Screen Use in Children and Impact on Development: What Has Changed?

Editor’s Note: This text is a transcript of the course, "Screen Use in Children and Impact on Development. What Has Changed" presented by Angie Neal, MS, CCC-SLP.
Learning OutcomesAfter this course, participants will be able to:
Identify the pros and cons of screen time use in young children.List key areas of development that are negatively impacted by excessive screen use.Describe strategies that help minimize negative consequences of excessive screen time.IntroductionThis course is an update to a presentation that I did for SpeechPathology.com in November of 2019, "Digital Diets and the Impact of Screen Time on Development." Since late 2019, there has been an increase in the amount of data collected about screen use in children, as well as an increase in screen time among children.  I wanted to provide an update because who would've thought that just a few months later in March of 2020 the whole world would make a tremendous shift in so many things that we do due to the pandemic?  That includes how we use technology, how much we use technology, and the impacts that we're seeing today.
One point that I didn't include in the slides that I want to give you a head’s up about is if you've not seen it on Netflix, there's a documentary film called, "The Social Dilemma" that takes much of what you're seeing here and builds upon it. That is good to watch from an adult's standpoint.
What’s DifferentFirst, let's talk about what has changed. More precisely, what are teachers describing that has changed? In case you're not working in a school setting, teachers are the ones spending so much time with little ones.
In my state of South Carolina, beginning this 2021-2022 school year, students were fully back in the classroom after having been in a virtual classroom the year prior due to the pandemic. I hear from teacher after teacher that students are struggling significantly more than they ever have before.  Students in school are struggling with just listening to a book being read to them. They're struggling with following simple directions, such as "get in line" and "get your backpack." They're struggling with basic problem solving or picking up on cues from their peers, like looking around to see if the other students are putting on backpacks or lining up.
Teachers are observing significantly more learned helplessness than before. I actually had a teacher friend tell me that a student came up to her and said, "Hey, can you open this snack for me?" She said to the student, "You have scissors in your desk. You can go do this yourself." He said, "I know, but can you just open it?" When the teacher said, "No," he just walked away and threw it in the trash.
Teachers are saying that attention spans are shorter, and the wiggles are more frequent. Many students get bored after 10 minutes of play, even with blocks. We're also seeing that academic readiness isn't there, including that language foundation that is necessary for building those early literacy skills.
Students are struggling to interact with their peers or be in a group of peers. One teacher noted that the interrupting and shouting is the worst she has ever seen in first grade, and she's been teaching for seven-plus years. Teachers are also saying students have a shorter fuse, and we're going to talk a lot about that as it relates to self-regulation and emotional regulation. They are seeing impaired fine motor development and are starting the first day with, "These are crayons. Here's how you hold them. Be careful with them because they'll break. Here's how you hold scissors."
Of course, while the pandemic certainly has its fair share of the blame, these are difficulties that were there before.  They're just now more intensified. Now, instead of teaching curricular standards as a result of all of these changes, teachers are starting the school year by teaching or reteaching some basic academic readiness skills.
Pros and Cons of TechnologyThere certainly are some good things about technology. First is virtual school. Can you imagine what would've happened during the pandemic if we did not have the option of virtual school? Also, there are new ways to socialize. During the pandemic, my family actually had a "Virtual Tailgate." We're big tailgaters and football game goers for Clemson, our favorite team. But we couldn't do that during the pandemic. So, we had a "Virtual Tailgate".
There are also so many apps that connect family and friends. We are able to FaceTime loved ones who are far away. We also have access to additional, very cool educational content that extends the learning in powerful ways. For example, students can now take virtual field trips to the Great Barrier Reef or to NASA. If they read a book about Egypt, they can pull up drone footage about the pyramids, artifacts, tombs, and all kinds of information related to that.
They can discover new hobbies and new interests. They can learn how to do all sorts of things on YouTube, like "Make Ice Cream in a Ziploc Bag" or do cool science experiments with things around the house.  They can learn magic tricks. They could find out so much about their favorite things like horses or dogs or rocks or minerals or presidents. Literally, there's almost limitless information that you can access with just the touch of a button.
But there are also the obvious cons. First, the rate of obesity has increased because there is increased eating while they're using screens, which then leads to more calorie intake. Also, when children are seeing advertisements for high-calorie, low-nutrition foods and beverages, that influences their preferences.
Then, of course, there's the disruption in sleep. When children have poor sleep, it's not just because of the blue light from the screen that makes it difficult to fall asleep. When children are staying up well past their bedtimes on a device, that also impacts their sleep and it impacts the appetite-related hormones.
Finally, screen-time impacts behavior. Behaviors have certainly been negatively impacted.  Before I explain why I want to clarify some important differences between screens. 
What’s The Difference Between TV and Handheld Devices?The research has extended what we already knew about television and is adding information about handheld screens like iPads, iPhones, and tablets. There are very important differences that do impact development. First, TV was usually experienced as a group, but handheld devices are meant to be experienced alone.  Let's think about this. With TVs, at least when I grew up, there was only one TV and when we watched it, it was together as a group.  We experienced shows together and talked about them even after the show was over. With handheld devices, they're watching shows alone. So, a discussion is not taking place about what has been watched.
Another big difference is that TVs are pretty much stuck to one location. They used to be a big, huge piece of furniture and now they hang on the wall. The difference is that smartphones and iPads can go everywhere and there are huge implications for this, which I will explain more throughout the presentation.  The general idea is that when children are attending to shows and activities online, they aren't attending to the people and the things going on around them. This leads to what I refer to as the “opportunity cost”. When technology no longer has to be plugged into a wall, conversations don't happen while they're riding in the car and they're on their tablet. Conversations in which we are pointing out new vocabulary in the grocery store, or even talking while waiting in line are not occurring. That's the opportunity cost of decreased vocabulary and background knowledge. Again, we're going to talk more about that later.
The other difference is downtime. Children today are no longer bored as they really don't have downtime.  They don't even know how to be bored and the result of not being bored is that you don't have that opportunity to wonder, to come up with novel thoughts, to be creative, to imagine and reflect.
American Academy of PediatricsThe recommended amount of screen time has changed as well. The American Academy of Pediatrics updated its stance on screen time because of the pandemic, while also sharing what the significant concerns are. First, in no uncertain terms, they talk about how excessive screen time has negative effects, especially in the early developmental period. They are also very clear in saying that it does more harm than good and that there are links to poor academic achievement, links to obesity and sleep problems, as well as behavior deficits and attention problems, especially, when excessive screen use is occurring during those critical periods of development.
The American Academy of Pediatrics used to recommend specific amounts of time, but again, that has changed. And, to be honest, parents needed a little bit of grace. The world changed, and the previous recommendations were no longer feasible, especially with online school being the norm. This, obviously, does not mean to throw caution to the wind and let children have as much screen time as they want, rather...