12 Month Old Baby Watches Cartoon Too Intently

Screen time and young children: Promoting wellness and evolution in a digital world

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Paediatr Child Health 2017;22(viii):461–468

Abstract

The digital landscape is evolving more quickly than research on the effects of screen media on the development, learning and family life of young children. This statement examines the potential benefits and risks of screen media in children younger than five years, focusing on developmental, psychosocial and physical health. Prove-based guidance to optimize and back up children'southward early media experiences involves four principles: minimizing, mitigating, mindfully using and modelling healthy utilize of screens. Knowing how young children learn and develop informs best practice strategies for health care providers.

Keywords: Development; Digital media; Health; Baby; Preschool child; Screen fourth dimension

BACKGROUND AND METHODOLOGY

Exposure to digital media in Canadian family unit life is increasing, as are concerns about how screen time affects children and families. This statement examines potential benefits and risks of screen exposure and employ on children younger than 5 years, and provides evidence-based guidance for wellness professionals to assist families. 'Screen time' refers to time spent with any screen, including smart phones, tablets, boob tube, video games, computers or wearable technology. 'Digital media' refers to content transmitted over the Internet or computer networks on all devices, unless item ones are specified.

A 2016 survey of Canadian Paediatric Society (CPS) members found that parents sought advice about their children'south screen time in four main areas: duration (how much is likewise much?), setting limits, the furnishings on health and well-existence and optimal content. A literature search [1] into the effects of screen media on children younger than five years included systematic reviews, guidelines and policy statements on screen media exposure and apply. Potential benefits and risks were categorized into developmental, psychosocial and physical domains. Recommendations are based on prove and expert consensus. Screen time in older children and adolescents, children with neurodevelopmental disorders and ecology health concerns are beyond the telescopic of this statement.

WHY FOCUS ON THIS Age GROUP?

Research recognizes important developmental differences between preschool and later on childhood, and Tv set-based data have established that a child's earliest screen encounters can exist determinative [2]–[iv].

They may be habit-forming, and early overexposure increases the likelihood of overuse in afterwards life [4][5].
Wellness routines, including family media apply, are established more easily in early childhood than subsequently on [4].
Screen utilize tends to increase over time to include more entertainment (versus exclusively educational viewing) [vi]–[eight].

Some important trends are reshaping early childhood:

Active Good for you Kids Canada reported in 2014 that children 3 to five years quondam spend an boilerplate of two hours per day in front of screens [9]. Merely 15% of preschoolers met current Canadian Sedentary Behaviour Guidelines for the Early on Years, which recommend limiting screen time to less than one 60 minutes per mean solar day [10].
TV still dominates total screen fourth dimension and appears to be increasing for this historic period group [11]. Many preschoolers accumulate screen time at dwelling and in kid care [5][12], from a diverseness of screens that are easily transportable.
In the USA, rates of mobile media employ among 2- to 4-yr-olds increased from 39% to 80% between 2011 and 2013 [12]–[15]. A contempo Great britain study found that about 51% of infants half-dozen- to eleven-months-old use a touch screen daily [16].
A 2012 Usa study found that the boilerplate child between viii months and 8 years of age is exposed to nearly four hours of background TV on a typical twenty-four hours [17].

IMPACTS OF SCREEN MEDIA ON DEVELOPMENT

Whether early exposure to screen media changes the developing brain is non known, and published research on how (and how much) children younger than 5 years of age actually learn from screens remains limited [6][18]–[21]. Yet, studies show that while babies do not absorb content from Goggle box, it tin take hold of and agree their attending. They can imitate specific actions they see on screen between 6 and 14 months, and remember cursory sequences by 18 months [6].

Children brainstorm to empathize content by the end of their 2d year [five][22]. There is solid evidence that infants and toddlers accept difficulty transferring new learning from a 2D representation to a 3D object (east.g., from screen to existent life) and are unlikely to learn from Goggle box at this age [6][23]–[25]. By contrast, they acquire intensely through face up-to-face interaction with parents and caregivers. Early learning is easier, more enriching and developmentally more than efficient when experienced live, interactively, in real fourth dimension and space, and with real people [26]–[29].

