Sam Greenberg (Host): This is a podcast today with Memorial Health System. I'm Sam Greenberg, and my guest today is Mykaela Davis, a primary care provider from Memorial Ohio Health System. Mykaela, thank you for joining today.

Mykaela Davis, PA-C: Absolutely. Thank you for having me.

Host: Today we're diving into a topic that's top of mind for many parents: screen time for their kids. How much is too much, and how does screen time affect the growing minds? So Mykaela, let's start really with the basics. What do we mean when we talk about screen time, and why has it become such an important topic for parents?

Mykaela Davis, PA-C: So, screen time can be a variety of different things because we have screens and phones and iPads and televisions. And screen time itself is any time, you know, the child is taking their focus directly to the screen, which is distracting them from the outside world. Any time that is focused just directly on that activity itself, I think is screen time, whether it's on the TV, whether it's on an iPad, whether it's on, you know, a sibling's phone or a parent's phone, all of that is considered screen time.

Host: I think there are times where I could march a parade through my living room and my five-year-old may not look up from whatever show is on. So, I'm telling you, it hits very close to home.

Mykaela Davis, PA-C: Absolutely.

Host: So, that being said, how can that screen time affect the child's developing brain?

Mykaela Davis, PA-C: Yeah. So, high screen exposures, especially before the age of two can alter visual processing and cognitive thinking. Outside of this, excessive screen can tke away from the outside activities that we need. And it's replacing the active like back and forth interaction that kids have with other human beings.

Host: So, you mentioned the age factor with everything. So, does the impact of screen time look different depending on the child's age?

Mykaela Davis, PA-C: Yeah, absolutely. So, the American Academy of Pediatrics actually recommends zero screen time for those that are 24 months and younger. And as you get older, the recommendation kind of goes up a little bit. So between two years and five years old, it is recommended one hour or lower. So, one hour is not going to have a negative effect. But if we go over the hour of screen time, then you're getting into the effects. This also does change with like elementary ages, especially because now schools are starting to use iPads and computers a lot more than, you know, books and paper.

Host: I'm really glad you mentioned that. With my son starting school, his first year of kindergarten now, so using those screens in the classroom, should parents take that screen time into effect? I feel like a lot of people don't, because it's being used in a different setting and being used for educational purposes. But is that factoring into screen time at home as well?

Mykaela Davis, PA-C: Yeah. So, we look at the screen time, whether it's beneficial or not. So like we said, those school-aged children, we don't think of it as a negative impact because it is used for their education. Now, any of the negative impact and what we take into those one to two hours per day is any screen time outside that is used at school. Because the ones that are happening at school are not the mindless things that we're doing, like watching the shows or playing the games. They're, you know, actually reading and doing their homework and the activities that will help them with these parts of the development of the brain.

Host: So, can screen time affect—and I know it can—but how does it affect a child's mood, their behavior, and their emotional development?

Mykaela Davis, PA-C: Yeah. So, we talk about this a lot, especially in practice. Once a kid becomes what we can basically say addicted to the screen, then that part of the brain is just wanting it all the time. So then, once we take that part of it away, they become very aggressive. They can have mood swings, they can have outbursts. That's when they, you know, don't listen as well as they should and have the behaviors that they don't typically have because you took that part of the brain away that they were feeding.

So, we think of it almost like an addiction, just like caffeine can be an addiction screen time can also be an addiction, and that's what they consistently want. So when you take it away, it's causing all of these outbursts that are then negative behaviors and they get in trouble and all the things that we have to fight at home.

Host: Oh, speaking of the fight at home, you said it perfectly. This is something I struggle with almost on a daily basis. How can parents like myself set those realistic boundaries around the screens without that constant conflict and the constant battles? Because I know even when I set the expectation at the beginning of, all right, maybe we watch one show or one episode of something for a certain amount of time, we get to that time and there's still often a battle. So, what are some ways that parents can work around those and reduce the battles?

Mykaela Davis, PA-C: Yeah, absolutely. So, this is starting from the young age, like you said, any of those under two years old. You, know, parents are going to be on their phone, so they think that's normal to be on your phone all the time and to be on the screen. So basically, what you're doing is also what they think they should be doing.

So as we get into the ages and we do allow some screen time, we can battle it as in setting time restrictions, like you said. Even if they do, they might fight back, but you have to start there. So, we can set time restrictions, and you can also use it as like a positive. So, "Hey, if you help around the house or you get your homework done, then you can earn 5, 10, 15 minutes of your screen time." And then, you know, if they don't do these things, they obviously don't get their screen time.

We also think of screen time as beneficial when we use—there's three Cs: content, context, and co-use. So when you're using it with like a sibling or a parent, they think of it more of a positive thing. So then, when you have to give it up, you know, the behaviors don't typically are there as much. There are some because they're already, you know, addicted or putting that part in. But if you're using it with a sibling or a parent, it's a positive impact for them, just like reading a book, so like you're putting that reading time with somebody else. So, those are a couple of different things that you can do.

Host: All right. I'm going to take those notes and I'm going to employ those, trust me. And going around those three Cs, you hit that main word that I know a lot of people are thinking about, content. So, does the type of content that the child is watching or interacting with, does that matter as much as the amount of time on the screen itself? I know it goes back to a lot of that beneficial versus non-beneficial. But it's, you know, with all the different mediums that are out there of the different apps, the YouTubes, everything that kids can get into on the screens, there's a lot of struggle to monitor that content. And does that matter as much as the time itself?

