Health 

Screen Time for Kids: How Much is Okay?

September 28, 2020 11 min read

Young kid holding a gaming controller

At a glance

Ready or not, Covid-19 has launched us all full-throttle into the digital world. And ready or not, we are forced to rethink what time on computers, tablets, gaming units, phones and other digital devices—collectively referred to as screen time—means for us and our kids.

Changes that may have taken years to introduce such as internet meetings, distance education, and socializing over video calls for everyone, became a part of daily life overnight. Lockdown left parents scrambling to fill the void in their kids' lives, who were suddenly cut off from direct social, educational and physical opportunities to be active.

So it’s not the least bit surprising that TV and internet use have shot up in these last few months. People have turned to screen time to help alleviate boredom, entertain, educate and communicate during the pandemic. Nielsen reports that TV viewing increased 81 percent during the lockdown phase of Covid-19, which equates to an increase of about four billion hours of use weekly in the United States(1). Although lockdown restrictions are lifting, or at least changing, viewership and subscription-based programming continues to see higher levels of use compared to pre-pandemic rates.

It’s little wonder that parents are looking for answers regarding how much screen time is really okay for kids. The trouble is that the research is not as clear as you might have hoped. It suggests that there are still more questions than answers regarding the risks and benefits of screen time for kids.

What is screen time?

Screen time is the amount of time spent in front of an electronic device that displays imagery. In the past, this was limited to TV time. Back in 1947, the only screen device in question was a television, and only a few thousand homes in the US even had one(2).

Fast forward to the 1990s and 98 percent of US homes have at least one TV. Personal computers hit the scene in the 1980s with the first dot-com name registered in 1985, but took another decade to become commonplace(3). Add in gaming consoles, video recorders, tablets, digital cameras, watches and any number of devices that expand the use of screens, and screen time has become ubiquitous in modern life. Smartphones hit the scene in the 1990s and today are so common that even many children have their own personal phone(4). Screens are literally everywhere.

That makes managing screen time a far greater challenge today than at any other point in history. Children are growing up digitally, and there are potential benefits and risks to consider.

Kid with sunglasses on looking at a smartphone

What are the benefits of screen time?

Screens, in their many forms, are deeply embedded in modern life. Children and adults alike engage in social, educational and entertainment activities using screens. The potential benefits of screen time for kids include:

  • educational opportunities
  • social engagement
  • access to quality content

Screens and education

Many education systems around the globe have introduced computer literacy into their programs for all ages of children (preschool to grade 12). The assumption is that learning computer programming will improve cognitive skills in all areas. A 2019 meta-analysis of 105 studies related to cognitive skills and computer programming in children found evidence of moderate transfer of skills to other activities such as creativity, reasoning and mathematics, with less transfer of skills such as spatial reasoning(5). However, overall school achievement and literacy improved the least in most of the study results.

Screens and social relationships

A large meta-analysis of evidence-based literature on the effects of digital technology on children conducted by UNICEF in 2017 found mostly positive effects of screen time on children’s mental well being and social relationships(6). The research suggests that a child’s mental well-being is more related to how the family functions, social dynamics at school and socioeconomic factors rather than screen time. In other words, the effects of screen time were minor in comparison to other more important influences which should be garnering our time and attention.

Quality of content versus amount of use

This view is echoed by Dr. Michelle Ponti, chair of the Canadian Pediatrics Society (CPS) Digital Health Task Force, who suggests that how a screen is being used (quality) is more important than how long it is used (quantity) (7). The most critical determinant parents need to consider is whether using the device is interfering with other aspects of a child’s life. The CPS recommends that parents prioritize the following four things before kids reach for a device:

  • school activities
  • physical activities
  • sleep
  • social activities (e.g., family meals)

What are the negative effects of screen time?

The evils of screen time have been purported for about as long as screens have been in existence. Although the first study on the effects of TV viewing by families was done in the 1940s and suggested viewing increased family cohesion and unity, that study sparked a debate on the potential negative impacts of screens that has carried on to this day(8).

For many years, parents have been told to limit their child’s screen time to less than two hours a day to limit potential negative effects which are often cited as slower development, poor social skills and cognitive impairment (6). The idea was that screen time was having a negative impact on children’s mental well-being, social relationships and physical activity levels.

