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Physical, psychosocial adversities associated with excessive digital media use among kids and teens

13 Jun 2022

  • Measures needed to prevent, identify, and treat children to minimise long-term harmful impact of screens
  • Collaboration between various stakeholders needed, including parents, healthcare professionals 
BY Ruwan Laknath Jayakody Owing to the physical and psychosocial adversities associated with the excessive use of digital media among children and adolescents, measures should be taken for the prevention, early identification, and treatment of these children in order to minimise the long-term harmful impact of screens, and this requires the participation of and collaboration between various stakeholders including parents and healthcare professionals. These observations and recommendations were made in an article on the “Excessive screen use in children and adolescents: Impact, risk factors, and interventions” authored by Y.M. Rohanachandra and published in the Sri Lanka Journal of Child Health’s 51 (2) in June, 2022. Parents have the greatest role in preventing their children from the excessive use of digital media. The first step in the prevention of excessive screen time is to have age-appropriate rules and limits around screen time. These rules should not only focus on the overall time spent on screens, but should also include limits on the timing of use and the content accessed. For example, it is recommended that screens should not be allowed during meal times and one hour prior to bedtime. Chassiakos et al. noted that keeping electronic devices in their bedroom should also be discouraged. However, enforcing strict rules around screen time on older adolescents may be practically difficult and may actually be counterproductive. For older adolescents, open communications about the dangers of online environments and online safety, while enforcing only essential rules around screen time is more practical. It is also essential for parents to familiarise themselves with social media and digital technology so that they are able to monitor the content accessed by their children on electronic media. It is also necessary to periodically check as to what content or apps have been downloaded by children and remove any inappropriate content. Using software to limit access to inappropriate content online is also essential. With younger children, co-viewing (i.e. watching TV with the children) is important to make sure that they understand the content that is being viewed and to give them an opportunity to clarify any doubts. Parents should encourage their children to engage in physical activity, hobbies, face-to-face social interactions, and screen-free play. It is also important for parents to spend quality time with their children and build close family relationships. Furthermore, parents should refrain from using electronic screens as a means of controlling difficult behaviour. Chassiakos et al. and Blum-Ross et al. noted that it is vital for parents to be vigilant about their own electronic media use and make sure that they model the behaviour that they expect from their children. Given the high prevalence of excessive electronic media use in children, healthcare providers working with children need to inquire about screen time as a part of routine paediatric history taking. A more detailed history on screen time is needed in children and adolescents presenting with autism-like features, developmental delay, headaches, and visual problems, due to their clear association with the excessive use of electronic media. This will enable the early identification of children with screen dependency, allowing early referral to specialised child and adolescent mental health services. Primary healthcare providers and paediatricians have the most contact with children and adolescents and therefore have the chance to provide advice with regard to the healthy use of electronic media. Every opportunity should be taken to advise parents about recommended screen times, the impact of the excessive use of screens, and practical strategies to overcome these problems. Clinical experience suggests that the great majority of Sri Lankan parents are unaware of screen time-related recommendations. They also have poor awareness on where to obtain such information and what services are available in cases of problematic screen use in children. This is especially difficult since most parent education material available online is also in the English language, making it inaccessible to a majority of parents who are not competent in English. Therefore, policymakers should pay attention to developing culturally appropriate parent educational material in the Sinhala and Tamil languages, which is widely accessible to parents of all socio-economic states. One way of achieving this is through incorporating this information into the Child Health Developmental Record (CHDR), which is provided free of charge to all parents, as including this information in the CHDR will help in preventing early exposure to screens and the resulting negative impact on child development. In addition, educational material in the form of leaflets and posters can be prepared and distributed to child welfare clinics of all the Medical Officer of Health areas, in order to ensure the wide availability of this information. Primary healthcare workers have a pivotal role in educating parents about the healthy use of digital media. However, clinical experience suggests that there is a lack of awareness about healthy screen use among primary healthcare workers, and these workers themselves are unaware of the measures that can be taken to prevent problems related to the excessive use of screens. Therefore, widespread awareness programmes aimed at primary healthcare workers, especially public health midwives, is essential in order to promote healthy screen practices among parents. Similarly, conducting awareness programmes for teachers is also important as they are also in close contact with both children and parents. Teachers should be encouraged to have open communication with parents about balancing their children’s screen time with education, leisure, and face-to-face interactions. Finally, at present, various online websites and apps are being marketed as “educational websites and applications/apps” in Sri Lanka, and therefore, the authorities should take measures to monitor these apps and websites so as to ensure that they meet the required quality standards.  


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