Mykaela Davis, PA-C: Excessive digital media use that are mindless, you know, puts people at increased risk for sedentary lifestyle because they're just sitting and watching. So when you're sitting and watching, you want to snack and, you know, we're just going to sit there all day and you can scroll in what we call doom scrolling, especially in the teenage years. So, this is going to lead to a sedentary lifestyle, which can lead to weight gain, which can lead to lower academic achievement. And then, this also takes away from attention because you don't really need to pay attention when we're just mindlessly scrolling.

Now, if you're using it for more educational purposes, so they do make apps that help with, you know, reading and mathematics and cognitive skills, those are going to be way more beneficial than the mindless scrolling is going to be.

Host: Mykaela, do you have any recommendations of certain apps or different types of content that parents can steer their kids towards for that beneficial activity?

Mykaela Davis, PA-C: Yeah, absolutely. So, early learning kids and elementary kids, especially ages like even starting at three through eight years old, there's an app or a program called ABC Mouse that I know elementary kids use. And there's also a Khan Academy Kids. Khan Academy is also used with high school and college age kids and content, but they also have a younger kids version. So, those are the two that I know that we have talked about a lot with our patients to recommend for them to use.

Host: One thing that again is top of mind for me, I know I struggle with if my son is, say, on my phone looking at one of those apps or whether it's watching TV, does the distance of the screen, how does that sort of impact the development as well? I know every time he's on my phone, I have to say, "All right, move it away your face." Yeah, back away. Whereas the TV may be a little bit farther, even if he's watching the same thing or interacting with the same type of material.

Mykaela Davis, PA-C: Yeah, absolutely. So even with just the blue light itself that comes from all the screens that we get, blue light emitted from these screens obviously can affect our sleep. You always hear like the blue light glasses and these kinds of things. So, the closer it is to your face, the more light you're going to get and the more strain you're going to get on your eyes. So this definitely affects vision in the end.

The blue light itself will then suppress the hormones that we need to sleep, like melatonin, and this can cause like a shift in our sleeping cycle. So, we're going to get sleep disturbances, especially with screen time closer to the end of the day. So, definitely toward the end of the day, you know, back up, you need a dim the light or even most like iPads and stuff now have a nighttime mode that takes away that blue light. So, that's the biggest part of it for me, is the sleep disturbance.

Host: What are your recommendations for timing for that before bed, when to turn those screens off and kind of shut it down so that those sleep cycles aren't disturbed?

Mykaela Davis, PA-C: I think anybody of all ages from toddler even up to, you know, 18, 19, 20 years old into adulthood, we need what's called a wind down time before sleep. I recommend this starting at least one hour before bedtime; sometimes, you know, two depending on age. Younger kids might need more time to wind down. So, this is the time to turn the screen off.

I get, you know, teenagers are going to text and talk to their friends later into the night, but at least put your phone down, you know, an hour, 30 minutes before you plan to go to bed or turn it on that nighttime mode. And then, you really want to shut it off 30 minutes before bedtime, like that way you're not getting that light emitted.

But yeah, for younger kids starting even two hours before, I would say, you know, wind it down, turn down the screens. That way. We can shut it off and, you know, get a good night's sleep because that's important.

Host: Mykaela, how important is it for parents to model those healthy screen habits themselves? And I know we've talked a little bit about it, but what are some recommendations that you can give of how parents can model that? Because you said it earlier, it's an addiction. It's an addiction for kids. It's an addiction for parents. And we like to, as parents, wind down at the end of the day. The kids are in bed, and then we do doom scroll. You know, and while the kids may not be seeing that, it's still not a healthy screen habit. So, what are some ways that we can model that and parents can model that for the kids?

Mykaela Davis, PA-C: Yeah. So, one of the biggest things I think too is, you know, you go out to eat and you see kids on their iPad at dinner, and they have to have the iPad at dinner time. So, I think the best part is to model what you want your kids to do even at dinner time. So, put your phone down at dinner, have a family meal. You know, because if you're not on your phone, they're not going to want to be on a screen either.

And just like kids, I think we also need good sleep. So even if the kids aren't there, you know, we should also take the time, and adults need their brain to wind down too. So, the biggest thing is just setting boundaries for yourself that you would also set for your kids.

Yeah, like you said, and it's an addiction. We always want a phone in our hand. We want to be on social media. We want to be a part of everything. So, I think especially blocking hours you want specific family time and to spend with your kids, don't let that time be on a screen. That time needs to be spent interacting, reading, coloring, doing activities with them, going outside. You know, the things that the screen has replaced can be spent time together

Host: Family time is the most important thing of all, if you ask me. All right, Mykaela. So navigating screen time with our kids is definitely an ongoing struggle. But hopefully, today's conversation gives a little bit more peace of mind, along with some real-world tools to handle it all. I know it helped me quite a bit, and like I said, I've got my notes that I can use and try and get my son away from those screens. And Mykaela, thank you again very much for your time today.

Mykaela Davis, PA-C: Yes. Thank you guys for having me.

Host: For more information or to connect with a provider, visit mhsystem.org and be sure to subscribe for more conversations from Memorial Health System. If you found this podcast helpful, please make sure to share it on your social media. Thank you again for being part of a podcast today with Memorial Health System.