In reality, screen time can be a helpful tool. Some programs are even educational, especially when watched with a caregiver. Shows with songs and rhythmic melodies, for example, can help with language production. There is a danger in overusing screen time, however. It can quickly take away from quality time spent learning from a caregiver. Here is how I think about balancing screen time as both a doctor and a mom.
Question: How much screen time should my child actually get?
The Doctor Answer
Screen time is everywhere! In my office, I often find parents using screens as they wait to be called back. I understand—the wait is long, and sometimes it is OK to use some screens. But many parents feel guilty because they think they are giving their child too much screen time. The American Academy of Pediatrics (AAP) guidelines are based on a variety of research that has been done on screen time. They recommend the following:
Children 18 months or younger: No screens, except for video chats with family and friends.18 months to 2 years old: Limit screen time and do not allow your child to use screens alone. Choose high-quality educational programming, and watch it with your child to ensure they are comprehending the material.2 to 5 years old: Limit screen time to an hour a day and watch together, if possible.6 years old or older: Place consistent limits on screen time as determined by the family. Ensure that screen time does not impact your child’s sleep, exercise, or behavior.
The concern with too much screen time is that it can impact memory, language development, and literacy skills. The foundation of expressive language comes from interacting with caregivers and seeing their faces. For example, when you are playing with your child face-to-face and they point to something or make a sound, you will likely gesture or imitate their sounds. This helps them develop both pre-verbal and verbal skills. However, too much screen time can mean your child is not having as many of these face-to-face interactions. (The faces on TV or in videos do not help with this kind of development, since they are not responsive to your child’s actions.) Research shows that kids who use excessive screens have less of an ability to read books as compared to peers their age. Studies have also shown that children who exceeded the AAP’s screen time recommendations perform worse on cognitive tests than those who follow the recommendations. Additionally, researchers have found that increased screen time leads to shorter attention spans, worse behavior, and higher instances of anxiety and depression. A different study reported that toddlers who use more mobile devices daily are more likely to experience speech delays. All this to say, too much screen time can impact your child’s development. But what this research does not show is the importance of spending quality time with your child when they are not using screens. This is something we often overlook. When I provide screen time guidance to patients, I always take into account the age of the child and the parents’ social circumstances. I ask: Is the child under 1? Do the parents have any social support such as daycare, family members, or hired help? Depending on these answers, I remind patients to limit the screens as much as possible for their circumstances. And I always advise them to balance child development and the convenience of screens. With toddlers, I generally recommend holding off on too much screen time until they are showing a consistent use of words and adding new words. This shows that their language foundations are in place. As the child gets older, I advise parents to try to use screen time as part of a well-rounded roster of activities. I recommend they come up with other developmentally appropriate activities a child can do instead of using a screen. If you have chores to do, for example, perhaps your child can play independently, sit in a bouncy swing, or be watched by an older child. If there are no other activities available, it is OK to turn to screen time! I then remind patients to make sure to include other activities and meaningful interactions with their children, too. This can be anything social: playing together, going for a walk, or having a family dinner are all options. Even co-watching programs can help! Any activity that involves you and your child talking is beneficial.
The Mom Answer
As a mom, I approach screen time a bit differently. I rely on screens with our son in a way that does not meet the AAP rules. Before 14 months, we did not use any screen time besides video-chatting with friends, which does align with AAP guidance. After 14 months, our son started using more words and becoming more expressive with his language, so we felt comfortable introducing some screen time. We began by co-watching sing-along cartoons, which allowed us to have bonding time as we connected over a TV show. It also gave us parents a break from active playing. As he got past 18 months, we allowed him to have more independent screen time. Similar to how I counsel my patients, we always make sure to balance extra screen time with quality interactions, and we set boundaries that we stick to. For us, these boundaries include no screens at mealtimes, no screens outside the home, and time limits on how long screens can be used. The most important expectation for us to set is that when screen time is up, devices will be put away, no matter what. Of course, we do bend the rules when we need to. For example, when our son is sick, we allow him to relax with his favorite programs more than we normally would. Or, we will spend more time in front of the TV to watch a beloved movie together, like “The Lion King.” Occasionally, if I am cooking dinner and our son is already hungry and antsy, I will turn on a show so he can unwind as I finish dinner. Generally, if we do go over the AAP’s recommended screen time, we are co-watching with our son. As our son nears 20 months, he has begun to cry when we take away a device. When that happens, we calmly explain that screen time is “all done,” give him the chance to shut off the device himself, and offer up two choices for a new activity. We will ask something like, “Would you like to play with your balls or blocks?” This gives him autonomy after we made a choice to turn off the TV. Toddlers often get upset when the TV turns off because they were enjoying it and it was not their choice to stop. Giving them the power to physically turn off the device and choose what activity to do next gives them some of that control back, while still enforcing screen time boundaries. This is the best approach for my family because it is flexible. It allows us to have some time to ourselves if we are busy and balances appropriate screen limits.
The Takeaway
Remember, when deciding how much screen time to allow, it is OK to think about our needs as parents. Do you need a break for 30 minutes? If so, do not feel guilty about setting your child up with a screen. Try to balance that time with another activity where you engage with your child. My general advice when making screen-time rules is the following: Avoid screen use until you see pre-verbal and some verbal skills. If your child can say “Mama” and “Dada,” that is great! But I recommend waiting until you see at least three to five other words being used consistently before you introduce screen time. This is because we want to be sure the child is processing language from a caregiver in a productive way before swapping face-to-face playtime with screen time. Avoid using screens with meals. Mealtime is for eating. Screens only distract from that. I suggest thinking of screen time like playtime. Set aside a designated time for it during the day. Try to co-watch TV when possible, especially with those under 5 years old. This makes screen time a social activity. Your child can then spend their alone time doing other developmentally appropriate activities, like playing with age-appropriate toys. Avoid screens in the bedroom. Bedrooms are for sleep and relaxation for kids. (And for adults, too!) Try to avoid introducing an iPad or a tablet until your child is 3 or 4 years old. Personal devices are more likely to be used on the go, which quickly adds up to more screen time. Tablets are also very convenient for toddlers to grab, so we can risk overusing them. Remember, the earlier you introduce it, the more frustrated your child will be when you take it away. If you use screen time as a way to get a break, aim to also spend quality time with your child. Use their screen time to decompress. Then you can come back refreshed and prepared to positively interact with your child. I would rather that than a parent who is stressed and frustrated! The goal when determining screen time usage is to understand child development and create rules that work for your family. This may sometimes mean not following the AAP guidance, but it is up to you to decide what is best for your situation. As you make screen time rules, keep your child’s development in mind and balance screen time with impactful family activities, like co-watching screens together, going for an outing to the park or in nature, and/or family mealtimes. Screens are here to stay, so it is important we know how to use them effectively.
