building better brains and bodies through screen time reduction
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Building Better Brains and Bodies Through Screen
Time Reduction
Jean Rystrom, Practice Director – Pediatrics, Kaiser Permanente Northwest
EMO November, 2010
Take Home Messages
Screen time is associated with many health and development risks
The total number of hours spent watching determines many of the outcomes, and reduction helps
How we can do our best for the kids
Possible health effects of screen time: starting with early childhood
Weight Reading and scholastic achievement and
development of the brain Violence and aggression Sleep problems Attention problems Risk behaviors (older kids): Early
sexualization, tobacco and alcohol abuse
What is “screen time”?
It’s all screen activities for entertainment: TV, movie, video game, computer game, cell phone game, etc.
The number of hours with the screen means greater exposure to risks and fewer hours for other activities.
No guilt! (If you are thinking about your own experiences, remember: you didn’t
know what you didn’t know)
Part 1: Screen Time Usage
7
Usage: Under age 12 months
The AAP recommendation is no screen time before age 2, but…
By 3 months of age, about 40% of children regularly watched television, DVDs, or videos
The median age for introduction was 9 months Average 1 hour per day by age 12 months
Zimmerman et al, Arch Pediatr Adolesc Med, May 2007
8
School Age
AAP recommendation: no more than 1-2 hours per day, but….
KFF report “Generation M2”• Increase of over 1 h/day from 5 years
previous on total media use• Over 4.5 hours per day screen media• Smart phones….(39% to 66% have them –
but this doesn’t count talking or texting)
Focus
Cope
For every hour watched
Read
Run
Talk
TVTVTalk Create
Imagine
Play
BuyMore
EatThis
Violence Is Fun/Normal
SitMore
Explore
Interact
Sleep
Part 2: Weight
Screen time and Weight:Possible mechanisms
MoreCalories
In
Fewer Calories out
Food advertisements,Product placements,Normative behaviors,
and Snacking
Very sedentary behavior
==
12
167 calories Additional calories consumed per hour of
watching television in teens
Wiecha, et al, Arch Pediatr Adolesc Med, April 2006
13
Activity level is very low
84 Calories per hour to sit quietly 114 Calories per hour to play cards 198 Calories per hour to walk (2 MPH)
The President’s Council on Physical Fitness and Sport, Exercise and Weight Control (based on 150 pound person)
Part 3: Reading, Scholastic
Achievement and Brain Development
15
“Educational” Claims No proof of benefit for
baby products Slows development in
language, reading and math
No studies compare to beneficial activities
Christakis and Zimmerman, The Elephant in the Living Room
Educational Impact
Bedroom TV: lower 3rd grade standardized tests (math, reading, and language arts)
Regression models predicted up to 24% of the variation in scores
71% had a bedroom TV TV in bedroom predicts greater viewing time
Borzekowski and Robinson, Arch Pediatr Adolesc Med, 2005
Long Term Impact
30% lower college degree associated with each additional hour of media watched age 5-15 in longitudinal studyHancox, et al, Arch Pediatr Adolesc Med, July 2005
Brain development
Brains are “plastic” – especially young kids (even older adults)
Stimulus influences structure: babies need interaction with all senses during critical periods
Baby videos: little dialogue, short scenes, disconnected images, no interactive practice
No human interaction: babies experience world in relationships
Part 4: Violence and Aggression
Preschool Aggression
Sustained exposure > 2 hours/day of TV/video from age 30-66 months associated with much higher levels of aggression (also problems with sleep, self control, attention and cooperation).
Content not specified (what is watched)Mistry et al, Pediatrics, October 2007
Elementary Bullying Behavior
For every hour of daily TV at age 4, increased chance of bullying age 6-11
Content not specified (what is watched)
Zimmerman, et al, Arch Pediatr Adolesc Med, April 2005
22
Updates 2009/10
AAP has revised policy statement “a significant risk to the health of children and
adolescents” “media violence is 1 of the causal factors of
real life violence and aggression” “The debate should be over.”
3 year olds exposed to more TV have greater risk of aggressive behavior (Manganello and Taylor, Arch Pediatr Adolesc Med, Nov 2009)
Part 5: Sleep Problems
TV and Sleep
More television viewing among infants and children = more irregular sleep schedules
Thompson and Christakis, Pediatrics, October 2005Owens, et al, Pediatrics, 1999
Possible mechanisms
Bedtime resistance Delay of sleep onset, duration Melatonin and light Less relaxed after watching Anxiety, nightmares
Part 6: Attention problems
Early childhood
10% increase in symptoms of ADHD at age 7 per hour watched at ages 1 or 3
Christakis, et al, Pediatrics, April 2004
Possible factors Causality may be bidirectional Brain development: Interaction between
genetics and environment may condition risk, severity and progression of attention problems
Conditioning: Frequent edits, pans, zooms, etc. = “rapid distraction”
Displacement: In place of other activities which promote attention
Content may have a role
29
“2nd hand TV”
“Background adult television is a disruptive influence on very young children’s behavior” Reduced toy play episode length Reduced focused attention during play Effects in all ages (12, 24 and 36 months) They weren’t “watching” much
Schmidt et all, Child Development, July/August 2008
Part 7: What do we do about it?
What children and youth need
As much time as possible for: Interaction with other humans Verbal experimentation, with feedback from
other humans Creativity and exploration Reading and prereading activities Being physically active
Quantity matters
For children under the age of 2, the recommendation from the expert group (American Academy of Pediatrics) is NO screen time at all.
For older children, the Academy recommends no more than 1-2 hours per day of total leisure screen time.
What can faith communities do? Educate!
Newsletter and/or materials Post information on site Create activities such as
• Log sheet• Draw “What do YOU like to DO?”• Do More/Watch Less program • “Get My Life Back” contest• Screen Free Week
What can parents do? Set environment
Keep the TV out of kids’ bedrooms Place the TV in a less desirable area Reduce total number of sets Have TV-free meals Make new family traditions (walk after dinner)
Set limits – aim for 1 hour a day for older kids No TV under age 2 TV only on certain days of the week
Part 8: Summary
36
Focus
Cope
For every hour watched
Read
Run
Talk
TVTVTalk Create
Imagine
Play
BuyMore
EatThis
Violence Is Fun/Normal
SitMore
Explore
Interact
Sleep
What you’ve learned!
Health risks of screen timeReducing hours reduces risk
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