Monday, September 30, 2019

Healthy Habits: Screen Time and Kids' Sleep



Over the past 15 years, there has been growing concern about the association between electronic media use and sleep. Studies show that screen-time before bedtime can lead to shorter sleep duration, irregular sleep schedules, daytime fatigue, and more.

According to Professor Lauren Hale, this is especially true for adolescents.  She calls the confluence of environmental challenges (i.e., earlier school start times), behavioral changes (e.g., less parental control), and intense preoccupation with screen-time a “perfect storm," making teens particularly prone to the negative effects of electronic media on sleep.

I had a chance to interview experts  to learn more.

Lauren Hale, Ph. D. Professor at Stony Brook University and Scientific Advisory Board Member of Children and Screens
1) Why does screen time have an adverse effect on sleep?
Spending time in front of a screen before bed affects a range of sleep outcomes, including later sleep onset, shorter total sleep duration, and lower sleep quality. There are four mechanisms through which screen time affects sleep:
  1. Time spent in front of a screen displaces time you could be sleeping, and frequently pushes sleep onset to a later time.
  2. The content of the activity you are doing on the screen could be psychologically stimulating -- for example, social media could result in feelings of social exclusion and lead to rumination.
  3. The blue light emitted from the screens suppresses the sleep promoting hormone melatonin.
  4. Around a third of people report checking phones in the middle of the night at least once.
Many of these effects could be reduced if parents and teens work together to keep smartphones out of the bedroom, charge them in a central place, and focus on prioritizing sleep and healthy sleep–related routines.

Pamela Hurst-Della Pietra, D.O., Founder and President of Children and Screens: Institute of Digital Media and Child Development
How can parents help manage screen time for younger kids?
There is good reason to believe that milestones in early child development are best supported by the child’s interactions with caregivers and his or her environment, specifically by creating a nurturing bond and ensuring that the baby/toddler feels safe and engaged. When a screen starts to replace, displace, or disrupt any of these necessary interactions or developmental milestones, it can become problematic. Here are some helpful tips to keep in mind:

Avoid giving your very young child digital media, and be aware when you do so.
Video chatting with Grandma in Florida or showing your toddler a video of a gazelle running on a savannah are clearly beneficial uses of digital media. On the other hand, handing your child an iPad when he or she is crying is not. Instead of allowing him or her to self-soothe or calm down, it can set up a dependency pattern. Try to refrain from using the iPad or phone as a digital babysitter. Prioritize co-viewing digital content with your young child.

Additionally, understand how other people in your child’s life interact with screens when you are not present, including caretakers, babysitters, and family members. Confirm that you are all on the same page about how digital media is used around and with your infant or toddler. It can be challenging to stay on top of your young child's digital environment. The most important aspect of healthy long-term screen interaction remains modeling healthy behaviors and clarifying your expectations and rules from the beginning. It is much easier to introduce healthy digital habits before your child gets into a regular routine with screens.

Avoid technoference.
As a parent, paying attention to your child is critical for healthy development. “Technoference,” or technology’s interference in daily life, can detract from meaningful parent-child interactions and has been linked to behavior issues in young children (1). To ensure that your device use is not detrimental to your relationship, limit your own screen time when spending time together. Place your devices in separate place like a drawer, turn off or limit notifications, turn off background TV, and wait until your child is asleep to check your emails, texts, and social media feeds.

Keep your young child engaged with off-screen activities. 
Sometimes simple solutions such as blocks, puppets, puzzles, or even a cardboard box are all a child needs for hours of entertainment. Creating options for screen-free fun keeps your child active and even reinforces healthy development and executive function (2).

