Screen Time: A Therapist’s Perspective

Greetings friends and families! Spring is upon us and it’s a great time to start a new activity. How about a 1 week challenge? Screen Free Week is April 29th-May 5th and to encourage participation in this challenge we are asking you to give us your goals/plans for reducing screen time! Please email us at or post a comment on our Facebook page with your ideas on how to reduce screen time in your home. Anyone who contributes will have their name entered into a drawing for prizes!

In our blog this month, our Occupational, Physical and Speech Therapists have provided important reasons, based on their individual expertise, to consider this challenge! Please keep reading below…

Reasons to Monitor Screen Time
Occupational Therapy
Sarah Shifley, COTA/L

Do I think screen time is bad? Sometimes.
Do I think screen time is good? Sometimes.
Are there studies that both support and condemn screen time? Absolutely.
Do I think all families would benefit from screen-time limits? Definitely.

In occupational therapy, I work to help children meet their developmental milestones and participate in age-appropriate play as well as complete their daily activities. I feel it is definitely worthwhile for families to consider how excessive screen time can interfere with their children’s play time (skill acquisition), sleep and self-regulation skills. Below are some questions to help guide you in evaluating how screen time is affecting your child.

Play Time: Does my child have age-appropriate play or engage in a variety of play?

“A Kid’s Job is to Play!” is Idaho Pediatric Therapy Clinic’s motto for an important reason. Play is the natural and optimal process through which kids learn. Playing in a variety of environments (inside, outside, under the kitchen table, in a laundry basket, in the fort made with your couch cushions, etc.) provides kids the necessary opportunities for movement, touch, human connection and exposure to nature. With this variety of play, kids gain skills such as postural control, gross motor skills, bilateral coordination, sensory regulation and body awareness. Two-dimensional screens fall short in these areas! When children’s play time is consumed by electronics, they are missing out on valuable learning. This concern is highlighted in a study published by The Journal of American Medical Association which found that excessive levels of screen time are associated with delays in meeting developmental milestones. You can offer your child more opportunities to learn and grow through unstructured play. One of my favorite mantras to help kids in play is the old Scandinavian saying : “There is no such thing as bad weather, only bad clothing.”-meaning bundle up and go outside!

Sleep: Is my child experiencing sleep disturbances?

When working with kids who are struggling with self-regulation or behavior, one of the first areas a pediatric occupational therapist will inquire about is sleep. Many people can relate to feeling more in control of themselves and their emotions when they are well rested. The same is true for children. Electronic devices such as tablets, TVs and phones can all interfere with sleep due to the blue light that is emitted. Blue light, which is helpful during the day to keep us alert, has been found to delay the body’s natural production of melatonin. This means screen exposure near bedtime can delay sleep onset, disrupt sleep and lead to decreased self-regulation the following day. If your child is struggling to fall asleep or even stay asleep, consider a screen-time curfew of at least 1-2 hours before bedtime and do not allow devices in the bedroom where they can be a temptation.

Self-regulation: Do I notice an increase in negative behavior with my child transitioning to/from a device?

Self-regulation is a common skill that is addressed in occupational therapy. Therapists work to increase a child’s self-regulation skills, but what does that mean? Self-regulation describes the child’s ability to control their response appropriately to a situation. Some examples include both sensory regulation (engage functionally with responses to movement, body awareness, sight, smells, taste, touch, sounds, social situations, etc.) and emotional regulation. So, what does that have to do with screen time? Poor attention, increased impulsivity and obesity are all linked to excessive time spent on electronic devices. These are vital functions of self-regulation. If your child is struggling in these areas of self-regulation you can increase their opportunities for learning by reducing screen time.

One particular sensory system that gets overstimulated with use of screens is the visual system. Video games or other high-speed media are moving at a pace that is not found in the natural environment. Without added physical movement a child may have difficulty regulating this rush of visual information. (Most video games and shows tend to have the child in a stationary position.) Tantrums or meltdowns with transitions away from devices can be the red flag that your child is struggling to regulate their sensory system. In addition, the child may only seek this exciting information and make demands for the device all the time instead of being able to engage in play that develops balance, coordination and other important skills. Eliminating or reducing the amount of time on the screen to prevent over-stimulation is how we can best help children in those situations. In addition, going outside to play or other big physical movement activities can calm the nervous system to help prevent a sensory meltdown. If you strive to increase play time that incorporates all senses for learning, you are providing more opportunities for your child to improve self-regulation skills.

The following link provides the recommended screen-time guidelines from the American Pediatric Association. I think these are excellent guidelines and encourage you to start with these limits and see how your child’s play skills expand with less screen time!

Screen Time, A Physical Therapy Perspective
Brianna Albrecht, DPT

Screen time has been a “hot topic” in the news lately. With increased media coverage and new research articles being presented all of the time, it can become an overwhelming topic for parents. I wanted to share my perspective on some of the concerns related to pediatric development and orthopedic pathology and provide some positive ways to use screens in your everyday life.

As Sarah mentioned above, there was a recent study published in the Journal of the American Medical Association Pediatrics which linked higher levels of exposure to screens to delayed achievement of motor milestones in children 2 years to 5 years of age.1 Translation? More screen time = slower development. Kids tend to remain stationary while using various screen devices. This significantly reduces their time spent in various types of play. It is incredibly important for children to have the opportunity to learn new skills through exploration of their environment.

