Scott Webb (Host): This is Children's Health Checkup, where we answer parents' most common questions about raising healthy and happy kids. I'm Scott Webb, and today we're talking about screen time and its effects on children with our expert, Dr. Lana Harder, Board Certified Pediatric Neuropsychologist at Children's Health and Professor at UT Southwestern.  

Scott Webb (Host): Doctor, it's so nice to have you here today. We were just talking about kids and adults and our phones and the obsession and all of that. So, great to have you on. We all know that these screens are a part of our lives, whether it's the little screens in our hands or bigger screens in our family rooms.

What can we do as parents to better understand how screen time affects our kids' brains, you know, as they're growing, as they're maturing? I know the brains are still developing till they're 25, so we've got a long, a long period of time here to try to help them. So what do we do?

Lana Harder, PhD, ABPP: Yes. Such an important topic and I know we can all appreciate screen time is, it is great tool for learning, creativity, entertainment. So we're by no means thinking or saying that we should eliminate screens altogether. But we do need to adapt in this kinda ever-changing world that we live in, where screens are all around us, really all the time. I think to your question about you know, as our kids are developing and growing, their needs, their interests are going to change with that. That's very natural and we want to see that happen. I think where we want to be really mindful, is particularly in our younger kids. So there is this growing body of literature that tells us that too much screen time can be problematic in our younger kids, in particular.

Too much screen time can be a problem across the lifespan, to be clear, but especially when it comes to that brain development in younger children. So what we're learning is this can negatively impact language and communication. If you think about how the brain develops, it's all about interacting with others, interacting with your environment, problem solving, all of those things.

So the recommendation is that, you know, watching one hour or less of screens is really, associated with more favorable health outcomes. So that's thinking about kind of our younger kids.

When thinking about our school age, children and teens, there are really not specific time-based suggestions. Quality versus quantity is important to consider, and making sure that our kids are getting the things done that they need to outside of screen time. I think, qualitatively there's a big difference between the passive consumption of watching TV, movies, scrolling, social media versus interactive like gaming, or using apps for creative, building of things.

 Other things to consider relate to conversations about online safety, digital citizenship. So being responsible and respectful online, engaging in the safe use of technology. Those are pieces to keep in mind. And I think just having an open dialogue about social media and screen use is really important and can foster a supportive and non judgemental environment.

Host: Sure. Yeah, in my era, Doctor, we listened to the radio, we watched a little bit of television, we read newspapers. I don't recall my mom ever saying, you're listening to the radio too much. But you know, now, today it is something to worry about. And as you say, it's really something that's affecting all of us.

The little kiddos, medium kiddos, and then adults of course. Give us a sense of what kinds of behavioral or emotional changes might signal that a child's screen time habits just need a little more balance.

Lana Harder, PhD, ABPP: Yes, definitely. And this is a great question and one I discuss with the patients and families that I work with at Children's Health. So, I also think it's a conversation that's kind of general when we think about when things are out of balance in any area. This idea of the importance of moderation in life, for many things, it definitely applies here.

So I think that's something to keep in mind. When we are spending time on screens, we're likely doing this to the exclusion of something else. So we want to think about, you know how this impacts the other things that we should be doing. One question we might ask is, is your child doing the things that they need to do each day? Or any areas neglected.

Host: Hmm.

Lana Harder, PhD, ABPP: So does screen time take over or dominate the daily schedule, which could mean that we're not, you know, getting up, showering, brushing teeth, getting dressed for the day. We just go straight to our gaming console or whatever the case may be. Are we missing out on sleep? I can't underscore this enough as a neuropsychologist. When we don't get enough sleep, all bets are off really for everything else. Our cognition, our coping skills, um, how we interact with others, are we getting enough exercise, completing schoolwork, unless it's the summertime? So when we are looking for signs that there could be a problem, you could start to imagine the downstream effects of some of the things I mentioned. Maybe grades are going down or we're really sleepy during the day. We're having trouble and maybe with irritability and coping, things like that.

Host: Sure.

Lana Harder, PhD, ABPP: That's one thing that I, I really like to have people think about. Another one is, is your child struggling to manage stress or difficult feelings without screens? So it's important to watch for this to make sure that a child over their you know, development is really building coping skills and addressing problems outside of screen use or distraction. So that's a really critical skillset to develop as we age.

And on a more extreme end of things, there are some kids that may just have trouble managing the time that they're spending on gaming. I think that's a great example. It may show difficulty regulating emotions without the games if they're unable to play, and that might signal something a little more concerning that should probably be discussed with, you know, a pediatrician or provider of some sort.

Host: I guess I'm wondering, does the type of screen time matter, meaning like, is it okay to spend a lot of time on educational apps, let's say, versus shows and games? You know, so kids have different needs and does the screen time, the type, does that matter?

Lana Harder, PhD, ABPP: You really do want to think about quality versus quantity. I mean, I know a lot of guidelines talk about hours a day that you spend on screens. And really the quality, the content is so critically important. And we, of course, encourage parents to really research what their kids are watching and to understand not everything is educational.

And especially for those younger kids. Any viewing, if screens enter the picture at all, should be high quality. They should be really education based and coviewed with a parent so the child can understand what they're watching. So, I do think the content is really important and just making sure the content, whether we're talking about you know, TV, movies, video games, just making sure it's developmentally appropriate for the child and for their specific child. And I also want to acknowledge that screens can do a really good job of making something that might normally be kind of mundane, if it's learning how to type, I think about this from my education years, can make it more interesting or engaging to kids and can kind of gamify that.

