An optometrist’s tips for managing kids’ screen time
Kids are using screens more and more frequently as technology becomes more prevalent. Some parents may wonder what the impact of this is on their eyes, and how to manage it. We talked to an optometrist to get her take, and have some ideas for screen-free activities you can do from home.
Sometimes it’s easy to lose track of time watching shows or playing games on devices. When it comes to kids, they may really enjoy playing with them too. But how much screen time for kids is too much? We chatted with Dr. Hadassa Rutman, a Toronto based optometrist, to find out. We also got some tips for screen-free activities that may come in handy as Canadians continue to stay home.
What do screens do to children’s eyes?
Dr. Rutman explained researchers are not certain of the long-term effects.
“We have very few clinical research studies showing the long term effects of screens on children’s eyes,” she says.
What we do have, she says, is research that suggests screen time in general can cause:
- Dry eyes
- Eye strain
- Headaches
- Blurry vision
- Visual fatigue
“There are also additional symptoms such as neck and shoulder strain in adults,” Rutman notes. “We can extract what we know from adults to understand what is happening to kids.”
The key difference between children and adults though, she explained, is that a child’s brain is still developing.
“Neuroimaging research on toddlers using screens for more than 1 hour day has shown white matter changes in the brain,”* she says. “And the eye is an extension of the brain.”
“We are seeing an impact from screen use on areas of the brain responsible for:
- Language skills
- Early literacy
- Cognitive development
This is a cause for concern on potential long-term effects on visual development,” Rutman says.
“We are also seeing a significant increase in the prevalence of myopia (near sightedness) in children over the past decade. We are seeing these children daily in our practices and their prescriptions continue to get significantly stronger every year. This increase may be due to less time spent outdoors. Screen time hasn’t been proven to directly impact near sightedness. But we need to consider why our children are spending less time outdoors. The only thing that has dramatically changed in our lifestyles in recent years is the increased use of technology.”
What is the recommended amount of screen time for kids?
The Canadian Association of Optometrists have guidelines for recommended screen time for kids. The amount depends on a child’s age:
Age 0–2 years: No screen time at all
“This age is so crucial for development and learning how to explore the world,” Rutman says. “Toddlers at this point are crawling and grabbing. They’re using their eyes and bodies to navigate and interpret their three-dimensional environment. Their eye tracking, eye focusing, and eye coordination skills are emerging, foundational visual skills for their later school years. The learning process in this stage of development is so important. If you put a screen in front of them, suddenly they are in a 2D world. They’re no longer exploring, which may hinder their visual, motor and language development.”
Age 2–5 years: One hour per day
“Educational content only is ideal,” Rutman notes when it comes to this age range.
Age 5–18: No more than two hours per day
“This one is tough,” acknowledges Rutman. “Kids are going from using computers at school to digital devices at home,” she says. “It’s one long continuum from the beginning to end of the day. Try to instill a clear distinction about when and why we use devices.”
And regardless of age, she says, no one should be on their device an hour before bedtime.
How can parents manage their kids’ screen time?
As a mom and professional, Rutman knows striking the balance can be easier said than done.
“I think it’s a work in progress for us,” she observes. “Avoiding digital devices completely is not realistic. I try to adhere to the guidelines as best I can. And any downtime I have with my kids, I try to not have them use digital devices. We also try to encourage outdoor play as much as possible.”
But when your kids are using screens, there are some things you can do:
Watch shows on a TV instead of a tablet
If you are watching a show or movie, watch it on a TV instead of a personal device. The further away, the better.
“When my kids watch shows it’s almost always on a TV, ideally from 8 feet away,” Rutman says. “They rarely use an iPad for media, except for the odd time at grandma’s.”
Follow the 20–20–20 rule
“I recommend this to adults as well as kids,” Rutman says. “Take a 20 second break from screens every 20 minutes to look at something 20 feet away.”
Practice the fist-elbow distance rule
“Try to figure out how far away your elbow is from your face by placing your fist on your chin and extending your elbow outwards**,” she says. “That’s how far away you should hold your device.”
Rutman also recommends monitoring posture, and decreasing the glare and brightness of screens. Try using a laptop board or tilt stand to avoid straining your neck.
Watch for signs
Children may not always report symptoms such as headaches or eye strain when using digital devices. Watch for signs such as increased blinking, eye rubbing, postural changes, fatigue or changes in sleep patterns. Make sure to have your children’s eyes examined yearly.
Lead by example
Your child may be watching you and following your lead when it comes to screen use. Be mindful of the example you set for them through your own behaviour with your devices.
Always have alternatives
“If I have a choice between a screen and a book, I’ll pick the book,” Rutman says. We discussed how to go about limiting screen time for kids. She says having some alternatives to using screens is important.
With changes due to COVID-19, this may be even more of a challenge than usual. But according to Rutman, it’s more important now than ever to take breaks from screens.
“The clinical guidelines at this point in time are not realistic if online learning is taking place. Our younger kids are now clocking as much screen time as our older kids,” she says. “I think we have to recognize now that it’s even more important that we have breaks from digital devices.
We’ve compiled a few screen-free activities that you can do indoors with your kids that may come in handy:
10 screen-free activities your kids can do at home
1. Play a board game
2. Put on a play or skit, or play improv games
3. Build something (a Lego set, a puzzle, a fort out of couch cushions)
4. Read a book
5. Cook or bake something with mom or dad
6. Write a letter to their friends or grandparents
7. Paint or draw
8. Help out cleaning a closet or a junk drawer
9. Start a journal
10. Learn to sew
Less is best
“Minimize as much as you can.”
This is what Rutman said when asked what her most important takeaway was when it comes to kids and screens. “Try to have clear distinctions between when and for what purpose they’re using devices. Instilling these habits in your kids will help carry them into adulthood.”
Written in consultation with Dr. Hadassa Rutman, optometrist.
*Hutton JS, Dudley J, Horowitz-Kraus T, DeWitt T, Holland SK, Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children. JAMA Pediatr. 2019 Nov 4:e193869.
**With the prevalence of COVID-19, we recognize the importance of effective handwashing and avoiding touching your face. We do not recommend this tip with unwashed hands.
Originally published on Lumino Health