Headlines around the world have jumped on this possibility, including terms like “hijacking” and “rewiring” kids’ brains, screen addiction and other dramatic language that can leave any parent rushing to implement strict rules around screen time.

The potential negative effects of screen time may include:

  • impacts to mental well-being and social relationships
  • screen time and obesity
  • blue light effects
  • screen addiction
  • exposure to inappropriate content
  • slower development in children under two
Young kid playing on a digital tablet

Screen time, mental well-being and social relationships

Most of the science claiming negative effects of screen time has not stood up to rigorous experimental design. Many of the studies are small in scale, short in duration and rely on self-reported data that is notoriously unreliable, especially when involving children.

Large cross-sectional studies have only identified negligible negative effects of screen time on kids, such as in a 2017 UK study of more than 120,000 15-year-olds (9). In fact, this study showed that no use at all was associated with lower mental well-being of the kids.

And doesn’t this make intuitive sense in our world where everyone is connected by digital systems these days? We cannot forget just how fast technology, and our access to it, has changed in even the last few years. These changes can shift the balance between what is seen as negative and positive.

The 2017 UNICEF report, based on a review of the best available science on screen time and kids, provides the following context for potential negative effects(6):

“ . . . the results from this review supports the statement that the internet (or digitaltechnology) by itself is not a main effect cause of anything, but that it is the contextual and individual factors that determine impacts on social interaction and relationships.”

Screen time and obesity

Surely there is a link between the amount of time kids spend on screens and their physical activity and weight? Isn’t screen time part of theobesity crisis?

Not so fast. It turns out the science on this factor is mixed and inconclusive as well. How can that be? As parents, we see our kids playing video games or watching TV, and we assume that if they were not sitting on their machines, they would instead be doing something active. But sound research demonstrates the relationship is not that simple or direct.

Studies suggest we need to be looking at screen time and physical activity as two independent behaviors(6). For example, data from a 2013 study demonstrates that reducing screen time does not automatically result in increased physical activity for 11- to 13-year-old children(10). Our assumption that less screen time will result in more physical activity is largely wrong, and thus focusing only on reducing screen time will not necessarily have a direct impact on diet, weight control and obesity.

Screen time and blue light effects

Parents may have heard that screens can emit blue light that is harmful and may accelerate macular degeneration, a condition where objects become blurry or spots appear before your eyes. However, according to a recent post in Harvard Health Publishing, the light emitted by even the strongest screen pales in comparison to other light sources we are routinely exposed to(11). The probability of developing macular degeneration or blindness is much more strongly influenced by other factors such smoking, heart disease and obesity.

Children and adults may develop eye strain after long hours of screen use. Eye strain can be reduced by adopting the following habits(12):

  • having routine eye care provided by a qualified professional
  • avoiding using screens in the dark
  • minimizing glare and adjusting screen brightness and contrast
  • taking frequent breaks
  • supporting eye health through a nutritious diet

What about screen addiction?

Although popular in the media headlines to grab your attention, screen addiction and whether it exists at all is up for debate. The 2017 UNICEF report puts it this way(6):

“Addicted in a clinical sense means that the consequences of the behaviour are so severe that normal functioning in society is no longer possible. To justifiably describe a child as ‘addicted to digital technology’, their use should lead to clear functional impairment and impact negatively on multiple domains of life.”

The question is: Does excessive screen time lead to significant life impairment over time for kids? The challenge in answering that lies in the fact that heavy use of screens really only began in the 1990s, making the technology less than 30 years old. On top of that, the nature of technology, its ease of use and its dominance in our daily lives has also shifted dramatically since then.

What were once status-symbol gadgets of the rich are now common in every household. What was deemed excessive in the early days of screen use pales in comparison to what would be considered excessive in 2020, because the way we use technology has changed. The bottom line is that more rigorous studies are needed to determine if there are negative effects of screens and what the long term consequences of those effects might turn out to be(13).

Mom sitting on the couch watching a screen with two young kids

Screen time and exposure to inappropriate content

Even with the most rigorous rules in place for screen time, the more time children spend on devices, the more likely they are to come into contact with inappropriate materials, either on their own or from someone else. Negative consequences for your child may result from exposure to content that is upsetting for them.