Potential benefits for development

Kickoff at almost 2 years, quality TV—well-designed, age-appropriate programs with specific educational goals—tin can provide an additional route to early on language and literacy for children [thirty]. Quality programming also fosters aspects of cognitive development, including positive racial attitudes and imaginative play [31]. Early bear witness suggests that interactive media, specifically applications that involve contingent responses from an adult (i.e., timely reactions to what a child says or does), tin help children retain taught data. This responsiveness, when coupled with age-appropriate content, timing and intensity of action, tin can teach new words to 24-month-olds [21][22][32]. There is early on show that interactive 'acquire-to-read' apps and eastward-books can build early literacy by providing exercise with letters, phonics and word recognition [21][33]. However, while screens may help with language learning when quality content is co-viewed and discussed with a parent or caregiver [34], preschoolers learn all-time (i.due east., in expressive and vocabulary terms) from alive, direct and dynamic interactions with caring adults [35].

Risks for development

Research examining TV exposure has demonstrated associations, although not direct causal relationships, between heavy early screen exposure (more than than 2 hours/solar day past infants younger than 12 months in one study) and meaning language delays [26][36]. Prove of an clan betwixt screen time and attentional difficulties is mixed, with negative furnishings merely clearly apparent when exposure is extremely high (i.e., more than than 7 hours/day) [6][37]. Loftier exposure to background TV has been constitute to negatively affect language utilise and acquisition, attention, cognitive development and executive role in children younger than 5 years. It also reduces the corporeality and quality of parent–kid interaction and distracts from play [17][22][35][38]. While e-books take been shown to offer benefits with children's reading engagement, parents appear to employ fewer reading strategies during these interactions. Further, east-volume sound effects and blitheness tin can interfere with story comprehension and consequence sequencing in preschoolers, when compared with newspaper books [21][39]–[42].

Some studies associate prolonged TV viewing with lower cerebral abilities, specially related to brusk-term memory, early on reading and math skills and language development [12][twenty][43]–[45]. Fast-paced or violent content tin negatively impact executive part [5][46], and these furnishings may be cumulative. The inability of young children (especially those younger than two years) to distinguish everyday reality from what happens on screen, along with their efforts to make sense of competing experiential realms, may interfere with and impede executive part [6][47].

What makes the difference? Minimizing and mitigating screen time

Considering there are no proven benefits of media exposure for infants and toddlers, and some known developmental risks [twenty][22][26][48], counsel parents to minimize young children'due south screen time. Minimizing screen time leaves more time for confront-to-face interactions, which is how young children learn all-time.

When children scout educational, age-appropriate content with an engaged adult, screen fourth dimension tin can be a positive learning experience. When adults mitigate screen time, they:

Lookout man with children. Adults tin can connect what is being viewed with real life, and build language and cognitive skills, such as attention, memory and thinking [6][38][49]. Shared screen time also avoids the disadvantages of solitary viewing.
Actively curate children's screen activities by prioritizing educational content or apps, avoiding mainstream or commercial programs and using a media classification rating (e.g., the Canadian Home Video Rating System) to guide viewing choices.
Combine bear on screen utilise with artistic or agile play [l].

Although a 'digital separate' between households with and without Net access persists in Canada, learning apps on mobile devices may help bridge the gap [12]. In 2016, the Canadian Radio-television and Telecommunications Commission pledged to provide Internet admission as a basic service for all Canadians [11]. However, fifty-fifty every bit screen-based educational content becomes increasingly accessible to all families, a new gap may be opening. Children whose parents take the ability to mentor and curate screen encounters may reap benefits that are less attainable in families with fewer financial resources or parents who cannot exist equally involved. Health providers should be warning to this gap, which may exist reflected in other parent–child interactions [51].

