More screen-bashing in the media, but the picture is far from clear

The Guardian  headline reads:Research links children’s psychological problems to prolonged screen time

As once again a complex and lengthy report is reduced to ‘screen time is evil’. The article bundles computer gaming, screen time and sedentary lifestyles together into a septic whole, and blames them for psychological problems (by which perhaps they mean mental health disorders). It might be worth pausing to think about whether such bundling is actually valid or useful, and what the report, by Natcen, actually says.

The report is called ‘Predicting well-being‘, and is based on a cross sectional analysis of the Millennium Cohort Study (7year-olds) and a cohort of the Understanding Society survey (11-15year olds). There’s already a problem here for the kind of causal linking suggested by the Guardian, in that this kind of analysis will only yield correlations, and as any science bore will delight in proclaiming, correlation does not imply causation.

So any casual claim made on the basis of this report needs to be treated with caution.
That said, the section on screen time in children is interesting, as much for what it doesn’t say as what it does. They asked about all sorts of screen time, but only found an association between computer gaming and well being in adolescents. This data is interesting, and I’ve grabbed one of their graphs below.

graph

So, gaming for more than 4 hours on average on a school night is associated with lower well-being scores. But imagine if you heard that a young person was shut in their room playing Call of Duty till 1am every night. Is it sensible to think “let’s throw away the Xbox”, or to ponder what issues are being avoided by escaping into this hermetic, predictable, rewarding world? The fact that the well-being scores seem to plunge so much at 4 hours seems to me to be consistent with this intensity of gaming being a warning sign of problems rather than their cause- if computer gaming was harmful in itself, how come 2-3 hours per night had no negative effect?

The correlations between computer gaming and well-being for less intensive patterns are not statistically significant, but it is worth pointing out that people who do a little gaming have slightly better scores than those who do none.

The Natcen report only includes positive results, so we can assume that there was no correlation between overall screen time and well-being, which certainly isn’t the impression gained from the media coverage.

Also, there’s no mention of screen time in younger children. This can’t be because the question wasn’t asked, because the same data was used for this study, published in March, which found a tiny association between TV but not gaming and conduct problems in 7 year-olds.  We have to assume therefore that Natcen didn’t find any correlations.

What about the Guardian’s claim that this study ‘supports doctors’ concerns’ about children’s lifestyles? The concern expressed was that children were getting too little exercise, which is certainly a concern as regards obesity and physical health generally, but exercise did not predict well-being in the 7 year-olds looked at by Natcen, and was not analysed in the adolescents (p.35). So the idea that screen time leads to less exercise leads to less well-being is not supported by this data.

So there may be reasons to limit children’s screen-time (and good reasons may emerge), but this study does not provide any.

To round this post off, I thought I would post what the Natcen researchers thought did predict well-being in children and in adolescents.

For seven year olds: “Primary school context and friendships emerge as important, but the data suggests that homelife and relationships with family are even more so. Seven-year-old children were happiest where they got on well with siblings, reported fun together with family at weekends, and had parents who did not shout or smack them. Children’s self-reported wellbeing was not affected by having a disabled parent or by living in social housing. Having one parent or two at home did not impact on how happy or worried children reported feeling, so long as they had a parental figure. However, parent perceptions of their child’s wellbeing were associated with some of these things. Lone, disabled or ill parents, and parents who could not afford to take their family on holiday, were all more likely to feel that their child was unhappy. It is possible that these parents feel anxiety about their circumstances affecting their child’s wellbeing. They may be reassured to know that more important than issues of family structure and physical health are the dynamics of warm, supportive and playful relationships within the family. Enjoyment in being together and engaging in a variety of activities in moderation were positive indicators. But young children’s assessments of their own wellbeing were also clearly and strongly associated with the wider neighbourhood in which they lived. After controlling for other factors, children as young as seven were more likely to feel unhappy and worried if they live in a deprived area. These findings support the continuation of public health policy focused not only on the family, but also on the wider neighbourhood”

As a prescription for family-friendly policy and early support for families in difficulty, it’s hard to better.

For teenagers: “As young people go through their secondary school years, child wellbeing progressively declined. This is a critical stage in the life course, when there are many physical, emotional and social adjustments to be made. Between age 11 and age 15, the proportion of young people with low levels of subjective wellbeing almost doubles. It would be easy to dismiss this as the inevitable consequence of hormones and physical change. However, when controlling for social and environmental factors, associations between wellbeing and age are no longer significant. This suggests that the very real dip in wellbeing in the teenage years, that is strongly evident in unadjusted analyses, is the result of social context and therefore responsive to changes in circumstance. Substance use and excessive computer gaming become more common as children grow into young people, and both of these activities were also associated with lower levels of wellbeing. Disruptive behaviour at school continued to be linked to low subjective wellbeing. This was the case both for the young people who were being disruptive, and for those who witness the disruption. A secure environment at school – free from bullying and classroom disruption – remains important to this age group. Home dynamics also continue to be critical to positive wellbeing. Similar to the findings for young children: whether parents were disabled, in ill health, or lone was not relevant to young people’s wellbeing once other factors were controlled for. What mattered were things such as feeling supported and sharing meals together as a family. In recent years there has been increasing focus on the early years, with the establishment of Sure Start and Children’s Centres across the country. There is also a clear rationale for support to address needs throughout childhood, including through the difficult teenage years as children increasingly start to feel low.”

The clinical take-home message for me is that if there’s excess screen use, we have to look at why the young person feels they need to escape from reality, and to understand this in their family, social and school context.

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