Children and screen use

On the day that a major study has found that using the internet alters our brains, in particular reducing our ability to focus, this article has been published by Dr Aric Sigman in the journal Pediatric Research.

Erring on the wrong side of precaution – Dr Eric Sigman.

Children’s screen media habits are embedded early and last for decades and probably for life. By the time the average American child finishes their 8th year, they will have spent more than a full year of 24-h days on recreational screen time. Shaping their screen media habits in a positive direction from an early stage is therefore imperative.

At a time when discretionary (non-homework) screen time (DST) is the single main activity of First World children, medical bodies from WHO to the US, Australian and New Zealand Departments of Health to the American Academy of Pediatrics and Canadian Pediatric Society increasingly offer parents recommended DST limits as a sensible precautionary measure while research continues. The paper by Pagani et al. and the lead author’s previous work reports ‘developmental persistence in how youth invest their discretionary time’ but adds a new dimension: screen location in early years predicts higher DST and significantly less favourable health and developmental outcomes years later and concludes that ‘This research supports a strong stance for parental guidelines on availability and accessibility.’

Yet on the journey to societal awareness, these public health messages are often met with various calculated obstructions. Parents, including health professionals, are often informed about children and DST through mainstream media, social media, blogs and free online encyclopedias where the issue is often portrayed as an ongoing ‘hotly debated’ cultural issue reflecting a clash between generations, with accompanying headlines such as ‘Screen Time: Is it good or bad for our kids?’.

The Times recently informed the British public that the ‘mental health risk of screens’ for teenagers is no greater than ‘eating potatoes’, explaining that medical concerns are based on ‘cherry-picking of vague research that throws up spurious correlations’.

The New York Times Health section asks ‘But surely screen addiction is somehow bad for the brain?’ and immediately answers ‘It’s probably both bad and good for the brain’, reassuring parents that because they watched hours of TV a day themselves as youngsters, ‘their experiences may be more similar to their children’s than they know’.

The BBC has just informed Britain ‘Worry less about children’s screen use, parents told. There is little evidence screen use for children is harmful in itself, guidance from leading paediatricians says’.

It is worth pointing out that, uniquely, information about the association between DST and paediatric health is increasingly controlled by and accessed through the very media being studied. Screen media often presents itself as a mere neutral platform through which to access information; however, it is worth considering, for example, that BBC Worldwide generates $1.4 billion in ‘Headline’ sales annually from its screen-based products and services. Furthermore, it is almost entirely unheard of for journalists or media to reveal that a DST health study being reported on in the news often emanates from an institution with significant funding from well-known screen media corporations including Google and Facebook.

There are more concerted overtures to influence public and professional perception of this health issue and prevent or discredit precautionary guidance. In 2017, a group of 81 predominantly British and American academic psychologists, including notable luminaries, were so ‘deeply concerned’ about the prospect of British Government health authorities merely offering loose precautionary guidance to parents on excessive child DST that they signed an open letter published in a national newspaper read by many doctors, urging Government doctors not to do so because it would be on the basis of ‘little to no evidence’ that ‘risks’… ‘potentially harmful policies’. Guidelines for parents should be ‘built on evidence, not hyperbole and opinion’.

The Research Director of the Digital Media and Learning Hub, University of California, has attacked the APA’s ‘killjoy ‘screen time’ rules that had deprived countless kids’, lamenting ‘but damage has been done.’

Such debate and conflicting stories may be good for news and social media, drawing the eye to contrariness. However, this is undermining ongoing initiatives to raise awareness among parents that excessive DST is an evolving health issue and to encourage and support them in limiting their children’s excess and late night use.

The purported justification for refraining from offering precautionary DST guidelines is a lack of evidence-based decision-making. Moreover, we are informed most of the evidence is correlational, some of the effect sizes are small, some findings are inconclusive, therefore precautionary guidelines are premature and unjustified.

This point of view appeals to our belief in the impartiality of science and preference for evidence-based decision-making, whereby any precautionary paediatric guidance is ‘grounded in robust research evidence’: systematic reviews of longitudinal randomised controlled studies.

