What is healthy screen time?

 

How the guidance of a Speech Language Pathologist can help parents use screen time with their child to their benefit

a child sits at the dining room table carefully scrolling and tapping on the screen to complete a speech therapy task, while sitting across from his speech therapist who is using co-engagement during speech sound therapy, using healthy screen time
 
 
 

A quick anecdotal story from one of my recent Speech Therapy sessions:

I was observing one of my clients during different play activities. This child is a toddler with Receptive and Expressive Language Delay, and often has difficulty using new toys appropriately until being shown how to do so. On this particular day, I took a step back to observe the child’s play during a couple solitary play opportunities.

I had my play food out, along with its matching play utensil and cutting board for pretend-cutting and meal preparation. The child reached for the play-cutting board, which is a yellow rectangle with a hole cut out on one end, much like a real cutting board except much smaller and plastic.

Next, the child picked up the cutting board and held it to their face. At first, I thought maybe the child will initiate symbolic play, by pretending the cutting board is a phone, and holding it up to their ear. To my surprise, that did not happen. The child DID initiate a form of symbolic play, however something else happened. Instead of holding the phone up to their face and pretending to speak from it, as we are accustomed to expect, the child started to pretend that it was a phone in a new way. You might think - “Oh that’s normal for a child to do at that age, great!” 

But if you are a “millennial” around my age or older, you’ll know that “phone” means something very different now than what it used to mean. What my client did with the play cutting board was not what you might think. Because what “phone” means today is not “device used for talking;” what “phone” means now is “screen to touch.” He pretended the cutting board was a screen. 

You may ask - “What exactly were they doing? Saying ‘hello?’ Asking ‘who is this?’ Placing the play cutting board up to their face to make sounds into?” None of the above. What this looked like was a two and a half year old staring at a small flat piece of plastic, and tapping their index finger against the plastic repeatedly, then staring intently at the plastic with their eyes, then pretend-typing, then staring some more. That was this child’s way of “playing phone.” And after this session, I realized that this is not just THIS child’s way of playing phone, but likely MOST children’s way of “playing phone” now. 

Realistically, it makes sense, right? This is what the child is observing their adult caregivers do while using their phone throughout the day. I use my phone to text more than I use it to speak, like I’m sure many others do between the ages of 20-40. It is more convenient and time-efficient. While this is true, we can also agree that a child pretending a phone is a screen versus a talking device essentially removes all aspects of language. But can we?

This is a question that I think is a controversial one at this current time, and triggers more questions than answers - Is “pretend-typing” a communicative gesture if the child has no concept of what typing is or how it is related to a person or social interaction? Can the gesture of looking or tapping on a screen be acknowledged as a communicative purpose in any way other than pure imitation of motor movements? Can the action of looking at a screen be considered a form of communication?

Screen time is an important topic for childhood development, and one that we should not shy away from, given that we are living in a world where screens are part of most of our daily routines. They make our lives easier, more efficient, and, for those of us who work in the tech industry, give us a job and means for livelihood. Aside from that, many interactions outside of work are done on screens as well - ordering food, facetiming or texting friends, planning trips, exercise routines, meditation routines - the list goes on. 

It would be a lie to say that technology is going away, or that when you have children, living without technology should be your ultimate goal. However the reality is also that we do not fully understand technology and screen time’s impact on child development. There have been numerous studies on this very topic and a few are included in the resource list below. Below I have summarized the general guidelines that experts offer from those research studies. 

What does research tell us about healthy screen time for babies, toddlers, and preschoolers as their language is developing?

  • Experts recommend no screen time for children under the age of 2. That means if your child is under 24 months, it is a healthy choice to avoid the use of screens for downtime (TVs, tablets, ipads, phones, computers, etc.) altogether. That means no screen time, zero minutes in front of a screen throughout the day, no matter what. Keep in mind, this is based on extensive research, and the “why” is to come. 

  • Professionals recommend no more than 1 hour a day for children ages 2 to 5 years, and they recommend that this includes something called “CO-VIEWING.” We’ll come back to this. 

  • Research shows that after the 5th year, experts recommend placing limits on screen time that allow the child to be functional in their daily routines. You may ask then, why is there no specified amount of time limitation after the age of 5? This is likely because prior to the age of 5, your child’s speech and language skills are developing at such an astoundingly rapid pace that anything impacting these skills has a far greater impact. This does not, however, make limiting their screen time after the age of 5 any less crucial, as children are continuing to develop their language skills until the age of 18, and their cognitive abilities until the age of 25! 


  • Research shows that when children are on screens for more than the above recommended time, there is a significantly higher risk for a delay in language and cognitive development.

What should a parent be aware of when it comes to healthy screen time?

