In 2019, The Royal College of Paediatrics and Child Health (RCPCH) published guidance which reflected research conducted into the health impacts of screen time use of under 18s. They found that pre-existing evidence for a direct ‘toxic’ effect of screen time was overstated and often only looked at television screen time instead of all devices. Subsequently, they choose not to recommend a cut-off for children’s overall screen time but instead to focus on practical ways which parents and carers could consider the health impacts of their family’s use.
Recommendations
The RCPCH’s primary recommendation is that families should negotiate screen time limits with their children based upon the needs of an individual child and family. This should take into account how their current useage is impacting on them, where and when devices are used or needed and looking at the quality of screen time as well as the quantity. For example, 1 hour spent watching TV or playing a game is different to an hour spent online completing homework or research. The RCPCH also recommends avoiding screens for an hour before bedtime to promote healthy sleep.
The RCPCH have developed four key questions for families to use as a guide to examine their screen time:
- Is screen time in your household controlled?
- Does screen use interfere with what your family want to do?
- Does screen use interfere with sleep?
- Are you able to control snacking during screen time?
They suggest that ‘if a family can ask themselves (or be asked by others) these questions, and are satisfied with the answers, then they can be reassured that they are likely to be doing as well as they can with this tricky issue.’
Questions answered in the guidance:
There have been many suggested links between screen time use and negative impact on a child’s health. The RCPCH have outlined these and commented on evidence base behind each:
- ‘Screen time is directly ‘toxic’ to health’ – RCPCH comments that this view is popular outside scientific research and literature, but has essentially no evidence to support it.
- ‘Screen time alters behaviour and thus leads to negative outcomes’ – RCPCH comments that there is some evidence for this when it comes to diet: watching screens can distract children from feeling full, and children are often exposed to advertising while using screens, which appears to lead to higher intake of unhealthy foods.
- ‘Screen use exposes children and young people to harmful content, through cyberbullying, watching violence or pornography, unrealistic imagery (unrealistic body shapes) or through monitoring online status (e.g. ‘likes’) with their peers’ – Check out our Digital Wellbeing hot topic which provides advice on supporting children and young people’s wellbeing when engaging with screens.
- ‘Screen time displaces positive activities’ – RCPCH comments that analysis of what leads to positive wellbeing has consistently supported socialising, good sleep, diet and exercise as positive influences. All of these can be displaced by screen-based activities, which may lead to an ‘opportunity cost’ in terms of other beneficial activities. For this reason the RCPCH felt that this is the main way in which screen time and negative outcomes may be linked.
The RCPCH suggest that there is no ‘safe’ level but this doesn’t mean that all screen time is harmful. To say that there is a safe level would be to suggest that below that level there are no negative consequences, whereas above this level there are negative consequences.
Childnet suggests that the amount of screen time appropriate will differ per child/ family and depend on:
- The age and maturity of the child
- The presence of any additional needs which may impact on the child being able to self manage their time online
- The quality of screen time
- The balance of offline activities
- The current level of impact screen time is having on a child’s mood, sleep or behaviour
The RCPCH have provided 6 top tips for reducing screen time:
- Have a plan and stick to it: It is helpful to sit down in a calm moment, as a family, and discuss the boundaries of screen use that you will be adopting, using the checklist questions as a guide. It is important that: everyone understands the boundaries; family members are praised and, if appropriate, rewarded for respecting these boundaries; and boundaries are consistently applied and, if necessary, consequences are put in place.
- Be aware, but not intrusive or judgmental, when it comes to teenagers’ use of the internet
- Think about your own media use: maybe what you are doing on your phone is important, but can it wait?
- Prioritise face-to-face interaction: online interaction is great, but no substitute for the real thing!
- Be snack aware: If you are going to combine snacks with screen use, do so as part of an overall diet plan.
- Protect sleep: No screens for an hour before planned sleep time is a sensible rule of thumb
Previous/ additional guidance
Prior to this guidance and for almost two decades, the American Academy of Paediatrics (AAP) were the sole organisation to set out guidelines relating to time boundaries, and their famous “2×2” historic recommendations stated that children under the age of two should have no screen time at all, and any child over the age of two should have no more than 2 hours a day.
In October 2016, these guidelines were revised in order to better reflect modern family life, the different types of technology that children come into contact with on a daily basis, and the huge variety of positive ways in which media can be used at home. Screen time now incorporates the use of TVs, DVDs, on-demand services, portable handheld gaming devices and consoles, mobile phones, tablets and laptops to name a few.
To navigate the world of technology as we currently know it, the AAP has provided more general and practical guidelines and now recommends the following:
- The creation of a personalised Family Media Plan, including rules for children and parents/carers. Our Family Agreement forms the perfect template for this activity. Alternatively, the AAP has provided a tool to create a family media plan and a media time calculator.
- Rather than policing children’s media use, it is more useful for parents and carers to think of themselves as ‘media mentors’ for their children, with a responsibility to ensure that media use forms part of a well-balanced range of activities and doesn’t displace sleeping, playing, conversation and physical activities.
- Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.