THE PSYCHOSOCIAL IMPACTS OF SCREEN MEDIA

Co-viewing quality screen content can touch on more than children's learning. Studies take shown that parents can positively influence children's social adaptive skills, sleep patterns and behaviours past being involved with and setting limits on their screen time [22][52]. Tv research shows that socioeconomic factors tin shape the content and arbitration of screen use. Further, TV viewing has been institute to be negatively associated with school readiness skills, especially every bit family income decreases [53]. Nonetheless, the time spent viewing—beyond diverse middle-income households, for example—is stable [half-dozen][vii][12]. In fact, socioeconomic status appears to have niggling bearing on the degree to which families comply with current screen guidelines [54]. Raising awareness around how children learn all-time and their need for screen time limits is of import for all families, regardless of economic circumstances.

Potential psychosocial benefits

Quality content can raise social and linguistic communication skills for all children aged two years and older, particularly for children living in poverty or who are otherwise disadvantaged [26][30]. Educational Telly reaches children in lower-income homes almost as much as higher-income homes, and amid children whose families own a laptop or mobile device, barriers to accessing and using educational content take almost disappeared [12]. Well-designed, age-appropriate educational programs and screen activities can exist powerfully pro-social, helping children to larn antiviolence attitudes, empathy, tolerance and respect [31][55]. Appropriately used, screen time tin calm a child who is overexcited or distressed (eastward.one thousand., during a medical procedure) [xv][56]. Merely screen learning tin affect behaviour both positively and negatively, then ensuring quality content is crucial [57].

Developing a family 'media action programme' can aid protect and reinforce quality family fourth dimension [58]. Ideally, planning begins prenatally; accounts for the wellness, education and entertainment needs of each child and family member; includes screen-based activities in kid care; and is reviewed periodically. Setting meaningful limits when children are immature and sharing them as a family is far easier than cut dorsum screen time when children are older. Studies have found that parents' comfort level with saying 'no' to their children's requests to play games on screen, along with their own media-related beliefs, intentions and attitudes, are fundamental components of constructive, positive limit-setting [iv][52][59]. For children—and parents—off-screen time is critical for developing essential life skills such as self-regulation [60], inventiveness and learning through concrete and imaginative play.

Psychosocial risks

Recent studies confirm a strong association between parents' screen time and that of their children [13], raising concerns that increasing media presence is displacing quality (face-to-face) parent–kid and family interactions [12]. A recent study of smartphone use in fast-nutrient restaurants observed that as time spent by parents on their phones increased, so as well did the likelihood of children acting out to gain attention, often leading to negative interactions [6][61]. Another written report found that parents who allow 1- to four-year-old children to apply their smartphones ofttimes also study offering the telephone to reward or distract more oftentimes. Consequently, their children ask for the telephone—and become upset if refused—more oftentimes [15].

Parents report that their own use of mobile engineering science demands more intense attention than other distractions, such as reading books or watching Tv set. Smartphones mistiness the line betwixt work and abode life, timing is unpredictable and responding often requires emotional investment. In a recent study, parents reported that shifting attention between screens and family life can be stressful, tiring and reduces their ability to collaborate 'in the moment' with children [62].

Recent evidence suggests an association betwixt elevated levels of TV exposure at age 2 and self-reported victimization, social isolation, proactive aggression and anti-social behaviours in middle babyhood [63][64]. Excessive TV viewing (more than 2 hours/mean solar day) has been conspicuously associated with early on babyhood self-regulation difficulties [26][60]. Such effects could exist more pronounced in children with special behavioural needs, and self-perpetuating because parents are more probable to utilise screen media to pacify a kid with challenging behaviours [22][lx]. Inquiry shows that excessive levels of screen media exposure are associated more strongly with depression levels of stimulation in the home and low parental involvement than with socioeconomic position [6][12][65].

A big-calibration The states study from 2013 institute that the spread of mobile devices did not appear to touch on the amount or frequency of reading to young children. However, information technology also found that reading was the least-common activity children engaged in on tablets or mobile devices [12]. Other studies suggest that parents found reading to their kid from an due east-book to be a less positive feel than sharing a paper volume, from both fun and learning perspectives [66][67]. Even the nearly interactive e-books do not support skills like page-turning, and cannot provide the same sensory experiences equally traditional books[37][68], which can be affectionately dragged around, manipulated and chewed.

