Screen time: the good, the bad and the ugly

Diverse types of electronic media devices (Computers, video games, television, smartphones, tablets, and reading devices) are available today. Interaction with related screens and multi-tasking is ubiquitous and a major contributor to a sedentary lifestyle. [Lelanc AG et al, 2017] 

Watching screen media ('screen time') is the main pastime of children [Sigman A, 2012] and adults. 

Not only does screen time begin earlier in life (as compared to earlier generations) but recent qualitative data indicate that children have regular residential access to an average of five different screens, and they concurrently engage in two or more forms of screen viewing [Jago R et al, 2011]. Children observe and learn from parent behavior and their activities [Bandura, 1977]. Recent US data indicate that parent screen time and parent attitudes are predictors of child screen time. Moreover child screen time is influenced by age and type of device [Lauricella AR et al, 2015].

Results reported by a systematic review of sedentary behaviour and health indicators in school-aged children and youth are summarized in table below.

                Source of above table: Carson V et al, 2016

Relevant excerpts:

1. "The physiological mechanisms that underlie the adverse health outcomes related to screen time and the relative contributions of different types of screen and media content to specific health outcomes are unclear" (Domingues-Montanari S, 2017).

2. ".....Exponential growth in the number of scientific publications related to sedentary behavior and screen time" [Lelanc AG et al, 2017]. 

3. "Systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years." "A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence" [Carson V et al, 2016].

4. "ST is no longer merely a cultural issue about how children spend their leisure time, nor is it confined to concern over the appropriate/inappropriate content of what is on the screen. It has become a medical issue, often exhibiting a dose-response relationship with disease risk." [Sigman A, 2012] 

5. "Using a nationally representative sample of more than 2300 parents of children ages 0–8, children's time spent with four digital media devices – television, computers, smartphones, and tablet computers – was examined. Results from linear regression analyses indicate across all four platforms that parents' own screen time was strongly associated with child screen time. Further analyses indicate that child screen time use appears to be the result of an interaction between child and parent factors and is highly influenced by parental attitudes. Results suggest that policymakers should consider the family environment as a whole when developing policy to influence children's screen media use at home.

• Parent screen time is the strongest predictor of child screen time.
• Parent screen time and parent attitudes influence child screen time.
• Child screen time varies as a function of child age and by device."

"First, Bandura (1977) posits that learning and behavior occur as a result of observing behaviors. Young children spend much of their early years watching and learning from their parents and siblings in their home. Children observe as their parents cook dinner, interact with each other, and use media"
[Lauricella AR et al, 2015].

References: 

1. American Academy of Child and Adolescent Psychiatry. Children & watching TV. Facts Fam 2001;54:1–2.
2. Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput JP, Saunders TJ, Katzmarzyk PT, Okely AD, Connor Gorber S, Kho ME, Sampson M, Lee H, Tremblay MS. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab. 2016 Jun;41(6 Suppl 3):S240-65. doi: 10.1139/apnm-2015-0630. PMID: 27306432.
3. Domingues-Montanari S. Clinical and psychological effects of excessive screen time on children. J Paediatr Child Health. 2017 Apr;53(4):333-338. doi: 10.1111/jpc.13462. Epub 2017 Feb 6. PMID: 28168778.
4. Lauricella AR, Wartella E, Rideout VJ, Young children's screen time: The complex role of parent and child factors, Journal of Applied Developmental Psychology, Volume 36, 2015, Pages 11-17, ISSN 0193-3973, https://doi.org/10.1016/j.appdev.2014.12.001.
5. LeBlanc, Allana G.; Gunnell, Katie E.; Prince, Stephanie A.; Saunders, Travis J.; Barnes, Joel D.; Chaput, Jean-Philippe. The Ubiquity of the Screen: An Overview of the Risks and Benefits of Screen Time in Our Modern World. Translational Journal of the ACSM 2(17):p 104-113, September 1, 2017. | DOI: 10.1249/TJX.0000000000000039
6. Jago R, Sebire SJ, Gorely T, et al. ‘I’m on it 24/7 at the moment’: a qualitative examination of multi-screen viewing behaviours among UK 10– 11-year-olds. Int J Behav Nutr Phys Activ 2011;8:85.
7. Sigman A, Time for a view on screen timeArchives of Disease in Childhood 2012;97:935-942.
8. Zero to Eight: Children’s Media Use in America. Common Sense Media. 2011. http://www. commonsensemedia.org/sites/default/files/research/ zerotoeightfinal2011.pdf 
9.