Course:KIN366/ConceptLibrary/Screen Time

Movement Experiences for Children
KIN 366
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Instructor:	Dr. Shannon S.D. Bredin
Email:	shannon.bredin@ubc.ca
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Screen time

Screen time includes any time that an individual spends on activities like watching television, playing videogames, browsing on electronic devices like computers, phones and tablets (ParticipACTION, 2015). There are certainly benefits to having these facilities for children; for example they can assist children in building skills for the future and help them in their intellectual development (Moffat, 2014). However, in recent years, children seem to be spending too much of their free time on electronic devices instead of being active (ParticipACTION, 2015). This has a major impact on children in regards to weight management and their overall health (Hesketh, Hinkley & Campbell, 2012). This is significant as research suggests that physical activity and screen time behaviours in early childhood have a major impact on individual choices over their lifetime (Hesketh et al., 2012). Therefore, it is vital for children to learn and make healthy choices when they are young, which can establish a template to follow for the rest of their lives (Hesketh et al., 2012).

The Statistics

A general trend signifies that young American children aged 9 to 13 years old from families with low socioeconomic status, single parent households and ethnic minorities are more likely to indulge in television (Andersen, Crespo, Bartlett, Cheskin, & Pratt, 1998). On average, Dutch children spend 12.7 hours a week watching television or browsing the computer (Berentzen, Smit, Rossem, Gehring, Kerkhof, Postma, Boshuizen & Wijga, 2014). Many studies have found similarities between boys and girls when it comes to television watching; however boys are more likely than girls to play video games (Anderson, Economos, & Must, 2008). On a weekly basis, boys tend to accumulate more screen time with 14.2 hours a week compared to girls who average at 11.2 hours per week (Berentzen et al., 2014).

In Canada: Fewer than 20% of Canadian youth in grades 6 to 10 met the total screen time guidelines, which are 2 hours of screen time per day for children and adolescents (Mark, Boyce, & Janssen, 2006). In grades 6 to 10, only 41% of girls and 34% of boys in watch 2 hours or less of television per day. When the time of leisure computer use is included, only 18% of girls and 14% of boys meet the guidelines, according to the Health Behavior in School-Aged Children Survey (HBSC). The prevalence of those meeting the screen time guidelines is higher in girls than boys (Mark et al., 2006). In Canada, statistics from 2007 show that computer use is replacing television as the screen time activity of choice for younger populations including children and adolescents (Statistics Canada, 2014). Surveys have found that tablet computers are also on the rise from 20% to 51% between 2012 and 2013 (Moffat, 2014). About 91% of children between the ages of 5 and 15 have some form of internet access in their households (Moffat, 2014).

Studies show that children who watch more than 20 hours of screen time per week consume a greater amount of snacks by 1.9 times the regular proportion per day (Berentzen et al., 2014). They were also less likely to be physically active than those who had a maximum usage of 6 hours a week (Berentezen et al., 2014). These factors are contributing to an increased risk of obesity and other health problems (Hesketh et al., 2012).

Also, recent immigrants are less likely than people born in Canada to be frequent television viewers, but more likely to be frequent computer users (Statistics Canada, 2014). In the United States, 26% of US children watch 4 or more hours of television per day and 67% watch at least 2 hours per day, not including computers, cell phones, and other electronics. Non-Hispanic black children have the highest rates of watching 4 or more hours of television per day (42%). Boys and girls who watch 4 or more hours of television each day have greater body fat and had a greater body mass index than those who watch less than 2 hours per day (Andersen et al., 1998).

Negative Effects

Health

In the 1980s, researchers identified television viewing as a correlate of childhood obesity, a finding that has been confirmed by numerous other investigators (Mark et al., 2006). This is true especially when coupled with low levels of physical activity (Harrison, Bruns, McGuinness, Heslin, & Murphy, 2006). Too much sedentary screen time is associated with being obese, lipid abnormalities, sleep problems (Hesketh et al., 2012), poor fitness and smoking (Hancox, Milne & Poulton, 2004). These issues might have long lasting effect in case of excessive viewing (Hancox et al., 2004). A longitudinal study was conducted on a lifespan of 5 to 26 years of age (Hesketh et al., 2012). They found that excessive television use during childhood resulted in increased risk of being overweight and obese, raised serum cholesterol, poor cardiorespiratory fitness and increased likeness of smoking (Hesketh et al., 2012). On the other hand, there is no significant correlation between screen time and blood pressure (Hancox et al., 2004).

Sedentary behavior is also associated with an increased risk of metabolic disease, which is independent of physical activity (Berentzen et al., 2014). Watching television could affect the individual’s health by displacing the time used for physical activity, which would otherwise be spent on more active pursuits (Berentzen et al., 2014). For instance, physical activity at 15 years of age was inversely correlated with adolescent television viewing, and significantly predicted adult cardiorespiratory fitness (Hancox et al., 2004).

Another mechanism for health deterioration is that television disrupt habituation to food cues, thereby increases motivation for food and energy intake in children (Temple, Giacomelli, Kent, Roemmich, & Epstein, 2007). Current estimates suggest that 20 –25% of daily energy is consumed in front of the television. In addition, children and adults eat an increased amount of high energy-dense foods, drinks and fast foods which result in high total energy intake (Berentzen et al., 2014). All this is made seem normal through advertisements on unhealthy food choices on television (Berentzen et al., 2014). For example, engaging in a difficult arithmetic task while playing a video game slows salivary habituation more than in a no-stimulation condition (Temple et al., 2007). The same observation applies to computer and television viewing (Temple et al., 2007).