Can you share a little more about the "perfect storm" for adolescents and teens? 
Adolescence is a developmental period known for impulsivity, risky behaviors, and seeking rewards. During this stage, sensitivity to peer pressure can also be high. Teens’ frontal lobes, a part of the brain that helps with decision-making and impulse control, are still developing. According to Pew Research, 95% of teens have access to a smartphone, which offers continual access to largely unregulated online domains (3). Altogether, this creates the “perfect storm,” which can have the following consequences:
  • Problematic or addictive use of devices that drives or consumes a teen’s life, replacing or sacrificing all “real-life” friends, family, schoolwork, clubs or hobbies, personal hygiene, or other responsibilities
  • Distracted driving which leads to disastrous consequences
  • Posting photos of illegal, harmful, or sexting behavior online
  • Viewing pornography which can lead to dating violence and sexual aggression (4)
  • Talking to strangers on social media and revealing personally identifying data
  • Frequenting chat rooms filled with hate, prejudice, or bigotry
  • Perpetuating or experiencing peer pressure or online bullying
  • Playing video games, going on social media, or texting while in class, at lunch, or doing homework, which can contribute to decreased academic performance. Media multitasking can lead to poorer attention and memory (5).
How can parents of older kids and teens help them learn to self-regulate screen time to set themselves up for good habits?

Here are some tips that you can use to help your teen develop healthy habits around media:
● Maintain open communication Make a habit to regularly check-in with your teen about his or her media use and online experiences. Discuss what sites, apps, and games your teen is accessing. Help your teen assess his or her own digital media use, how he or she feels about it and whether it is problematic. Some of the warning signs of potential negative effects associated with prolonged usage or excessive digital consumption include:
○ Loss of interest in regular activities
○ Feelings of anxiety and depression
○ Decreased academic performance
○ Withdrawal symptoms when devices are taken away
○ Inability to reduce use
○ Continued usage despite problems
○ Use of digital devices to relieve negative moods

Start by asking your teen the following questions:
  • Do you feel like digital media affects your relationships?
  • Do you feel distracted by your devices?
  • Do you feel like you spend too much time on social media, games or texting?
  • Do you feel stressed when waiting for messages from friends?
  • Are there any social media sites that you can live without?
  • Is your phone use making you feel overwhelmed or anxious?
  • Would limiting the number of friends you follow on social media be helpful to you?
If your child suggests that he or she is having problems, arrange for a more thorough self-assessment to see if digital media use is an issue in his or her life, and if necessary, seek out professional help.

●Recognize the obstacles. Recognize that you are asking your teen self-regulate use of a powerful device that most adults struggle to manage. Did you know that 45% of teens admit to using the internet “almost constantly,” making it a lifeline for many of them (6)? Making your child aware of the methodologies employed by internet developers can help him or her realize that he or she is being manipulated. This persuasive technology is designed to draw users’ attention and make it harder to quit an app or turn off your phone.

Likes and follows correlate with increased activity in reward pathways in the brain. A 2016 study of adolescents showed through fMRI data that when pictures on Instagram with many likes were viewed, there was greater neural activity in the areas associated with “reward processing, social cognition, imitation, and attention” (7).

●Promote an intentional mindset. Help your teen think about what he or she loves to do, what relationships and activities are valuable and important, how your teen wants to remember these years, and what role technology plays in this narrative. Advise him or her create a checklist of what he or she would like to accomplish each day. This activity will help develop and reinforce time-management skills and involvement in off-line activities and hobbies. Turning off digital notifications or even his or her phone can help limit distractions.

●Establish clear and consistent expectations around device use. Each family has a different set of values and expectations around device use. Adolescence is a stage of separation and individuation; and teens have a high need for autonomy. Children and Screens suggests that you have an open conversation about your expectations about daily media use inside and out of your home, but give your teen the opportunity to participate and voice his or her perspective. Some basic rules for promoting healthy screen habits include:
  • Keep all devices out of the bedroom. Buy your teen a digital alarm clock to replace his or her phone alarm
  • Do not use screens an hour or two before bedtime
  • Do not use screens during mealtime, snacktimes, at restaurants or during family car trips
  • Put phones away while hanging out with friends
  • Stay off of screens while participating in a club, sport, or other activity
●Create awareness. In an open and respectful dialogue, show your teen some of the findings about digital media’s effects on cognition, mental, and physical health (for more information, visit Children and Screens’ website). Children and Screens does not dispute the obvious tremendous benefits of technology for communication, information, and entertainment. However, depending on the duration, content, and context of use, this new digital childhood can contribute to an increased risk of anxiety and depression, ADHD, insomnia, academic performance, aggression, obesity and sexual risk-taking. Establishing good screen habits now can help ensure a productive, fulfilling, and creative life in the future.

