As with much advice from pediatricians, when it comes to keeping screen time in check, prevention is better than cure, Dr. Dimitri Christakis said March 18.

And the single most important thing parents can do to help their kids moderate their use is to be a good role model of it themselves, said Christakis, a sought-after expert on the risks—and lure—of screen time and what can be done to manage it.

“You are your children’s most important teacher,” he said. “You are making a very serious impression.”

The sobering reality of the topic was brought home by a stark message displayed as some 90 attendees arrived at the free talk at The Dalles Middle School. It read, “Digital Addiction: a 21st Century Public Health Crisis.”

He listed nine other steps parents can take: start addressing the matter early on; use low-risk games that don’t have addictive features to them; set up an app that monitors device use; set a “digital curfew” of no screen time for an hour before bedtime; sign a “smartphone contract” where the parent sets boundaries; have daily screen-free time; take “digital holidays” in places where screen time is impossible, like a hike; cultivate mindfulness; and set and enforce limits.

The talk was sponsored by YouthThink, a local organization aimed at preventing youth substance abuse and other risky behaviors. It is the first in a four-part series of talks.

Christakis, a pediatrician and epidemiologist, is an international expert on children and media. He’s been interviewed by numerous national media outlets and is director of the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute.

He said the time suck of devices really happens when a kid gets their own phone, and they’re getting them younger and younger. Kids as young as five get deactivated, hand-me-down phones with apps still on them.

He described the science behind addiction. The reward pathway in the brain is the same in all addictions: If something is pleasurable, the person gets a rush of the brain chemical dopamine, and they want to do it again. This leads to habit formation.

Apps that spew out “likes,” and games that provide ever-changing scenarios and rewards light up the pleasure pathways in the brain, making users want more and more.

Boys are more drawn to games, and girls prefer social media, he said.

Christakis described how apps and social media are carefully and intentionally designed to be hard to step away from.

A famous study involving a monkey who was rewarded with juice for tapping a bar revealed that he soon developed anticipatory enjoyment about getting juice. The same anticipatory excitement, when it applies to devices, can rob children of sleep.

Indeed, just having a phone in the room makes it 80 percent more likely a child will have sleep disturbances, Christakis said. “There’s a reward out there that’s incredibly distracting, that inhibits sleep,” he said.

But Christakis doesn’t recommend going cold turkey. Research has found that youth who have 1-1.5 hours of screen time are less depressed than kids with no screen time at all. Moderation is key, he said.

He said parents should ask themselves why they want to give their kid a phone. Usually it’s because they want to be able to call them. But the last thing kids do with a phone is use it to call people, he said. A simple flip phone would serve the purpose of communication.

He said phones are not a right, but a privilege, and the phone belongs to the parent and is the child’s to use as the parent deems fit.

He encouraged the use of “family media agreements” and said to use them right away when a child first gets a phone. If it’s already been a while, he encouraged signing one now.

They can cover areas like how much media time is allowed, and what the penalties are for exceeding those limits.

He described various phenomena that have cropped up around the use of smartphones, like FOMO (fear of missing out), which keeps people latched on to their phones to see what’s happening.

There’s nomophobia (no mobile phobia), which is fear of not having a phone.

Social media also distorts reality, with people only showing the lovely Thanksgiving dinner spread, and leaving out the part about the family fight that happened later.

The unexpectedness of apps, games and social media is what hooks users.

Studies over 40 years ago by famous behavioral psychologist B.F. Skinner predicted this behavior. He conditioned rats to stare constantly at a series of randomly flashing lights. Because they would go off randomly, the rats were transfixed, waiting for the next light to unexpectedly go off.

Randomness and unexpectedness triggers the same behavior in humans.

Christakis showed a short video of an infant who was first given a toy guitar; then a simple, predictable game; and finally a device playing a game that featured unexpected aspects. The infant was able to quickly hand back the toy and the simple game, but could not break its gaze from—much less hand over—the game with unexpected features.

It’s the same with social media, he said. Rewards are random: A “like” here, a comment there.

Christakis said infants are especially at risk of device addiction. We’re wired to try to understand how things work, and “old media,” like TVs, have no interactive aspect. It’s completely passive. That all changed with iPads. Now, previously passive viewers can make something happen.

“The various games and apps on an iPad don’t stop,” Christakis said. “They’ll keep giving that dopamine squirt as long as the baby wants it.”

Skinner also did studies with rats about punishment avoidance, and how it leads to habits. The same thing happens with devices, as many apps penalize a user for leaving, Christakis said.

Psychologists have found people feel gratified when they can accomplish something with a little help from others. It creates a sense of achievement. Games are intentionally designed to start easy and ramp up intelligently, Christakis said.

Games also incentivize staying engaged. A newer game, Fortnite, has exploded on the scene in recent years, he said. “This is an incredibly addictive game” that has taken everything learned in the past about luring in, keeping and monetizing users and brought it to the next level.

The game gets users to spend real money to buy what are called v-bucks, or virtual bucks. They can use those virtual bucks to buy things for their avatar (persona in the game.)

The game has raked in $1.2 billion, some from monetizing user data, Christakis said.

The in-app purchases are done by credit card, and a parent can end up spending $25 so their child’s “avatar has a cool virtual backpack,” Christakis said.

Other apps reward users for having ongoing daily contact with another user, in what’s called a streak. A mom at the talk said her daughter paid her friends to maintain her streaks when she was grounded.

Christakis said children are “literally immersed in technology from birth.” The near-universal use of devices means that anyone who is prone to addiction will get addicted. He likened it to the idea that if everyone was forced to consume three glasses of alcohol a day, all those prone to alcoholism would become alcoholics.

Christakis said the people who made the addictive features of social media are wary of them.

When the iPad was introduced in 2010, Apple’s Steve Jobs said, tellingly, that his own kids haven’t used it: “We limit how much technology our kids use at home,” Jobs said.

“In spite of the fact he thinks it’s such a great product for us to have, he had concerns about it,” Christakis said. Inventors have insights into their creations that many others don’t have.

Not only that, but some of the creators of addictive features of social media are now creating apps to help limit time on devices.

“I think we’re actually reaching a turning point in our relationship with devices,” Christakis said. There are now hundreds of apps that help monitor and limit device use.

He said parents worry that their kids can get around any limiting features parents put on their phones.

Christakis said they’re not easy to hack, and the easiest way would be for a kid to get their hands on their parent’s phone, which is where the limits are managed.

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