kids retreat more often to their phones when they don’t feel like socializing, which gives them a hit of dopamine and a feeling of “pseudo-connection,” which keeps them coming back for more until they are hooked. This pulls them further away from the real-life, face to face organic social networks that buffer from stress and nurture good mental health.
Screen time can be one tool that helps kids (and adults) relax, unwind and decompress, but when it is used in excess, the array of tools they have to work with to manage stress and anxiety becomes more and more limited and insufficient, and in severe cases, the only tool they have.
So, what are parents to do? Screens aren’t going anywhere and neither is our digital culture. We can’t eliminate them, but neither do we need to (at least not completely). We can and should set healthy limits for ourselves and our kids, and teach them by example and structure to use these devices in healthy ways.
In fact, if we use it right, media can be a powerful tool to increase connection, promote health, and pursue learning. Technology can either be our tool or our master. But it all depends on how we use the screens.
Ultimately, whether screen-time is harmful depends on the age and developmental level of the child using it, how much time they are spending, and what they are using it for.
In this way, screens are like cars- we could conclude that cars are dangerous or not dangerous depending on the drivers we studied. However, there is no doubt that cars are inherently dangerous and do kill too many of our sons and daughters every year. Similar to when they learn to drive, proper training, supervision and safety precautions are just as essential for teens using electronic devices, for the reasons discussed above.
For ideas for teaching kids how to use media responsibly, see my future “Brain Hacking” posts. Subscribe on the front page to receive my next post via email.