●Model healthy behaviors. Teens will learn more from what you do than what you say. Put away your devices when your son or daughter comes home from school or is in the same room. A recent nationally-representative survey found that more than half of teens have felt that their parents are often too distracted by their devices when they are trying to engage in conversation (8).

●Use apps that track and limit screen time. Apps such as Apple Screen Time, Google Family Link and Moment allow teens and parents to monitor and track how much time is spent online, and can also set limits for usage. Other apps like Flipd help prevent distraction and promote focus while online.

●Encourage independent thought and critical thinking. Teach your adolescent how to be media literate, think critically about information sources, and develop his or her own point of view. We understand that this is no easy task: the Stanford History Education Group tested 8,000 middle school, high school, and college students from both well and poorly resourced schools on student’s ability to judge the credibility of online resources. The group found that “at every level, students are underprepared for determining the credibility of what they see online” (9).

About Children and Screens Children and Screens: Institute of Digital Media and Child Development is a 501(c)(3) national non-profit organization founded by Dr. Pamela Hurst-Della Pietra, who has spent her career in public service ranging from non-profit development, medicine, and philanthropy devoted to children and adolescents. She started Children and Screens: Institute of Digital Media and Child Development in 2013 to provide a forum for researchers, clinicians, and other experts from a wide variety of disciplines to meet, collaborate, and share research; advance funding in the study of digital media’s effects on children; and provide parents and educators with the resources and answers they need to raise happy and healthy children in the digital age.

Children and Screens is publishing a white paper “10 Digital Dilemmas Facing Parents Today,” featuring expert insight and guidance. We want to hear from you. Please write to us at parents@childrenandscreens.com. The article will be available on our website along with guidelines and recommendations for parents, research findings, and an online bookstore.

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(1) McDaniel, B. T. and Radesky, J. S. (2018). Technoference: Parent Distraction With Technology and Associations With Child Behavior Problems. Child Dev, 89: 100-109. doi:10.1111/cdev.12822 (2) Zosh, J. M., Hirsh-Pasek, K., Hopkins, E. J., Jensen, H., Liu, C., Neale, D., ... Whitebread, D. (2018). Accessing the Inaccessible: Redefining Play as a Spectrum. Frontiers in psychology, 9, 1124. doi:10.3389/fpsyg.2018.01124 
(3) Pew Research Center (2018). Teens, Social Media & Technology 2018. Retrieved from https://www.pewinternet.org/2018/05/31/teens-social-media-technology-2018/
(4) Rostad, W. L., Gittins-Stone, D., Huntington, C., Rizzo, C. J., Pearlman, D., & Orchowski, L. (2019). The Association Between Exposure to Violent Pornography and Teen Dating Violence in Grade 10 High School Students. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-019-1435-4 
(5) Uncapher, M. R., Lin, L., Rosen, L. D., Kirkorian, H. L., Baron, N. S., Bailey, K., ... Wagner, A. D. (2017). Media Multitasking and Cognitive, Psychological, Neural, and Learning Differences. Pediatrics, 140(Supplement 2), S62–S66. https://doi.org/10.1542/peds.2016-1758D 
(6) Pew Research Center (2018). Teens, Social Media & Technology 2018. Retrieved from https://www.pewinternet.org/2018/05/31/teens-social-media-technology-2018/ 
(7) Sherman, L. E., Payton, A. A., Hernandez, L. M., Greenfield, P. M., & Dapretto, M. (2016). The Power of the Like in Adolescence: Effects of Peer Influence on Neural and Behavioral Responses to Social Media. Psychological Science, 27(7), 1027–1035. https://doi.org/10.1177/0956797616645673 (8) Pew Research Center (2018). How Teens and Parents Navigate Screen Time and Device Distractions. Retrieved from https://www.pewinternet.org/2018/08/22/how-teens-and-parents-navigate-screen-time-and-device -distractions/ 
(9) Stanford History Education Group (2016). Evaluating Information: The Cornerstone of Civic Online Reasoning. Retrieved from https://stacks.stanford.edu/file/druid:fv751yt5934/SHEG%20Evaluating%20Information%20Online .pdf

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