Screens have become one of the most symbolic elements of modern society. Where we once gazed cheerfully at sunsets and the grime above our fireplaces, we now spend endless hours replete in the satisfaction of the wonders of iPhones, television, and the glorious wonders of our home computers.
The world really has changed a lot in the last few decades.
And screens are one of those things that we really love to hate. Whether it’s because they are artificial, or because we rely on them for nearly every action these days — try banking entirely by paper, it’s a nightmare — screens are something that we are both drawn to and terrified of in equal measure.
Which brings us to recent headlines that have sprung up across the world proclaiming that the evil screens are doing terrible damage not just to us, but our children. According to media from around the globe, screen use for infants may not just be a good way to keep them quiet for half an hour, it might also be causing them to develop autism.
Apparently Netflix isn’t just for fun, it’s also hurting our babies.
This is especially worrying because we are all trapped inside with not much to do right now. As COVID-19 sweeps the globe, reported screen usage is trending upwards dramatically, and many parents are struggling to keep their kids entertained even with the Wiggles’ Netflix special on repeat.
The problem is, the science really doesn’t say that screens are bad at all. While screens may yet turn out to be evil — I know I don’t trust my Samsung S20 entirely — the evidence shows that you probably don’t have to worry too much about them hurting your kids.
The new study that everyone’s talking about was a pretty basic piece of epidemiological research looking at a group of infants (age 12–18 months) and their screen use. The scientists took an existing sample of kids, asked their parents how much TV they watched, and then followed them up a few years later with a questionnaire used for diagnosing autism. They found that babies who were exposed to more screens had a 4% higher score on this questionnaire, meaning that they were more likely to be autistic than the kids with no screen time.
Cue the dramatic music and terrified screaming.
But while this was the only finding from the study that was reported by the media, it actually wasn’t the only thing that the study found. The primary analysis used a clinical cut-off for autism diagnosis — the point on the questionnaire that a doctor would use to make a decision — and found there was no difference for the risk of autism at all. The study also looked at both 12 and 18 month olds, and while there was a minor increased risk for 12 month olds and screens, by 18 months this had disappeared entirely.
It’s also worth noting just how minor this increase is. The 4% reported increase is based on a 0–20 scale, where each point represents a ‘yes’ answer to a series of questions. While some children scored highly on that scale, the majority score below 10, and many score below 5. A 4% increase in this scale doesn’t even represent a single digit increase in the scale itself, making it virtually meaningless clinically.
To put it another way, we don’t really care if a child scores 5.1 or 5.2 on this scale, because they’d both be the same.
There were, unsurprisingly, a huge number of other issues with this research. As with most similar studies, there were a large number of unknown confounders that almost certainly impacted the findings. In fact, the authors even demonstrated this in the text using a fancy statistical analysis — they themselves showed that it’s unlikely that screens were causing the results that they found!
There were also problems with exposure assessment — they only asked about TVs and DVDs, and I doubt those are the biggest worries for most parents and screen time — and potential issues with the sample itself.
In other words, it’s hard to take much away from this study at all.
Screens And Kids
We’ve known for years that screens are associated with a huge number of bad outcomes in kids. Children who have more screen time are less likely to exercise, more likely to have depression, more likely to have low self-esteem, and a host of other problems.
It does sound bad for screens, I grant you.
The problem here is that all of these are associations, rather than definitive causal factors. Children who use screens more often are less healthy in a lot of ways than those who don’t — they’re richer, have more access to exercise facilities, are less likely to be from minority groups, the list goes on. It’s entirely possible that when we measure screen use we’re just using it as a proxy for social disadvantage generally, because screens are far cheaper than things like dancing lessons and weekly trips to the zoo. We know that kids who use screens more are less healthy, sure, but what happens when we actually intervene to get them to use screens less?
The answer, generally, is not all that much.
A recent systematic review from 2016 looked at interventions to reduce screen time in children, and found that even in successful interventions lasting nearly a year, there was at best a tiny decrease in BMI. This is despite the fact that the average reduction in screen time across these studies was nearly 5 hours a week, which is considered to be pretty massive in most of the observational trials. You’d expect such huge reductions in screen time to have a correspondingly big health benefit — instead, there seems to be hardly any.
Which begs the question: are screens really all that bad for kids?
Keep Calm: There’s A Pandemic On
Ultimately, we can’t really answer the question of how bad screens are because the evidence is pretty mixed. Yes, there’s suggestive observational research, but there are also interventional studies that haven’t found much of a benefit from reducing screen time. The most recent study about screens and autism was enormously flawed, and tells us basically nothing about whether screens are risky for kids anyway.
And honestly, we all have bigger things to worry about right now.
My advice is not to stress too much about screens and your children. Chances are that they’ll be spending more time in front of their glowing companions for the next few months than usual, but that’s mostly a function of the global pandemic and doesn’t reflect on your general parenting skills at all.
Screens may not be the best thing in the world for kids, but they’re probably not ruining their mental health either.