Q&A: Screen time and developmental delays

Plus, signs of depression in teens

Welcome to Questions from Sapiens, where I answer your questions about psychology, technology, and parenting. Today, we’ve got two questions: one about that new study on kids’ screen time, and another about symptoms of depression in teens. Q&As are typically available only to paying subscribers, but this one is free for everyone.

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What’s the deal with that new study about screen time and developmental delays? I’m seeing it all over the news. Would love to hear your take!

Me? An opinion on a screen time study? Why, I thought you’d never ask!

The study in question was published last month in JAMA Pediatrics and is titled “Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years.” I’ve also seen this one all over the news (e.g., New York Times, CNN). Emily Oster wrote about it last week over at ParentData and—I think accurately—summarized this news as “panic headlines.”

So, here’s the deal. This study is part of a larger cohort study in Japan that enrolled over 20,000 pregnant women between 2013 and 2017, and then followed them (and their babies) over time. For these analyses, researchers looked at a subsample of 7,097 of those families. Parents answered questions about their children’s screen time at age 1 (“On a typical day, how many hours do you allow your children to watch TV, DVDs, video games, internet games [including mobile phones and tablets], etc?”). They also answered questions about their kids’ development across five domains at ages 2 and 4 (i.e., communication, gross motor, fine motor, problem-solving, and social skills).

Researchers then put the one-year-olds into four screen time categories: less than 1 hour (49% of the sample), 1 to 2 hours (30%), 2 to 4 hours (18%) and 4 or more hours (4%). Compared to the “less than 1 hour” group, kids in the higher screen time groups showed lower levels of communication and problem-solving skills at ages 2 and 4. Results were less consistent for other domains. For communication and problem-solving, effects occurred in a “dose-response” pattern (i.e., each additional hour of screen time was associated with worse skills).

So, what to make of this? The short answer is probably…nothing. The study is rigorous—longitudinal over 3 years, following a massive number of families, etc. It’s a good one to add to the larger body of literature on this topic. But should it change what you do as a parent? I mean, no. The data shows that there are a lot of other differences between families who allow more versus less screen time (income, education, etc.), and those other differences could easily explain the findings. 

That said, from a common sense perspective, 4 hours of screen time is a lot for a one-year-old. Even two hours of screen time is getting up there, when you consider the fact that a one-year-old’s day is already consumed with roughly 14 hours of sleeping and, if my experience is anything like yours, 2 hours of spreading yogurt all over their hands, faces, and the walls of your home. Kids at this age need plenty of time for high-quality interactions with caregivers, and for physical activity and play. If screens are getting in the way of that, this is a problem. But we knew that before this study.

PS: For more on screen time guidance for young kids, check out this post.

How do I know if my teenager is depressed? How can I tell the difference between normal teen moodiness and a bigger problem? What should I be looking out for?

Emotional ups and downs are a normal—if challenging—aspect of the teen years. It’s also common for times of transition (e.g., back to school) to cause stress and, in some cases, raise questions about whether a child’s response to that stress is “normal.” If you have concerns about your child’s mental health, it’s always a good idea to talk to your pediatrician, a school counselor, or a therapist (see: how to find a therapist).

Here is a standard screening measure for depression in teens. In a professional setting, a mental health provider would ask a teen to fill out the questionnaire indicating how often they’ve had each symptom in the past two weeks. Of course, diagnosing depression is more complicated that just scoring a questionnaire, but getting a sense of the items on this measure can help us understand common signs and symptoms. 

In particular, if these symptoms are happening most days, and this has been going on for a couple weeks, it’s likely time to get professional help:

• Feeling down, depressed, hopeless, or irritable. “Hopeless” might look like feeling that they have nothing to look forward to, or that things will never go their way. Also, depression can often present as extreme “irritability” (crankiness), not just sadness.

• Little interest or pleasure in doing things. Are they no longer enjoying activities they used to enjoy (spending time with friends, extracurriculars, etc.)?

• Difficulties with sleep. This might include sleeping too much or too little (i.e., hypersomnia or insomnia)

• Difficulties with eating. This might include eating too much or too little, losing or gaining significant amounts of weight, or major changes in appetite.

• Feeling tired or having little energy. It might seem like they’ve lost all motivation, or are having trouble getting off the couch or out of bed to do basic activities.

• Feeling bad about self. Are they thinking or talking a lot about being a failure? Or letting people down? Or feeling guilty for things that are not their fault? Are they struggling a lot with self-esteem?

• Trouble concentrating. This could be in relation to school work, but also activities like reading, watching TV, or participating in conversation.

• Changes in “movement.” This might include moving or speaking noticeably more slowly than usual, or the opposite—being more fidgety or restless.

• Suicidal thoughts. If your child is talking about being better off dead, or thinking of harming themselves, you should get them help immediately (988 is the Suicide & Crisis Lifeline).

For more on what to do if you’re concerned your child might be depressed, check out this helpful article from the Child Mind Institute. Visit the Youth Mental Health Project for a good list of other resources. 

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Note: as always, the information provided in this newsletter is for educational purposes only and is not intended as a substitute for professional mental health health treatment or advice. Contact your medical or mental health professional, or 911, for emergencies.