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Joey Wahler (Host): Many children are now into online gaming, but some potential health pitfalls exist. So we're discussing healthy online gaming practices for kids. This is UK HealthCast, a podcast from UK HealthCare. Thanks for listening. I'm Joey Wahler.

Our guest, Dr. Anthony Limperos. He's Associate Dean for Graduate Programs and Communication at the University of Kentucky and specializes in the psychology of video games. Dr. Limperos, thanks for joining us.

Dr Anthony Limperos: Oh, thank you for having me.

Joey Wahler (Host): So first off, what is it in your background or your interests or both that got you so heavily involved in the psychology of video games? That's not obviously a very common area of expertise, is it, even today?

Dr Anthony Limperos: Oh, no, not exactly. There's a limited number of us that do this research and it does kind of start back at home for me. And so, I've been a gamer my entire life. I started gaming probably when I was five or six years old. I have two older brothers. And as I came up through my education and got more interested in doing more social science-type research and psychology-style of research, I've naturally sort of migrated toward video games.

Joey Wahler (Host): Interesting. So let's get into this. And first, what is it that makes online gaming different than other forms of video game play, and why are young people so attracted to it?

Dr Anthony Limperos: So online gaming is attractive for pretty much three key reasons. There's of course a social component to it, the competitive aspect of playing against others and also just this general idea or feeling that we experience greater immersion or engagement when we're playing with others on a network. So, I mentioned my experience of growing up playing games and playing games together in, say, the 1980s and 1990s was getting together at a friend's house or piling into a basement and everyone playing in the same place. Well, now, that we have everything networked, it's become lot more fluid and dynamic and changing. And so that social engagement component of it is oftentimes a catalyst for deeper immersion and also for people to experience new aspects of games because there's less predictability online, potential for new experiences. And it just brings a whole lot more to the table.

Joey Wahler (Host): Gotcha. So what are some of the physical stressors or implications on children from prolonged online gaming and can that excess cause health problems?

Dr Anthony Limperos: Well, there is some research that links things like anxiety, depression, obesity and stress and sleep disorders and things like that to online gaming. But the important thing to remember here is any type of gaming, whether it be online or just not networked involves regulations. So parents might automatically assume that they either need to ban a game or allow unlimited play to keep their kids happy. But in actuality, most kids that play are not learning just about things in the game environment, they're also learning how to regulate their game play. And so those ideas of stress and things to look for might be manifest in certain ways, like kids playing too long, so they're having trouble engaging with friends and family outside the gaming environment. Those are the proximal things that you're probably going to see. But the worst things that you're going to see are probably not going to be common for the majority of online gamers. They're only for the small percentage that might be addicted.

Joey Wahler (Host): So, to pick up on one of the things you just mentioned there, is there an appropriate amount of time for kids to engage with online gaming and how can parents best monitor or even, if needed, restrict that to some degree, especially keeping in mind that a lot of kids know others that might not have those same reigns on them, right?

Dr Anthony Limperos: Oh, absolutely. So, we could look at this a couple of different ways, but I'll go through a quick one here. So we have the American Academy of Pediatrics. They recommend no screen time for kids under the age of two. And then, they recommend about an hour of screen time for kids ages two to five. And then, after the age of five to approximately adulthood, they recommend two to three hours per day.

I'm sure the listening audience, the parents out there, are probably shocked to hear this, because they likely have children that are playing much longer than what the actual recommendations are. But I think setting limits and sticking to them is typically what works best. So I have a seven-year-old son myself, and we often let him game for about an hour a day, and sometimes he plays only for 20 minutes at a time, because he wants to save his time for different bursts. But we have to sort of set those limits and impose them. And so far, because he's not old enough, we haven't experienced the, "Well, so and so gets to do this and I don't get to," but we're going to cross that bridge when we come to it. But that's more of a parental choice than anything about how to approach that.

Joey Wahler (Host): I love what you just mentioned there. It sounds like time management is a skill that your son has learned already. He's already kind of negotiating with you, saying, "No, no, I've only been on here 20 minutes. I'm going to use another 20 this afternoon, and then I've got 20 more tonight."

Dr Anthony Limperos: Yeah, he's very intelligent like that. He's figured it out so he can figure out how to break it up during the day, but he wouldn't be doing that if we didn't have those limits.

Joey Wahler (Host): That's great. So how about the chosen platform for these games? Does a kid's chosen platform, be it a console, a PC, smartphone, tablet, et cetera? I'm probably leaving out one or two that I'm not thinking of. Does that matter in terms of the implication on kids when it comes to their gaming habits?

Dr Anthony Limperos: Well, I'm not as up on the research in that particular area as I should be, but I do know that there's been some concerns about screens and the health of our eyes. But when it comes to the platform choice, the properties that keep kids engaged are pretty much prevalent, whether they're on a console, PC, tablet, or smartphone. So if you notice that your children are gravitating toward one or the other, I would have the same kind of recommendations. But in terms of one being a catalyst or a predictor of a greater impact of health or have health impacts, I'm not really familiar with anything that suggests that one is more detrimental than the other.

Joey Wahler (Host): You know, we touched on this or you did briefly a moment ago. But to maybe hash it out a bit more, how might online gaming either inhibit or enhance a child's social and mental development?