Anecdotally, the therapists at IPTC have also seen an increase in children reporting orthopedic pain symptoms related to increased use of screens. While engaged in screen time activities, our bodies are held (often for long periods of time) in abnormal positions. Think about your posture as you read this blog on your phone or computer. Your head is likely bent forward, your shoulders are rounded, and your spine is slouched. Small amounts of time in this position probably won’t cause any issues; however, if we stay in this position for extended periods of time repeatedly throughout our day, abnormal forces exerted on our muscles and joints can eventually cause pain. Making changes to your posture while using devices and decreasing time spent using these devices will typically alleviate the pain. One way to do this, are to bring the device to eye level so you can sit up straight with your head upright. Another way, my personal favorite, is to challenge your core muscles while using the device by sitting with appropriate posture on an unstable object such as a therapy ball or SwissDisc.

BUT… I am not here to tell you that all screens are bad! In fact, you will see the therapists at the clinic utilize screens during sessions from time to time. Examples include the Xbox 360 Kinect system which requires higher level motor planning and active participation by the patient, the iPad which can be used as a motivator during static activities such as stretching or balancing, and the television which is a great distraction while engaged in endurance tasks. We use our judgement to determine if a child will respond well to the use of one of these devices.

Where does that leave us? There are definitely appropriate uses for screen devices. It is important to utilize your resources such as your child’s pediatrician, therapists, and teachers along with guidelines available from sources such as the CDC and the American Academy of Pediatrics to develop daily limits on screens for your children (and yourself!). It is also important to be mindful of HOW and WHY you are using the device.

We invite you to participate in the Screen Free Week challenge to see what you can GAIN by eliminating screens for just one week. And remember, if you are struggling for ideas on how to transition away from the use of screens or activities to do in place of using screens, we are here to help you. Good luck & happy spring!

Reference: Association Between Screen Time and Child Development | March 1st, 2019

Screen Time, Influence of Screens on Communication
Speech Language Therapy
Rachel McKell, M.S., CCC-SLP, Jen Martin, M.S., CFY

There are a lot of foundational skills that are being built during the early years of communication. Some foundational skills of language that must be in place to ensure successful communication include: eye contact, joint attention, cause and effect skills, using gestures, understanding turn-taking, imitation skills, engaging in pretend play, and making facial expressions. Each of these skills is complex in nature, contributing to all areas of communication such as understanding language, expressing language, and the use of language. The development of each skill is not usually binary. There can be times when a skill is completely absent, but most of these skills are developed on a continuum. There is a complex interplay between each skill. When children are spending large amounts of time in front of a screen, they can lose the opportunity to develop the potential they have in one or all of these areas. For example, a 2 year old child may have the skills to make eye contact and share attention with someone, but if this is only happening 3 times a day then we know there is cause for concern. The more opportunities we can give children to socially interact with the world around them, the more likely they are to increase their potential in each area. I will cover briefly only a few areas I have mentioned, including: joint attention, cause and effect, and pretend play.

Joint attention is a huge component of all communication. Joint attention is the shared attention we have with people. We joint attend with people both verbally and non-verbally. Most of us have noticed when a typically developing one-year old starts to show us everything they are interested in. It can be as a subtle as a glance between your eyes and an activity or object of interest. Eye contact is not made with people or objects on screens. Joint attention gradually develops into increased spans of time. For example, as adults we can hold a long conversation with others on one topic for a very long time. Children’s joint attention develops in frequency and duration as they are exposed to interactions. As children grow, they learn about the social rewards of attending to conversations rather than the extrinsic reinforcement of a screen.

Joint attention is tied to another huge area of communication: cause and effect. Children learn through experience that they have an effect on the world around them. They learn that when they laugh, other people often laugh with them. When they cry, someone comes to help them. If they do something, the behavior of the people around them changes. As an adult, we know that if we say something, we will get a response; and then we start to learn the subtle differences between how social rewards are obtained. We learn that we can form long lasting friendships with other people by constantly interacting with them. Through this experience of cause and effect, children start to learn the complexities of the emotions of others around them. When interacting with a screen, they learn that if they press something on a screen, they get a reaction on the screen. This can negatively impact their understanding of how their emotions affect other around them. If they aren’t learning to be persistent and develop a long term understanding of how they affect the word around them, then they do not develop higher emotional understanding of themselves and other people.

The last area I will cover is pretend play. There is so much we learn during pretend play. One skill we learn is to image things that are not there. Being able to imagine things that are not there allows us to engage in learning down the road. As adults, we can understand large amounts of information when someone is retelling a story because we can imagine everything. We don’t need visuals to help us because we have already developed the ability to visualize things that are not concrete. We need this skill during communication for planning, understanding, and memory. We also learn about social relationships during pretend play, and have the opportunity to generate our own ideas. Most of language involves generating our own ideas to express our thoughts and ideas and to socially engage. Watching videos of someone playing with toys doesn’t allow children the opportunity to come up with their own ideas and to practice important role playing.
Human connection is critical to our growth and overall communication abilities. Children require opportunities to engage with the world around them. When they are focused on the high stimulation of a screen, they miss opportunities in quiet moments to understand how relationships develop and why relationships are important

SUMMARY: As you can see, excessive screen time can have a very real impact on a child’s physical and emotional development, as well as their communication and play skills. Remember, “A Child’s Job Is To Play!”, so please join us in participating in Screen Free Week April 29th-May 5th! And, don’t forget to enter our drawing by sending us your suggestions/goals on how you plan to reduce screen time in your home!