COMMENTARY

A Shocking Amount of Non-school Screen Time

F. Perry Wilson, MD, MSCE

Disclosures

November 02, 2021

This transcript has been edited for clarity.

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I'm Dr F. Perry Wilson of the Yale School of Medicine.

How many hours are there in a day? I need to ask this question this week because of this study, appearing in JAMA Pediatrics, which found that during the pandemic children were spending, on average, 7.7 hours a day on screens. Excluding screens used for schoolwork.

I'm literally doing the math here.

There are 24 hours in a day. Say 8 for sleeping (on the low end for the kids in this study — age range, 12-13 years); 6 for school; 8 watching screens. That leaves 2 hours, maybe, for homework, extracurriculars, going outside, eating food, bathroom stuff, and talking to other people.


 

And that's the average. The standard deviation is 6 hours which means that, well, 16% of kids are spending more than 13 hours a day on a non-school–related screen.


 

I usually describe how the study works before I talk about the results, but I just wanted to get this out there at the beginning. That is a lot of screen time.

So here's how the study worked. This is a dataset from the Adolescent Brain Cognitive Development (ABCD) study, a long-running, multicenter platform study that conducts a variety of analyses on kids as they develop from age 9 to 20.

The current study examined responses to a standardized screen time survey in just over 5400 kids age 12 and 13 years.

Now, digging into the methods, there is some room for overestimation here. Kids may be rounding up their screen time estimates to whole numbers of hours. For example, here are the choices offered for watching TV shows or movies.


 

The authors also sum the screen time assigned to various activities (like time spent playing video games vs time spent streaming TV shows). Insofar as today's multitasking tweens can do both of these at once, summing may not be totally appropriate here.

So maybe, at least I hope, these numbers are slightly lower in reality? Even so, the breakdown is interesting. These kids are spending a plurality of their time streaming videos and gaming, with less time than I might have expected on social media — which honestly might be a good thing.


 

Demographically, girls used screens about an hour less than boys, and Black kids used more screens than other ethnic groups. Kids with more educated or wealthier parents also used screens a bit less.


 

To assess the impact of screen use, the researchers looked at mental health questionnaires. After adjustment for demographic and parental factors, kids who used more screens tended to report worse mental health and higher stress levels, less social support, and poorer coping behaviors. (Of course, the direction of causality here is anyone's guess.)


 

This level of screen usage, by the way, is not normal. This same survey, administered pre-pandemic, found that kids' average screen time was around 3.8 hours a day. Kids have doubled screen time during the pandemic.

Of course, we can guess why. As social activities and sports shut down, and playdates became reframed as infection-spreading opportunities, kids had more free time. Screens fill the void.

My hope is that these trends will reverse as life starts to return to normal. Vaccination for children, expected this week, will hopefully make people more comfortable getting their kids out of the house and back into the real world.

But we should not forget the cognitive harm that the pandemic has done to this group of children. From school closings to reduced socialization to, yes, hours and hours of TikTok videos, the effects of the COVID-19 pandemic on our youngest generation may not be fully appreciated for decades.

F. Perry Wilson, MD, MSCE, is an associate professor of medicine and director of Yale's Clinical and Translational Research Accelerator. His science communication work can be found in the Huffington Post, on NPR, and here on Medscape. He tweets @fperrywilson and hosts a repository of his communication work at www.methodsman.com.

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