Today’s blog post is written by Karen Powell, who is in private practice, is a member of the SAISI Board and has a special interest in the decline of the child’s occupation of play.

Screen time debate – some real facts

I think we all have come to a realisation that screen time is bad for us, and our kids.  Some people take it more seriously than others.  When we are confronted with yet another debate about screen time and device use, be it in our practices or the parking lot, it helps to have some facts to back up the claims.  This photo was taken recently in a popular retail shop in the Boys 2-8 years old section and is an indictment on our society:

The average child will see over 20 000 adverts on TV each year. Children between the ages of 6 and 17 spend about five hours a day in front of the TV or computer and only 15 minutes reading books. In Britain today, children by the age of 10 years have regular access to an average of five different screens at home. In addition to the main family television, for example, many very young children have their own bedroom TV along with portable handheld computer game consoles (e.g. Nintendo, Playstation, Xbox), smartphone with games, internet and video, a family computer and a laptop and/or a tablet computer (eg, iPad). Children routinely engage in two or more forms of screen viewing at the same time, such as TV and laptop. Viewing is starting earlier in life. Nearly one in three American infants has a TV in their bedroom, and almost half of all infants watch TV or DVDs for nearly 2 hours/day.

Across the industrialised world, watching screen media is the main pastime of children. Over the course of childhood, children spend more time watching TV than they spend in school. When including computer games, internet and DVDs, by the age of seven years, a child born today will have spent one full year of 24 hour days watching screen media. By the age of 18 years, the average European child will have spent 3 years of 24 hour days watching screen media; at this rate, by the age of 80 years, they will have spent 17.6 years glued to media screens.

Yet, irrespective of the content or educational value of what is being viewed, the sheer amount of average daily screen time (ST) during discretionary hours after school is increasingly being considered an independent risk factor for disease.

So what is the risk?

  • Radiation:

There’s a video you would do well to watch: “The truth about mobile phones and wireless radiation: what we know, what we need to find out, and what you can do now”.  It is presented by Dr Devra Davis. She details the effects and dangers of mobile phones and wireless radiation. She outlines the evolution of the mobile phone and smart phone, as well as global studies on the health consequences of mobile/wireless radiation, including children’s exposure and risks.  You can watch the video here.

  •  Blue light

Blue light, emitted from our devices, affects both our retinas and our sleep patterns.   Blue light is not necessarily even blue, as chemical compounds are added to make the light on our screens appear white, and therefore less strange to us. Blue light causes the cells of the retina to produce melanopsin, which suppresses the release of melatonin, a hormone which times your circadian rhythms – and affects when we feel awake and when we want to sleep.  Watching screens disrupts the release of melatonin, preventing us from feeling sleepy and tricking our brain into thinking it is day time. Disturbed biological rhythms have long term effects for children and adults, who not only struggle to fall asleep but also have poorer quality of sleep.

Blue light has also been found to damage the photoreceptors of the retina.  These cells do not regenerate, and thus increased exposure to screens accelerates the degeneration of the macular, which controls visual acuity, and results in poor eyesight.

  • Loss of play and the physical effects thereof

Research has found that children aged 4-7 are spending less time playing in the real and three-dimensional world, with less time exercising their gross and fine motor skills. This is  resulting in poorer hand function, in-hand manipulation, visual-motor integration skills and sensory processing skills.  One therapist described it as a decrease in three-dimensional hand skills (grips, arches and manipulation) while two-dimensional (flat) hand skills are exercised by interaction with screens (e.g. swiping, scrolling). The time spent on devices does not allow for the repetition required for the fine motor skills to develop before children enter Grade 1.

Not only hand function is poorer.  Therapists are finding that children with excessive screen use have decreased sensory processing skills, as they spend less time in the preschool years stimulating all the senses, and while the visual system is often overwhelmed and tired, children present with under-developed and poorly integrated vestibular (movement), tactile (touch) and proprioceptive (deep pressure, tension) systems.

  • Obesity, junk food and caffeine

As most screen time takes place in a sedentary manner, it has led to an increase in obesity in school-going children. Research has found that children and teens consume more junk food when watching television and consume more caffeine. If eating takes place in front of television, tastes aren’t noticed as well as satiety and we eat more than necessary.

  • Decreased interaction and atunement

When discussing screen time, we need to be aware not only of the effect of the screen on our physical bodies, but also the effect on our interaction and attunement.  Attunement is a term used to describe the phenomenon that occurs when mothers and infants appear to be coordinated behaviorally and/or are concordant physiologically during early interactions. This phenomenon was observed by Dr Edward Tronick in the Still Face experiment (watch it here), and is now being replicated with mothers looking at their phones instead of paying attention to the needs and communication efforts of their babies.

