With the increased use of technology in our everyday lives, it is not surprising that children and adolescents are using screens at higher rates than ever before. Parents estimate that children ages 2-8 spend about 2 hours per day on digital devices, children ages 8-12 spend about 4.5 hours per day on screens and teenagers spend about 6 hours per day on digital devices (excluding time for school work). As a result, there is growing concern about what is too much use and what are the effects of excessive screen time on a child’s social and emotional development. This is particularly a hot topic as parents worry about screen “addiction” in themselves and their children.
There is no DSM V diagnosis currently for screen addiction for children and teens. Internet Gaming Disorder was added to the list of “Conditions for Further Study” in the DSM V but is limited to internet use only and teens and adults ages 14 and older. But there are concerns that behavioral and mood problems can arise from excessive screen time and researchers are beginning to assess this in more detail.
There is research being conducted to look objectively as this idea of addiction to digital devices. One group has developed a measure, the Problematic Media Use Measure, which is a parent report on use of screen-based media for children age 4-11. The questions for this measure are adapted from the criteria for Internet Gaming Disorder in the DSM V.
Identifying that use of digital devices is problematic goes beyond the number of hours a child spends on the device. It is important to assess if the use is negatively interfering with the child’s life. Signs that parents should be worried about their children’s screen use include:
- Unsuccessful control – it is hard to get the child to stop using screen media
- Loss of interest – screen media is the only thing that is motivating to the child and/or the child uses screen media to improve mood or avoid stressors
- Preoccupation – screen media is all that the child seems to think about
- Psychosocial consequences – the use interferes with family activities and leads to power struggles and other family tension
- Withdrawal – the child becomes frustrated when s/he cannot use screen media
- Deception – the child sneaks using screen media
- Tolerance – the amount of time the child wants to use seems to keep increasing
- Setting limits – it becomes increasingly difficult getting the child to stop using screen media
If it is determined that a child is engaged in problematic use of screen media, there are steps that can be discussed to help reduce the use. It is important that the reduction happen slowly and not abruptly, because many children have anger outbursts when parents try to place limits on their screen use. It is also important that parents replace the time spent on screen media with other positive activities (a team sport, social outings, family time). This can sometimes be challenging because many parents find that their children are not demanding of their time during the time they are spending on digital devices. This might be a hard thing for parents to commit to giving up, even on a temporary basis. It is important to have these conversations with parents prior to implementing a behavioral modification plan, to ensure that it can be successful in reducing the problematic screen use.
In conclusion, even though screen-time addiction is not a diagnosable behavioral health condition, many people are concerned that they and their children feel “addicted” to their screen-based media. It is important as professionals to provide education on prevention of problematic screen use (have screen-free times, engaging in active family time, monitoring their own screen use). An important take home point is to ask about the impairment from the screen media use rather than just asking about how much time a child spends on digital devices. The provider can then help a parent set up a behavioral plan to reduce the problematic use.