The Interview SeriesApr 02, 2020

How to Shift Your Perspective on Screen Time: Tips from a Paediatrician

Dr. Max Davie is Officer for Health Improvement at the Royal College of Paediatrics and Child Health. With a special interest in the neurodevelopment and mental health of school-age children, he’s intimately familiar with the great debate that’s come to define a generation of parents: screen time. And as a father of three, he also understands the way families in the real world engage with technology.

We sat down with Dr. Davie to learn a bit more about the work he’s doing to help professionals and parents better understand the risks—both real and imagined—that come with screen time.

What are the common questions about screen time and child health? Where should people look for reliable advice?

One of the constant conversations that doctors have is about screen time and its impact on children’s development. But, there are broader questions about children’s health and screen time, which come up all over the place in healthcare. I get questions about screen time as it relates to obesity, mental health and eyesight as well.

Doctors are just as prone as anyone else to take a very small nugget that they’ve heard on the radio and then reproduce it. There’s some quite bad advice being handed out. But, at the Royal College last January, we produced a policy document giving advice to professionals in order to help parents to manage screen time. But, it also could easily be read by parents and is certainly very accessible for them as well.

What are some key insights and recommendations?

You basically end up counting only screen time that you disapprove of as screen time. But, from a physiological point of view, it’s still screen time. However, screen-based activities can displace beneficial ones, such as social interaction, sleep and exercise—those are three of the really beneficial things that you can do as a child. Rather than thinking about screen time as a toxic thing that you have to limit, I think it’s more helpful to think of it as something that can potentially displace other things.

With screen time, you know almost nothing about the benefits or harms of that activity. But, there are a few exceptions to that. It seems to be a bad idea to take a screen to bed if you want to go to sleep and it also doesn’t seem that we have a way for screen-based activities to effectively teach language and communication. Now that may change, but people from the speech and language field are very concerned that children get one-to-one interaction—not by their screen—as part of their development for their social language skills.

Having said that, the evidence that there is an association between particular forms and screen time and speech delay is not very good. So, it’s a plausible link, but doesn’t seem to be backed up by particularly good evidence.

How have you seen the screen time debate change in the last five years? Do you think the misconceptions have grown?

You can go back to Socrates and he disapproved of writing because he thought that it would rust our brains because we wouldn’t be able to remember anything if we put it all down, which now seems like an absurd view. There was moral panic about novels when they came out in the 19th century. People worried about young ladies going all pale because they spent their time reading novels and not being outside. Whereas now, we think that novels themselves are improving us.

So, there’s always this undercurrent. What we have at the moment is a series of technologies, which are for youth. They’re information technology and also games, so you have this perfect storm of moral panic.

The underlying moral panic has moved into addiction in online gaming and to some of the ways that game mechanics can be akin to gambling. That is a valid concern that needs to be unpacked on an individual game basis to see if it’s more likely to lead to worrying behaviour and gambling later on. But addiction has associations with withdrawal and needing more and more to get the same hits. Video games and online user interfaces don’t work quite like that. They draw you back certainly, but you don’t need more and more Twitter in order to get a thrill out of Twitter.

Persuasive design is something that comes up in magazine articles, almost as if it’s a new thing, but it really isn’t. Supermarkets have been using persuasive design for years, and so the fact that we’re now worrying about it in video games when it’s been a part product design for many years seems perverse.

What should parents focus on when they’re thinking about screen time?

Thinking generally about screen time, I think that they should ask if their child is engaging in these very compelling activities to the detriment and exclusion of the things that you as a family want to do.

One of the other things that I’m concerned about is whether kids are snacking in an uncontrolled manner while they are engaging in screen-based activities. Are they getting through a whole box of popcorn before you finish the movie? That’s more or less what we said in the Royal College Guidance for Parents.

And what should parents keep in mind when choosing screen activities or tech products for kids?

It can be helpful if a platform is very easy to use and you know who it is you’re interacting with. A platform that facilitates conversations between people who know each other in real life is obviously much more reassuring as a parent than one where you are potentially picking up interactions with complete randoms.

What are some of the positive ways that you see kids interacting with technology today?

We’re often quite negative about video platforms and video sharing like YouTube or TikTok. But there is a real creativity and democratization through those platforms, which has to be celebrated. The fact that people are able to produce extremely popular, original content in their own homes to be accessed all around the world is absolutely phenomenal.

And for some LGBTQ+ young people, the online environment can be a positive place to find advice and people like them. I had a number of conversations with people who were involved in online role playing games. Many people of non-conventional sexuality and gender were involved in those games early on because they didn’t feel they belonged in the “real world” and the virtual world is a real pull to them. I don’t have scientific evidence about that, but just anecdotally, an awful lot of people have sought refuge in that world.

What advice do you have for kids who are going online?

Two things: one is critical thinking. The internet is a wonderful playground for spotting nonsense. If you see something, think carefully about what it actually is. That goes for news stories, things that people post and interactions. Ask yourself, “Is this person really who they say they are?”

And, if you’re interacting with screens, check yourself and ask if you’re extracting real value from them. If my daughter is having a really nice digital chat with her friend, that’s valuable. I don’t think any parent should say that’s not valuable time. And the fact that it’s not a face-to-face interaction—if they’re having a proper conversation by text or using a series of gifs, that’s also fine. It’s a totally valid form of emotional and personal communication. But if you are literally just watching a series of ten-second cat videos, that is rather different. There’s nothing wrong with a bit of switch-off zombie time, and watching TV can be completely mindless as well, but just check yourself: are you just switching off mindlessly or are you actually extracting value?

To keep up with the latest advice from the Royal College of Paediatrics and Child Health, follow along on Twitter, Facebook and Instagram.

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