Inappropriate content will vary with a child’s age and maturity, but may include images or streaming that is(14):

  • violent
  • traumatic
  • sexually explicit
  • racist
  • unlawful
  • dangerous in a way that can lead to physical harm

Exposure to graphic and traumatic images can impact adults and create mental health issues and raise anxiety levels(15), which can also happen to children exposed to such images. Parents need to set limits appropriate for the sensitivities of their own child and circumstances. Finding alternative programming and helping children to navigate through the experience can help children make better choices.

Although many parents worry that shooting-style video content may lead their child to become more aggressive in real life, it should be noted that recent research has not found a link between video game violence and gun violence(16).

How screen time impacts children under the age of two

Although the potential negative consequences of screen time are debatable for most age groups, there does appear to be broad support for limiting the amount of time children under the age of two spend interacting with screens.

A 2020 meta-analysis of studies collectively involving 18,905 children demonstrated that more time using screens was associated with poorer language skills(17). However, higher quality screen use, such as educational programs and co-viewing content with parents, was associated with higher language skills in young children.

The World Health Organization recommends that for children under the age of five to grow up healthy, they require (18):

  • less time being sedentary
  • more physical activity
  • quality sleep

WHO-specific recommendations for children under the age of two include limiting screen time to one hour or less, and no screen time for children under the age of one. The critical formation of early behaviors, language, and socialization occur rapidly in children under two and screens do not provide the face to face communication and direct interactions that human caregivers do. Focusing on interactive play, language, and movement are more important in the first two years of life than screen time.

Infographic displaying acceptable screen time limits for kids
Table 1. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva: World Health Organization; 2019.

So how much screen time for kids is okay?

In the end, parents are left withapplyingcommon sense to the question of how much screen time their child should have. Strongly limiting screen time for children under the age of two, and instead focusing on physical activity, social interactions and time together provides the best opportunity for your child to grow up healthy(18). When it comes to older children, it’s important to remember that screen time is only one component affecting your child’s social, mental and physical well-being.

Teaching your child to recognize and react to their own needs, both physically and emotionally, can influence whether screen time is positive or negative for your child. Just like adult office-workers are encouraged to take regular breaks away from their computers to walk, stretch, drink, and rest their eyes, so too can children be taught that regular breaks are important for them(19). Engaging in physically active screen time, like dancing or active video games, staying in touch with friends, and focusing on age-appropriate content are all strategies that can make screen time beneficial. If your child is enjoying playing video games, then the games may be providing much needed stress relief(16), especially during these isolating Covid-19 lockdowns.

If you notice your child is reacting strongly to digital content, or having nightmares or issues later when away from the screen, then inappropriate content is likely the cause. Content filters, parental controls and limiting screen time may be appropriate for your child. Common sense is key, and as a parent you know your child’s sensitivities better than any filter. Switching to higher quality content or more active supervision can help remedy the situation.

Children also model what they see their parents doing. While Covid-19 has created a lot of anxiety for us all, there are ways to mitigate that stress. Eating a healthy diet, connecting with friends and family through social media, using time outside asnature therapy can all contribute to better well-being for the whole family. Adults can also consider stress reducing supplements likeAshwagandha.

In Summary

Screen time is a rapidly changing concept in our modern world. What was considered excessive even a few years ago has suddenly become normal. Many hard and fast guidelines on setting limits on screen time for children were not based in rigorous science. In many ways, our reluctance to embrace a digital world has more to do with how we ourselves were raised, than with potential impacts of screens on our children’s health.

Children today are growing up digital in more ways than most of us can imagine. The rapid acceleration of screen time and technological features will mean that parents have to keep adjusting their sense of what is appropriate for their own child. Long-term studies on the impacts of technology for children will struggle to keep up with the fast past of these advancements.

But the reality check for us all is that even as adults, we are spending more and more time looking at screens. It seems rational to embrace the concept that our children will require higher technology literacy than we had growing up. As always, it’s about finding a balance between how we spend our time, and where our energy gets focused.

The question is less about how much screen time our children should have versus the quality of content they access and whether that screen time (good or bad) is displacing other important life opportunities.

Sue Senger - Contributing Writer, Physician’s Choice