Over the past decade, screen-based technology has continued to infiltrate children’s lives. According to a recent survey by Common Sense Media, a nonprofit that provides parents with entertainment and technology guidance, American children ages 8 to 12 spend an average of almost five hours a day looking at screens; children under 8 spend about half that time, and teenagers spend more than seven hours a day. That doesn’t count the time they spend using screens for schoolwork.

Other statistics from Common Sense Media also point to the proliferation of technology in young people’s everyday lives:

• More than half (53%) of American children own a smartphone by age 11, and nearly 70% have one by age 12.
• Children under 8 spend 39 minutes a day watching videos online (YouTube, TikTok, and the like), a number that has doubled over the past few years.

The data predates COVID-19 and its global lockdowns, which sent an estimated 1.5 billion children home by the end of April 2020. Stuck at home due to the pandemic, children have spent excessive time in front of screens, from TVs to smartphones to tablets. Online activity on children’s devices doubled in the early days of the pandemic, according to Qustodio, which tracks how children use devices and developed an app to help parents manage their children’s tech habits.

While the prevalence of technology affords opportunities for education and social connection, its increased usage presents unique challenges to children’s physical and mental health and development — challenges that COVID-19 has exacerbated. Learning more about the effects of technology on children can enable parents, educators, and health care professionals to develop strategies to counteract its potentially negative impact.

Pandemic-induced business and school closures have caused many families to adjust to a new reality. Parents have converted bedrooms and living rooms into home offices, while children have transitioned to online learning and an increasingly digital social life. Meanwhile, many parents have eased restrictions on devices so their children can stay entertained, engaged, and connected. The availability of technology during the pandemic has been a double-edged sword.

The upside of devices is that they can provide an opportunity for children to continue their education and maintain relationships with friends and family.

• Remote learning. Computers, tablets, and smartphones have allowed students to remain connected to the classroom, albeit virtually. Many students have appreciated the less structured nature of remote learning and ability to work at their own pace and on their own terms. Distance learning has also been a blessing for students with social anxiety.
• Staying connected. In the age of social distancing, devices and other forms of technology have been a social lifeline for many, especially children. Young people have relied on screens to stay safely connected with grandparents and other family members and chat with friends while playing video games online. Studies have shown that using social media and messaging platforms to stay in touch with loved ones improves mental and emotional health, particularly in times of crisis.

The downside of devices is the reality that children may use them too much and that screen time may supplant family time:

• Too much screen time. Screens already occupied a significant chunk of young people’s lives before the pandemic — and even more so during it. Qustodio reports that children spent an average of 97 minutes a day on YouTube in the early days of the pandemic, twice as much as in 2019. Too much screen time poses several potential negative consequences, including vision impairment, sleeplessness, anxiety, and even addiction to the device itself.
• Family avoidance. In some cases, the more time children spent with their screens, the less time they spent with their family. While useful to remain connected, devices can be a poor substitute for in-person interactions that help children — particularly very young children — develop valuable social skills. In response, many parents have sought to impose restrictions on their children’s tech use.

Numerous studies overwhelmingly indicate that, in general, children today spend significantly more time inside in front of screens than they do outside playing. Plenty of evidence shows that issues such as obesity, sleeplessness, and vision problems are among some of the negative physical health effects of technology on children.

While children across all age groups spend several hours a day in front of screens, some estimates suggest that they may spend as few as four minutes engaged in physical activity outdoors. COVID-19 has exacerbated this issue, leading to school closures and the temporary suspension or cancellation of many sports clubs and leagues, limiting children’s opportunities for both social connection and exercise. Additionally, about 25% of children don’t live in neighborhoods with sidewalks or walking paths, potentially limiting their physical activity, according to the Kaiser Family Foundation.

Research has shown that children who spend two or more hours a week playing sports or engaging in other organized physical activity are also less likely to experience mental health issues.

