Preventive Care: Raising healthy kids in the technological age

As a family doctor, my parent patients will ask me about strategies to cultivate healthier habits around screen time for their children.

For better or for worse, screens have become deeply interwoven into the fabric of our lives. All of us use screens for a variety of reasons: education, entertainment, family connection, boredom and connecting with friends. For younger children, video chats are a great way to connect with long-distance relatives. For the older children, much of what they learn is now found online in a video, article or application.

But I am also a parent to two young kids and know firsthand that screens are very effective ways to give me time to complete other tasks or to simply give me a break in the day. But what are screens doing to our children? Are they helpful or harmful? Is there a healthy line we must draw to protect them? What is a parent to do?

Healthy screen habits 

A screen is any device that displays images or text, such as televisions, video games, computers, cellphones, tablets and e-readers. Screens can be actively used (watching, playing, scrolling) or passively used (a TV playing in the background or the child observing a parent using a screen). When it comes to healthy screen habits, we must look at the two ways children interact with screens: the number of hours devoted to a screen per day and how they are engaging with technology.

It’s without question that inappropriate screen use can harm our children. Screen time has been linked to obesity, insomnia, anxiety, depression and poor emotional regulation. Even having background TV noise can diminish the quality and quantity of parent-child verbal communication. In teenagers, media multitasking has a negative impact on executive functioning, especially when it comes to memory, focus and the ability to switch between tasks.

However, screens can also be beneficial. Studies show that age-appropriate television shows can help children with language development and imaginative growth, especially for those growing up impoverished or with other socioeconomic disadvantages. Watching television as a family can increase social connectedness and foster richer engagement with the content. Lastly, the internet can provide an outlet for teenagers to explore their interests and broaden their understanding of the world around them.

By the numbers

So how can we best think about screens and our children? Let’s break it down by age.

• Children under 2 years old
  • I recommend avoiding screen use for children under 2. At this age, children are unable to comprehend what they are watching, so there is little to no “educational” or entertainment value. Secondly, screen time takes away from opportunities for language development, physical play and parent-child bonding.
• Children 2-5 years old
  • At this age, children are more able to understand what is being shown on a screen and can better follow simple plot lines. I recommend limiting screen use to age-appropriate content for less than one hour per day. In our home, we use screen time to more efficiently cook dinner, clean the house or simply to provide everyone a break during the day. Family movie night is also a great way to promote family bonding.
• Children 6-11 years old
  • For this age, video games start popping into the mix, and you may see more online use with school curriculum. This is a great age to start teaching your children how to self-regulate their own screen use, developing family rhythms around screen time and learning what content is considered “good” or “bad.” Parents may want to consider implementing screen timers, parental controls and limiting when and where screens can be used.
• Children 12-18 years old
  • Honestly, this is the age group I worry about most. According to 2023 data from the national Centers for Disease Control and Prevention, over 50% of teenagers spend more than four hours in front of a screen for nonschoolwork use, with most of this time being spent on YouTube and TikTok. Thanks to the internet, teenagers are exposed to way more than their brains can reliably handle: unlimited information, virtual bullying, pornography, violence and a world without boundaries. It is precisely these things that contribute to plummeting rates of self-esteem and confidence in our kids as well as rising rates of depression, anxiety, suicide, homicidal thoughts and inappropriate beauty standards.

What is lost to screen time

What is lost in these four-plus hours online? Physical activity, real social interaction, experiential learning and boredom tolerance. These real-world activities are crucial at this stage for physical and mental health; for learning how to handle challenge, success and failure; for avoiding loneliness; and for nurturing creativity, problem-solving, attention and self-confidence.

In his book The Anxious Generation, Jonathon Haidt writes that two big mistakes we’ve made as parents have been “overprotecting children in the real world (where they need to learn from vast amounts of direct experience) and underprotecting them online (where they are particularly vulnerable during puberty).”

As parents, we must guide our teenagers through this time carefully and intentionally. Some of this will require uncomfortable limitations: delaying smart phones and personal computers for as long as possible; limiting screens in bedrooms; and using stronger parental control settings and timers. But this age group also deserves honest conversations from parents about healthy internet use, its potential dangers and the importance of fostering a life in the real world.

Lastly, we parents are not off the hook. Our own screen use directly impacts how our children will relate to screens. What are we communicating to our children when it seems like the screen is more important than they are? What is so enticing on a screen that distracts you from watching their silly dance or talking to them about their day? In a way, we are our children’s first influencers. Therefore, we must first address our relationship with screen time and screen use before expecting our kids to do the same. This will mean following the same rules we are setting for our children.

Whether we like it or not, we are in the age of technology, and it will likely only increase. Part of our job as parents (and doctors) is to help teach our children healthy habits around screens, defining what is gained and lost with increasing screen time, dedicating ample time to nonscreen activities and setting rules in place that protect our children’s minds.

If you have a specific medical topic you’d like for me to explore or a question about health you’ve always wondered about, please write to me directly at troyjackson@authentichealth.com with the subject line “MountainX Health Question.”