We are surrounded by technology to such an extent that many of us would have a hard time adapting to live without some of the things that did not even exist until a few years ago. And, as it is common with all "novelty," this topic also has its fair share of defenders and critics.
Let's start with the basic recommendations on this topic and then we will go on to analyze why these recommendations are given. After examining the available scientific evidence on the exposure of children to TV and other screens, the position of the American Academy of Pediatrics (AAP) is quite emphatic.
As they see it, there is a dire need to completely avoid exposure of kids to TV as well as other screens prior to 2 years of age. For older adults, it is recommended that parents create screen-free zones in the homes.
This will help limit their combined total exposure to a maximum of one or two hours, provided that they watch good quality and age-appropriate content on the TV.
The AAP says that it is critical for parents to establish "screen-free zones" in the home, making sure there is no television, computer as well as video games in the children's bedrooms, and turning off the television during meals. Children and adolescents should use these media for no more than one or two hours a day, and always with high-quality content.
It is important for children to spend their time in outdoor games, reading, hobbies and using their imagination in free play situations.
What Is the Current Situation?
According to a study by the Kaiser Family Foundation, 43% of children under 2 years of age watch television daily and almost one in five (18%) watch videos or DVDs every day. The majority of parents (88%) of these children under the age of 2 watch television every day, and claim to be in the same room as their children while watching TV, either all or part of the time.
However, as demonstrated by Pempek in 2014, the simple fact of having the TV set in the background affects the development of a child's language substantially. According to this same study, 74% of children under 5 years of age have watched TV before 2 years of age (contrary to the recommendation of the AAP).
On average, children under the age of six spend almost two hours a day in front of screens. It's almost the same time they spend playing outside, and three times as much time as they spend reading or listening to what someone reads to them.
Regarding children under 6 years:
- 77% turn on the TV by themselves.
- 67% ask for permission to see certain programs in particular.
- 62% use the remote control to change the channel.
- 71% ask for their favorite videos and DVDs.
The data collected by Abelman and Atkins is even more worrisome. According to their research, children spend more time watching television than in any other activity while awake. Children and adolescents (between 2 and 17 years old) see 19 hours and 40 minutes of television every week on average.
This means that a person of 70 years will have spent the equivalent of anywhere between 7 and 10 full years watching television.
Why is the AAP so emphatic about screens? Does it suffer from television mania? No! They have analyzed the available scientific evidence and based on this; they have elaborated their recommendation.
Broadly speaking, it has been found that excess exposure to television has been associated with a wide variety of negative effects on health. These effects range from an increase in violence and aggressive behavior, distorted sexual images, body image problems, and obesity or nutritional problems.
Let's start with a truism that supports the position of the AAP regarding not having a television in the children's bedroom. This 2015 study shows that the children diagnosed with ADHD who have a television in their bedroom see more television than those who do not.
Specifically, they watch an additional 25 minutes of TV a day, and they are 32% more likely to watch television for more than two hours a day.
It is also common sense, but this other 2014 study published in JAMA Pediatrics states that a part of the hours devoted to watching television is subtracted from areas that are very important for their health and development such as sleep.
Michel Desmurguet, a French researcher at INSERM (National Institute of Health and Medical Research), in his 2012 article, extensively analyzes the effects of screen exposure in children. In this article, he points out that the increasing exposure to screens has a very negative influence on the cognitive development of children and adolescents, especially in areas such as academic performance, language, attention, sleep, and aggressive behaviors.
During the last few years, the time spent in front of several screens, including television, video games, smartphones, and computers, has increased dramatically. Desmurguet believes that this problem, usually underestimated (if not denied), should be considered as an important public health problem.
Primary care physicians should inform parents and children about this issue and provide effective prevention.
In this same article, he cites a striking study carried out by the pediatrician Peter Winterstein on children and TV, which has ended up being very popular. You have probably seen it on Facebook or in the press.
This German pediatrician asked almost 2000 children between 5 and 6 years old where all of them were public school students, to draw a human figure. Then, he analyzed those drawings based on the time children usually watched television.
The results were shocking.
The loss of detail and finesse in the execution of children who watch television for more than three hours a day was very striking, as compared to those who see it for a maximum of 60 minutes.
Among all these negative effects that have been associated with exposure to screens, let us focus on three areas of special importance for babies and children: obesity and health, attention and language!
Television, Obesity, And Health
In general, watching television and, even more, having a television in the bedroom is strongly associated with an increased risk of overweight and obesity, especially in low-income families. This 2002 study published in Pediatrics analyzes it.
As seen in a recent study published in Child Obesity, having a TV in the bedroom influences children to consume more sugary drinks and, therefore, are more at risk of developing obesity, being overweight or having diabetes.
Another study, in this case of 2013, shows how watching television increases the risk of overweight and obesity in adolescents, even independently of physical activity or the consumption of obesogenic foods.
On the other hand, Gidwani found that children aged 10 to 15 years who watched more than 2 hours of television per day were at least 5 times more likely to start smoking than those who saw less than two hours of television a day. In fact, they advocate including television as a risk factor for the development of tobacco addiction.
