To game or not to game

When to introduce kids to screens and gaming is a complex decision

Issue #11 of The Journal Club is about introducing screen time to kids. Sometimes, assumptions are made and wrong conclusions are drawn by people who read study headlines — in this case, that all screen time is bad. I hope to provide a more balanced perspective to that conversation especially given the limitations of this study.

Hello JOMT Reader!

I have two young kids, aged 10 and 8. They were born in a world not tethered by coiled phone lines or annoying commercial breaks. Their world was filled with screens—TVs, computers, laptops, phones…almost every commercial appliance now has a screen, silently screaming for attention.

Screens, screens, screens.

My world as a kid was very different. The only screen I had access to was the family TV. Well, and the Gameboy that I spent countless hours on. But the allure of screens didn’t take hold and to this day, I have trouble sitting down in front of a screen for longer than a movie’s length.

Now, as a parent, I wonder about how to manage screen time and gaming for my kids. When should they start using screens, and how much is too much? What impact will screen time have on their development? These are big questions that many parents and researchers are trying to answer.

One helpful resource is Patrick Klepek’s publication, Crossplay, about the crossroads of parenting and gaming. If you’re wondering about how to navigate technology with young kids, make sure you subscribe to Crossplay!

The screen time story to date

Screens can be a lifesaver for exhausted parents. They can calm kids quickly and help avoid potentially awkward situations in public. But is it healthy?

The American Academy of Pediatrics advises against screen use before 18 months of age and suggests careful monitoring from 18–24 months.¹ Part of the reasoning for these recommendations is that screen use could interfere with the child’s brain development, language skills, motor skills (ability to manipulate things in space), and emotional development.

Other studies have shown that playing with a tablet reduces the quantity and quality of infant-parent interactions² and infant-parent verbal interactions.³ A large study in Japan found that screen time at 1 year of age was associated with language and developmental delays at 2 and 4 years of age.⁴

Despite all of this evidence about the effects of screen time, researchers are still exploring why screens might have these negative effects. So the researchers of the study, Mobile Media Content Exposure and Toddlers’ Responses to Attention Prompts and Behavioral Requests, looked into the reasons why these developmental effects occur.

What the researchers did

63 kids (supervised by their parent/caregiver) were analyzed for the their responses to different behavioural requests while distracted by one of the following playtime conditions:

1. physical toy (farm toy)

2. watching another kid play with a farm toy on a screen

3. virtual toy (farm-related puzzle app)

4. virtual game (farm-related simulation)

The behavioural request was to look at a poster on the wall or redirect their attention to a different toy in the room, while they were distracted by one of the four conditions above (technically, this is called the joint attention task). If the kid turned their attention from the playtime condition to the behavioural request, it was counted as a successful response.

At the end of the playtime session, the experimenter asked the kid to return the toy. The number of requests before the kid responded (saying “no” counted as a response) was recorded.

What the researchers found

Unsurprisingly, the number of successful responses was lowest when kids were distracted by the virtual game. The order of playtime conditions from most successful to least successful number of responses was:

watching another kid play > virtual toy > physical toy > virtual game

The same pattern appeared when kids were asked to return the toy or tablet. They were most likely to return the tablet if they were watching another kid play and least likely to return it if they were playing a game on it. Virtual games made it hardest for kids to redirect their attention.

What does this mean?

I think one of the most striking findings of this study is that playing, whether it is physical or virtual, affects how likely kids will respond to adults. Kids were the least successful when responding during either forms of play, which suggests that it isn’t the presence of a screen that matters. What matters is what the kids are doing on those screens.

Although the authors don’t say it this way, another way to frame it is how engaged kids are in the activity. Passively watching someone else play wasn’t a strong enough magnet that prevented kids from responding to behavioural requests. It’s a bit surprising that the tablet puzzle was not a strong magnet, but it’s possible that the kids were too young for puzzles.

The distinction between screen time and what they are doing with those screens is important because the two are used interchangeably to suit a particular perspective. Most of the conversation against screen time for kids doesn’t distinguish what they are doing: screen time is bad. Even the guidelines recommend against “digital media use.” But as this small study showed, some kids still responded despite using digital media, so it isn’t the necessarily the screens themselves.

What does an unresponsive kid mean in terms of their development later in life? After all, that was the initial question the researchers posed. Unfortunately, the authors don’t really get into the details, other than to say that engaging virtual games disrupt social interactions and communication with others. Maybe this becomes learned behaviour that results in kids growing up thinking that it’s ok to ignore adults? And that affects their ability to intake new information, delaying development? I’m not really sure — and it is an unanswered question in this paper.

Limitations of the study

It’s unclear how applicable the study results are to the general population, given that the authors call this 63-person study a “proof-of-concept.” But many more children will need to be analyzed for the results of this study to have real-world significance. Hopefully, larger studies are being planned for the near future.

But there are still more questions left unanswered. Do kids who don’t respond while engaged with a virtual game develop differently than kids that do? Would the study results change if it was a different kid (and not an adult) requesting something? Would the kid have responded differently if the environment was even more distracting, as it tends to be in real life?

Given some of these findings, when is the right time to introduce gaming to kids? If games make it less likely that they will respond (potentially with developmental effects), should parents wait until they are older? Are there “better” types of games to introduce first? And should parents prepare higher value activities to distract them from games when they need to?

The answers to these questions are likely very complex—and there is a different solution for every parent-kid combination that works for them. But understanding the impact of screen time and using it accordingly can help parents guide their kids through our screen-filled world.

If you’re interested in the study, you can read it for free here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820972

If you liked what you read, please consider giving this post a like and sharing it with your community! If you’re a parent, how are you thinking about introducing digital media to your kids? What have you learned that you would be willing to share with other readers? Please let me/us know in the comments below!

1. https://publications.aap.org/pediatrics/article/138/5/e20162591/60503/Media-and-Young-Minds
You’ll find this information in the recommendations section right before the references.

2. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2478386
It was a tiny study (only 26 parent-child pairs) so take it with a grain of salt.

3. https://publications.aap.org/pediatrics/article-abstract/143/4/e20182012/76785/Differences-in-Parent-Toddler-Interactions-With
It’s another tiny study (37 parent-child pairs), but the combination of all of these studies at least points towards a trend.

4. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2808593
This one, by comparison, is a huge study with 7097 parent-child pairs.