Sleep, academics, and behavior all improved by limited screen time

A study shows that limiting screen time improves sleep quality, academic performance, and behavior in children. JR

Parents may not always see it, but efforts to limit their children's screen time can make a difference. A new study, published inJAMA Pediatrics, found children get more sleep, do better in school, behave better and see other health benefits when parents limit content and the amount of time their children spend on the computer or in front of the TV.

Douglas Gentile, lead author and an associate professor of psychology at Iowa State, says the effect is not immediate and that makes it difficult for parents to recognize. As a result, parents may think it is not worth the effort to monitor and limit their children's media use. But Gentile says they have more power than they realize.

"When parents are involved it has a powerful protective effect across a wide range of different areas that they probably never would have expected to see," Gentile said. "However, parents aren't likely to notice that putting limits on the children's media is having these effects seven months later."

Considering that children average more than 40 hours of screen time a week, not counting time spent on a computer at school, even small changes can make a difference, researchers said. They are not suggesting parents completely eliminate screen time, but find a healthy balance.

The study found there is a ripple effect associated with the benefits of limiting both screen time and media content. Gentile is not surprised to see a direct impact on sleep, academics and behavior. However, limited screen time also indirectly affects body mass index. The study found that children got more sleep if parents limited screen time, which also resulted in lower risk of obesity. Parents limiting exposure to violent media resulted in increased prosocial behavior and lowered aggressive behavior seven months later.

Researchers analyzed the media habits of more than 1,300 school children who were recruited to participate in an obesity prevention program. Students and parents were surveyed about everything from screen time limits, to violent media exposure, to bedtimes and behavior. Teachers reported grades and commented on student behavior and school nurses measured each student's height and weight.

Data were collected at the start of the program and seven months later at the end of the program. By looking at these factors collectively with a group of children over a school year, it was easier for researchers to identify patterns that are hard to recognize in individual children.

"As parents, we don't even see our children get taller and that's a really noticeable effect. With media, what we're often looking for is the absence of a problem, such as a child not gaining weight, making it even more difficult to notice," Gentile said.

"Even with changes that we do notice, we really don't recognize in the moment how all these things are related to each other across time," he added. "Yes, as screen time goes up, school performance goes down, but that doesn't happen overnight. If I watch a lot of TV today, I don't get an F in my class tomorrow."

Doctors can make a difference, too

The American Association of Pediatrics recommends no more than one to two hours of screen time a day for children two years and older. Reality far exceeds those recommendations, which might explain why doctors feel it is futile to talk with parents about guidelines for media use, Gentile said. The study provides further evidence of why pediatricians need to have that conversation.

"Hopefully, this study will give pediatricians a better sense of efficacy that it's worth taking the time to talk to parents," Gentile said. "Even if doctors only influence 10 percent of the parents, that's still millions of children having much better health outcomes as a result."

Researchers recommend doctors talk with parents about setting limits and actively monitoring media use. This can include talking with children about media content, explaining the purpose of various media and providing overall guidance.

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No technology helps kids get healthy sleep

This article explains why having no technology in a child's bedroom is pivotal to ensure the child gets healthy and quality sleep.

Here's the scenario: A child is glued to his Xbox, or maybe his iPhone or iPad and won't go to bed. Frustrated, mom or dad gives up the fight and walks away, letting the kid play just a little longer -- even though it's a school night.

But an expert on children's sleep says parents need to buck-up.

Dr. Daniel Lewin, associate director of Pediatric Sleep Medicine at Children's Medical Center, says he too has a child who wants to be on the computer constantly.

"It's simply modeling and limit setting, which is critical," Lewin says.

It comes down to parents limiting their own exposure to electronics, especially while in front of children. This helps show the behavior they'd like their kids to mimic.

Lewin says in a culture with constant access to electronic media, there's a lot of pressure to perform.

But "those kids who are on media devices to do their homework and when that's done right before bedtime they're impacting their sleep," says Lewin.

When it comes to kids, Lewin recommends making sure the electronics are off at least an hour before bedtime. That's because the light actually shuts down the biological process that initiates sleep.

