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expert reaction to new guidance on children’s screen time

Research published by the Royal College of Paediatrics and Child Health presents evidence that higher levels of screentime are associated with health harms for children and young people.

Prof Stephen Scott, Director of the National Academy for Parenting Research at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, and Head of the National Conduct Problems & National Adoption and Fostering Services at the South London and Maudsley NHS Foundation Trust, said:

“This review of the actual evidence of the effects of screen time on physical and mental health is welcome.  It finds an association between watching more screen time and being overweight, and feeling down and miserable.  However, the association between playing violent video games and being violent in real life is not discussed, and the main type of screen time reviewed is television, so restricting screen time to this is now relatively out of date in comparison to the use of video games and social media which have become far more prevalent in recent years.  A major concern is it is not clear the extent to which studies control to the confounder of social class, which is strongly associated both with increased use of screens and increased obesity.

“The parent guidelines are sensible insofar as they go, but again do not distinguish between different types of screen time.  The notion that it should stop one hour before bedtime is welcome, but more detail on exactly how to turn off Wi-Fi access and keep smart phones out of the bedroom would help parents.  Likewise it would have been good to have some specific number of hours recommended, e.g. one hour a day during weekdays, perhaps 2 to 3 hours at weekends, or whatever a family feels comfortable with.  Given that surveys show that many children use screens for 4-6 hours a day this would be quite a reduction in vulnerable groups.”

Prof Kevin McConway, Emeritus Professor of Applied Statistics, The Open University, said:

“Generally, I like this new guidance on screen time from the RCPCH.  That’s for two reasons.  First, it’s based on evidence.  The research report1 by Stiglic and Viner, published alongside the new guidance, reviews much of the existing evidence on effects of screen time on children and young people, and makes it apparent that it has many shortcomings.  There are good reasons for this.  Research in this area is not easy, for several reasons.  It’s not clear whether just measuring amounts of screen time is an appropriate way to do things anyway.  An hour using a good educational app or doing some research for homework isn’t likely to have the same effect on a child as an hour watching TV with advertisements, let alone an hour on social media possibly being bullied.  An important issue, that Dr Max Davie draws attention to in the press release, is that it’s difficult to determine what causes what in research like this.  Most of the research reviewed by Stiglic and Viner is observational.  So if young people who report more screen use are also more likely to be depressed, that could be because screen use tends to cause depression, or it could be because young people who are depressed anyway tend to spend more time using screens.  It’s difficult or impossible to tell which it is from observational research, but doing non-observational research, where children and young people are allocated to different amounts of screen time by the experimenters, is really challenging to design and carry out.  Most of the research that was reviewed is on TV screen time specifically, but the RCPCH guide points out that most screen time these days is on phones, tablets and computers rather than TV.  The concentration of research on TV use is because much of it was carried out some years ago when television watching was generally a bigger part of young people’s lives.  It’s difficult for the research to keep up with usage patterns when research studies take a long time to carry out but the way people use screens changes quite rapidly.  And it’s hard for researchers to generalise about the effects of cutting down screen time, because they will vary between individuals depending on what alternative ways of using their time are available.

“My second reason for liking the RCPCH guidance is that much of it is based on general ideas and principles of parenting.  That’s backed up by far more experience and, indeed, research than is the case for screen time specifically.  I can’t comment on its statistical aspects, but I’ve been a parent, and the advice to parents does seem admirably sensible and practical.”

‘Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews’ by Neza Stiglic and Russell M Viner will be published in the BMJ Open at 00:01 UK time on Friday 4 January 2019, which is also when the embargo will lift.

‘The health impacts of screen time: a guide for clinicians and parents’ was published by the Royal College of Paediatrics and Child Health at 00:01 UK time on Friday 4 January 2019.

Declared interests

Prof Stephen Scott: “No conflicts of interest.”

Prof Kevin McConway: “Kevin McConway is a trustee of the Science Media Centre.”

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