While quality educational programming is a leading mitigator of psychosocial run a risk on whatever screen, studies show that children's access to and choice of optimal content peaks early: at two to 4 years former [7][8][12]. As children historic period, they are more than likely to view entertainment programming.

What makes the difference? Mindful employ of screen fourth dimension

Children younger than 5 years learn best from alive, immersive interactions with family members and caregivers. Given the choice, they will most always opt for talking, playing or being read to over screen fourth dimension in whatsoever form [22]. Past using screen time mindfully, parents and caregivers:

Actively raise—and limit—media encounters by choosing them together and purposefully ('Let's watch or play this content, at this fourth dimension, for this reason').
Limit screen use in public places and during family unit routines, such every bit at meals. Family times are prime number opportunities for social learning.
Select content from quality, non-commercial sources, to minimize exposure to advertising.
Pay attention to messages about gender, torso image, violence, diversity and social issues when choosing content [69].

THE IMPACTS OF SCREEN MEDIA ON PHYSICAL HEALTH

For preschool children, physical activity is associated with improved measures of health, while sedentary behaviour is associated with less favourable wellness outcomes [seventy].

Potential benefits for physical health

Children's screen time does non have to exist passive; digital media use can encourage and complement physical action [51]. Particularly afterward historic period 3, children respond to activity-based programming when information technology is fun, designed for them and encourages false or participation [39][71]. I study found that active video games could acutely increment low-cal-to-moderate or moderate-to-vigorous physical action (PA) in the curt term [72]. Families and kid care programs may consider using fun, age-appropriate motility (east.one thousand., yoga or trip the light fantastic) and fitness apps or console games to integrate more PA into daily routines [51][73][74]. Mobile devices with apps for exploring the natural world tin raise outdoor PA [50]. Quality content connects on- with off-screen experiences, fosters engagement with caregivers and peers and supports active, imaginative play [51][75][76]. Ane 2010 written report found that while time spent watching commercial TV was significantly correlated with BMI, fourth dimension spent watching non-commercial educational TV was not [77].

Risks for physical health

Although evidence for an association betwixt screen fourth dimension and body mass alphabetize in very immature children is inconclusive, several studies have suggested that risks for overweight established by early screen utilize tin can persist into subsequently life [2]–[6][12][78][79]. TV viewing in the early years can become routine, placing children who are heavy viewers at higher take a chance for beingness sedentary or overweight [35]. One 2012 Canadian written report found that children who watched just ane hr of Television/day were l% more probable to be overweight than those who watched less [80]. Another report from 2009 measuring PA and trunk fat in middle-class preschoolers linked TV viewing to higher body fat, and constitute this relationship did not change when children's variable PA rates were taken into business relationship [81].

While reinforcing sedentary behaviours, commercial TV as well exposes children to advertisements for unhealthy foods and encourages snacking, which increases overall food intake [82][83]. A 2012 systematic review of Idiot box watching and adverse dietary effects in children ii to 6 years old constitute near studies reported negative effects with equally little every bit 1 hour/day of viewing [84].

The amount of time spent viewing screens earlier bedtime is associated with an increment in slumber bug for this age group [6][85], and evidence suggests that volume of screen time—rather than content alone—is detrimental to sleep patterns [45][53][86][87]. The presence of whatsoever electronic device in a chamber is associated with fewer minutes of sleep per night, due in part to melatonin suppression [26][85].

What makes the departure? Modelling screen time

Children younger than 5 years require active play and quality family fourth dimension to develop essential life skills, such as language, self-regulation and creative thinking. Regardless of age, children should non take to compete with screens for parental attending. When parents model healthy screen habits, they:

Minimize their ain screen use when immature children are present, especially for mealtimes, play and other prime number opportunities for social learning.
Prioritize interactions with children through conversation, play and good for you, agile routines.
Cull when to use media together, and turn off screens when they are non in utilize.
Help children to recognize and question advertising letters, stereotyping and other problematic content, and ensure that media used in the presence of children is complimentary of such content.

