Doctors and government health officials should set limits, as they do for alcohol, on the amount of time children spend watching screens – and under-threes should be kept away from the television altogether, according to a paper in an influential medical journal published this week.
A review of the evidence in the Archives of Disease in Childhood says children's obsession with TV, computers and screen games is causing developmental damage as well as long-term physical harm. Doctors at the Royal College of Paediatrics and Child Health in the United Kingdom, which co-owns the journal with BMJ Group, which publishes the British Medical Journal, say they are concerned. Guidelines in the United States, Canada and Australia already urge limits on children's screen time.
The review was written by psychologist Dr Aric Sigman. On average, he says, a British teenager spends six hours a day looking at screens at home – not including any time at school. In North America, it is nearer to eight hours. But, says Sigman, negative effects on health kick in after about two hours of sitting still because of increased long-term risks of obesity and heart problems.
The critical time for brain growth is the first three years of life, he says. That is when babies and small children need to interact with their parents or caregivers, eye to eye, and not with a screen.
Professor Mitch Blair, officer for health promotion at the college, said: "Whether it's mobile phones, games consoles, TVs or laptops, advances in technology mean children are exposed to screens for longer amounts of time than ever before. We are becoming increasingly concerned, as are paediatricians in several other countries, as to how this affects the rapidly developing brain in children and young people."
The US department of health and human services now specifically cites the reduction of screen time as a health priority, aiming "to increase the proportion of children aged zero to two years who view no television or videos on an average weekday" and increase the proportion of older children up to 18 who have no more than two hours' screen time a day.
Sigman goes further, suggesting no screen time for under-threes, rising gradually to a maximum of two hours for the over-16s. Parents should be aware that their own viewing habits will influence their children, he said.
But the issue is controversial and his opinions and standing are questioned by Dorothy Bishop, professor of developmental neuropsychology at Oxford University.
"Aric Sigman does not appear to have any academic or clinical position, or to have done any original research on this topic," she said. "His comments about the impact of screen time on brain development and empathy seem speculative, in my opinion, and the arguments that he makes could equally well be used to conclude that children should not read books."
Sigman says he chooses not to have a job at a university and works in health education. "I go into schools and talk to children – usually about alcohol, trying to delay the age at which they start drinking," he said. Limiting the use of electronic media, he said, was a similar health issue.
Dr Louise Arseneault, senior lecturer at the Institute of Psychiatry in London, said: "The findings from this study are intriguing and add to an increasing body of evidence suggesting that a sedentary lifestyle is not optimal for the future of young children."
It is "crucial to keep this activity in context with the rest of children's lives". Screen media could be a marker of a more generally unhealthy lifestyle that needs to be talked about by health practitioners.
Justine Roberts, founder of Mumsnet, said it was hard for parents to compete with technology. "It would be great if someone could invent a lock that could automatically ensure a daily shut-down of all the different devices in and around the home after a designated period. Until such a thing is invented, it's going to be an ongoing battle to keep on top of everything," she said. – ©Guardian News & Media 2012.
Sarah Boseley is the Guardian's health editor
Technology breaks the silence
More than 200 newly qualified doctors may be left with worthless degrees if provinces can't raise funds for internship positions
South Africa is one of just 23 countries globally that supports HIV self-testing. Find out how to take an HIV test at home.
Blood donations are scant in South Sudan as the process is frowned upon and treated with suspicion by locals.
Bhekisisa means "to scrutinise" in Zulu
In South Africa, Zulu patients who would like to be thoroughly assessed by a doctor, would ask the physician to "bhekisisa" them.