'Quality over quantity': Youth screen time climbs after pandemic

Scrolling, scrolling, scrolling — not all screen time is created equal, according to Dr. Amy Malkus, professor of early childhood education at East Tennessee State University. With technology continuing to expand in new and innovative ways, research is struggling to keep pace. From debates over video games in the 1990s to the smartphones many people carry today, experts are continuing to study how increasing screen use affects youth. "Kids are spending more time on screens — little kids less than older kids," Malkus said. "Their brains are rapidly changing, and we have to ask, 'What is this doing to their brain development?' There's not a whole lot out there about that yet." A National Institutes of Health meta-analysis published in March examined 60 studies conducted between 1991 and 2022 involving children from birth to age 19. "It's basically a meta-analysis … and it looks at the changes that have happened between the early '90s and now, including pre- and post-COVID," Malkus said. The analysis found that television viewing declined over time while computer use and video gaming increased. Overall screen time rose significantly, particularly after the pandemic, as children relied on digital devices for school, socializing and entertainment, though the analysis noted that studies varied in how they defined and measured screen time. Malkus said the findings show the conversation is more complicated than simply counting hours. "We're spending more time on screens because digital devices are so much more prevalent, but I think it's a much more nuanced issue than people think," she said. "You really need to look at the type of screen activities and the quality of screen activities, and what they would be doing if they weren't doing the screen activities." The review found younger children generally spent less time on screens than teens, while boys typically spent more time gaming than girls. It also linked excessive screen time to poorer sleep, lower physical activity, weight gain, mental health concerns and exposure to harmful online content, while dually noting technology can also support learning, creativity and social connection. "Some screen time is better than other screen times," Malkus said. "It's not just the quantity, it's the quality that's vital. Sometimes I'm just mindlessly doom scrolling on my phone, but other times I'm reading an article." Malkus said many of the habits developed during the pandemic have persisted. "It just made not leaving your house so much more convenient," Malkus said. "I think that runs a risk for little kids because little kids need to have hands-on, real-world experiences." The NIH researchers recommended that parents, schools and communities encourage balanced technology use alongside physical activity, healthy sleep and offline experiences. "We know that little kids benefit from engagement with real people, especially their parents and caregivers," Malkus said. "You do have to approach these things with caution and make conscious decisions about your child's screen time in the same way that you should be making conscious decisions about your own." Potential for addiction Researchers are also examining whether frequent cellphone use can become addictive. "The phones reward us the way slot machines do — they're very addictive," Malkus said. "If you go over in countries like South Korea, there are actually kids being treated for cell phone addiction." She said studies are exploring withdrawal-like symptoms in youth when phones are taken away. "There is evidence that it activates your brain's reward system and releases dopamine, and then it gets harder and harder to stop scrolling," she said. Advice for parents Malkus said the best advice for parents would be to stay engaged with what their children are doing online. "It's really important that you know what they're watching or what they're playing," she said. Malkus said parents should remember that, not just phones or computers, even gaming consoles connect to the internet, allowing children to communicate with strangers online. "That can be really problematic because a lot of kids think, 'I'm playing this game in my home, so I'm safe,'" she said. "They don't think about the fact that maybe the person they're playing with is a 60-year-old sexual predator … They may think, 'This is a friend I play Roblox with or Minecraft with.'" She said monitoring children's screen use can help parents identify problems ranging from excessive use to cyberbullying or online grooming. "It can really easily get out of control when your child's being cyberbullied and you don't know about it … or just that your child is spending all their free time on screens." She encouraged families to replace some screen time with everyday learning opportunities. "I always tell family members if you're going to the grocery store with your toddler, that's a great opportunity for learning experiences like counting, ABCs, color identification and shapes." She also recommends removing televisions from children's bedrooms and limiting screens before bedtime. "We know there's a lot of studies that show that having a TV on at night is very disruptive to your sleep," she said. "I would not let them have a TV in their room." Setting daily or weekly limits can help families create healthier habits. "One of the things that my mom did with us … she gave us an allotment of TV hours a week," Malkus said. "We knew that once we used up that five hours, that was it." Malkus also said parents should consider the example they personally set. "I think that's the part that a lot of parents and caregivers don't want to look at," she said. "What they're modeling to their child. If you're on your screen, they're on their screen." Future research The NIH researchers said future studies should examine not only how much time children spend on screens but also the quality and type of digital activities. Malkus said that remains challenging because technology changes faster than researchers can study it. "There's still so much unknown as far as whether it makes lasting changes in your brain," she said. "You can learn about the effects that it had, but that research is already five to 10 years out of date by then, and the technology has evolved so rapidly we're not sure it still applies." Rather than focusing only on potential harms, Malkus said she hopes future research will also explore the positives of advancing technology. "I don't think technology's going anywhere," she said. "I would like to see more research done on ways to get families actively engaged with technology with each other."