How does screen time affect our little ones?

This is an issue that has received widespread media attention. But what is the scientific evidence? And what do the current guidelines advise?

The Debate brings together the latest scientific evidence, including findings from our own TABLET project, with current guidelines for screen use.

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We want to know how families make decisions about screen time. What do you think are the pros and cons? And does greater understanding about the complex question of toddler screen time increase confidence to make decisions that work for your family?

How old is your child/children? (Please select as many as applicable).

Tell us what you think about touchscreen use in children:

How confident do you feel when making choices about screen time in your family?

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What others have said about touchscreen use in children...

 

“Screens are good to communicate with friends and family who are far away.”

“Good for following instructions and learning. However, too often and too long isn't good.”

“We live in a world of touchscreens, children need to learn to use them just as they learn to eat with a knife and fork.”

“Toddlers don't have to use touchscreens; it’s parents who give them to the toddlers. Parents need to understand the issues better.”

Tell us what you think about touchscreen use in children?

Guidelines

The scientific studies needed to inform evidence-based guidelines are still in their infancy, especially when it comes to new portable media such as smartphones and tablets. However, several international agencies have decided to issue guidelines to parents as a precaution. The leading agency in this field is the American Academy of Paediatrics (AAP) who make several concrete suggestions (AAP, 2016; full recommendations here):

  • Time limits:​​

    • –17 months – no screen time (except for video calls)

    • 18 – 24 months – a limited amount of screen time

    • 2 – 5 year olds – one hour a day​ or high quality content

​​

​BUT, the UK’s Royal College of Pediatrics and Child Health (RCPCH) criticised the American guidelines; they argue that they’re not all based on strong evidence (RCPCH, 2019)​. The only recommendation they feel confident to make is for all children to avoid screens in the hour before bed (further explanation within Sleep section of Evidence below).

The UK’s Chief Medical Officers also suggest a ‘precautionary approach’ balanced against the potential benefits of using screen devices (Davies et al., 2019).

The picture is very muddled and meanwhile parents are making decisions about their child's screen time on a daily basis. To help ease the stress of these decisions there are various 'Resources' available online.

 

Resources

Sleep


Several studies have reported consistent evidence that longer screen use during the day is associated with sleep problems (Carter et al., 2016). Our own study looked at touchscreen use and sleep in 6– to 36–month-old children. We found that for each hour of touchscreen use, there was a roughly 15 minute decrease in the amount of sleep, as well as children taking longer to go to sleep ( Cheung et al., 2017). Why might this be? 1. Children who have problems with sleep are given a touchscreen The majority of studies show simply an association between sleep and screen use. We cannot say for sure screen use that is causing worse sleep. It is possible that children who sleep less simply have more time available in which to use screens. 2. Using touchscreens may be exciting This can make it hard to feel relaxed. A 5-year-old from our Science of Screen Time event said “you think about it [tablet] when you go to bed”. 3. Inactivity Spending time on a screen might mean less time moving around and tiring yourself out, so you feel less sleepy. 4. Bright/blue light Cells in our eyes respond to the darkness by telling our brain produce a hormone called melatonin which makes us feel sleepy. If we look at a bright light, especially blue light then the brain doesn’t produce as much melatonin. Bright light from our phones can have the same effect, reducing melatonin production and sleep. Lights from touchscreens like iPads and phones have particularly high frequencies of stimulating blue light. The overall picture seems to be that there are links between screen use and sleep, but the reasons for this are not clearly understood. The AAP guidelines suggest no screen time in the hour before bed and to keep devices out of the bedroom.

What do you think? Do your children (or you!) use devices before bed? How feasible would it be to follow the AAP guidelines?




Hand and Finger control


A child's ability to manipulate objects with their hands (known as "fine-motor control") rapidly develops over the first few years of life and is an important skill for the child's growing independence. The evidence for how touchscreen use is associated with the development of fine motor ability is still very limited. However, several studies, including our own, have shown that increased touchscreen use, particularly active use of the screen, is associated with better fine motor skills, such as stacking blocks, drawing lines etc (Bedford et al., 2016; Moon et al., 2019; Souto et al., 2019). Why might this be?

  1. Children with good hand and finger control may be good at both stacking blocks and swiping a screen. In other words, it may be that both touchscreen use and fine motor tasks such as stacking blocks are measuring the same thing – the child’s level of proficiency in hand and finger control.
  2. Practising hand movements like pinching and swiping on the screen might transfer to real-world actions such as holding a pencil, or vice versa!
However, before grabbing the nearest touchscreen and swiping away, it’s important to note that not all findings are positive. One large Canadian study found that higher overall screen time was associated with general delays in developmental milestones, including language, motor and social skills. For more information see our segment on BBC One's Babies: Their Wonderful World on the topic of fine-motor development and touchscreens here:





 

Evidence

Sleep


Several studies have reported consistent evidence that longer screen use during the day is associated with sleep problems (Carter et al., 2016). Our own study looked at touchscreen use and sleep in 6– to 36–month-old children. We found that for each hour of touchscreen use, there was a roughly 15 minute decrease in the amount of sleep, as well as children taking longer to go to sleep ( Cheung et al., 2017). Why might this be? 1. Children who have problems with sleep are given a touchscreen The majority of studies show simply an association between sleep and screen use. We cannot say for sure screen use that is causing worse sleep. It is possible that children who sleep less simply have more time available in which to use screens. 2. Using touchscreens may be exciting This can make it hard to feel relaxed. A 5-year-old from our Science of Screen Time event said “you think about it [tablet] when you go to bed”. 3. Inactivity Spending time on a screen might mean less time moving around and tiring yourself out, so you feel less sleepy. 4. Bright/blue light Cells in our eyes respond to the darkness by telling our brain produce a hormone called melatonin which makes us feel sleepy. If we look at a bright light, especially blue light then the brain doesn’t produce as much melatonin. Bright light from our phones can have the same effect, reducing melatonin production and sleep. Lights from touchscreens like iPads and phones have particularly high frequencies of stimulating blue light. The overall picture seems to be that there are links between screen use and sleep, but the reasons for this are not clearly understood. The AAP guidelines suggest no screen time in the hour before bed and to keep devices out of the bedroom.

What do you think? Do your children (or you!) use devices before bed? How feasible would it be to follow the AAP guidelines?




Hand and Finger control


A child's ability to manipulate objects with their hands (known as "fine-motor control") rapidly develops over the first few years of life and is an important skill for the child's growing independence. The evidence for how touchscreen use is associated with the development of fine motor ability is still very limited. However, several studies, including our own, have shown that increased touchscreen use, particularly active use of the screen, is associated with better fine motor skills, such as stacking blocks, drawing lines etc (Bedford et al., 2016; Moon et al., 2019; Souto et al., 2019). Why might this be?

  1. Children with good hand and finger control may be good at both stacking blocks and swiping a screen. In other words, it may be that both touchscreen use and fine motor tasks such as stacking blocks are measuring the same thing – the child’s level of proficiency in hand and finger control.
  2. Practising hand movements like pinching and swiping on the screen might transfer to real-world actions such as holding a pencil, or vice versa!
However, before grabbing the nearest touchscreen and swiping away, it’s important to note that not all findings are positive. One large Canadian study found that higher overall screen time was associated with general delays in developmental milestones, including language, motor and social skills. For more information see our segment on BBC One's Babies: Their Wonderful World on the topic of fine-motor development and touchscreens here:





 
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