Sanford R. Cohen, OD, FCOVD, discusses screentime guidelines for children using video devices (computers, smartphones, tablets and TVs) in this blog post.
Video devices enrich our lives; experts, however, are expressing concerns about children’s usage of them. When kids play video games or surf the net, we must address some important health-related issues.
Basic Visual Abilities Necessary for Video Device Usage
By preschool, children have acquired the basic visual abilities needed for simple video device operation. These abilities include focusing, tracking, fixation, eye-hand coordination and binocularity. They develop as children interact with their environment and integrate visual experiences with other sensations. When a child has developmental delays, such as autism, ADHD, PDD-NOS or Sensory Processing Disorder, visual abilities are often delayed, too. Delays may also affect trunk, neck and head control; fine motor coordination of the eyes; and sensory integration – all essential for any visual activity.
How Devices Affect Vision
Video images are comprised of pixels – dots of light that are brighter in the center and progressively dimmer toward the edges. Because pixels lack the sharp edges of printed symbols, they do not provide the contrast that human eyes require for sustained focus. The eyes thus drift and refocus in cycles that are repeated over and over. Repetitive efforts of the focusing mechanism to maintain clarity leads to visual fatigue. Dr. Jane Healy states: “Computer use is even more stressful than book reading in terms of the demands it places on the visual system.”
Children – especially those with developmental delays often do not know the difference between normal and abnormal visual experiences. They may not complain of any discomfort. Therefore, parents and teachers must watch for computer-related symptoms, including:
- Blurred or double vision
- Headaches; back and neck aches
- Frequent eye rubbing
- Squinting
- Head turns or other unusual postures
- Trouble seeing the chalkboard and words in books
Screentime Guidelines for Children
Limit Computer and Device Use
I recommend a maximum of 40 minutes per day of screentime usage for 7-to-11 year-olds. For 4-to-6 year-olds, the recommended total maximum is 20 minutes. To minimize the adverse effects of screentime usage, periodic breaks are imperative. After 10 or 15 minutes of use, your child should leave the device for at least 5 minutes and look outward, through a window or into a large indoor space.
Limiting video device operation promotes development of skills because children learn to value their time. It also gives them more time to explore their environment and play physical games, which encourage growth of the whole child.
Encourage Stretching
Video-device operation and most desk activities are highly restrictive and discourage movement. Arms, legs, necks, shoulders and backs stiffen and fatigue, leading to poor posture. Also, excessive use of the eyes for this concentrated, near vision activity can produce myopia, astigmatism and binocular dysfunctions. Stretching allows the body to release the stress that builds from restriction and repetitive movements.
Adapt the Workstation
When using a computer, bring your child’s eyes level with the top of the monitor. They should gaze downward at 10 to 15 degrees. Place pillows on the seat and provide a footrest that positions the thighs parallel to the floor.
Avoid Bright Lights
Bright lights create glare by shining directly on the screen. Use gooseneck table lamps to provide direct light for viewing papers, or indirect light for minimizing glare. If necessary, attach an anti-glare screen.
Schedule Regular Examinations
A developmental optometrist can identify video device-related vision deficiencies by performing near vision tests. The doctor should ask about video-device use and any symptoms specific to computer operation. The specialist determines whether glasses will help sustain focus, improve performance and minimize symptoms and adverse adaptations.
Choose Carefully
Choosing developmentally appropriate games and activities on video devices can be challenging. Ask your child’s teacher for recommendations. If your child is developmentally 4 to 8 years old, seek programs that require simple responses. Content should employ concrete, familiar images and integrate different senses. As your child approaches the 9-to 11 age level, introduce symbols, abstract figures, reading for meaning, and math concepts. Your child’s future will probably involve video devices. By understanding how these devices impact the visual system, you can teach your child proper care of his precious eyes.
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Sources & References
Hood, R., et al. "Coronavirus Changed the Rules on Everything": Parent Perspectives on How the COVID-19 Pandemic Influenced Family Routines, Relationships and Technology Use in Families with Infants. Int J Environ Res Public Health. 2021 Dec 6;18(23):12865.
Hood, R., et al. "It helps and it doesn't help": maternal perspectives on how the use of smartphones and tablet computers influences parent-infant attachment. Ergonomics. 2024 Feb;67(2):148-167.
Hood, R., et al. The association of mobile touch screen device use with parent-child attachment: a systematic review. Ergonomics. 2021 Dec;64(12):1606-1622.
Hood, R., et al. 'There's good and bad': parent perspectives on the influence of mobile touch screen device use on prenatal attachment. Ergonomics. 2022 Dec;65(12):1593-1608.