We would all like to have the luxury of formulating public health guidance on the basis of comprehensive neatly quantified data from prospective randomised controlled trials. And it is frustrating to find that the study of DST does not conform to that of other more established areas of paediatric public health.

However, this copious popular refrain ‘evidence-based’ reported in the media is an entirely disingenuous misappropriation of the entire concept of evidence-based medicine. When it comes to policy-making and guidance on child health, the established position remains ‘an ounce of prevention is worth a pound of cure’. For example, WHO considers the precautionary principle ‘a guiding principle… for WHO and everyone engaged in public health’.

There are times in paediatric public health/preventive medicine when the luxury of ‘robust research evidence’ is not yet available. Moreover, as Pagani et al.’s study design makes clear, DST is obviously not a pharmaceutical substance but a complex, multi-factorial lifestyle behaviour.2 Therefore, producing definitive proof of causation in the many domains of study, from neurobiology to psycho-social, will be a long time coming.

And this is where the calculated obstructions come in to play. As WHO observes, ‘The precautionary principle is occasionally portrayed as contradicting the tenets of sound science and as being inconsistent with the norms of “evidence-based” decision-making… these critiques are often based on a misunderstanding of science and the precautionary principle… people must humbly acknowledge that science has limitations in dealing with the complexity of the real world… thus, there is no contradiction between pursuing scientific progress and taking precautionary action.’

Positioning themselves as standard-bearers of high empiricism, those opposed to offering precautionary DST guidance have appropriated the term ‘evidence-based’ in an attempt to mislead society into thinking that to selectively highlight research findings of unfavourable associations between screen misuse and health outcomes and err on the side of the precautionary principle while research continues is a form of unprofessional ‘cherrypicking’ of the evidence. It implies an attempt at public deception through the intentional omission of unsupportive evidence. Misutilitising the term ‘evidence-based’ is a move to misportray those erring on the side of precaution as employing lower empirical standards, and to those unfamiliar with the precautionary principle and standard protocols in paediatric public health—the public and most media—this may seem a convincing exorcism of shoddy practice. It certainly makes for provocative, entertaining media.

This media carnival, in essence, leaves the AAP, the US, Australian and New Zealand Departments of Health, and WHO among others, along with the authors of many highly respected studies conducted at highly respected institutions published in highly reputable journals, as incompetent, untrustworthy and unprofessional. It wrongly casts them as ignoring the intellectual and social benefits of screen technology and preventing children from ‘exploring the world around them’ and developing their full potential.

Such a position indicates either a profound misunderstanding or the intentional obfuscation of the relationship between science and the precautionary principle, and a high disregard for the experience and clinical judgement of child health professionals.

Those opposed to offering precautionary DST guidance have wilfully avoided the distinction between in-house empirical arguments between scientists versus the routine need to develop responsible general protective health guidance for children. They have misappropriated and emphasised the obvious limitations of existing research as a way of casting doubt on the entire public health issue and on the credibility of those simply advocating moderation and sensible precaution, in the hope that DST guidelines will be perceived as impetuous and premature scaremongering. We are urged to err on the wrong side of caution.

However, rigidly adhering to an abstract principle of high empiricism, with a distorted interpretation of evidence-based medicine taking precedence over the protection of children’s health, should be considered self-indulgent and medically unethical. Furthermore, it reveals a high disregard for the important role of the experience and judgement of child health professionals to interpret available evidence, and promotes a hubristic picture of psychology and ‘educational technology’ researchers knowing better than the many paediatric and public health professionals what is best for protecting child health.

The burden of ‘proof’ must now be on them to demonstrate that high and/or premature exposure to DST—and now bedroom screens—pose no health and development risks to children. The time has come for health professionals to begin to scrutinise the motives of those attempting to obstruct provisional guidance on child DST. They are violating the precautionary principle. Fortunately, research teams such Pagani et al continue to uphold it by addressing the elephant in the room—the overlooked issue of how the mere location of a screen may potentiate greater DST and attenuate necessary developmental experiences. We should follow their advice.

Digital vs. Human: Bibliography


Here’s a list of books referenced in my new book Digital vs. Human or otherwise useful. I will update the list across 2016. If readers have any further suggestions please add to the comments. And yes, I know, the links are mostly to Amazon, but this is a blog and I figured it was easy in this particular instance. Order from a physical bookshop if you can.

