Screens and Kids: How Much Is Too Much?

You’re making dinner or ordering at a restaurant, and you just need a few minutes of peace. Handing your young child a phone or tablet seems like a harmless distraction, and it is — in small doses.

But the latest evidence connects young children who spend too much time in front of a screen with a host of problems, like smaller vocabularies and a lack of social skills.

New physical activity guidelines from the World Health Organization (The full WHO report is here) suggest kids under 5 shouldn’t spend more than an hour a day sitting in front of a screen.

Michelle Young, a speech-language pathologist at AdventHealth Sports Med and Rehab, says she’s not totally against screen time for kids.

“Like candy and fast food, it’s fine in very small doses,” Young says, “but when screen time becomes a constant presence, that’s when it becomes a danger.”

She compares excessive screen time with smoking: Just as it took years before the health effects of cigarettes became known, only now is research showing the problems with screen time.

Parents often ask her for alternatives to a screen, especially when they’re driving or busy. So we asked her to share four replacements to screen time that help kids learn and grow.

But first, what do the latest guidelines say?

Screen Time: An Hour, Max

The new WHO report sets out these guidelines:

• Infants (less than 1 year old): No screen time and be physically active several times a day — especially through interactive, floor-based play. Their neck shouldn’t be restrained (as in a car seat or stroller) for more than one hour at a time.
  
• Toddlers (1 to 2 years old): One-year-olds should not spend any time inactive and in front of a screen. Two-year-olds should limit this time to less than an hour a day. Toddlers should spend at least three hours a day in physical activity.
  
• Children (3 to 4 years old): Should limit inactive screen time to up to an hour a day, and have three hours of physical activity. One hour of that time should be moderate or vigorously active, like brisk walking, playing ball games or swimming.

The WHO report is really about physical activity, not screen time. In some ways, screens are bad for kids because they’re replacing healthy behaviors with the developmental equivalent of junk food.

What’s the Harm in a Screen?

When a child is in front of a screen, they’re not doing the healthy, skill-building activities kids need to develop at a normal pace. To continue the analogy with candy, screen time may be sweet, but it’s just empty calories.

“Kids learn by involving as many senses as possible,” Young says. When they play with a shape sorter toy, kids are seeing the objects, feeling the shapes and textures of the blocks, hearing what it sounds like when it plops into place and even smelling the plastic or any other family member who has previously touched the blocks. Engaging more senses engages more of the brain, which builds better, stronger connections.

This is why even an “educational” video or touch-screen game may not be teaching your child much, Young says. Studies have found that young kids who learn shapes and colors on a screen struggle to translate that knowledge into the real world.

It may seem like there’s nothing new about cell phones or tablets. After all, many of today’s parents grew up watching “Sesame Street” or “Mister Rogers' Neighborhood,” so why is a cell phone any different?

A television program doesn’t demand a child’s full attention, Young says; they can still talk to a parent or play with a toy. That said, TV shouldn’t be a replacement for getting moving, and toddlers under two shouldn’t be watching TV, she adds.

So what are the long-term consequences of too much screen time? Young said they include the following:

• Toddlers: Children typically begin speaking in gibberish, called “jargon.” But excess screen time is linked with kids not moving beyond this stage. They may also have smaller vocabularies (a 2-year-old is generally supposed to know about 200 words). They may understand what adults are saying, but struggle to express themselves.
  
• Adolescents: Too much screen time may blunt a preteen’s social skills, including the ability to have a back-and-forth conversation. “They’ll talk about what they want to talk about and have no interest in what others have to say,” Young says. They may also have a hard time ignoring background noise, like a classmate tapping their pencil.

If toddlers or children start showing these issues, Young recommends removing screens.

“It may seem like screens are the only thing that can calm them down,” she says. “But it can worsen their symptoms because they’re not moving, exploring and making the brain connections they need to.”

What to Do Instead?

Young sees the following happen often enough to be peeved by it: A toddler at a restaurant or other public place is pacified with a screen. On the one hand, it’s easy to understand why.

“I get it, I’m a parent, but a child is learning social cues at a restaurant even if they’re not talking,” she says.

But what should parents do instead of the screen? Here are four tips:

• Let them draw: Many restaurants have drawing mats and crayons that help them build coordination and creativity.
  
• Get a toy: Small toys that kids can manipulate (some are attached to a car seat) help them to use the small muscles in their hands.
  
• Have a singalong: Sing a kids song in the car.
  
• Engage their attention: If you’re in the car, tell the child to announce when they see a red car or an object that starts with a given letter.

One positive way to introduce a cell phone or tablet is to use it as a tool to engage with family, like making a video call with grandma, Young says.

For many parents, a phone or tablet isn’t the first choice but seems to be the only way they can calm a crying or temperamental child. The urge to end that crying is understandable, she says, as no parent wants to see their child upset.

But it’s OK to let them cry and figure out how to calm themselves without a phone. A toddler who needs a phone to calm down may grow into a teenager who needs a phone to feel peaceful.

“Kids need to learn how to calm themselves down or fall asleep without a device,” Young says.

When to See an Expert?

As a speech-language pathologist, Young works with children and adults who have head injuries, autism, neurological disorders and other developmental delays.

Often, a developmental delay may show up in the child’s two-year checkup or in preschool.

If you’re looking for a health provider who sees your family’s whole-person health, consider AdventHealth Sports Med and Rehab. We work with families to develop goals and meet them with your routine and lifestyle in mind.

Our 19 locations around Central Florida provide support close to home. For more information, call Call407-303-8080 or visit our website.