The Correlation Between Increased Screen Time and Developmental Delays in Children

As the technology around smartphones continues to progress, a Calgary-based study on childhood development is suggesting that, ultimately, the best thing we can do for the next generation is to model restraint.

Illustration by Marne Grahlman

On July 11, 2008, Canadians in six cities, Calgary among them, lined up at Rogers stores to buy Apple’s new iPhone 3G. Rogers was the only Canadian network capable of running the phone, which the company billed as “revolutionary.” Stores opened early, at 8 a.m., and staff distributed prizes and food and drinks to those who waited in line. The scenes were later made available to media on B-roll distributed by Rogers, and included “glamour shots of product.” People could now talk on the phone and surf the internet simultaneously. They could network twice as fast. A whole new world of multi-tasking possibilities opened.

One month later, a baby born in Calgary became the first child registered with a research study called All Our Babies. For the study’s principal investigator Dr. Suzanne Tough, the birth outshone any developments in smartphone technology. The All Our Babies study (now called All Our Families) was unprecedented in its scope in Alberta. In the space of three and a half years, Tough and colleagues recruited 3,200 pregnant women who were not yet at 25 weeks gestation and were undergoing prenatal care. The women completed surveys during pregnancy, when their children were four months old, then at one, two, three and five years old.

Tough wanted to examine all the factors that could influence a child and family’s well-being: parental education and mental health, lifestyle and child care, community and health services. Mothers answered questions about things like depression and childhood trauma, as well as things relating to the socio-economic status and cohesiveness of their neighbourhoods, and were asked to give updates on their kids, year after year. And year after year, most mothers did. Even now, more than 11 years after the first woman enrolled, approximately 75 per cent of the original cohort still participate (a sky-high response rate for an era in which people increasingly ignore requests to fill out detailed surveys).

As time went on, the survey questions changed. When the first kids in the All Our Families study turned three, Tough and her colleagues began to ask mothers about screen time.

Researchers have been asking about screen time and kids for nearly 70 years, starting soon after Howdy Doody made his television debut in 1947. One of the first known studies of screen time and kids was carried out in Western Canada in 1959, surveying kids in two small towns. Only one of the towns had televisions. First-grade children in the town with television watched for an average of one hour and 40 minutes per day; they also spent 35 fewer minutes listening to radio, 33 fewer minutes at play, 13 fewer minutes sleeping and 20 fewer minutes reading and watching movies.

The study authors did not draw any conclusions about the negative effects of more time in front of screens, other than noting that the kids who had more TV time spent less time doing other things. But in the scientific literature of the era, psychiatric and behavioral specialists were beginning to question what the long-term effects of television might be. In one American analysis, published in 1963 in a journal by the National Council on Family Relations, observers noted that television offered “vicarious satisfaction” when children were confronted with real-life frustrations. They found television violence may blunt children’s sensitivity to cruelty, and observed that children were more frightened by the dark than the violence they saw on television.

Five decades later, researchers are still probing the relationship between screen time and childhood development. Tough and colleagues started asking the All Our Families mothers about their kids’ screen time in October of 2011. By then, Apple had unveiled the iPhone 4S with its groundbreaking new feature, Siri. David Pogue, the New York Times weekly tech columnist, wrote that Siri profoundly changed the definition of “phone.” The All Our Families researchers knew parents were using their phones and other electronic media devices around kids and that kids were using their parents’ phones and devices. But they were astonished by their findings. Two-year-olds were watching screens 17 hours a week, three-year-olds 25 hours a week and five-year-olds 11 hours a week. (Researchers attributed the drop in screen time among older kids to the fact that they were in school.)

The results, published last year in the Journal of the American Medical Association, showed that children who spent more time in front of a screen at age two were more likely to score worse on developmental screening tests at age three. The pattern continued as children aged: more screen time at three, worse scores at five. The Calgary study addressed the question that researchers have debated for decades: which comes first, developmental delays or excessive time in front of a screen? All Our Families provided some of the strongest evidence to date that excessive screen time is a predictor of problems (due to the screen itself or as an indication that more time in front of a screen could signify other problems such as abuse or neglect that would lead to developmental delays).

The Calgary study is just one part of an enormous body of research coming out about modern screen time, examining the ways that constant connectivity to digital technology affects humans — young and old. In his recent book Digital Minimalism: Choosing a Focused Life in a Noisy World, Georgetown University computer science professor Cal Newport makes the case that we’re ceding more and more of our autonomy to phones, because we’re irresistibly drawn to the experience on the screen. Smartphone users didn’t sign up for this loss of autonomy, he writes.