"Sleeping with a dim light in the bedroom is fine. But sleeping with electronics on in the bedroom is really not optimal," Lewin says.

For children who take ADHD medication, Lewin says it's extra important to make sure he or she is getting a good night's sleep.

"Getting enough sleep at night is critical for attention, for regulation of emotion," says Lewin. He says it's really important to be able to recognize the signs of sleep disorder and to recognize the signs of inadequate sleep.

"We have a lot of kids who are on ADHD medications. We could start by optimizing sleep before putting kids on medications. Some certainly need it," Lewin says.

There's also a relationship between sleep deprivation and mood, including suicidal thoughts. Chronic sleep deprivation can lead to high blood pressure, strokes and Type 2 diabetes.

Children around the ages of 12 and 13 should get 9.5 to 10 hours of sleep. Older children and adolescents should get about 9.5 hours of sleep.

And, Lewin adds, "The American Academy of Pediatrics has been very clear: no TVs in the bedroom and no electronics in the bedroom absolutely critical."

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Too much computer time makes autistic children sleep less

Autistic children are prone to sleep disorders, and excess screen time could add to the likelihood of sleep disorders in these children.

Kids with autism and related disorders are prone to sleep disturbances but a new study finds that screen time, especially in the bedroom, may make their sleep problems worse.

When researchers compared boys with autism spectrum disorders (ASD) to other boys, they found that all the kids with bedroom access to media slept fewer hours, but the relationship was twice as strong for the boys with autism.

"In-room media access was associated with about 1.5 fewer hours of sleep per night in the group with autism," said Christopher R. Engelhardt, who led the study at the University of Missouri-Columbia.

"This association can potentially be problematic, particularly if the reduction in sleep interferes with other daily activities, such as school, homework, interactions with other people, or driving," he told Reuters Health in an email.

Past studies suggest that up to 80% of kids with autism, and related conditions like Asperger's disease, experience sleep troubles, including difficulty falling asleep or staying asleep through the night.

Hormone melatonin

Children with attention deficit hyperactivity disorder (ADHD) also are known to have a high rate of sleep disturbances. With both conditions, it's unclear why sleep is so difficult.

Theories include a disruption in sleep-wake cycles that are regulated by the hormone melatonin, which is often deficient in kids with ASDs, Engelhardt and his colleagues write in Paediatrics.  Because kids with autism spectrum disorders, like those with ADHD, also tend to spend a lot of time watching TV and playing video or computer games, the researchers wondered whether that could be contributing to their sleep problems.

So they recruited the parents of 49 boys with autism spectrum disorders, 38 with ADHD and 41 comparison boys with typical development to fill out questionnaires about their children's bedroom screen access and sleep patterns.

 All the kids were between ages eight and 17. Boys with autism who had TV, computers or video games in their bedrooms got less sleep than all the other boys, including boys with autism who didn't have media in their bedrooms.

Limiting electronics

Without a TV in their room, boys with autism spent an average of about nine hours sleeping, compared to less than eight hours among kids with an ASD and a bedroom TV.

In contrast, bedroom TVs didn't seem to make a difference for boys with ADHD or typical development. Boys with autism with computers in their rooms slept nearly two hours less than boys with autism and no bedroom computer.

A lot of time spent playing video games, regardless of where they were located, was also linked to shorter sleep times among boys with ASDs. Even for typical children, too much time with TV or video games has been linked to attention problems, hyperactivity, arguments and physical fights, Engelhardt said. "We can't say that access to a TV causes less sleep," only that the two are linked for some kids, he said.

Last month, the American Academy of Paediatrics called for limiting screen time for all kids to one or two hours per day. ”This is a good recommendation for all children," Dr Beth Marlow, Burry Chair in Cognitive Childhood Development and director of the Sleep Disorders Division at Vanderbilt University Medical Centre in Nashville, Tennessee.

"Following this recommendation for kids with (autism spectrum) and ADHD is good, although children with (autism spectrum) or ADHD who are still having difficulty with sleep despite limiting electronics really deserve a sleep evaluation by their paediatrician or sleep specialist.

