We live surrounded by digital media 24 hours a day, whether it’s mobile phones, tablets, smart watches, computers or advertising screens. Most of the population has had to learn to navigate this omnipresent exposure already in adulthood. New generations, on the other hand, have begun to interact with the digital environment from birth. This relationship with screens in the midst of the cognitive, motor and social development of children has raised concerns among parents, researchers and administrations. In the midst of a debate that is still fully open, trying to find out the maximum, or optimal, amount of screen time that is recommended for children is quite a challenge. In this document we present some indications for families based on what has been published by reference entities and agents.
Agents recommending avoiding or limiting screen time
The World Health Organization published strict recommendations in 2019 on the amount of time children should be exposed to videos or online games. The WHO states that this exposure should not occur in the first year of life and rarely in the second. Children aged 2 to 4 should not spend more than one hour a day in front of a screen. These recommendations are framed in the context of the development of guidelines by an expert committee on physical activity, sedentary lifestyle and sleep for children under 5 years of age.
The American Academy of Pediatrics also recommends avoiding exposure to digital tools under 2 years of age (except in the case of video calls). For preschoolers, it proposes limiting their use to no more than one hour of high-quality content per day. For elementary school children and adolescents, it recommends that the use of digital devices not displace other important “analog” activities, such as sleeping, doing physical activity or attending family meals. In any case, for any age, it recommends that adults share and supervise the use of these digital content and tools by minors.
For its part, the American Academy of Child and Adolescent Psychiatry also issued guidelines in 2016, which it updated in 2020, in which it reported that, on average, children between 8 and 12 years old in the United States spend between 4 and 6 hours a day looking at or using screens and that adolescents spend up to 9 hours. In these guidelines, the organization warned that excessive use can cause problems and recommended limiting the use of screens in children under 18 months to only video calls. Between 18 and 24 months, they recommended exposing children only to educational and supervised programming. For children aged 2 to 5, they recommended consuming non-educational content for one hour on weekdays and 3 hours on weekends. For those over 6, they recommended encouraging good usage habits and limiting activities that include screens.
The Generalitat de Catalunya, in the context of the Comprehensive Care Plan for People with Mental Disorders and Addictions, published the guide Digital Technologies in Childhood, Adolescence and Youth in 2022. In this case, the limitations are even stricter and recommend that children not use any type of screen until they are 3 years old. For children aged 4 to 6, they recommend limiting their use to less than one hour per day, which must be accompanied. For children aged 7 to 12, they propose a progressive and supervised increase to a maximum of one hour per day.
Negative effects of excessive screen use
These guidelines for limiting or even avoiding digital and multimedia content point to a series of harms of these tools on the health of children and adolescents:
- They promote a sedentary lifestyle and increase the risk of childhood obesity and diabetes. Regarding the risk of obesity, a study conducted with children between 2 and 11 years old showed that it increases when the television is in the room.
- The use of screens can affect sleep patterns.
- Activities performed with a screen increase the alert level of the central nervous system, which can increase anxiety.
- There is a risk of exposure to inappropriate content, misinformation, or contacting strangers online.
Are there negative effects on children’s cognition, language and mental health?
So far we have equated the concept of screen exposure, which includes looking directly at mobile phones, tablets, but also television, with the concept of using digital tools, which opens up a very diverse range of interactions, such as watching audiovisual content as a spectator, playing video games, publishing content on the internet or interacting through social networks. It is clear that when we talk about using digital tools and devices we are dealing with a complex activity in which several factors are involved.
Regarding mere screen exposure, the possible negative effects that have been described have to do with healthy lifestyle habits related to the prevention of childhood obesity, sleep hygiene habits, physical activity and avoiding anxiety problems in children.
In 2020, a study found an association between increased screen use and reduced microstructural integrity of the white matter pathways in the brain that support language and early literacy skills in preschoolers. However, the authors themselves acknowledge that more studies are needed, especially during the early stages of brain development.
However, the use of digital tools and platforms involves more than just exposure to screens. It involves the content that is consumed, the pace and manner in which this content is consumed, the specific family context in which the digital tool is used, the social dynamics that are established, and also a series of consequences of the digital world on the analog world.
For example, although there are studies that suggest an effect of screen exposure on developmental test scores, the same authors admit that both screen time and test performance were associated with a variety of personal and contextual factors, such as family income, maternal depression, the child’s sleep, whether the child is read to regularly, and whether the child is a girl. This suggests that many contextual factors can influence a child’s propensity to spend excessive screen time.
On the other hand, one study negatively associated screen time at age 2 with the development of executive functions in children aged 2 to 3, which are a set of skills related to inhibitory control, working memory, and cognitive flexibility.
Regarding the relationship between screen use and children’s language acquisition, solid results showing a direct influence are still lacking, since there are still few publications on the subject. For example, a 2019 study found a significant association between cell phone use and parent-reported speech delay in 18-month-old children. A 2013 study found preliminary (non-significant) results suggesting that children who watched more than 2 hours of television per day were more likely to score low on communication tests.
Regarding the way we consume digital content, one study found that, during shared storytimes between parents and children, parents and children verbalized and collaborated less when using interactive e-books than when using printed books. On the other hand, a neuroimaging study published in Nature Communications in 2018 suggested that the use of social media may affect the brains of adolescents, as some neural systems are still developing and undergoing changes. Specifically, social media may contribute to heightened sensitivity to online rejection, acceptance, peer influence, and emotionally charged interactions. The underlying processes of social reward, emotion processing, regulation, and image construction of others may also make adolescents particularly susceptible to false news, unrealistic self-expectations, or emotion regulation through adverse media use.