Thoughts on guidelines from a mother and researcher
As a mother of two small children, the subject of screen time is something that often occupies my mind. As many other parents can probably agree, an episode or two of Paw Patrol can be quite helpful in the afternoon if anyone is to ever have some sort of homecooked meal — but somehow, the “screen-guilt” still often creeps up on me, with all the different opinions out there about how much is too much, and an increased focus on the possible negative impact on the mental wellbeing of the children in the long run.
In Denmark where I live, we have no official recommendation on cut-offs regarding screen time, and most of the time I am able to trust my gut and tell myself that my kids are not damaged by the amount of screen time that we currently allow at home. But recently, the debate flared up in Danish media once again, following the publication of new guidelines from the Norwegian health ministry, Helsedirektoratet, recommending no screen time at all for those under the age of two, and no more than an hour a day for those between three and five years of age. The reaction in Denmark (being quite close neighbours with Norway) was immediate - should we follow in their steps with an official recommendation on completely eliminating screen time for the youngest? Admittedly, my first reaction came from the mom within — we would of course have to completely turn off all devices at all times so as to not risk the development and future of our kids!
I am a medical doctor from Copenhagen who completed her Ph.D. in neuroinflammatory processes in psychotic disorders. As well as being a mother, being also a researcher, I luckily tend to be quite skeptical by trait, and once I had gotten over my immediate panic I started to wonder; do we really know enough to be this confident in the discussion of children and screen time?
So, I started researching on what grounds these new Norwegian guidelines had been formulated. Everywhere I looked — from the comments of those that highly welcomed this new banning of screens as a corroboration of their previous beliefs, to the established Danish media — all I could find was that it was based on the guidelines by the World Health Organization (WHO) as if that should be enough to end any debate on the topic. I quickly realized that I would have to go directly to the source to figure out what sort of evidence existed out there. But, digging into the material published by WHO themselves turned out to be quite the task, with more than 100 pages in total if one also wanted to evaluate the actual data behind the guidelines.
So instead, I decided to approach the topic in a different way; I set out to read up on the opinions of researchers and experts on the matter, in the hopes that they would have been less lazy than me and had actually taken the time to read through it all.
Gladly, I found that I was not the only one wanting to add nuances to the debate. In an article by the Guardian, experts raised concerns about the lack of evidence. They highlighted the complexities that arise with, for example, having a household with children of different ages, in which it seems next to impossible to spare the youngest of any exposure to television. Similarly, the Danish health ministry, Sundhedsstyrelsen, has reacted with caution to the guidelines, and will continue with a softer approach to guidelines for screen time, with recommendations for the youngest such as “make sure that your kid does other things than watch screens” and “do shared screen activities with your kids”.
Likewise, the UK’s Royal College of Pediatrics and Child Health stated that they were unable to recommend specific cut-offs based on the current evidence, and highlighted instead the importance of individual needs and thoughtful use of screens.
With this, I am in no way saying that children should just have completely unlimited access to screens, nor am I stating that screen time is harmless regardless of the amount. What I end up concluding is that we do not really know yet.
There are a lot of problems with the current evidence, including the amount of studies, but also the impact of many factors other than the screen time itself, such as socioeconomic status. When both the American Academy of Pediatrics and WHO recommended no screen time at all for the youngest ones, they did not do so because we knew that it harmed the children — they did so because we did NOT know IF it harmed them, and it seems that the benefits of screens on development at this age is very limited. This distinction is important.
The risk with strict recommendations, as opposed to an open and informative discussion, is that it adds a lot of pressure on the daily lives of parents, a group of people who rarely find themselves needing more things to worry about. Conveying not just the guidelines, but the evidence (or lack thereof) that was taken into account in the decision making, can help nuance the picture, and perhaps alleviate some of the screen-guilt that can arise with even just occasional use of screens in the busy lives of today’s families.
So how will I approach screen time at home going forward?
I am not sure that my mind is completely made up, and I will definitely keep an eye out for new evidence emerging. But one thing I can honestly say: there is no realistic chance of us reducing screen time to zero.