In addition to the connection between technology and lack of exercise, researchers have found strong correlations between too much screen time, such as from television watching and computer use, and obesity in children. Some evidence suggests that children often eat less healthy food, and more of it, when they spend an excessive amount of time in front of screens.

Screens present numerous vision problems. Eyes may get tired and strained from extended screen time, especially when the lighting around the screen causes glare. Long stretches of screen time can also dry out and irritate eyes. Screen time also keeps children indoors — exposure to natural light is critical for young children. Studies suggest that ultraviolet light plays an important role in healthy eye development and that too much time spent indoors can lead to nearsightedness, cases of which have increased dramatically in children over the past 30 years.

According to SleepFoundation.org, the blue light from digital screens, particularly at night, affects melatonin production by tricking the brain into thinking it’s daytime, and thus possibly altering the brain’s sleep rhythms. For children, who ideally should get as much as 10 hours of sleep a night and often use their devices in the evening, that can be detrimental.

• BMJ Open, “Effects of Screen Time on the Health and Well-Being of Children and Adolescents: A Systematic Review of Reviews.” This study examines the existing research into the impact of screen time on children’s physical and mental health and development.
• Children’s Hospital of Philadelphia, How Too Much Screen Time Affects Kids’ Eyes. This source explains how screens impact children’s vision and provides tips for parents to help their kids practice good eye habits.
• Organization for Economic Co-operation and Development, “Impacts of Technology Use on Children: Exploring Literature on the Brain, Cognition and Well-Being” This paper provides an overview of research into the effect of technology on children’s health.

Beyond the physical health impacts of technology, a growing body of research on the potentially negative effects of technology on children’s mental health exists. Excessive tech use has been associated with anxiety, depression, addiction, and other issues. This research has taken on new urgency during the COVID-19 pandemic.

Multiple studies have shown a link between social media use and increased feelings of anxiety and depression, particularly in children. During the pandemic, many young people have turned to social media to stay in touch with friends and family. Though ostensibly intended to connect people, social media — with carefully curated feeds of people’s idealized versions of themselves — can often lead to loneliness and envy. Many users also get their news from social media (much of it negative), which can cause anxiety. Conversely, evidence suggests that the less time people spend on social media, the less depressed and lonely they feel.

Remote learning during the pandemic has helped children continue their education during school closures. However, for many young people, the value of school goes beyond education and includes social interaction; no amount of remote learning can replicate that. School also provides structure and a built-in support system of friends and educators who help children cope with problems, from schoolwork to emotional issues. Without that support system, struggling children may feel more isolated and stressed, especially if parents are dealing with issues of their own.

Too much screen time has also been linked to addiction. Various forms of technology, particularly smartphones and social media, have been associated with addiction, and a recent study showed that excessive video game playing can lead to addictive behaviors. The sensory stimuli and interactive nature of a lot of digital content is particularly appealing to young children. Apps and video games also often reward the user with points or virtual stickers, which like drug use can trigger the release of dopamine in the brain.

Young people may use technology and screens to avoid complex or negative emotions, which have been in abundance during the COVID-19 pandemic. Experts agree that emotion regulation is a critical component of mental health and that interfering with its development during childhood and adolescence can lead to issues such as anxiety and depression. Additionally, screens are an easy means of distraction, allowing children to ignore boring or complex tasks, such as schoolwork, and can lead to attention problems.

A Canadian study found that children who spent two hours or more looking at a screen every day were more likely to meet the criteria for a diagnosis of attention deficit hyperactivity disorder (ADHD) than children who spent 30 minutes or less on a screen.

• ABC News, “More Screen Time Linked to Higher Risk of ADHD in Preschool-Aged Children: Study.” This University of Alberta study explores the link between excessive screen time and ADHD in very young children.
• Mayo Clinic, Teens and Social Media Use: What’s the Impact? This article discusses the pros and cons of social media use by teens, including its impact on mental health, and provides suggestions for parents to protect their children.
• WBUR, “Social Media Use Linked to Anxiety, Depression Among Teens, New Study Finds.” This media report discusses how increased social media use can lead to depression and anxiety in teens and adolescents.

