Screen Time for Kids: What’s the Big Deal?

Ann L. Contrucci, MD

November 03, 2022

"Congratulations, you have a beautiful baby boy!" Or, "Congratulations, you have a beautiful baby girl!" Those are words that change our lives like no other. And then, reality hits, and parents are terrified. How do they do things "right?" How do they teach their baby? How do they…? Sometimes, there seem to be more questions than answers!

When it comes to building babies' brains, what is one of the most important things a pediatrician or primary care physician can tell parents?

Just say no to screen time!

First, the "official recommendations" by the American Academy of Pediatrics: Babies from birth to 18 months of age should have zero screen time. For toddlers 18 months to 2 years of age, the only screen time recommended is "video chatting." Children age 2-5 years should have 1 hour or less of screen time a day. It should only be with the parent participating alongside the child, and only with quality educational programs, such as Sesame Street.

Now, for some observations from this old pediatrician. When the phrase "screen time" began popping up years ago, and smartphones seemed to be in everyone's hands, I became quite concerned about what I was seeing in the interaction between parent and child. I noticed less playing together, less hands-on interactions, and less physical touch, such as hugging or sitting in parents' laps. In other words, I didn't see the same parent-child connections that I was used to seeing, especially with very young children. When I would start a conversation about these observations, I would get the following responses: The kids want to play their games on the tablet or phone. It keeps them busy and gives me a moment of peace to get something done or just have a cup of coffee. What's the harm in that? Look what they are "learning" on the tablet. They can operate my phone better than I can! What's the big deal?

While I feel that no parent would purposely do something to harm their child's development, I have seen how parents are being sucked in to this technology, thinking instead how it will help their child. Parents do not realize that many apps and programs are not appropriate for young children nor have they been properly checked out by real child-developmental specialists. Great marketing does not mean the same thing as certified professionals giving a stamp of approval. Remember that when giving recommendations.

I also completely understand wanting a moment of peace to yourself, especially with toddlers and preschoolers (I had twins so I remember the chaos! I feel parents' pain!). However, it is important for parents to understand the associated pitfalls of screen time for developing brains. Cold fact: Young developing brains learn best with hands-on interactions and experiences as well as real-life interpersonal reciprocal actions. That has not changed in centuries and probably never will, no matter how "smart" phones and digital media becomes.

Parents also need to be cognizant of their own digital media use, and this is something I have used as teaching moments in exam rooms when both the parent and child is on a device. Have some parents been miffed when I call them out? Yep, but most are embarrassed and are thankful when they realize that they didn't even know they were doing that. In my office, I did not have a TV or Wi-Fi available for parents. But there were plenty of puzzles, books, blocks, and even stethoscopes for children to use.

That world of infants, toddlers, and preschoolers needs to start off from the beginning "in real life." Blossoming young minds learn so much by having someone talk to them, smile and laugh with them, and hold and cuddle them. It makes sense, right? Watching a flat screen on a tablet or phone or TV does not give any of the crucial feedback a real live person does. None of these interactions or activities need to be high tech. They can be as simple as stacking plastic food containers, banging on pots and pans, singing and dancing, scribbling on paper, talking about things seen on a walk outside, or playing with blocks. The examples are endless. Simple is best.

Let's break it down a bit. The four areas of development for babies and young children include: social-emotional, language, motor (movement), and cognitive (intelligence). Each of these areas sets up success for babies and beyond as they grow and develop into little people. We know from research that young brains cannot transfer knowledge learned in a two-dimensional space (meaning a TV, phone, or tablet) into real-world interactions. Babies and young children need that vital interaction with their parents and caregivers for their brains to literally develop and grow. You may say having the TV on in the background seems like no big deal, right? However, this has also been proven to decrease real-life interactions and is very distracting for young brains. Your child's brain is like a complicated machine and is constantly filtering so much information in the surrounding environment. Background TV is like an annoying insect flying around your face — distracting and making it difficult to focus!

Partner with parents to understand that low-tech and simple activities and toys are the best thing for their young babies' brains. Always. No flash nor batteries required. Ultimately, parents need to understand that more than anything, their child wants to simply be with them. There is no screen anywhere that can substitute for that. So just say no to screen time; children's brains will bud, blossom, and grow from that — guaranteed!

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About Dr Ann Contrucci
Ann L. Contrucci, MD, is a board-certified pediatrician with almost 30 years' clinical experience. She has practiced rural and suburban primary care as well as urban and suburban pediatric emergency medicine throughout her career. She also had her own solo practice in Ontario, Canada. She is currently an Assistant Professor of Pediatrics in the Clinical Education Department at Philadelphia College of Osteopathic Medicine. Her particular areas of expertise and passion include mental and emotional health issues in children and adolescents, in particular anxiety, emotional dysregulation, and eating disorders.


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