One of the most common complaints of parents in my practice is that their children are “addicted” to screens. According to Common Sense Media (Rideout & Robb, 2019), about 2/3 of parents of tweens and teens believe that their child is “addicted” to mobile devices. Even children ages two- to eight-years old are using mobile devices, on average, about an hour a day (Rideout, 2017). 

In my practice, I often hear parents describe nagging kids to get off their gadgets, arguing about how long kids have been on, and dealing with kids ignoring rules and sneaking to be on their gadgets when they shouldn’t. Parents insist, “It can’t possibly be good!” for their children to spend so much time on screens, but they also recognize that that’s where kids interact with their friends.

For drugs and alcohol, we have established criteria, such as withdrawal, tolerance, and increasing use, that point to a substance abuse disorder, but it’s harder to figure out if screens are actually addicting. We need to be careful not to pathologize normal behavior. Children wanting to spend more time online than their parents like or being crabby when asked to stop doesn’t necessarily count as addiction. 

Children's Problematic Media Use Measure

A recent paper by Sarah Domoff and colleagues (2019) presents a scale called the Problematic Media Use Measure that parents can use to evaluate their four- to 11-year-old children’s screen use. The items were adapted from the criteria for Internet Gaming Disorder which is under consideration for inclusion in the American Psychiatric Association’s Diagnostic and Statistics Manual. 

Parents are instructed to rate nine items on a five-point scale ranging from 1=Never to 5=Always. Most of the items focus on a child’s intense desire for and preoccupation with screen media:

“It is hard for my child to stop using screen media.”
“Screen media is the only thing that seems to motivate my child.” 
“Screen media is all that my child seems to think about.”
“My child becomes frustrated when he/she cannot use screen media.” 
“The amount of time my child wants to use screen media keeps increasing.”
“When my child has a bad day, screen media seems to be the only thing that helps him/her feel better.”

Several more items pertain to difficulties created in a child’s life because of screen use. This is an important consideration in any diagnosis for determining whether or not someone has a clinically significant problem. Children’s screen use can be harmful when it hurts important relationships or interferes with healthy functioning. The relevant items are:

“My child’s screen media use interferes with family activities.”
“My child’s screen media use causes problems for the family.”
“My child sneaks using screen media.”

Domoff and her colleagues found that the items tend to hang together, meaning that the response on one item predicts a similar response on other items, which suggests that the scale is measuring a single concept. They also observed that the scale independently predicted children’s difficulties in functioning (i.e., problems with peer relationships, emotional symptoms, and misbehavior), over and above hours of screen time, which suggests that it’s a useful measure. Higher scores were also linked to greater parent-child conflict. 

Difficulties deciding if children's media use is a problem

At this time, there hasn’t been enough research with this scale to establish norms indicating what is typical or cut-offs indicating when kids’ screen use “counts” as problematic. There’s some correlational evidence linking higher scores and more problems, but, as the authors acknowledge, it’s not clear whether the media use cause those problems, is caused by those problems, both greater media use and greater problems are caused by some other factor (e.g., loneliness, social skills problems, poverty), or some combination of these. 

It’s also easy to imagine a situation where a parent rates a child high on only one or a few items, but the child’s screen use is still very problematic.

However, I think there are more fundamental issues with this scale. At a conceptual level, many of the items reflect parents guessing what their child thinks or feels. We don’t know how accurate those guesses are. It’s possible that higher scores reflect parent anger or communication difficulties rather than children’s actual reactions to screen use. Conflict between a parent and child doesn’t always mean that the child’s behavior is the main problem. More objective items that emphasize a parent’s observations of what a child does, rather than inferences about children’s internal experience, could be more useful.

Another issue is the focus of the items. The scale seems to emphasize the intensity of children’s desire for screen use, but this reflects a limited view of how children’s media use can be problematic. It does not address issues that I commonly see in my practice such as children 1) engaging in or being the target of cyberbullying or other unkind online behavior, 2) sharing private information in unsafe ways or places, 3) spending money online without permission, 4) viewing or posting inappropriate content, or 5) using media at inappropriate times, such as when they should be sleeping or studying. 

Moreover, the items pertaining to screen-use-related difficulties only mention family, not friends, schoolwork, or emotional or physical issues. The authors may have wanted to keep the scale separate from outcome variables that would validate the usefulness of the scale, but these are areas that I would typically assess with a family when trying to understand issues related to children’s screen use. 

Bottom line: as a clinician, although this scale is nice and short, I’m not convinced it’s useful for parents. 

So, how can parents tell if their children have problems with screens?