A majority of U.S. parents (66%) believe that raising a child is harder today than it was 20 years ago, and many of them cite technology as a reason why, according to a March 2020 survey by Pew Research Center. The same survey found that more than 70% of parents of children age 12 and younger are concerned that their kids spend too much time on screens; it’s not difficult to imagine why given the potentially negative effects of technology on children.

The World Health Organization (WHO) recommends only one hour of daily screen time for children ages 3 and 4, and none for kids younger than 2. Parents play a critical role in limiting their children’s use of devices, though they should be mindful not to completely restrict screen time, particularly during the pandemic, when devices may be a primary source of social connection. The Children’s Hospital of Philadelphia offers several tips for managing screen time, including the following:

• Setting limits on daily screen time and sticking to them
• Establishing “screen-free” zones (e.g., no smartphone use at the dinner table or in the car)
• Forbidding screens in the bedroom when it’s bedtime
• Leading by example by demonstrating responsible use of technology

While having their own pandemic-related stressors to cope with, parents can help their children mitigate the stress of remote learning in some simple ways:

• Incorporate breaks into a child’s schedule, making time for fun activities, healthy meals and snacks, and outdoor play. If possible, parents should take breaks with their children.
• Provide children with hands-on activities, such as puzzles, painting, and drawing, either to supplement online learning or just get away from screens.
• If age appropriate, introduce children to mindfulness and meditation apps that help them practice deep breathing and relaxation techniques to ease anxiety.

Health experts recommend a balanced diet, regular exercise, and quality sleep as additional ways to help children manage anxiety and depression. The American Academy of Child and Adolescent Psychiatry suggests that parents create an open dialogue with their children and provide a safe space for kids to express their feelings, especially during COVID-19, when they may not always understand what’s going on. Parents should establish trust by always being honest.

To help parents manage the effects of technology on children, the American Academy of Pediatrics (AAP) developed a personalized family media plan that allows families to work together to structure how they use devices. The plan is designed to maximize the value of these devices, so they enhance daily life, not take away from it. Socially distanced playdates and virtual get-togethers with friends and family, using FaceTime, Zoom, or other tools, can also help establish a responsible approach to device usage.

• American Academy of Child & Adolescent Psychiatry, Resources for Helping Kids and Parents Cope Amidst COVID-19. This resource provides a host of links to help families and children cope during the pandemic, including activities to do with kids, ways to talk to children about COVID, and stress management tips.
• Boston Children’s Hospital, Parenting During the Coronavirus Pandemic. This resource has a wealth of links and tips for helping children and families cope during the pandemic, including how to deal with children’s anxiety and suggestions for getting a good night’s sleep.
• Centers for Disease Control and Prevention, COVID-19 Parental Resources Kit — Childhood. This resource provides several links to help parents care for the social, emotional, and mental well-being of children during COVID-19.
• The Philadelphia Inquirer, “Homeschooling a Child With ADHD? Here’s Some Expert Advice.” This article offers tips for parents who have children engaged in remote learning, with special emphasis on helping children with ADHD.

The COVID-19 pandemic has been a jarring and sometimes frightening experience for many, especially for children who may lack the ability to process and understand the crisis. Forced into their homes with little else to do, children may turn to devices and screens as a means of avoiding scary or stressful situations. Research has repeatedly shown that excessive use of technology can lead to various physical and mental health issues, such as obesity, sleeplessness, anxiety, and attention problems.

Screens aren’t all bad though and have, in fact, enhanced the children’s lives in many ways through remote learning and apps that allow them to stay in touch with loved ones. Parents and health care professionals can help children live healthier lives by encouraging and demonstrating responsible use of technology and offering healthier alternatives to screen time.