When Lucas Miranda, 7, and his sister, Carolina, 6, of South Miami go out to dinner with their parents, they don’t sit and play games on their parents’ phones. They don’t watch movies on an iPad or Instagram their friends. Instead, their parents, Sofia and Felipe Miranda, bring coloring books or small toys to entertain the kids.
The Mirandas also have strict guidelines about screen time at home.
During the week, the kids get one hour of TV time a day, and computer time only for homework. There is no phone access. On weekends, they get a little more time to watch sports or a movie.
Sofia Miranda said in her job as a pediatric nurse practitioner for Kidz Medical Services, she sees a lot of childhood obesity, partially the fault of too much screen time.
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“Part of it has to do with kids being inactive and not playing outside as much as they used to. There is overstimulation from games and apps, and before you know it, hours have passed by,” Sofia Miranda said.
In her house, they balance screen time with outside play time or other physical activity. Sofia Miranda said she and her husband, Felipe, a neonatologist, are trying to foster healthy habits at a young age.
Kids 8 and younger spend an average of 2 hours and 19 minutes a day with screen media, according to advocacy group Common Sense Media’s 2017 survey of U.S. parents.
The American Academy of Pediatrics recommends no screen time for children 18 months and younger, other than video chatting. Parents of children 18 to 24 months can begin to introduce high-quality programming. Children ages 2 to 5 should be limited to one hour a day. Kids 6 and older should have consistent limits, with media-free times such as meal time or bedtime.
Research shows overuse of digital media and screens can lead to obesity, insufficient sleep, problems in the classroom and risky behaviors.
“For parents, the major question is, ‘How much time is my kid spending with their screens?’” said Alan Delamater, director of clinical psychology in the pediatrics department at the University of Miami Miller School of Medicine. “Nowadays kids are spending as much time with their screens as they are sleeping or being in school.”
Teens who watch more than five hours of television per day are five times more likely to be overweight than teens who watch zero to two hours, according to the American Academy of Pediatrics. Watching television for more than 1 ½ hours daily is a risk factor for obesity for children ages 4-9. Seeing ads for high-calorie foods and snacking while watching contributes to the risk.
“There are decades of research on the effects of TV exposure,” Delamater said. “We know that kids who watch lots of TV end up having a host of unhealthy outcomes, including being overweight, being more aggressive and being more likely to engage in sexual behaviors at earlier ages.”
Heavy video gamers are at risk for Internet gaming disorder, a mental health condition in which persistent gaming can lead to clinically significant effects on functionality and social development, according to the American Psychiatric Association.
About 4 to 8 percent of youths have problems limiting Internet use, and nearly 10 percent of U.S. youths 8 to 18 may have Internet gaming disorder, according to the American Academy of Pediatrics.
“If you spend a lot of time playing games on a phone, you are isolated, and if that’s the only way you’re interacting with the world, that’s not a good thing,” said Gilda Moreno, a child and adolescent psychologist at Nicklaus Children’s Hospital.
Kids who get together with friends but spend the time playing on phones also are missing out on socialization, Moreno said.
“This is a problem, because we need to communicate with each other,” she said. “We need to be talking.”
Nicole Rodriguez, a licensed mental health counselor and psychotherapist with Baptist Health South Florida, said younger children are losing the ability to socialize because they’re stuck on YouTube or watching shows on their phones.
“We learn how to socialize by engaging in communication with other people, and a lot of that is face to face, learning how to read social cues,” Rodriguez said.
Kids who are on their screens all the time sleep less, and studies show that kids who sleep less do less well at school, said Delamater of the University of Miami. Stimulating content and exposure to a screen’s blue light can delay or disrupt sleep.
The light “does fire up the brain and makes it less easy to fall asleep,” he said.
Problems at school
“Research shows that kids who are on their screens for many hours a day have lower school performance as well as increased levels of stress and decreased quality of life,” Delamater said. It’s leaving less time to concentrate on schoolwork, and they’re distracted when they do, he said.
Parents of patients say their kids are not doing well in school because they are always texting or interacting with friends online. The distractions result in less quality time for study and homework, Delamater said.
Studies show that screen time may contribute to or exacerbate anxiety or depression, Rodriguez said.
“For teens who are on social media, it becomes comparing my life to your life, and life looks really great in a picture,” she said. “We’re seeing a lot of that comparing game, and teens thinking everyone else has a such a great life, which can cause depression.”
Sedentary screen time also can interfere with normal development. Our brains are not fully developed until we’re in our mid-20s, Rodriguez said.
“Children and adolescents, as their brains are developing, the more that they’re in activities where they are using their hands, learning languages, learning an instrument, playing a sport — all that improves brain development.”
The news isn’t all bad. Quality programming, educational apps and social media interactions can have a positive impact.
“There are good examples of the use of video games and screen time for educational purposes,” Delamater said. “For example, kids who play video games that require a lot of good visual motor skill end up testing better on tests of visual motor skill, which is not surprising.”
There also is evidence of the educational effects of certain games.
Video games where players connect and talk to each other, group chats and social media also can help teens feel connected.
A phone, an iPad or a computer are privileges. Treat screen time like all privileges, Moreno said.
“It starts when the child is small, teaching them who’s in charge and how much time they are going to be able to do things,” she said. “Parents think they have no control over the situation when in reality they do, just like they have control over how much time kids can go in the pool or how much time they can play outside.”
Delamater said parents also should monitor what their child is doing during screen time, “so kids can learn how to think critically about what they are exposed to online.”