If you’re wondering whether your child’s media use is problematic, I’d recommend focusing on its impact. Specifically, is screen time negatively affecting your child’s sleep, mood, schoolwork, activities, friendships, or family interactions? Try to be realistic in answering this question. If your child is an average student, cutting down on screens isn’t suddenly going to turn her into a straight-A student. If he tends to be on the shy side, he’s not suddenly going to become a life-of-the-party extravert because you set stricter limits on media. 

It’s important to consider the possibility that your child’s excessive screen use might be a symptom rather than a cause of problems. If that’s the case, it may make sense to address the underlying issue(s) before tackling screen use. For instance, sometimes kids lose themselves in screens because they’re anxious and avoiding schoolwork, or they constantly check social media because they’re looking for external reassurance to try to boost their self-esteem.

Also think about whether the way you’ve been intentionally or unintentionally communicating with your child about screen use might be contributing to difficulties. Too often, I see a pattern where parents suddenly get fed up, angrily restrict everything, then later give up and have no rules when they find they can’t maintain the strict rules or when they’re tired of arguing with their kid or spouse about about screen use. I’ve also seen situations where parents try to make up for the other parent being too strict or too lenient about screens. This never works.

Best ways for parents to manage children's screen time

Figuring out how to manage children’s screen time is complicated. Reasonable, caring parents can arrive at different solutions. (See my post on parents’ options for dealing with violent video games). Also, parents may need to adjust solutions for different children or at different ages. 

Kids generally do best with clear consistent rules and routines—so they know what to expect—and they’re most likely to comply when they feel they’ve had some say in creating the rules or at least understand the rationale behind the rules. If there’s more than one parent involved, it’s less confusing for children if all adults agree on and enforce the screen-use game plan. 

Screens are part of our kids’ lives. They’re not going anywhere, so we need to help our children learn how to manage them. Here are some ideas for positive steps you can take to help your child navigate the online world in healthy ways.

- First try to understand your child's screen use

Invite your child to teach you about her favorite online activity. Why does this appeal to your child? Set aside any initial preconceived ideas you may have and genuinely try to see what draws your child to this activity. When you understand the why behind your child’s screen use, you may be less concerned about it, or you may be better equipped to help your child manage difficulties related to this activity. It could even become something you enjoy doing together.

- Ask about your child’s suggestions regarding limits.

It’s tempting to just lay down the law—and sometimes that’s necessary—but it can often be useful to ask children what they think are reasonable limits on screen time. A friend of mine did this recently and was pleasantly surprised when her children came up with very sensible suggestions. This is not to say that parents can’t set limits (they can and should!) but starting by asking about kids’ perspectives can set the stage for agreement or compromise and avoid unnecessary arguments.

You could also ask questions about whether your child knows anyone who spends too much time on screens. What does your child think might be signs of excessive screen use? Questions about self-regulation might also be useful: How does your child know when it’s time to shut down devices? How has your child felt after accidentally overdoing it online? 

What if your child suggests limits that you don’t think will work? You could point out the problems, but instead of immediately shooting the idea down, you might want to say, “Let’s try it that way for a week and see how it goes. How will we know if it’s working? How will we know if it’s not working?” If your child’s solution is successful, great. If it isn’t, your child has learned something, and you have some additional data to draw from as you continue the conversation and together work your way toward a better solution. 

- Offer your child guidance about online activity

Kids don’t automatically know how to handle online situations. Try to anticipate problem areas. Asking questions along the lines of “What would you do if…?” “What could happen if…?” “Why do you think it’s important to…?” is more effective than lecturing. These questions give kids the chance to think through responses to problems before they happen, and they give you a chance to see what your child does or doesn’t yet understand. With younger or more impulsive kids, you’ll need to do closer monitoring of their online activity. 

Tell your child that she’ll never get in trouble for coming to you for help and that you won’t freak out and take away her devices if she makes a mistake or gets into a difficult situation online. This makes it easier for your child to seek your help.

- Seek or create non-screen alternatives

By far, the most effective strategy for getting kids to spend less time on screens is to help them find face-to-face activities that they enjoy. In general, it’s easier for kids to replace a behavior than to stop it. Use your knowledge of your child to figure out alternatives that your child is likely to find appealing. These could be family activities, individual hobbies, or activities with peers. 

- Be a good digital role model 

Leading by example is essential for teaching your child how to use screens responsibly. If you’re on your phone or laptop all the time, your kid will be, too. Let your child see you deliberately putting your gadgets away during dinner, family outings, or at bedtime. It will seem more like good manners and less like a punishment when you ask your child to do the same.

Related posts:

The Truth About Violent Video Games and Kids—What Parents Can Do

Teen Sexting in Perspective    

What We Get Wrong About Children’s Self-Esteem

©2019 Eileen Kennedy-Moore, Ph.D.