Angwin, Julia, Dragnet Nation: a quest for privacy, security, and freedom in a world of relentless surveillance, Henry Holt, 2014. Video here.

Arkin, Ronald, Governing Lethal Behaviour in Autonomous Robots, Chapman and Hall, 2009

Armstrong, Stuart, Smarter Than Us: the rise of machine intelligence, Machine Intelligence Research Institute, 2015. Video here.
Barrat, James, Our Final Invention: artificial intelligence and the end of the Human Era, St Martin’s Press, 2013. Video here.
Bartlett, Jamie, The Dark Net: inside the digital underworld, William Heinemann, 2014. Video here.


Bell, Gordon and Gemmell, Jim, Total Recall: how the e-memory revolution will change
everything, Dutton, 2009.


Bostrom, Nick, Are You Living in a Computer Simulation?, Video here.


Boyd, Danah, It’s Complicated: the social lives of networked teens, Yale University
Press, 2014. Video here.

Brynjolfsson, Erik and McAfee, Andrew, Race against the Machine: how the digital
revolution is accelerating innovation, driving productivity, and irreversibly
transforming employment and the economy, Digital Frontier, 2011. Video here. See also PDF.

——, The Second Machine Age: work, progress, and prosperity in a time of brilliant
technologies, WW Norton, 2014. Video here.


Bywater, Michael, Lost Worlds: what have we lost, and where did it go?, Granta, 2004


Carr, Nicholas, The Glass Cage: automation and us, WW Norton, 2014. Video here.


Christodoulou, Daisy, Seven Myths about Education, Routledge, 2014


Clippinger, John, Crowd of One: the future of individual identity, PublicAffairs, 2007
Coupland, Douglas, Microserfs, Regan, 1995


Cowen, Tyler, Average is Over: powering America beyond the age of the great
stagnation, Dutton, 2013. Video here and here.

Davis, Devra, Disconnect, Dutton, 2010. Video here.

Dorling, Danny, All That is Solid: the great housing disaster, Allen Lane, 2014. Video here.

Dyson, George, Darwin among the Machines: the evolution of global intelligence,
Perseus, 1997

Ford, Martin, Rise of the Robots: technology and the threat of a jobless future, Basic
Books, 2015. Video here.

Forsyth, Mark, The Unknown Unknown: bookshops and the delight of not getting what
you wanted, Icon, 2014

Gardner, Dan, Future Babble: why expert predictions are wrong — and why we believe
them anyway, Scribe, 2010, Video here.

Gardner, Howard and Davis, Kate, The App Generation: how today’s youth navigate
identity, intimacy, and imagination in a digital world, Yale University Press, 2013. Video here.

Gleick, James, Faster: the acceleration of just about everything, Pantheon, 1999. Discussion of book on video here.

Greenfield, Susan, Mind Change: how digital technologies are leaving their mark on our
brains, Rider, 2014. Video here.


Greenstein, Shane, How the Internet Became Commercial: innovation, privatisation, and
the birth of a new network, Princeton University Press, 2015. Video here.


Handy, Charles, The Empty Raincoat: making sense of the future, Hutchinson, 1993


——, The Second Curve: thoughts on reinventing society, Random House, 2015


Harari, Yuval, Sapiens: a brief history of humankind, Harvill Secker, 2014. Video here.


Harris, Michael, The End of Absence: reclaiming what we’ve lost in a world of constant
connection, Current, 2014. VRadio interview here.


Head, Simon, Mindless: why smarter machines are making dumber humans, Basic
Books, 2013


Johnson, Steven, Future Perfect: the case for progress in a networked age, Riverhead,
2012. Video here.


Kaplan, Jerry, Humans Need Not Apply: a guide to wealth and work in the age of
artificial intelligence, Yale University Press, 2015. Video here.
Keen, Andrew, Digital Vertigo: how today’s online society is dividing, diminishing, and disorientating us, St Martin’s Press, 2012.  Video here.
——, The Internet is Not the Answer, Atlantic, 2014. Video here.


Lanier, Jaron, Who Owns the Future?, Simon & Schuster, 2013. Video here.


