Technology, The Double-Edged Sword

By Chelsea Roszak, Pediatric OTR/L

Although technology has changed our worlds for the better, MODERATION is key (like everything else!) In today’s digital age, there are more and more OT referrals for decreased strength motor skills, attention, the inability to form letters, and difficulty with impulse and self-regulation. Many colleagues and I ponder if today’s technological and instantaneous methods are at the root of these difficulties. Less kids are doing arts and crafts, or using their imaginations to create and play. More and more children are sedentary, using their index fingers to swipe an endless screen full of animation and clips.  So many caring parents are simply unaware of the developmental damage caused by exposure to screen time/media, beyond the obvious (laziness, watching and learning/imitating violent, inappropriate behavior, reducing social interaction). For this reason (and many others) I decided to research and provide you with the many differing areas screen time can negatively affect our children and how:

1. Impulse control and self-regulation

• Due to the immediateness of technology today, children seldom experience “being bored,” decreasing the opportunity for creativity, play, and the ability to entertain themselves. With hundreds of games and videos at their little fingertips, children in the digital age do not learn the idea of “waiting”, increasing impulsiveness and “behaviors” and the ability to self-regulate their bodies and their emotions. Think about it: if you make a mistake on the computer, you can hit “undo”. If you do not like a YouTube video, you can click the next and go through a hundred videos in minutes. If you don’t like the game you are playing, or you are losing the game, you can escape, “X” out or go to a different game. If you don’t like a TV show, you can immediately choose another. If you DO like a TV show, you can watch a dozen episodes instantly. In prior times, you might have had to wait a week until the next episode, OR months until the next season! Today, with instantaneous technology such as Netflix, Hulu, Amazon, YouTube, this concept is a rarity. Further, phones and tablets are often used as “babysitters” when families are out to eat or out in the community. This minimizes children’s opportunities to socialize, learn the culture of waiting and interacting with others. Children need to learn to wait and act appropriately when out to eat, walking through stores, or waiting in “waiting rooms”. This may not always be an easy solution (especially in moment of desperation when your child is screaming in a quiet waiting room) but the long-term effects are detrimental. Further, children who have “poor play skills” are not given enough opportunities to be creative and use their imagination. Lastly, the increase in screen time has taken away from the idea of “self-reflection” at the end of the day. Their minds are constantly distracted by screens, diminishing the time to reflect back on the day such as accomplishments or things we can do better, etc. Therefore, remorse and self-correction are not being practiced, as well as pride and desire to please or do better.
  
  It’s simple: less screen time = more time children are “forced” to be creative and play
• Next time your child is coming to you for entertainment, or crying, and you want so badly to take out your phone, resist. It is okay if your child is not always entertained. It is okay if your child cries sometimes (in public or at home). Letting a child deal sometimes with boredom and frustration is important for their ability to develop resilience and self-regulation. You can use this experience as a learning opportunity to give them tools and ideas(“Do you want to go play with your blocks?” “Would a hug help you feel better?”) but then give them the space to grow, develop and cope with the inevitable challenges of life.
• Games and applications operate in brief segments that are not attentionally demanding. In addition, they offer immediate rewards with a strong incentive to increase the reward by “winning” or trying the next level. The time spent on these games may also exacerbate impulsive or decreased attentional symptoms, if not directly, then through the loss of time spent on more developmentally challenging tasks.
• The prolonged hours of Internet and gaming use may further reinforce and consolidate the child’s tendency to impulsive, rapid, hyper-focused reactivity. This is also in contrast to the types of activity that might have otherwise filled the same leisure hours such as complex play, sports, music and arts, or organized youth clubs, which would help develop attention, self-control, behavioral inhibition, self-discipline, team skills, and socialization. Lack of exposure to these activities might be associated with a decrease in practice opportunities for working memory, patience, attention, and executive functioning (Diamond 2007; Diamond et al. 2007).

2. Fine Motor Skills

• Children are not exposed to as many arts and crafts activities, tinker toys, or again opportunities to play more with their hands. Engagement in these activities are crucial to development of fine motor skills including development of arches of the hand, finger isolation, intrinsic hand strength, coordination and separation of the hand which are all critical and needed in all aspects of life including self-care, dressing, writing, opening lids/containers, manipulating small objects, etc, etc. Deficits in any of these areas can be relatable to the decrease in function of someone who has had a stroke and experiences decrease strength, dexterity and coordination of one arm.
• In a cohort study of early childhood development in 2441 mothers and children, higher levels of screen time in children aged 24 and 36 months were associated with poor performance on a screening measure assessing children’s achievement of development milestones at 36 and 60 months, respectively.