Dr Anthony Limperos: Absolutely. That's what everybody wants to know, because kids are spending a lot of time with games whether we like it or not. And there's really just two main sides of the research to look at. Games have been connected with increases in spatial rotation skills in young children. There's been research to suggest that online games and games in general can help brain development because, of course, they're an interactive type of media versus more passive medium like television.

There are also lessons that are inherent in games. So going back to my son for example, he's learning about winning and losing and cooperating with others. And those are powerful lessons that we can take from the gaming environment that apply more widely in life. But of course, the other side of the coin is that people worry about things like mental health, propensity for violence, addiction. Those are the number one things that typically come up when we think about the concerns that people have about games having some sort of detrimental effect on kids.

And again, not to reiterate, but this kind of stuff becomes concerning when kids are engaging more than they should be. So I used the word addiction earlier. It's incredibly hard to say that somebody's addicted to media. But if you see the manifestations or signs of that where kids are displacing other activities, school work might be suffering and things of that nature, social life might be suffering, that's probably when you want to look out for maybe some of the more serious things that could potentially result from playing for a prolonged amount of time.

Joey Wahler (Host): Well, two things in response to that for me. One, great job mentioning that part at the end about signs to look for because now I can cross another one of my questions off the list. And also, you touched as well on your son already starting to learn about winning and losing from these gaming experiences. So what should parents tell their kids about how to conduct themselves when they're playing online gaming, and should they encourage them to share with their parents if they come across anything that crosses the line by others, anything inappropriate that they experience?

Dr Anthony Limperos: Absolutely. So I think one of the biggest things that all parents want to do is we want to monitor our children and engage with them. And some of them might not be game players. I happen to be a game player. And so, I will oftentimes play the games alongside my son and we can talk about things that are appropriate, inappropriate, in a way that I can often do that without having to hover over him because sometimes he doesn't like that. You know, "Go away, dad. I'm fine." So I try to talk to him about the things that he's experiencing in the games, and he'll actually come talk to me. He'll say, "Hey, Look at this gamer tag," and I look at it and I'm like, "Oh gosh, that's something he shouldn't be seeing," but he doesn't know what it means yet. And so I'll try to find a way to explain that that's not appropriate behavior and he needs to watch out for it if it's something that he notices. If it's something that he doesn't really understand, then I might give him a pass on that one. But it's about talking to your kids about engaging with the content that they're engaging with and really understanding what it is that they're doing.

Joey Wahler (Host): Well, as you mentioned, the fact that you've been a gamer certainly helps in your relationship with your son, but obviously not all parents have that because some don't play and are completely oblivious to what's out there. So how can parents familiarize themselves with the games their kids are playing online, how much familiarity should they have? How do they get that? And what about trying to at times play alongside their kid, even if it's just for a brief time here and there to show that either they're paying attention or they're interested, or maybe a little bit of both, right?

Dr Anthony Limperos: Sure. There's a couple of resources. The most visible one is the Entertainment Software Ratings Board or the ESRB. This is the video game industry's self-regulatory approach to their content. So they keep the government out of it. It's very much like the Motion Picture Association ratings for movies. And so if you go online and look, the ESRB rates all games across all consoles with five categories being games for everyone, those that are 10 plus, teen, mature, or adults only.

But the very important thing to note here is that the ESRB does not rate online content because of its dynamic nature. And so if you think about it, how can you rate what someone is going to say over a microphone or a derogatory name or gamer tag they might use or something they might say when they're engaging with a game that's rated for everyone. It's just not possible. And so that's where it is important for parents to understand, by either playing alongside, accessing even YouTube videos because there's been some games my kids are into that I don't quite understand and they might be on a tablet. And so I'm like, "What are they actually doing here?" And so I've actually consulted YouTube videos, when I couldn't get close enough to then to see exactly everything that they were doing. And that's been the ways that I've hedged against or trying to understand the content of my kids are engaging with, what's safe, what's not safe. And they're going to become interested in this stuff from either parents or most likely from their friends. And so just keeping a keen eye on what their friends are doing and what they're doing when they're with their friends is going to be helpful.

Joey Wahler (Host): So I guess in summation here, it sounds like you're saying that a lot of this from a parent standpoint is just using some of the same good practices that you use when it comes to parenting and other aspects of your child's life, right?

Dr Anthony Limperos: Yeah, absolutely. That's a big takeaway and that's why, as much as I know about the connections between certain properties of a game and propensity for certain behaviors and stuff, at the end of the day, the biggest thing is involvement. Now, I could say that when I was younger, and I played games, my parents weren't constantly watching us, they weren't constantly monitoring us. But we had to learn and they would help us with how to regulate that there was more beyond the gaming environment. So it's really all about moderation, all about balance and reinforcing some of those good parental practices.

Joey Wahler (Host): Absolutely. Well, folks, we trust you're now more familiar with healthy online gaming practices for your kids. Dr. Anthony Limperos, thanks so much again.

Dr Anthony Limperos: Thanks for having me.

Joey Wahler (Host): And if you think your child is experiencing issues because of online gaming or for more info and to schedule an appointment with one of their providers, please do visit kentuckychildrens.com. Again, that's kentuckychildrens.com. Now, if you found this podcast helpful, please share it on your social media, and thanks again for listening to UK HealthCast, a podcast from UK HealthCare hoping your health is good health, I'm Joey Wahler.