The amount of time children and adolescents spend with a screen is absolutely stunning. Lots of people, including parents, health leaders, educators, elected leaders from both parties I might mention, and even children themselves, are highly concerned and are discussing what might be done about all this. I'm delighted to begin this series of podcasts on children and screen time. Today we're welcoming two very special guests who can talk about this topic in general, and especially about what's being done to protect children and adolescents. Several podcasts will follow this one that deal with food and nutrition in particular. Our first guest, Kris Perry, is Executive Director of Children and Screens, an organization devoted to protecting children. In the digital world by addressing media's impact on child development, communicating state-of-the-art information, and working with policymakers. Prior to joining children in Screens, Kris was senior advisor of the Governor of California and Deputy Secretary of the California Health and Human Services Agency. Our other guest, Dr. Dimitri Christakis is a professor of pediatrics at the University of Washington School of Medicine, and director of the Center for Child Health Behavior and Development at Seattle Children's. He's also editor-in-chief of JAMA Pediatrics and both Chief Scientific Officer and Chair of the Scientific Advisory Board of Children and Screens. He's also the co-editor of a new book that I'm very excited to discuss.

Interview Summary

Download The Handbook of Children and Screens: https://link.springer.com/book/10.1007/978-3-031-69362-5

Kris, let's start with you. Could you set the stage and give us some sense of how much time children spend in front of screens, children and adolescents, and what devices are being used and what kind of trends are you seeing?

Yes, I'd be happy to. I had better news for your listeners, but as you might imagine, since the advent of the smartphone and social media, the youth digital media use has been increasing each year. Especially as children get older and have increasing demands on their time to use screens. But let's just start at the beginning of the lifespan and talk about kids under the age of two who shockingly are spending as much as two hours a day on screens. Most spend about 50 minutes, but there's a significant chunk spending up to two hours. And that rises to three or three to five hours in childhood. And eventually in adolescence, approximately eight and a half hours a day our adolescents are spending online.

Also wanted to talk a little bit about middle childhood children, six to 12 years of age. 70% of them already have a social media account, and we all know social media wasn't designed for children. And there are restrictions on children under 13 using them, and yet children six to 12 most have an account already. Over half of four-year-olds have a tablet and two thirds of children have their own device by the age of eight; and 90% of teens. This probably won't be surprising, and yet we should really think about what this means; that 90% of teens are using YouTube, 60% are on TikTok and Instagram, and 55% use Snapchat. I'll stop by ending on a really alarming statistic.

Oh my, there's more?

There's more. I know it! I told you. I'll be the bearer of bad news so that we can talk about solutions later. But, children are checking their devices as often as 300 times per day.

300 times.

300 times per day, and we're talking about screen time right now. And we know that when you're using time to be on screens, you are not doing something else. And we know that childhood is full of challenges and skill building and mastery that requires repetition and tenacity and grit and effort. And the more children are on their screens, whether it's social media or other entertainment, they're not doing one of these other critical child development tasks.

That's pretty amazing. And the fact that the older kids are spending more time on before a screen than they are in school is pretty alarming. And the younger, the really youngest kids, that's especially alarming. So, Dimitri, why should we fret about this? And I realize that fret is kind of a mild word here. Maybe all I'll panic would be better. But what are some of the major concerns?

Well, I don't think panic is ever the right reaction, but the numbers Kris conveyed, you know, I think do paint a, let's say, concerning story. You know, the simple reality is that there's only so much time in a day. And if you think about it, teenagers in particular should sleep for eight to 10 hours a day at a minimum. They really should be in school six and a half, seven hours a day. And then when you add the numbers, Kris conveyed, you realize that something's giving because there isn't enough time left to spend eight and a half hours a day. The two things at a minimum that are giving are sleep. Kids are losing sleep to be on screens. And I'm sorry to say that they're losing school while they're on screens. We just published a paper that used passive sensing to see where and when children are on their screens. And found that the typical child in the United States spends an hour and a half during the school day on their device. And it's not, before any of your guests ask, on Wikipedia or Encyclopedia Britannica. It's on the usual suspects of social media, TikTok, etc. So, you know, we talk about displacement, and I think it's pretty obvious what's being displaced during school hours. Its time focused on learning if it's in the classroom, and time focused on being authentically present in real time and space if it's during recess. School hours are precious in that way, and I think it is concerning that they're spending that much time in school. And I told you the median. Of course, some kids are above that, a significant half of them are above it. And at the high end, they're spending 30 to 40% of school time on screens.

Now, some schools have enacted policies. They don't typically enforce them very well. One of the things that drives me nuts, Kelly, is that as an academic, you know we love to argue amongst ourselves and hem and haw. And this issue about whether or not there's such a phenomenon as digital addiction is still being hotly debated. Honestly, the only behavioral addiction that's being seriously considered at this point is gaming disorder. The DSM-5 didn't consider gaming, considered it, but didn't include, it said it needed further study in 2013. In 2022, the WHO did include gaming disorder as an ICD-11 diagnosis. But just as further evidence how slow science is compared to technology., I mean gaming, while it's still an entity, represents a small fraction of most people's screen time. And the numbers that Kris conveyed, a small fraction of that for some on average was gaming. For some people, it's their screen use of choice, but for many, it's social media. YouTube, although I consider YouTube to be a social media, etc. And at the high end when you hear the numbers Kris conveyed in my mind that's a behavioral addiction any way you define it.

Well, and if you think about things that we all agree are addictive, like nicotine and alcohol and heroin, people aren't doing it 300 times a day. So it's really pretty remarkable.

And that's exactly right. One of the salient criteria for those addictions is that it's interfering with activities of daily living. Well, you can't be on a screen for nine hours a day when you're supposed to be asleep for 10 and at school for six without interfering with activities of day. The math isn't there.

And things like being physically active and going out and playing.

That's right. It doesn't add up. So, you don't need the DSM-5. You don't need a psychiatrist. You need a mathematician to tell you that there's too much time on this thing.

Alright, so Kris, talk to us if you will, about the Children and Screens organization. I have a lot of respect for the organization and its work. Tell us how it got started and what its objectives are.

Well,