Time distortion

"Sleep troubles can also stem from anxiety, sleep apnoea, pain that the child might not be able to express, gastrointestinal problems or seizures, she said.

For typically developing kids, bedroom TV access doesn't usually seem to cut into sleep. "However, (Engelhardt's) finding for teens with ASD concurs with our clinical impressions – that these teens have difficulty 'switching off'' videogames," Michael Gradisar said.

Gradisar is a clinical psychologist who studies technology use and sleep, especially among teens, at Flinders University in Adelaide, South Australia. "Many teens have a distorted sense of time passing when playing videogames, however, it may be that this time distortion is stronger for teens with ASD," he said.

Parents can have a tough time managing how much their children play games or watch TV, he said. "It may take quite some time to do, but one option is for parents to introduce other hobbies and activities into their teens lives, so that video gaming eventually occupies less time."

Engaging features

"People with autism tend to spend more time with media outlets, researchers think, because the electronic worlds have engaging audio and visual features and their social interactions are easy relative to real life interactions."

This doesn't necessarily mean that parents should take TVs or video games out of their autistic children's rooms, but might consider limiting or monitoring media consumption, he said. "Screen media can certainly be good for kids with autism," he said.

"Scientists have long known that video games are great at teaching and reinforcing certain behaviours, so it's possible that these games can be used to adjust and shape the types of behaviours generally valued by society, such as behaviours intended to help others."

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Too much TV hurts children's chances at kindergarten success and social skills

This study claims that extra TV time beyond recommendations hurts children's chances for kindergarten readiness and certain social and developmental skills.

Every hourly increase in daily television watching at 29 months of age is associated with diminished vocabulary and math skills, classroom engagement (which is largely determined by attention skills), victimization by classmates, and physical prowess at kindergarten, according to Professor Linda Pagani of the University of Montreal and the CHU Sainte-Justine children's hospital.

"This is the first time ever that a stringently controlled associational birth cohort study has looked at and found a relationship between too much toddler screen time and kindergarten risks for poor motor skills and psychosocial difficulties, like victimization by classmates," Pagani said. "These findings suggest the need for better parental awareness and compliance with existing viewing recommendations put forth by the American Academy of Pediatrics. The AAP discourages watching television during infancy and recommends not more than two hours per day beyond age 2. It seems that every extra hour beyond that has a remarkably negative influence."

Pagani conducted the study to discover the effect of television viewing prior to kindergarten. He said, "Much of the research on school readiness has focused on how kindergarten characteristics predict later success. Kindergarten entry characteristics predict long-term psycho-social adjustment and economic characteristics like income and academic attainment. Being innovative, my focus has been to examine what predicts kindergarten entry characteristics. Adding further originality, I also wanted to focus on neglected yet crucial aspects of school readiness such as motor skills, which predict later physical activity and reading skills, likelihood of being "picked-on," which predict social difficulties, and skills at linked to doing what you are supposed to be doing when having been given instructions, which are in turn linked to attention systems that are regulated by the brain's frontal lobe development."

991 girls and 1006 boys in Quebec whose parents reported their television viewing behaviour as part of the Quebec Longitudinal Study of Child Development.

One extra hour of TV

Pagani noted that the standard deviation is a commonly used statistic tool that tells us what is within a normal range compared to the average. One standard deviation from the average daily amount of television viewed by the toddlers in this sample (105 minutes) is 72 minutes. Some of the children who participated in the study were two or even three standard deviations away from the average, and their kindergarten indicators were correspondingly worse than those who were one standard deviation away.

This study only looks at the most common form of screen time, which is in the home. However, it may be an underestimate because many child care settings use television as an activity during care giving.

Pagani said that "because of kindergarten's power to predict future productivity, the identification of modifiable factors that foretell not being ready for the transition to formal schooling represents an important goal for a productive society. By statistical standards, the results show highly controlled modest associations, yet these are net effects which suggest a developmental course which could ultimately compromise achievement, social relations, physical prowess, and preferences and habits toward a healthy lifestyle."

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