As social media companies sought to increase revenues, they intentionally re-engineered the way we engage with screens and social media. Take the case of Facebook: it went public in 2012 and now ranks among the top 10 most valuable companies in the United States. In the years leading up to its IPO, its advertising revenues jumped as viewers kept their eyeballs locked on the screen for longer periods. More screen time meant more opportunities for advertisers to get our attention, thus more revenue for Facebook. The company accomplished this feat by switching from a platform where users shared mostly personal news with friends and families to one that spit out an endless stream of indicators of our social acceptance. The consequences, argues Newport, are tremendous: loss of concentration (which is our most valuable resource in a knowledge economy), disconnection from our real-life communities, an inability to sit in solitude and a greater sense of isolation.

The disconnect from other human beings that arises from our connection to devices has the greatest effect on young brains — especially those in kids three years and younger — but it is felt across generations, says Dr. Karen Benzies. A nurse and co-investigator with the All Our Families study in its early stages, Dr. Benzies studies the way young kids and adults interact, working with parents, nurses and caregivers, and teaching adults to recognize cues from kids.

Even when she’s not working, Dr. Benzies watches the way parents interact with their kids in public, studying them in grocery stores and observing the way parents respond to their kids’ needs. Her interpretation of these interactions is that adults and kids are losing the critical skill of reading social cues from other people. “When people get caught up with their devices, they are interacting with something inanimate … If you do that early on, your brain never learns how to understand and interpret human social behaviors,” she says.

Dr. Benzies calls herself “an advocate for an increased focus on human social interactions at an early age, interactions that are not mediated by devices.” Humans can’t survive without reading each other’s social cues, she says, and the consequences of not being able to do so are wide-ranging, from social isolation to professional challenges. “If you watch a good CEO in the boardroom, they’re reading the social cues around the table,” Dr. Benzies says. She worries about how kids raised with devices will interact in the future. “People don’t learn to be with other humans on a device,” she says.

But it’s not as easy as just flipping a switch. Ever since the first days of television, screen time has proven to be a hard habit to break. In 1959, the New York World-Telegram and Sun ran a story with the headline “Mom Delivers Baby While Watching TV.” (In the story, the new mother reportedly said: “it was a good movie and I didn’t want to turn it off.”)

In the smartphone era, more opportunities and incentive to check screens means our attachment has only strengthened. Users can check email, Twitter and Instagram anywhere: on the road, walking the dog, at dinner, in line at the grocery store. But there’s also a growing movement around restricting screen time and smartphone usage as part of the course of everyday life. Like any kind of restrictive action taken toward curbing a compulsive activity, however, the “digital detox,” as it’s known, isn’t an easy thing to do — at any age. And the people who are experts at holding your attention online, who make their living online, know best how difficult it can be to break our digital habits without tremendous effort and determination.

Illustration by Marne Grahlman

Ernest Barbaric is one of those people. If you’ve ever read anything online about Calgary, you’ve likely seen his work: he’s an independent digital marketing strategist who has worked for brands including Parks Canada, Travel Alberta and the University of Calgary. His work is woven into the online presence of hundreds of local, national and international companies and non-profits. Barbaric founded the social media for business certificate program at Mount Royal University, and teaches digital marketing for the Canadian Marketing Association. All to say that he is very much aware of the algorithms that keep people’s eyes focused on their screens. As a result, he is very strict about his own phone use.

Barbaric holds up his iPhone to display the minimalist home screen with its 12 apps in total, several related to mindfulness. When Barbaric is on vacation, his out-of-office reply couldn’t be more clear: “I will not have access to e-mail, phone, laptop, or a carrier pigeon. You can expect my enthusiastic reply within a few days of returning.”

It wasn’t always this way. A few years ago, Barbaric felt anxious and depressed. On the advice of an executive coach, he started keeping a journal to track his energy. He found phone use, particularly social media, sparked many of his emotional struggles. “For me, a lot of the triggers are around comparison. What would happen is that I would see someone launching a conference and I wanted to do that, too. And then I would see someone spending time in the mountains … it triggered all these feelings of inadequacy.”

Social media feeds use a system that provides variable rewards; they are algorithmic rather than sequential, organized by what a company predicts will be consequential rather than by time. This system of variable rewards is what makes gambling attractive — and also addictive. Barbaric points out the similarity in the motion of pulling down your thumb to refresh Twitter to pulling down a lever on a slot machine. “You refresh your feed and you don’t know what’s going to happen.” It’s the uncertainty, the potential for something better or newer or more satisfying than last time, that keeps you coming back. Pull down, possible reward; pull down, possible reward. It is a compulsion loop engineered into the app.