We all need language and communication to survive. It is a basic human right, just like nutrients or safety. Like any huge problem, there is likely not just one cause. While I have many speculations as to why this issue is not being talked about, if I were to list these out, at the end of the day, they would be just that: speculation.  What is important is that much like nutrition, I believe that when it comes to technology, what works for some people may not work for others. 

In today’s world, it is not always feasible to expect every parent to make the huge leap to suddenly place huge restrictions on their child’s screen time. On top of that, what about parents who are on THEIR phone all day and night? Do they get the pass since they are over the age of 18? As pediatric health professionals, do we have the right to tell parents to limit their own screen time as well as their child’s?

I strongly empathize with parents and caregivers who may feel confused and defeated when it comes to using healthy screen time. Much of the information on the internet is riddled with fear-inducing statements and lacking in acceptance and acknowledgement of how enmeshed we all are in technology as a whole. Furthermore, the term “healthy screen time” has for some odd reason, included the limitation of screens altogether - but to me, this is a misnomer. If healthy screen time means the absence of screens, then why not call it something else?  Shouldn’t it be called “healthy non-screen time” then? Why not emphasize the alternative activities that parents CAN use to keep their children busy in times of need, or the ways that parents can use screens to ENHANCE their screen time experience? 

As health professionals I think it is our duty to not only give evidence-based recommendations on how to limit unhealthy habits, but also to meet parents and families where they are. There is so much that parents and caregivers can do DURING screen time that can help our child benefit from technology and open new pathways to learning. Screen time limitations means taking devices away altogether during specific times of the day, but can we do when our child IS inevitably using a device or watching their parents use one? This is where Co-engagement comes in.

What are healthy screen time strategies from the lens of a Speech Language Pathologist? 

Any time that your child is using a device (TV, iPad, tablet, phone, etc.) - and that means your child is using their eyes to look at the screen for an extended period of time (more than 20-30 seconds) - experts recommend using co-engagement.

What is Co-engagement?

Co-engagement, Co-viewing, shared screen time - these are all terms that mean the same thing: SHARE your child’s screen time experience with them. Share your screen time experience with your child. Press “pause” while they are watching a video or playing a game, ask them questions, make your own comments, wait for them to respond.


Co-engagement is a way to counter the unrealistic and trance-like aspects of a screen-time experience. Basically you want to interrupt your child’s viewing experience (or your own) as much as possible. To those of you who hate being interrupted while watching a TV show or movie like myself, this may sound like a form of torture, stay with me...


Think of this strategy as a way of enhancing your interactions with your child while keeping the practical sense that screens are not going to disappear from all of our lives entirely. This strategy is beneficial to you and your child.

Think of screens as a tool for YOU, rather than a tool for your child to use independently. Just like if you were to hand them a hammer and nail, your child needs your constant guidance and help along the way, for them to find any benefit from this tool. Like any teaching opportunity, it is important to be looking at the person guiding you, so having your child shift their eye gaze from their device, to your face repeatedly during your interactions, is a crucial part of co-engagement. 


For enhancing your interactions specifically while using a tablet or phone with toddlers between the ages of 2-4, try holding your iPad or tablet in your hands at all times, as your child presses buttons on the screen or responds to you during co-engagement. Avoid letting your child hold the tablet or phone independently, or grab the tablet from you.


Think of this as a rule for YOU rather than for your child. If you set this rule for yourself, you will not be able to allow your child to be on the phone or tablet as often as you might otherwise, because you simply will not be able to hold the device at all times of the day. That means your child will have to find other means to entertain themselves, and that’s okay! 

For ideas about how to use at-home items to enhance their speech and language skills, check out my blog on Six Ways to Elicit Language Opportunities at Home. 


Lastly, although these guidelines may seem daunting at first, if you take one thing from this article, let it be this: try out co-engagement just once this week. See where it takes you. You may find that it comes pretty easy. Once you start a routine of using co-engagement daily, whenever your child is looking at a device, and becoming more aware and intentional with your screen time, you may find that using this strategy is a far more fulfilling experience and wonder “Why wasn’t I doing this the whole time?”

How can a Speech Language Pathologist (aka, Speech Therapist) provide guidance about healthy screen time and co-engagement?

If you have concerns about whether you are using healthy screen time practices, or if you suspect that your child or toddler may be showing signs of speech or language delay, a Speech Language Pathologist can provide valuable support and expert guidance tailored to your needs.



An SLP can provide support parents in managing healthy screen time for children by emphasizing the importance of balancing digital interactions with offline activities. They can assess how screen time may impact a child's speech and language development and suggest age-appropriate educational programs that support communication skills.



Additionally, SLPs can offer strategies for incorporating interactive and engaging content that promotes conversation, listening, and vocabulary development during screen use, as well as coach parents on co-engagement strategies during the use of this content. By educating parents and caregivers on setting limits and encouraging breaks, SLPs play a crucial role in fostering a balanced approach to screen time that benefits overall developmental health.

 
Heather IsmayComment