Screen time withdrawal in children can be seen in acts of behavioural outbursts such as tears, tantrums and aggression when things don't go their way. Internet addiction disorder is well on its way to being recognised as a clinical diagnosis and doctors are seeing the effects in children who spend excessive amounts of time using screens.
Sydney paediatrician Dr Scott Dunlop sees many children for behavioural and developmental issues from young children to school leavers and said the increase in patients seeking treatment for behavioural issues over the past decade reflects the changing nature of the issues facing families.
"Screen time is a massive problem, something that I might have to deal with in my practice every day predominantly among school age kids although I am seeing pre-schoolers with access to screens that is excessive and unfettered in terms of time," said Dr Dunlop.
"There is evidence mounting that excessive screen access changes kids' brains physiologically - it's having a neurological effect and changing the nature of kids' brains to be more addictive, to have less focus, to be less patient, to need more responsiveness in their tasks.
For school aged children Dr Dunlop says the maximum amount of healthy screen time is one hour on school days and two hours on weekends, albeit age dependent.
"That's provided everything else is going well. That the kid is compliant with the rules around that, they're getting all their school work done, engaging with the family, they are sleeping fine, and there's no behavioural issues.
"But certainly in my practice if kids come to me with behavioural difficulties, and particularly and sign of aggression with those behavioural difficulties, I would ban the screens all together. These kids are addicted to [screens] and the behavioural aggression is often a response to having the addiction withdrawal when time's up.
"Sometimes parents might mistake this for children being naughty or throwing a tantrum because things aren't going their way. But in actual fact there's a physiological withdrawal process they are going through, and in a child that manifests as behavioural tantrums," he said.
Games: friend or foe?
When comparing TV viewing with playing games, Dr Dunlop believes it's the interactive element of games that creates the addiction.
"They're constantly looking for the next response and the next interaction rather than just taking in images off a TV that they're not engaging with. TV doesn't seem to create the same addictive qualities," he said.
While Dr Dunlop doesn't have an issue with educational games, he believes there are better ways to learn the valuable skills of problem solving and overcoming obstacles which psychology research has promoted as being beneficial outcomes of the interactive nature of videogames.
"Problem solving can be learned in many ways - we don't need screens to learn that skill."
The other issue with this theory is that many times games and screens are just used as a babysitting tool, often with kids given free rein on devices where they mindlessly consume content, he said.
"There are educational benefits to be gained from technology, but It needs to be highly managed to prevent it from becoming a leisure tool.
"I see heaps of kids that watch YouTube videos, just over and over - it's the main thing kids do from my experience. I think most parents supervise what parents are doing on the devices - it's just the kids spend excessive time on them, they become addicted to them, and that leads to behavioural difficulties," he said.
Removing the problem
"Most parents don't manage that very well, and they often need to be educated on how to do that better. If parents are already struggling with kids who are showing signs of addiction or withdrawals, Dr Dunlop says the screens should be removed all together.
"The kids should go at least a school term without any screens whatsoever. I don't always include TV in there. I think TV is different; but tablets, smartphones, gaming consoles should all be taken away."
"Parents are the ones to make the changes - children can make significant progress once the addiction is removed," he said.
Screens and homework
In terms of balancing school screen time requirements and family rewards, Dr Dunlop said the parents can set this as they see fit.
"Parents might have the rule that you can use the screen for homework only, and you can't use it for anything else," said Dr Dunlop.
"I think if that leads to usage of the screen for leisure and then that becomes addictive, then the rule still applies: that all access gets removed. I have written notes to school teachers advising that a child is not to engage in any electronic homework and needs to be provided their homework on sheets.
"Some families and households just can't manage the school work only rule, and it is still leading to issues. It creates a temptation that is too much so we've had to remove the temptation," he said.
Healthy screen use
In advice to parents trying to determine if their children are developing bad habits, Dr Dunlop said parents need to be in complete control of when screens are used, and not allow children to determine that.
"If the kids have excessive focus towards getting onto the screen; if they manoeuvre and manipulate and come up with reasons why they need to be on the screen - that's a sign they are headed towards addiction.
"The big clue is signs of withdrawal from screen time," said Dr Dunlop.
Healthy screen use is where:
- parents are controlling access
- time is limited
- there are no signs of withdrawal when time is up
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