When a person checks an app constantly, their productivity decreases, says Barbaric. Research from the American Psychological Association shows that quick mental switches that result in alternating between tasks can cost as much as 40 per cent of someone’s productive time.

In response to his energy journal findings, Barbaric undertook a systematic digital detox. He announced on each of his social media platforms that he was signing-off for a week, and could be reached only by calling him directly. He restricted his computer use to checking things directly related to work. He and his wife sent a message to their families that if they wanted to talk, they needed to visit or make a plan to get together. Barbaric kept a diary of his detox, which he later published online (he is a digital marketer, after all). The first two days, he wrote, he physically reached out to check his phone and compulsively patted down his pockets to make sure he had it on him. When he sat down to his computer, his fingers automatically hit the shortcut keys to open new tabs for Twitter and Facebook. On the fourth day of his detox, he received emails from Twitter, Yelp and LinkedIn, reminding him that he hadn’t checked them out for a while and offering the latest updates from friends and contacts. But by the week’s end, Barbaric said he felt more productive at work and spent more time engaged with his family.

“What it boils down to is it’s a distraction that can be addictive,” he says. “At the very basic level, we need to have an awareness, so that we can make intentional decisions about our use, where it’s not just getting sucked into this for hours with [our] decision-making ability removed.”

In many ways, digital detoxing is reminiscent of dieting: everyone knows someone who is doing it. There are over 200 million Google hits for “digital detox,” and you’ll find recommendations galore on how and what to do. Just like with food, a burgeoning industry is selling products to help you detox. Sign up for a retreat! Go on a detox vacation! Download the app! For $34 USD, you can buy digital-detox bath salts to fight “wired and tired syndrome” (supposedly hand-harvested grey sea salts that can “help eliminate toxins”). Or for $26 USD, you can buy an eight-piece “essentials” digital-detox kit with an eye mask, earplugs, a manual alarm clock and game piece with activity suggestions like “take a walk” and “write a letter.”

It is unlikely that adding to the physical clutter of our lives will positively contribute to our efforts in digital de-cluttering, however. A better approach is something you do not buy: exercising deliberation about when you’re picking up your phone and why, or what Newport calls “developing a philosophy of technology use.” Instead of buying apps that can tell you how often you check your phone, delete all the apps you don’t need and be intentional about bringing them back.

At the end of his detox week, Barbaric considered launching a project with “zero social presence” to see what would happen. But he didn’t. In fact, post-detox he picked up some of his old habits (he returned an email regarding this story when he was supposed to be out of office). But there have been small victories: he has removed some of the psychological triggers on his phone that encourage compulsive behavior; he has deleted social media apps, and he tries to call rather than text, keeping away from his phone for the first two hours he is awake.

Now, Canada stands to enter the 5G era, heralded as yet another game-changer in wireless communications: faster communication, higher speeds, more devices. Likewise, separation from 5G-equipped devices stands to become more difficult. As the technology advances, Dr. Tough and colleagues are continuing their study with plans to ask updated questions about screen time: What kind of screens? How often? For what purpose? They recommend families develop personalized media plans to prevent screen time from interfering with face-to-face interactions.

Dr. Benzies suggests keeping kids away from screens until they are at least three years old, a full year older than the current guidelines suggested by the Canadian Paediatric Society (CPS). The CPS also recommends maintaining daily screen-free times, especially in the hour before bed, for kids of all ages and calls on parents and physicians to encourage meaningful screen use for older kids, noting that children — even those who are not excessive screen-media users — have reported experiencing eye problems, headaches and fatigue. A growing number of spaces in the city are also supportive of restricting screen time for young minds. Last year, Lycée Louis Pasteur School opened a new library that is free from screens and Calgary Reads, a non-profit that promotes literacy, hosts regular events that focus on reading aloud in the age of distraction.

Dr. Tough also says that while being mindful of the screen habits of their kids, parents need to be mindful about their own screen time as well. She personally tries to avoid picking up her phone when she’s in meetings or around her family and friends. Humans are nourished by what’s called “social snacking” — small informal interactions that help build civic society, she says. And when we constantly deprive ourselves of that kind of person-to-person engagement to compulsively check on the latest algorithmically generated reward from our phone, we starve ourselves of a world of possibilities.

Learn more about the people and organizations moving Calgary forward with Avenue's Innovation Newsletter.

This article appears in the February 2020 issue of Avenue Calgary.

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