AS a paediatrician, I am trained to examine crying, unhappy, and anxious children. I find that the child’s distress during physical examination is often dwarfed by that of their parents. There was a time when parents, in desperate need of soothing their child, would take out a favourite toy, rattle, or book from their bags. Nowadays, they only have one solution to placate their child — a mobile phone. This makes me unhappy and anxious!

The portability of mobile devices has allowed them to increasingly be used to keep children quiet and distracted. They are a new addition to the list of devices that contribute to children’s screen time, which includes television, computers and gaming devices. In paediatrics, there has always been concern over exposing children to screens too early and for too long. We have long advised parents to refrain from using the television as a stand-in babysitter. Just as this recommendation started to make a dent, in came the handy, 24-hour alternative.

If parents do not grasp the harmful effects of extended screen time on children, our future generation will be burdened with aggravated mental health issues. Studies are already showing a higher association of behavioural problems, hyperactivity, and inattention in children with increased screen time.

Quality time with parents has decreased as a result of mobile devices. This lack of interaction with parents impairs language development, emotional self-regulation, and academic performance. Additionally, mobile devices have reduced time spent with one’s peers — a rich resource for developing creativity, solving problems, and self-expression. All of this can stunt a child’s ability to respond to everyday setbacks and form strategies to overcome them.

Mental health issues can result from extended screen time.

As a result, the child may become socially isolated and will lack basic social competency and well-being. Children with more than the recommended screen time are shown to have sleep disturbances. Moreover, a sedentary lifestyle, in the absence of sports and activity, can lead to obesity. Watching violent and aggressive programmes can desensitise children and, consequently, they may accept violence as a way to solve problems. Children are also vulnerable to the dangers of cyberbullying when online. Relatedly, predators searching for vulnerable children may groom them online — eventually leading to sexual assault. Inadequate parental supervision can also lead children to inappropriate websites — many with pornographic material.

While we know that mobile phones emit radio-frequency, non-ionising radiation, we do not yet know the effect this radiation has on a growing brain. Studies are currently under way to establish whether radiation through a mobile phone leads to brain tumours or other types of cancer.

There are also concerns about the effect of radiation on cognitive development, which is the development of intelligence, language, perception, reasoning, and memory. While the jury is still out on this, it may not be worth risking a child’s mental growth. It will take years to complete these studies and the water may be way above our heads by the time we know.

The American Academy of Paediatrics discourages screen use for infants under 18 months old except for the purposes of video-chatting. Additionally, they recommend not letting toddlers aged 18 to 24 months use any form of media by themselves. Any exposure to a screen should be short and under the supervision of parents. For children older than two years, screen time should not exceed an hour per day.

All children and teens need an adequate eight to 12 hours of sleep along with physical activity and time away from the media. In this Covid-19 era, when schools are online and we are more dependent on our devices, it is impossible to keep school-aged children away from them. Therefore, parents are encouraged to be ever-vigilant and create personalised programmes according to the child’s needs and development.

Parents often inquire when is the right time to give a mobile phone to a child. The main question to ask yourself is if your child is responsible enough to carry a mobile phone. Studies have shown middle school may be an appropriate time. If given to elementary schoolchildren, it should only be for medical or emergency reasons.

Some additional tips for parents are: know how much screen time your child is exposed to; no screen time one hour before bed; meals and family time should be phone-free. This rule also applies to parents, who should: use parental control apps; foster open communication with children and be easy to reach out to; keep themselves updated with the negatives of social media; explain the advantages and disadvantages of mobile phones before buying children a phone.

The writer is a paediatrician.

Published in Dawn, October 14th, 2020