 3. Gross motor skills:

•  As children are introduced to, and use technology, it is obvious they become less physically active. Not only does technology encourage a more sedentary lifestyle, children are losing opportunities to grow important motor skills during the most critical years of development. More and more children are being referred for services such as Occupational therapy and Physical therapy secondary to decreased muscular strength and coordination skills. Often, no neurological or sensory conditions are present; this child simply has little experience being physically active and participating in motor-skill games such as jump rope, hop scotch, red rover, tag, sports, etc. With that being said, being more sedentary decreases the opportunity for our sensory systems to develop. Without the proper amount of running, jumping, rolling and spinning, more children have sensory processing difficulties, or underdeveloped sensory systems. The body simply lacks the ability to process sensory information including our inner ear system (vestibular) which is responsible for balance, equilibrium, and spatial orientation for the purpose of coordinating movements with balance. This leads to decrease socialization, confidence, and self-regulation and increase risk of anxiety, depression, isolation, and obesity.
• Besides the vestibular system, our visual systems are affected as well. The rapid ever-changing screens affect our ability to visual attend to one thing for increased periods of time, a skill children desperately need to be success in school, work, and life. Further, the faster the changes in the sensory information you’re taking in, the faster your brain needs to process it in order to keep up, (Guttmann, 2017). According to Guttmann & Guttman, “If the pace required is so fast it exceeds your brain’s threshold, you may experience sensory overload. The rapid-fire changes on typical screen entertainment are much faster than the typical visual changes of ordinary, unscreened life (like teacher’s teaching in a classroom). Yet these rapid changes don’t often cause noticeable sensory overload. The child can keep up with the processing, but their brain is working super-fast to do so, and is becoming wired this way. Often parents of children with ADD/ADHD diagnoses will report “I don’t understand. My child has trouble focusing on most things, but when it comes to TV or video games, I can’t get him to stop. I can wave my hand in front of his face, touch him or say his name loudly and it’s like I’m not there. He seems super-focused!” … because he is- to animation.
• To reset the pace of your child’s body and brain, jump her back INTO her skin. Use the vestibular system.Get your child moving. Jump, swing, run around. The linear acceleration will reset the vestibular system and calm the entire body.There is a concern, however, that repeated incidents of super-busy processing during stages of development could cause permanent changes in the processing pace that the brain seeks. Your two-year old could potentially grow up feeling “comfortable” in the super-fast pace of screen media stimulation and uncomfortable in the normal pace of everyday life, including attending to a teacher in class or a “still” worksheet a child is struggling to focus and complete.Your child’s performance might be high in gaming and internet information processing, but what about performance in low-tech activities such as building relationships? Parenting? Achieving greatness at anything, from sports to music to business?”

4. Cognition:

•  Children are less aware of their surroundings as they are often distracted and engaged in an application or game when driving around in the car, or getting pushed in the stroller around the store. From a cognitive point of view, it has increased the use of visual relative to auditory communication and placed a premium on short snippets of communication rather than sentences and paragraphs. Where previously childhood consisted of free play in large group games, many children now live in a world of web-based media that may be foreign to many parents and even more alien to most grandparents.
• In addition, rapidly changing screens put minimal demands on attention and working memory (Van De Voorde et al. 2010), forced effort, or writing (Adi-Japha et al. 2007) all of which are part of development in young children.
• It’s simple: more screen time decreases the ability for a child to attend to a meaningful, functional task for longer periods of time. Often, they may appear “irritable”.

A thought about tablets for children with Autism:

• “Scripting” or “rehearsing” is a common characteristic in children with ASD. This is a characteristic most parents (and teachers) are concerned with because it appears as if their child is in another “world” (watchin and acting out a movie or video clip) and not focused in the present. Although a common trait, excessive view or “YouTube” short clips and other Apps, leads children to script even more, decreasing their opportunity to use imaginations and creative play. Instead, endless YouTube clips givw “more ammunition” to their rehearsing repertoire and tendencies.  Again, limited screen time (endless videos and animation) allows opportunity for creativity, play, and social skills, all the necessary skills needed to learn and build foundational self-regulation, strength, and social skills.

So, what are the recommendations?

1. Create strict limits with tablet use. Use timers for short periods of time. For example, every hour that your child participates in creative plays, completes homework, or chores, he/she can earn 20 minutes of screen time.
2. Make screen time “functional”. Learn how to “lock” other apps in parental settings (including youtube or freedom on the internet/google, social media, mindless “games”). Allow only use of approved, academic applications or “games”, approved “movies” when appropriate, calculators, schedules, calendars. Have your child use their imagination
3. Be sure not to allow screen time 30 minutes before bed, as this is scientifically proven to disrupt your child’s sleep cycle.
4. Avoid making screen time “isolated”. Co-Screen and see what your child is doing and make it a bonding session.
5. Ask inciteful questions such as “why, who, what”? (example: why do you think that character is wearing/saying/doing that?” or “how do you think that character feels and why?”  or who do you think made this story and why?”
6. Make your opinions known. Let your child know they need to do more physical play, more play with toys mommy and daddy buy, etc.
7. Don’t be a hypocrite. Limit your own screen time, especially in front of your children. They shouldn’t need to “work” for your attention because you are on a screen.
8. Play together. Play with your child, inside, outside, use toys, imagination. Model how it should be done!