An old article in The Signal (WA-IMH), describes how babies attribute meaning and value to items that fulfil a need i.e. a cup only holds value for them when it contains milk.  When it is empty they toss it away.  In the same way, when a parent/caregiver does not respond to a baby’s repeated requests for interaction, they are taught that the relationship holds little value.  This is tragic and holds dire consequences for the parent-child bonding and future relationship.

  • Mental health

I think many are aware of the negative effects social media can have on our mental health, whether it be by “compare-and-despair”, inappropriate comments by trolls or a misinterpretation of real life.  Problems that need to be considered include peer pressure, secrecy, decoy apps, live streaming, addiction to “hits” and “likes”, and unrealistic mirrors, not to mention increased anxiety and suicide rates. Our teenagers are particularly vulnerable to the dangers of the internet, interacting with strangers and sharing of videos.  Cyber-bullying is a real threat and parents of teens have a responsible to seek counsel and advice on how to journey with their children through this quagmire.

As can be seen, screen time affects not just our eyes, but our minds, our physical posture and weight, our mental health and our relationships – with our spouses, children and friends.  We have to be so careful to be mindful of the amount of intrusion we allow it in our everyday lives.

Next time we will discuss practical tips for reducing screen time addiction – from adults to babies.  In the meantime, empower yourself your clients and family with facts.  An extensive reference list of the articles referred to in this blog is given below.


  1.  Screen time and sleep among school-aged children and adolescents: A systematic literature review; Sleep Medicine Reviews, Volume 21, June 2015, Pages 50-58;
  2. Young children’s screen time: The complex role of parent and child factors; Journal of Applied Developmental Psychology, Volume 36, January–February 2015, Pages 11-17;
  3. Taking Another Look at Screen Time for Young Children Journal of Pediatric Health Care; Volume 31, Issue 2, March–April 2017, Page 141;
  4. Effects of television exposure on developmental skills among young children; Infant Behavior and Development, Volume 38, February 2015, Pages 20-26;
  5. To watch or not to watch: Infants and toddlers in a brave new electronic world; Developmental Review, Volume 30, Issue 2, June 2010, Pages 101-115;
  6. Janne E Boone, Penny Gordon-Larsen, Linda S Adair & Barry M Popkin. Screen time and physical activity during adolescence: longitudinal effects on obesity in young adulthood; International Journal of Behavioral Nutrition and Physical Activity, Volume 4, Article number: 26 (2007);
  7. Thomas N. Robinson, Dina L. G. Borzekowski. Effects of the SMART Classroom Curriculum to Reduce Child and Family Screen Time; Journal of Communication, Volume 56, Issue 1, March 2006, Pages 1–26;
  8. Byron Reeves,Annie Lang,Eun Young Kim &Deborah Tatar. The Effects of Screen Size and Message Content on Attention and Arousal; Pages 49-67 | Published online: 17 Nov 2009 (Media Psychology);
  9. Mary L. Courage, Alissa E. Setliff. When babies watch television: Attention-getting, attention-holding, and the implications for learning from video material, Pages 220-238;
  10. Aric Sigman. Time for a view on screen time. Correspondence to Dr A Sigman, Office 444, 91 Western Road, Brighton BN1 2NW. Disease in Childhood, Volume 97, Issue 11;
  11. School, health and behaviour suffer when children have TV, video games in bedroom Date: September 26, 2017; Source: Iowa State University Summary;
  12. Centers for Disease Control and Prevention October 20, 2010 Television and Video Viewing Time Among Children Aged 2 Years—Oregon, 2006-2007 JAMA. 2010; 304(15):1662-1667. doi: MMWR. 2010; 59:837-841
  13. Namanjeet Ahluwalia, Steven M Frenk, & Stuart F Quan. Original article Screen time behaviours and caffeine intake in US children: findings from the cross-sectional National Health and Nutrition Examination Survey (NHANES) BMJ Vol 2 issue 1;
  14. Russell Jago, Simon J Sebire, Patricia J Lucas, Katrina M Turner, Georgina F Bentley, Joanna K Goodred, Sarah Stewart-Brown, Kenneth R Fox. Parental modelling, media equipment and screen-viewing among young children: cross-sectional study; BMJ Vol 3 Issue 4;
  15. S Bowring. Book: Set free childhood—coping with computers and TV.
  16. Brown, T & Stagnitti, K. Relationship between screen-time and hand function, play and sensory processing in children without disabilities aged 4-7 years: A exploratory study.  Australian Occupational Therapy Journal.
  17. The Signal (WA-IMH), Vol 3 No 3 Jul-Sept 1995.