News Review From Harvard Medical School -- Mixed Results from Advice on Screen Time
Medical advice about cutting back on screen time didn't lead to a reduction for 3-year-olds, a study found. But the children did eat fewer meals in front of the TV. The study included 160 families. All had a child who was seeing a doctor for the regular 3-year-old "well visit." All of the families got information about media safety. They also answered questions about kids' eating and media habits. Half of the families, chosen at random, also received more advice. They were told about the health impact of excess screen time, such as TV and video games. They were given strategies to cut back. These included keeping TVs out of kids' rooms and not watching during meals. One year later, screen time remained the same for children in both groups. But kids whose parents were urged to limit screen time cut back from 1.9 meals a day in front of the TV to 1.6 meals a day. That's about 2 fewer TV meals per week. There was no change in the other group. The journal Pediatrics published the study. Reuters Health news service wrote about it November 5.
By Claire McCarthy, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
When it comes to TV and kids, people don't really listen to the doctor.
That was my take-home as a doctor from a study just published in the journal Pediatrics, the official journal of the American Academy of Pediatrics.
Researchers from Toronto worked with primary care practices to recruit families for the study. All of the families had children who were coming for their 3-year checkup.
Half of the families got general information on safe media and Internet use. The other half got 10 minutes of counseling about the health risks and other risks of television. The advice included strategies to decrease children's TV time. Specifically, families were encouraged to budget the amount of "screen time" during the day. They were discouraged from:
- Having a TV in the child's bedroom
- Eating meals in front of the TV
A year later, all the families were surveyed. There was basically no change in the media habits of either group. Children's body mass index (BMI), a measure of whether they are at a healthy weight, also did not change.
The group that got the counseling ate slightly fewer meals in front of the television. They averaged 1.6 meals per day instead of 1.9, so that's about 2 fewer meals per week in front of the TV. Im not sure that's much to be proud of.
Other studies have shown similar results. People don't seem to change their habits when they are told something briefly once a year. It has a better effect when people reinforce the message by talking to parents longer and multiple times. But these kinds of programs are really hard to carry out in a doctor's office, especially given everything else we have to do during a visit.
This is disheartening to me as a doctor, because we know that too much screen time is bad for kids. It increases their risk of obesity. In young children, it can lead to delays in language development as well as behavior problems. It's the families of young children we most want to influence. If we can get to families early, it can make a real difference. If we don't, too much TV can have lifelong effects.
What Changes Can I Make Now?
Here's the bottom line: Keep the TV off as much as possible. Be very thoughtful about when you turn it on. Most children watch about 4 hours of television a day. That's far more than the 2-hour limit recommended by the American Academy of Pediatrics. The academy also recommends that children under the age of 2 not watch any television at all. According to a recent study, many children also are being exposed to several hours of background TV each day.
Here are some specific suggestions:
- Don't ever turn on the TV just to turn it on. Turn it on to watch something specific -- preferably something educational, and not something violent.
- During those times when your child usually watches TV, encourage art activities, active or imaginative play, or reading a book. Do it with them.
- Try not to use the TV as a babysitter.
- Don't let your child have a TV in his or her bedroom. Not only does it increase the amount of screen time in your child's day, it interferes with sleep. Sleep loss leads to all sorts of extra health and behavioral problems.
- Don't eat meals in front of the TV. Talk with your kids instead. It's good for family relationships -- and, it turns out, may help your child stay out of trouble and get better grades.
What Can I Expect Looking to the Future?
This study mostly tells us what doesn't work. But when you are trying to figure out what does work, it can be useful to know what doesn't.
It's crucial that we figure out effective, practical, affordable ways of educating families about the healthiest ways to use media. If we don't, the next generation of children will be overweight and have problems with behavior and learning. This is not what we want for our children -- or our future.