Children spent an average of 84 additional minutes per day on computers and cellphones during the COVID-19 pandemic, data indicate.
A systematic review and meta-analysis of 46 studies indicates that children’s average daily digital screen use increased to more than 4 hours.
Well over a year after the restrictions have been lifted, this finding should put pediatricians and pediatric psychologists on the alert for the deleterious effects of excessive screen time, lead study author Sheri Madigan, PhD, professor of psychology at the University of Calgary in Canada, told Medscape Medical News.
The study raises questions about digital screen use by children. “We really only know about screen time changes at the outset of the pandemic, and now as the pandemic has changed and we’ve resumed a somewhat more normal daily routine, do we see that screen time continues to increase?” Madigan asked. “Or, as we engage in routines that are more typical of prepandemic life, do we see screen times go down?”
The study was published November 7 in JAMA Pediatrics.
Exceeding the Recommendation
The meta-analysis included 46 studies that evaluated digital screen use by participants aged 18 years or younger. The studies were published from January 1, 2020, to March 5, 2022, and included 29,017 children.
“We found that screen time has gone up quite substantially during the pandemic,” Madigan said. “We estimate a 52% increase.”
Before the pandemic, children spent an average of 2.7 hours per day on devices with screens. During the pandemic, that time jumped to 4.1 hours per day.
Among persons aged 12 to 18 years, the increase in daily screen time was even more pronounced: 110 minutes, or almost 2 hours. In total, this age group averaged almost 7 hours per day on screens during the study period, “which far exceeds the recommendation,” Madigan added.
“We know that when kids are on screens for too long, they’re not getting those other essential components of their day, like adequate sleep, adequate physical activity, time with family members — device-free time that we know can actually set them on the right track to healthy functioning,” said Madigan.
The investigators don’t advocate banishing cell phones and computers from children’s lives, however. The meta-analysis cited an analysis of the National Survey of Children’s Health that reported that children with moderate screen use have better psychosocial functioning than children who spend less than 1 hour per day on digital screens and children who spend excessive time on them.
Madigan referred to this as the Goldilocks’ analogy: “Not too much, not too little,” she said. “We want them to get the right amount from screens.”
A limitation of the study is that it didn’t evaluate children’s screen use after COVID-19 restrictions were lifted. Only one study in the meta-analysis accounted for virtual learning. Future longitudinal studies should evaluate screen time changes in this population over the full course of the pandemic and beyond, said Madigan.
This study is a call to action for pediatricians and pediatric psychologists, she added. “It’s really helpful to bring the conversation around screen use up and just to ask kids how they are using screens and how they can really promote a moderate amount of use,” Madigan said. Nutrition and diet provide a parallel. “You can have a little candy, but when you have a lot of candy or when candy is the only thing you’re eating, then it can be really dysregulating.”
Finding Balance
Commenting on the findings for Medscape, Nusheen Ameenuddin, MD, MPH, MPA, assistant professor of pediatrics at Mayo Clinic, in Rochester, Minnesota, said that the finding of increased screen time among children during the COVID-19 pandemic confirms pediatricians’ suspicions. “Although it may not be surprising or novel, it is important to be able to quantify the effect of the pandemic on screen time,” she said. The number of studies included in the meta-analysis “gives this review more power,” she added. Ameenuddin, who did not participate in the study, also is a spokesperson for the American Academy of Pediatrics.
The meta-analysis underscores the need for pediatricians to incorporate the discussion about screen time into wellness checks, she said. “We can also ensure that we are making it a point to ask about media use when there are concerns about mood, schoolwork, or other behavioral concerns.”
During the worst of the pandemic, social media was a way for children and teenagers to connect with friends and relatives and partake in cultural events such as virtual museum tours. “We need to think about things in balance,” added Ameenuddin. “I believe it’s important for us to consider how to maximize the benefits and use media as a way to reach out to populations that have otherwise been cut off for geographical, economic, or other reasons, including disabilities and chronic illness.”
No funding for the study was reported. Madigan and Ameenuddin report no relevant financial relationships.
JAMA Pediatr. 2022;176:1188-98. Full text
Richard Mark Kirkner is a medical journalist based in the Philadelphia area.
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