How Bad, Really, Is Screen Time For Young Children?

When we become parents, most of us start out with the best of intentions — so good, in fact, that they quickly crumble in the face of reality. When it comes to screen time, we learn quickly that it’s a powerful and effective tool: If you’re trapped on an airplane or in a waiting room and need a way to quietly engage a young child, pulling up a video on your phone or iPad will almost always do the trick. Goodbye ideals, hello Bluey.

Parents aren’t under any illusion that screen time is good for children. We’re simply grasping at ways to get through the day — and often feeling guilty about those choices afterward.

We’re aware of the mounting evidence that screen time can have negative impacts on children, particularly the littlest ones. The American Academy of Pediatrics recommends no media exposure (with the exception of video chatting) for children younger than 18-24 months.

Naturally, this recommendation causes anxiety and sows division among parents, who are familiar with the enchanting powers of a show or YouTube video to calm a screaming toddler, allowing you to eat a meal at a restaurant in peace or simply to get stuff done around the house.

It’s not clear whether the cognitive impact of screen time stems from the viewing itself, or, rather, that screen time is replacing the kinds of interactive and communicative activities that support healthy brain development, but experts agree that it’s best to avoid screen time (almost) entirely for the littlest children.

“Eighty percent of a child’s brain development occurs by the time they’re 3, and so those are really crucial years that we need that moving, playing, interacting, [having] face-to-face conversations,” Dr. Liz Placzek, a pediatrician at Children’s Minnesota, told HuffPost.

While we know that screen time is linked with negative outcomes, there is less data on how screen time impacts children’s brains. But new research regarding kids’ sensory processing sheds some light on the way that children’s cognitive development is affected.

A study published this month in JAMA Pediatrics found that toddlers’ use of screens was associated with atypical sensory processing. Here’s what that means, and what parents need to know about it.

What is sensory processing, and why do pediatricians monitor it?

Think of the classic five senses: sight, hearing, smell, taste and touch. Our brains take in information via all of these pathways and try to make sense of it. This is sensory processing. It’s why we back away from a hot stove, or lean in to better hear someone who is whispering.

“Sensory processing involves the integration of information received through the body’s sensory systems ... to perceive and understand the world around the individual,” Dr. Karen Heffler and David Bennett, two of the study’s authors, told HuffPost in an email.

There are a wide variety of behaviors that can indicate a sensory processing issue. A child might seek out sensory behaviors, for example, by spinning their body, or they might try to avoid a sensory experience by not trying a new food.

None of these responses alone necessarily signify a problem. Plenty of kids love to spin around, refuse foods of a certain texture or will only wear shirts without tags in the neckline. “Some of these behaviors are so common for kids, and that doesn’t mean that it’s a disorder,” Placzek explained. “It’s really when it starts to inhibit daily lives” and cause distress that providers get concerned.

Pediatricians are interested in children’s sensory processing for a couple of reasons. As Placzek mentioned, children’s brains undergo an incredible amount of development in the first three years. Health care providers want to catch any issues right away, when treatment will be most effective. Any potential signs of a problem, Placzek said, “should be caught at well-child checks.”

“There are things we can do about it,” she continued. Children with sensory processing issues are usually treated with occupational, behavioral or physical therapy. Another reason to screen and treat these conditions is that “sensory processing problems are linked to lower quality of life for youth and higher stress for caregivers,” Shannon Bennett, a clinical director at the Center for Youth Mental Health at NewYork-Presbyterian, told HuffPost.

Another reason for doctors to screen for sensory issues is that they often occur alongside ADHD and autism spectrum disorder (ASD). In the study, the authors note that 60% of children who have ADHD and 70-95% of children with autism also have atypical sensory processing. This doesn’t mean that every child with a sensory processing issue has one of these neurological conditions, but since most kids with these conditions also have sensory processing concerns, it may be a piece of a bigger diagnostic puzzle.

How do screens affect kids’ sensory processing?

In their study, Heffler, David Bennett and their co-authors looked at data gathered from from almost 1,500 families. Parents answered questions about children’s exposure to TV/videos at 12 and 24 months, and at 33 months they filled out the “Infant/Toddler Sensory Profile,” which is used to screen for potential issues in children’s sensory processing. Questions deal with a child’s auditory, visual, tactile, vestibular (balance) and oral sensory processing, dividing these behaviors into the categories of low registration, sensation seeking, sensory sensitivity and sensation avoiding. For example, a child who refuses to try new foods and resists having their teeth brushed is exhibiting sensation-avoiding behaviors in the area of oral sensory processing.

The authors found different types of atypical sensory processing associated with any screen exposure. This is important information for both parents and health care providers.

“This study adds atypical sensory processing to the list of other developmental and behavioral outcomes, including autism, attention problems, language delay, impaired problem-solving abilities, brain differences, behavioral problems and disordered sleep associated with early-life screen exposure,” Heffler and Bennett wrote.

It’s important to note that the study does not prove a causal relationship between screen time and atypical sensory processing disorders, only a correlation. We don’t know if screen time causes atypical sensory processing. It’s possible that screen time replaces the kinds of face-to-face interactions that young children need for healthy neurodevelopment. It is also possible, the study’s authors note, that parents “may be more likely to allow higher levels of screen time for children with challenging sensory behaviors.” In other words, if your child is particularly difficult to soothe or contain in certain situations, you’re more likely to turn to a screen.

In the study, the authors note that previous research found that children with autism experienced a reduction in symptoms when some of their screen time was replaced with “socially-oriented activities,” and these symptoms worsened again when they returned to high levels of screen time.

“Further research is needed to determine if reducing screen time in young children who are high screen viewers and have challenging sensory-related symptoms is associated with improvements in those symptoms,” Heffler and David Bennett said in their email.

What can parents do to minimize the impact of screen time?

While experts advise parents to minimize screen time — though they understand we all need to use it at times — they don’t believe that judgment and guilt are the way to make it happen. Strict time limits aren’t always helpful, either, as not all screen time is the same, and different kids and families have different needs.

The AAP guidelines, Shannon Bennett said, “also acknowledge that more research is needed on this topic and that each family needs to determine what is best for them, emphasizing the overall importance of high-quality content when engaging in screen time, plus opportunities for youth to laugh, play, read, and move during the day, and having access to caregivers who try to help them understand and appropriately manage their emotions and behavior.” It’s about how much time kids are on screens, what they’re doing when they’re on those screens and how they’re engaged when the screens are turned off: the whole picture.

Placzek said rather than imposing strict time limits on kids, it’s helpful to come up with what she calls a “family media plan” with guidelines for everyone’s media use. Common agreements for families include: no devices at the dinner table or in bedrooms and a check-in time for devices before bed (perhaps plugging them all in at a centrally located charging station). These norms help everyone prioritize face-to-face interaction and healthy sleep habits. One of the best ways parents can help their children limit their screen time is to model doing so themselves.

To help ensure that the content kids are accessing is age-appropriate, Placzek recommended using the parental control settings on devices that kids use. To assess whether a particular show or other content is age-appropriate, she suggested using Common Sense Media as a resource for parents. The AAP’s Healthy Children website is another place parents can turn to for evidence-based advice.

Rather than shaming or blaming ourselves, Shannon Bennett recommended that parents “seek to find balance in their home and provide ample time and opportunities for all types of learning, growth and connection.”

“Making changes now to your family media use and related activities can have a positive impact on your child’s future development and wellness,” she said.