—Nina Pierpont, MD, PhD

Children under the age of two should not watch TV at all, nor be exposed to movies, computers, or computer games.  That’s the sobering message from the American Academy of Pediatrics.

After their second birthday, the policy statement continues, children should watch no more than two hours a day of high-quality, age-appropriate, educational TV.  This means shows like “Sesame Street” or “Mr. Rogers’ Neighborhood.”  Geared towards 3-5 year olds, such programs have been shown to have a positive effect on school-like tasks, though only in the short term.

Unsupervised or non-educational TV watching and video game use are another matter.  The medical literature shows that TV watching in general is associated with irregular sleep schedules, obesity, aggressive behavior, and poorer school performance in children.  In adults, TV watching is associated with earlier onset of Alzheimer’s disease, when compared to other leisure-time activities such as reading, playing games, and socializing.

Media coverage of these research findings has tended to give the impression that the research is confused and inconclusive, even as the research has grown stronger over the years.

Personally, I think that the two-hour daily limit is too much, for all ages.  When I see families, I generally recommend limiting TV, movie, and video game exposure—combined—to 30 minutes a day, or 4 hours a week.  I know one family that turns the TV off for the summer, bringing it back out in September at dad’s urging, not the children’s.  The children find other things to do that are more fun.

For younger children (under 5 or so), limiting screen time is important because they are in a stage of “mapping” the world of their senses onto their nervous systems.  If the “world” pouring into the child’s imagination is flat, has no perspective, and moves and jumps around too fast, what does this do for the child’s ability to navigate through and notice things in a real environment?  Real, slower-moving environments include his own home and the people in it, school and its books, the family farm, and woods and lakes.  Higher levels of early TV watching are in fact associated with slower reading acquisition and with higher levels of diagnosed ADHD at age 7.

The violence in TV and video games also distorts children’s perceptions and expectations.  There are 3 to 5 violent acts per hour in American prime-time television, and 20 to 25 violent acts per hour of children’s TV.  Much of the violence is unrealistic, as it is shown without its physical, emotional, or legal consequences.  Viewing violence on TV is associated with aggressive behavior in children, teens, and young adults.  The best-designed studies show the strongest effects.  These studies include playground observations of children after watching different kinds of programs, interventions with third and fourth graders limiting how much TV violence they see, and long-term studies of aggressive behavior from childhood to adulthood.

In the United States, attempts to limit children’s access to violent programming and games tend to be blocked in court under the guise of “free speech.”  Thus parents need to be informed and take the job of limiting their children’s media use and violence exposure, since no one else is going to do it.  The research literature suggests some ways this could be done:

Play all new video games with your children, and look in on them frequently even after this initial screening.  It turns out that ratings of video games (E for Everyone, T for Teen, and M for Mature) are not as revealing as they should be.  E-rating does not mean free of violence.  Independent researchers have found that both E-rated and T-rated games contain more violence and more types of violence than indicated on the labels.  Among E-rated games indicated to be free of violence, for example, 44% contain violent acts.

Watch TV with your children frequently, to monitor what they watch and to discuss the content.  The behavior of people on TV teaches children concepts about human relationships and how the world works.  Conversations with a watchful parent can be very effective at dispelling the wrong ideas and moods introduced by violent or unrealistic content.

Don’t allow TV or video games in children’s rooms.  Children who have TV in their rooms are more apt to watch more hours, see more violence, be obese, and have lower school performance.  In California, having a bedroom television was significantly correlated with lower scores on the Stanford Achievement Test. Whereas having a computer in the home was associated with higher test scores.

The punchline:  TV and video games are best considered a treat, like dessert, but not a steady diet.  Children’s malleable brains need to learn at this early stage to get their enjoyment from interacting with people, solving problems, and being creative.  These are the mental skills which set the stage for life-long enjoyment of living.