RECOMMENDATIONS

To promote child wellness and evolution in a digital world, physicians and other wellness care providers should counsel parents and caregivers of young children on the appropriate use of screen fourth dimension. Specific recommendations include the post-obit:

Minimize screen time:

Screen fourth dimension for children younger than two years is not recommended.
For children 2 to v years, limit routine or regular screen fourth dimension to less than 1 hour per solar day.
Ensure that sedentary screen time is not a routine office of child care for children younger than 5 years.
Maintain daily 'screen-gratis' times, especially for family meals and book-sharing.
Avoid screens for at least 1 hour before bedtime, given the potential for melatonin-suppressing effects.

Mitigate (reduce) the risks associated with screen time:

Be nowadays and engaged when screens are used and, whenever possible, co-view with children.
Be aware of content and prioritize educational, age-appropriate and interactive programming.
Use parenting strategies that teach cocky-regulation, calming and limit-setting.

As a family unit, be mindful about the use of screen time:

Conduct a self-assessment of current screen habits and develop a family media plan for when, how and where screens may (and may not) be used.
Help children recognize and question advertising messages, stereotyping and other problematic content.
Recollect: too much screen time means lost opportunities for teaching and learning.
Be reassured that in that location is no evidence to support introducing engineering science at an early historic period.

Adults should model good for you screen utilise :

Cull healthy alternatives, such equally reading, outdoor play and creative, hands-on activities.
Plough off their devices at home during family time.
Plough off screens when not in use and avert background Television receiver.

Ten Questions to Consider Asking Families With Young Children

What kind of screens are in your home (e.g., TV, tablet, computer, smartphone)? Which does your child employ?
Is watching TV or programs/movies on other devices a shared family action and a common way to relax? How often is a screen on in the background although no one is really watching?
Does anyone in the family unit use screens during mealtimes?
What do you picket with your child? What does your kid picket alone?
Practise you encourage or discourage conversation with your child while you are using screens?
Do you ever watch adult/commercial programming with your child?
Does your kid employ screens while yous do chores around the dwelling? Often? Sometimes?
Are there any screen-based activities in your child's day intendance programme? Do yous know how much these are used?
Does your child use whatsoever kind of screen earlier bedtime? How long before bedtime? Is there a TV or computer in your child's bedroom? Does your child take mobile devices into the bedroom?
Does your family unit take rules or guidelines for screen use that anybody understands and shares?

Information for parents is available at www.caringforkids.cps.ca

Acknowledgements

The development of this statement was fabricated possible through an unrestricted grant from TELUS. This argument was reviewed by the Community Paediatrics Commission, the Early Years Job Strength and the Mental Health and Developmental Disabilities Committee of the Canadian Paediatric Society. Information technology was also reviewed past representatives of the Higher of Family Physicians of Canada. Special thank you are due to Professor Mary 50. Backbone, of Memorial University of Newfoundland and Labrador, to Dr Claire M. A. LeBlanc, with McGill University Wellness Centre, and to Dr Mark Tremblay, of the Salubrious Active Living and Obesity Research Group (HALO), for their reviews and feedback. Cheers also to Jennie Strickland, for statement drafting, and to Jessie McGowan, for reviewing the literature.

CPS DIGITAL HEALTH Chore FORCE

Chair: Michelle Ponti Dr.

Members: Stacey Bélanger MD (CPS Mental Health and Developmental Disabilities Committee); Ruth Grimes Doctor (CPS Lath Representative); Janice Heard MD (CPS Public Education Advisory Committee); Matthew Johnson (Director of Education, MediaSmarts); Elizabeth Moreau (Director, CPS Communications and Knowledge Translation); Mark Norris MD (CPS Adolescent Health Committee); Alyson Shaw Doc (Chair, CPS Literacy Promotion Informational Grouping); Richard Stanwick MD (CPS Public Education Advisory Committee); Jackie Van Lankveld (Director, Speech Services, Niagara Children's Eye); Robin Williams Physician (Chair, CPS Early on Years Task Strength)

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Disclaimer: The recommendations in this position statement do not betoken an sectional course of handling or procedure to be followed. Variations, taking into account individual circumstances, may be appropriate. Internet addresses are current at time of publication.

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Source: https://cps.ca/documents/position/screen-time-and-young-children