So I think that there are some examples of where, you know, we can really leverage screen and games to help our kids learn critical skills for the future.

Host: Yeah, you mentioned typing there and I was thinking about when I learned to type in high school on a typewriter, like an actual typewriter, there was nothing fun or engaging or anything about that. So you're so right. Like there are some really cool engaging things to learn those valuable skills.

 How do we start to develop some, maybe some realistic, doable first steps when we think about building healthier screen time habits?

Lana Harder, PhD, ABPP: Yes. I really appreciate, as a neuropsychologist talking about kind of the behavioral things, like what can we do, what are the action steps we can take? One of the first things I would recommend, and that I do talk to families about is just engaging your child in the process of setting boundaries on screen time and setting boundaries on screen time doesn't sound like a particularly exciting thing to do, but I think if, if it's thought of as more of a we're going to create a family media plan, and by the way, there are lots of resources online for how to do this.

Kids enjoy screen, we enjoy screens. So it's a way to empower the child to design a plan and to also self-regulate, and build self-control over screen time now and in the future, which is, I think we're all appreciating how critical that is. So if they're designing this, it's going to promote their buy-in.

So it's not like you're telling them what to do, as much as they're really helping design the plan for the family and for their own screen time use and within that, I think talking about goals, boundaries around screen use. There might be designated screen free zones, like the dinner table where, you know, we just, we don't ever have screens here.

You might create, screen free times, like an hour before bedtime or other periods during the day. And I think that also relates to you know, having parents model the beahvior they want to see. So if that plan includes a designated screen free zone, like the dinner table, following the rules and showing your child that you are fully present with them during that time I think is, is really important. Also creating a daily routine. I think especially in the summer months when we really don't have the structure of school on our side, we can start to think about, okay, we have these really important activities that we can build everything else around. You might think of them as anchors. So, what time we go to sleep, what time we wake up, mealtime, getting physical activities in. Other kind of self-care would take a shower, right? So then we can design everything really around that and then decide what portion of the time would be for screens, what portion is to get outside and get away from the screens. So I think again, having the child engage in all of that really helps them nurture their own executive functions like planning and organization that will serve them for years to come.

Host: Right. Yeah. Because we want it to feel positive, right? We wanted, we want them to participate in this process and buy in, you will. We don't want it to feel like punishment if we can help it, right?

Lana Harder, PhD, ABPP: Exactly. Exactly. Some people worry about, you know, boredom. If I don't have a screen, I'm going to be bored. I won't know what to do. And I just think it's important to say, you know, it's okay a nd even beneficial to experience some boredom sometimes. Puts the child in the position to problem solve and be creative.

And I think for younger kids, you know, they may need some help and guidance to come up with activities to do, that may not revolve around screens.

One great thing to consider is how you replace screen time. So if a child would otherwise be you gaming or online, somehow replacing those screen time activities with preferred activities, things that could build memories, like family game time, cooking, time in nature, or choosing your own non-screen activity like drawing, reading, engaging in crafts or journaling.

I think also quiet time and rest is really important to remember as well. On the note of spending time outdoors, some people talk about replacing screen time with green time or time in nature, and there is a growing body of research that highlights the mental health benefits of this and a relatively recent article that says that time in nature could actually kind of help or offset the consequences of high screen use. So really wanted to mention that.

Host: I always find it funny when I would encourage my kids to go outside and play and then I would look outside and I'd see them on their phones, out in the yard. I'm like, you guys, you guys have missed the point. The whole point was to go out and play outside, not use your phones outside. And you know, as you we're talking about here today, you know, this is a struggle for all of us.

We all love our phones, love our screens, and it's a daily struggle for all of us and we're just trying to do right by our kids as they're developing and try to get them to buy in and all that good, you know, parental type stuff. Just give you a chance here at the end, like give us one reassuring takeaway to offer parents to find a screen time balance that just really works for their family.

Lana Harder, PhD, ABPP: You know, many thoughts about this. As I've said, I have conversations about this on a regular basis. I encourage it. I think having an open dialogue is key. Everyone's trying to figure this out, you know, I know we said this earlier, no parent is alone in that. And we've said screens are all around us.

It's up to families to determine how to interact with screens based on values, goals, many other factors. And the key I think, is really just being intentional and thoughtful, especially around the quality, the purpose versus just the quantity of time, right? So there's no simple one size fits all approach.

Host: Right.

Lana Harder, PhD, ABPP: But, I, I love the thought though of how technology can actually connect a family. So if you think about watching a movie together and talking about it versus, you know, someone just scrolling through their phone in isolation, I mean, there's a big difference there. And so in one scenario, it's bringing people together to have a shared enjoyed activity versus doing something more kind of on their own that might just go on for hours on end. I think a big thing too is just all of us giving ourselves grace. Like so many things, there's going to be some trial and error in figuring out what works best. And remember that things are going to change over time, right? With child development things, interest, needs change.

 But there's a lot of great information out there to support all of us in navigating this, including books, other information, even templates on creating a family media plan. So it's nice to know that again, we're not alone in trying to sort all of this out.

Host: Yeah. All of us parents are fighting the good fight, if you will, of course, in best interests of our kiddos. And there are a lot of great resources, a lot of great experts like yourself. So really appreciate your time. Thanks so much. For more tips and expert advice, visit children's.com/health-wellness.

Host: I'm Scott Webb. And thank you for listening to Children's Health Checkup. If you found this podcast helpful, please rate and review or share this episode, and please follow Children's Health on your social channels.