——, You Are Not a Gadget, Knopf, 2010. Video here.


Lasch, Christopher, The Culture of Narcissism: American life in an age of diminishing expectations, WW Norton, 1978. Video here.


Louv, Richard, Last Child in the Woods: saving our children from nature-deficit
disorder, Algonquin Books, 2005. Video here.


Markoff, John, Machines of Loving Grace: the quest for common ground between
humans and robots, HarperCollins, 2015. Video here.


Marwick, Alice, Status Update: celebrity, publicity, and branding in the social media
age, Yale University Press, 2013. Radio interview here.


Mayer-Schnoberger, Viktor, Big Data: a revolution that will transform how we work,
live, and think, Houghton Mifflin Hartcourt, 2013. Video here.


——, Delete: the virtue of forgetting in the digital age, Princeton University Press, 2009. Video here.


Morozov, Evgeny, To Save Everything, Click Here: the folly of technological
solutionism, PublicAffairs, 2013. Video here.


Newton, Richard, The End of Nice: how to be human in a world run by robots, self-
published, 2015. Video here.


Pasquale, Frank, The Black Box Society: the secret algorithms that control money and
information, Harvard University Press, 2015. Video here.


Pinker, Susan, The Village Effect: how face-to-face contact can make us healthier,
happier, and smarter, Spiegel & Grau, 2014. Video here.


Postman, Neil, Amusing Ourselves to Death: public discourse in the age of show
business, Methuen, 1984


Rosen, Larry, iDisorder: understanding our obsession with technology and overcoming
its hold on us, Palgrave Macmillan, 2012


Rubin, Charles, Eclipse of Man: human extinction and the meaning of progress,
Encounter books, 2014.


Rushkoff, Douglas, Present Shock: when everything happens now, Current, 2013. Video here.
Saul, John, Voltaire’s Bastards: the dictatorship of reason in the West, Viking, 1991. Video here.


Schmidt, Eric and Cohen, Jared, The New Digital Age: reshaping the future of people,
nations, and business, Knopf, 2013. Video here.


Schumacher, E.F., Small is Beautiful: a study of economics as if people mattered, Blond
& Briggs, 1973. Short film here.


Seidensticker, Bob, Future Hype: the myth of technology change, Berrett-Koehler, 2006


Silberman, Steve, Neurotribes: the legacy of autism and how to think smarter about
people who think differently, Allen & Unwin, 2015. Video here.


Singer, P.W., Wired for War: the robotics revolution and conflict in the 21st century,
Penguin Press, 2009. Video here.


Snow, C.P, The Two Cultures, Cambridge University Press, 1959. Another download here.


Steiner, Christopher, Automate this: how algorithms came to rule our world, Portfolio,
2012. Video here.


Taylor, Frederick, The Downfall of Money: Germany’s hyperinflation and the destruction
of the middle class, Bloomsbury, 2013. Download here.


Toffler, Alvin & Heidi, Future Shock, Random House, 1970. Video here.


Tucker, Patrick, The Naked Future: what happens in a world that anticipates your every
move, Current, 2014. Video here.


Turkle, Sherry, Alone Together: why we expect more from technology and less from each
other, Basic Books, 2010. Video here.


——, Reclaiming Conversation: the power of talk in a digital age, Penguin Press, 2015. Video here.


Turner, Fred, From Counterculture to Cyberculture: Stewart Brand, the Whole Earth
Network, and the rise of digital utopianism, University of Chicago Press, 2006. Video here.


Twenge, Jean and Campbell, Keith, The Narcissism Epidemic: living in the age of
entitlement, Atria, 2009. Video here.


Wallach, Wendell, A Dangerous Master: how to keep technology from slipping beyond
our control, Basic Books, 2015. Video here.


Wallman, James, Stuffocation: how we’ve had enough of stuff and why you need
experience more than ever, Crux, 2013


Zarkadakis, George, In Our Own Image: will artificial intelligence save or destroy us?,
Ebury, 2015. Video discussion here.
Zeldin, Theodore, An Intimate History of Humanity, Sinclair-Stevenson, 1994


——, The Hidden Pleasures of Life: a new way of remembering the past and imagining
the future, MacLehose Press, 2015