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The Checkup

Is ‘Digital Addiction’ a Real Threat to Kids?

Think of screens as something to handle in moderation, like food, rather than something without any healthy place in our lives, like heroin, experts say.

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As we worriedly watch our children navigate the ever-changing digital landscape, there’s a great deal of talk these days about “digital addiction.” But several experts say we should teach kids to think of screens as something to handle in moderation, like food, rather than something without any healthy place in our lives, like meth or heroin.

Children’s use of devices ranges along a continuum from healthy to compulsive to addictive, said Dr. Dimitri A. Christakis, the director of the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute and professor of pediatrics at the University of Washington. “I think the phenomenon of tech addiction is quite real,” he said.

In a commentary published last week in JAMA, Dr. Christakis suggested that the relationship between media exposure and health in adolescents might turn out to follow an “inverted U” pattern, that is, that very high exposure and very low exposure might both be associated with poorer mental health outcomes than moderate amounts of usage.

Technology use is not analogous to drug use, because these devices serve important purposes in children’s lives and adolescents’ lives — indeed, in all our lives. Since most of us depend on technology to do our jobs and stay connected, we — and our children — need to find healthy ways to use it, sometimes quite intensely, without letting it take over.

Dr. Ellen Selkie, an assistant professor of adolescent medicine at the University of Michigan, who does research on adolescents’ use of social media, said, “It’s like food, it’s something we all need because of the way businesses run, because of the job market — and for teens it’s the way they socialize.”

With younger children, she said, there is evidence supporting limitations on the absolute amount of screen time; with older children, the situation is more complicated. “The question is, with a teen who always seems to be on their phone, is that addiction or is that where their friends are? And normal teen behavior is always to want to be talking to their friends instead of their family.”

Just as there are healthy and unhealthy ways to eat, there are daily decisions about the use of technology that add up to major health choices. “What gives me pause about the discussion of digital addiction is it doesn’t always take into account the meaningful things that happen with digital technology that cause kids to do it,” Dr. Selkie said.

Paradoxically, she said that there are times when a child’s avoidance of screen time may also be cause for concern. A child who seems more depressed or more isolated may need help, she said, and some children may manifest that depression by not wanting to look at their phones.

Dr. Jenny Radesky, an assistant professor of developmental behavioral pediatrics at the University of Michigan and an expert on technology use by children, compared technology to “an environment,” as the place where all kinds of activities take place, from work to entertainment to social life. But it is a deliberately designed and engineered environment, she said, and designed with a goal of making money.

Dr. Radesky said that she prefers not to use the term “addiction” in her research or clinical work, which is mainly with younger children, but that she understands why the word is invoked. Thinking in terms of addiction, she said in an email, helps people understand “the design of modern technologies is purposefully habit-forming and programmed with the sort of variable rewards that keep humans engaged.”

But at the same time, she said, “the main problem I see with calling problematic technology use a clinical ‘addiction’ is that it locates the illness or problem within the individual, rather than the digital environment that is shaping the individual’s behavior, often through methods that are intentionally exploitative or subconscious.”

Kids need to understand these methods that are being used to fix their attention, Dr. Radesky said, and there is a tremendous teaching opportunity in helping them understand the way the technology works — and works on them.

Children in middle school and even as young as 8 or 9 are hungry for this information, she said: “When your child sees something creepy, weird or persuasive, or won’t answer when you’ve called their name five million times, talk about it with them, demystify why it’s happening (and if you don’t know, try to look it up), and make them more digitally literate.”

And as children grow into adolescents, thinking about healthy — and unhealthy — internet behavior requires nuanced and highly specific understanding by researchers; it’s not just about the total amount of screen time.

In Dr. Christakis’s commentary, he contrasted the difficulty that researchers experience in trying to understand and quantify children’s use of devices, asking, “How can parents of a middle schooler possibly reliably recount their child’s use of recreational screen time given that many children and adolescents carry a device in their pocket at all times and use it to communicate, play games and do homework? How could teenagers estimate their screen time given the hundreds of times they check their phone during the day even for a few seconds, never mind informing scientists of what precisely they looked at?”

And yet, he pointed out, that kind of information is routinely — and efficiently — collected by the industry and used to increase the appeal of the devices and the programs. “While those of us in academia and research are struggling to get the data we need to put together coherent and robust guidelines for parents and policymakers, industry is mining this data,” he said.

In his commentary, he suggested that increased cooperation between industry and researchers might help establish those guidelines. Dr. Selkie also said that there are ways for tech companies — and even game designers — to be more thoughtful and to incorporate what is being learned about problematic internet use so as to diminish it rather than encourage it.

[Read more about minimizing phone use. | Read more about helping teens limit phone use.]

In the meantime, parents are navigating a difficult set of parameters. Common Sense Media offers a wealth of advice that can help with setting guidelines. One place to start is to require that phones be put down for dinner or on family excursions, and parents, of course, need to think carefully about their own use of devices and the examples that they are setting.

Beyond that, parents need to keep thinking about digital dangers like cyber bullying, but also worrying when the part of a teenager’s life that is lived on line is getting in the way of the other parts. “If a kid is not getting enough sleep, or not getting homework done,” Dr. Selkie said, or if there are fights over the phone every night, parents may need to set limits — or help a teenager set limits.

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