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Youth mental health in the digital age. Exploring a new world together

My son is seven years old. He and I grew up in different technological epochs.

I bought my first personal computer during university. He has been growing in an environment full of connected digital devices. At school, devices are fully integrated in his education: as a son of expats, he could learn through digital tools the correct pronunciation and the vocabulary of a different language that we could not provide at home. Digital tools became critical during the pandemic to buffer the effects of prolonged school lockdowns.

Through social channels, he maintains a connection with the rest of the family in another country. Through gaming he reinforces the bond with peers and also with someone older: we have a great time together when we take on the digital identity of two famous mustachioed Italian plumbers on a mission to save a princess.

Of course, I am fully aware that this environment (like any other environment being digital or real) is not without risk for him. Marketing aggressively targets children to trigger continuous consumption of products (games, apps). If left completely alone, cyberspace is full of threats and inappropriate content for him. I can understand some parents’ concern about the potential impact of this new digital world on the wellbeing of their children.

Reasons to be scared?

Being aware of the risks is one thing, assuming without clear evidence a nefarious effect of digital technologies on the mental health of the youngest is completely another. A few months ago, a harsh debate was spurred by a journal column taking no prisoners already from the title “Smartphones and social media are destroying children’s mental health”. The piece pictured the rise of smartphone technology in the last 13 years as the main cause of the increase in mental health symptoms in teens.

I am a concerned parent but I am also a researcher in Psychiatry and Epidemiology. The data discussed in the article could not prove a causal connection between smartphone use and teen mental health, but simply depicted a pretty crude correlation (the relationship between two things that tend to occur, or change, together). But two phenomena may go together simply by chance, or because a third unaccounted factor (the list of factors potentially determining an increase in depressive symptoms in teens in the last decade is virtually infinite: economic crises, wars, pandemic…) may be the real driver of the apparent correlation.

An expert point of view

Recently, my favorite science program on Italian radio discussed the release of a report by the Organisation for Economic Co-operation and Development (OECD) entitled “Empowering Young Children in the Digital Age”. One of the discussants was Dr. Tiziana Metitieri, a neuropsychologist at the Meyer Hospital in Florence, one of the first medical institutions in Italy exclusively devoted to child health care from birth to adolescence.

Dr. Metitieri is an amazing science communicator deeply committed to scientific integrity (member of the steering committee of the Italian Reproducibility Network). As a plus, I realised that we come from the same small Italian province. I decided to contact her to bring me some clarity on what is actually known about the impact of digital technology on children’s and adolescents’ mental health.

Dear Dr. Metititeri, what are the main conclusions of the OECD report regarding the impact of digital technology on the mental health of the youngest?

The OECD report released in early April focuses on early childhood and delivers three main messages concerning the promotion of a safe and responsible use of technologies, the reduction of digital divides by ensuring early digital literacy, and the continuing training for families, and for early childhood education and care professionals to enhance their digital skills.

The report is based on data collected from 30 countries and jurisdictions that have insufficient and heterogeneous approaches to the development of digitalisation and safe use of devices from early childhood. However, their incomplete policies, even if based only on digital safety regulations, do not include restrictive approaches and therefore do not reasonably argue that blanket digital device bans are a solution.

These facts contrast with the opinions of public experts who are sought after by the mainstream media and who build consensus around an assumed age (different for each expert) at which children would become capable of using technologies. Acknowledging that research on early childhood technology use is scarce and that screen time is too simplistic a construct to study a phenomenon as complex as digital experiences, the report points out that the collective anxiety generated by some flawed studies induces conflicts and confusion in families and professionals on the behaviors to be adopted to foster children's digital skills.

What is the actual status of the scientific evidence linking digital devices and mental health in children and adolescents?

Findings emerging from solid studies, committed to scientific integrity, show that there is no direct impact of the use of digital devices on psychological health. This means that contextual factors (socio-economic status, minority groups, previous psychopathological conditions, etc.) that can play a crucial role cannot be ignored.

The distinctions between the type of digital content and screen time, passive and active use, age groups in their longitudinal evolution, and groups of children and adolescents from different backgrounds will be the landmarks for identifying the research that will contribute more to increase scientific knowledge.

If these distinctions are missing in a study, and therefore context factors are ignored, and the bidirectionality between psychological variables and the use of digital devices is not explored, then it is highly probable that we are dealing with a study that should be discarded because dwelling on its results would slow scientific progress.

Based on what we know from research and your clinical experience, which suggestions would you give to a concerned father?

In recent years, as moral panic subsides, I am seeing a shift in the way children and teenagers talk about how they use digital devices. Before the pandemic they were very reluctant to answer the questions I usually ask in my clinical work about their use of smartphones or video games, fearing negative judgment and disapproval. Now they are more spontaneous in talking about their online experiences. Creating a climate of listening is essential.

Then there are some other things parents should do with their children: ask questions about the activities carried out and people met (this applies online and offline); discuss games, apps, and videos by expressing your preferences; share experiences online (e.g. playing a video game together); welcome reports of aggressive online activity; explain the risks and ways to deal with harmful situations.

There are also some things that parents should be careful not to do: do not ban devices for extended periods of time; do not interrupt conversations about online experiences; do not react with anger or fear to confidences about risky online activities or troubles in interacting with peers.

The key message for parents and also for teachers and professionals who deal with children and teens is to educate, thus continuing to foster healthy growth and civil coexistence both offline and online

Exploring a new world together

The digital world is a new virtually infinite horizon. For me, the key seems to keep on exploring it together with my son, learning form one another (as the older counterpart grew up in pre-digital world I’m often the one who needs to learn), protecting each other when necessary and, of course, enjoying it. It is time to salute now as I have an important appointment with my son: we are about to wear our digital moustaches and Italian plumber coveralls, there is a princess to be saved.

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