Television and Attention
Exposure to television during childhood increases the risk of attentional problems in adolescence. At least, this is what Landhuis shared in his 2007 article. TV viewing during childhood is associated with attention problems in adolescence, regardless of early attention problems or other confounding factors.
These results support the hypothesis that exposure to television during childhood can contribute to the development of attentional problems and that these effects may be long-lasting.
In the same vein, Swing published an article in 2010 stating that this exposure to screens was associated with greater attentional problems in childhood. This association of television and video games with attentional problems remained significant even when statistically controlling sex or the existence of previous attention problems.
However, not all studies obtained results in the same line. For example, Ferguson in 2011 concluded that attention problems are more related to anxiety, personality factors or family context than with watching television, so efforts should be directed to prevent such factors.
The results show that internal factors like male gender, family environment, antisocial traits as well as anxiety are better predictions of attentional problems. Academic results can be predicted best by family income.
The use of television as well as video games, even if the total time devoted to watching is specifically attributed to content that is violent in nature, did not go on to predict attentional problems or negative academic results.
Also, in a study published in 2014 in PlosOne with respect to video games, 192,000 students from 22 countries were analyzed. It was found that playing video games does not have a negative impact on academic results in areas such as science, mathematics or language.
Contrary to claims that greater use of video games may impair academic performance, differences in academic performance were negligible across the relative frequencies of video game use. The use of video games had little impact on the academic performance of adolescents.
Television and Language Development
There is a clear relationship between watching television from a very young age (before 24 months) and problems in the development of language. This is observed in this 2008 study conducted with children between 15 and 48 months.
In line with the recommendations of the AAP, they found that children who started watching television before 12 months for more than 2 hours a day were 6 times more likely to develop language problems.
His conclusion is clear. There is a relationship between the early onset of the high frequency of TV viewing and delays in language.
In this context, Zimmerman and a few other researchers found that in less than 17 months, each hour of daily television implies a decrease of 17 points on a scale that measures the development of language. However, they do not observe any effect on language (beneficial or harmful) in children older than 17 months.
This difference of 17 points is equivalent to between 6 and 8 words of the 90 that the questionnaire consists of. These same authors point out that while reading every day (as compared to not doing so) is associated with an increase of 7 points on this scale, watching an hour of television (as compared to not seeing it at all) is associated with the aforementioned decrease of 17 points.
This other study is very interesting, and the data it reveals is in line with what is already mentioned. It was carried out in 2010 on more than 250 families and was the first to be performed longitudinally (following for several years on these same families) to analyze the influence of exposure to media in childhood and the subsequent development during childhood.
They found that the children who were already exposed to screens at 6 months showed a lower cognitive development at 14 months (only 8 months later) and lower language development. In addition to that, they do not find differences depending on the content to which they have been exposed (educational or non-educational).
Of the 259 children, 249 (96.1%) were exposed to screens at 6 months with a total mean exposure of 152.7 minutes/day. The duration of exposure to screens at the age of 6 months was associated with a lower cognitive development at the age of 14 months and a minor language development.
Of the 3 types of content evaluated, only one (aimed at older children or adults) was associated with lower cognitive and language development at the age of 14 months. No significant associations were found in the exposure to educational content aimed at children or non-educational content.
This data strongly supports the recommendations of the AAP not to expose children to any screen before two years of age.
As we have seen, most studies give empirical support to the recommendations made by the AAP according to which, children under two years should not have any exposure to screens, and those over this age should see it restricted to only two hours daily.
Most studies warn of the negative effects that health can have at different levels on overexposure to screens (television, mobile, tablets, etc.)
At best, and provided that the maximum exposure time is respected, the vision of educational programs appropriate to the age of a child or the use of educational applications seem to have no negative effect or even show a certain beneficial effect.
However, this is not superior to what can be experienced through other educational materials or through direct experimentation with the environment.
Excess exposure to screens occupies a lot of time that could otherwise be used in problem-solving, reading, sports, hobby development or interaction time with family and friends, outdoor activities or in contact with nature, etc.
For Hammermeister, the little time spent in social interaction with peers can be the cause of the association that exists between the excess of television and more timid, lonely and depressive personalities, as compared to people who do not watch television or do it in a more moderate way (following the recommendations of the AAP).
If we speak in economic terms, we could say that exposure to screens has a high opportunity cost: the lack of involvement in other alternatives that may have clear benefits at the psychosocial level.
Technology is not bad; neither is the television, or the mobiles, the tablets, or the cars. You only have to take into account to whom it is directed toward and to regulate its use in a conscious way.
Cars are not bad, but we do not allow children to drive, and it will always be more advisable and environmental-friendly to walk than to drive. However, this is not simply why cars are bad, but excessive use of them can have very negative health implications too.
Children know the world through their parents. Screens disconnect them from nature, and they cease to be children for a while. It is comfortable, but it has a cost that translates into fewer opportunities for interaction and learning.
For the same reason, we must also limit the use of these personal devices in front of them because, in the same way, we are reducing the quantity and quality of interaction with them, which will have consequences for their development.