Finally, auditory distracters reduced habituation in children when compared with a no auditory stimulation control condition. Thus, shifting attention away from eating is another way in which watching television can Influence habituation to food cues (Temple et al., 2007). This influence results in an increase in meal frequency and therefore an increase in energy intake (Temple et al., 2007). Screen time in general and television viewing specifically are part of a highly prevalent sedentary behaviour in young people that has been implicated in the aetiology of pediatric obesity (Andersen et al., 1998).

Physiological

Exposure to certain television shows and imagery can affect children’s physiological health. Too much exposure to certain media can result in problems with being attentive, aggressive, externalising behavior, emotional reactivity and development of poor reading skills (Hesketh et al., 2012). It has also been attributed to lower education attained during adulthood (Hesketh et al., 2012) Inappropriate content like violence, news, adult advertisement can also cause harm to children and can lead to temperament (Hesketh et al., 2012). One in 10 children between the ages of 8 to 10 have reported seeing inappropriate images on the internet during a year; the number doubles for children between the ages of 12 and 15 (Moffat, 2014).

Socioeconomic Trends

In Canada: Girls living in low Socioeconomic status (SES) neighborhoods engage in significantly more weekly overall screen time and television/movie minutes compared to girls living in high SES neighborhoods. However, the same relationship is not observed in boys (Salmon, Ball, Crawford, Booth, Teleford, Hume, Jolley & Worsley, 2005). Children living in low SES neighborhoods are significantly more likely to be video game users and less likely to be computer users compared to children living in high SES neighborhoods (Salmon et. al., 2005). Also, children living in medium SES neighborhoods are significantly less likely to be computer users compared to children living in high SES neighborhoods (Salmon et al., 2005). It is possible that children living in lower income neighborhoods engage in more screen time because there are fewer resources for after-school programs and recreational facilities in these neighborhoods (Carson, Spence, Cutumisu, & Cargill, 2010).

Parental influence

Parents have a huge impact on the amount of time that children spend watching television or the time that they spend being physically active (Langer, Crain, Senso, Levy & Sherwood, 2014). A research study has found that parental television watching was strongly correlated with the child watching television for both genders (Jago, Stamatakis, Gama, Mourao, Nogueira, Rosado & Padez, 2012). Children who lived with parents who watched more than 2 hours a day were 1.5-8 times more likely to watch 2 hours per day as well (Jago et al. 2012). The case shows that there is a higher influence when the child watched television with their mother than with their father (Jago et al., 2012). The information is significant as children tend to model their parent’s behavior and in order to make changes, the family needs to first realize there is a problem. Second, it is recommended that they seek counselling so they can make changes to their lifestyle and aim for a healthier one (Jago et al., 2012).

Parents have such an impact on their children; they can use this influence to lessen the time that their children spend on electronics and increase the time that they spend being physically active. The best way to accomplish this is by being a positive role model, providing a social and physical environment that encourages physical activity (Hesketh et al., 2012). It is important for the parent to start at a young age as starting young often shapes behavior of the child as they grow up (Hesketh et al., 2012).

Awareness Campaigns

ParticipACTION

The Canadian non-profit organization is directly targeting children and the amount of time that they spend on electronics rather than on play. According to the director of marketing Rachel Schantz, Canadian children spend an average of 7 hours and 48 minutes a day using some form of electronic device (Dipardo, 2015). While only 5% of children are making the minimum requirement of 60 minutes a day of moderate to vigorous physical activity (Dipardo, 2015). The advertisements focus on children playing in groups, usually in an outdoor setting. As the commercial goes on, a black screen representing screen time covers the screen and eventually the children are unable to play their games (ParticipACTION, 2015). The commercial is a clear pictoral representation of how screen time takes away time where kids can be physically active and simply play. The commercial is meant to target parents of elementary school children to take action and increase their physical activity (Dipardo, 2015). They have guidelines on their website to help parents get started.

The use of technology to encourage movement

Active video games

Over the past 5 years, there has been an increase in popularity of active video games powered by consoles such as “Nintendo Wii” and the “Xbox Kinect”. These gaming devices have sophisticated controllers that enable a whole body movement with the assistance of depth cameras, accelerometers and pressure sensors (Barnett, Bangay, McKenzie & Ridgers, 2013). The technology allows players to participate in the game with body movements. Research has found that active video games have doubled the energy expenditure of seated video games and has also shown to elevate heart rate, increase step count, and may produce overall health benefits (Mears & Hansen, 2009). Several studies have accessed the energy expenditure based on the muscles being activated. The results show that active video games enable light to moderate physical activity with energy expenditure being significantly lower for games played primarily through upper body movements compared with those that engaged the lower body (Biddiss & Irwin, 2010). Energy expenditure during active video game play is comparable to moderate-intensity walking (Biddiss & Irwin, 2010). Thus, for children who spend considerable time playing electronic screen games for entertainment, physically active games seem to be a safe, fun, and valuable means of promoting energy expenditure (Biddiss & Irwin, 2010). Such interventions can be considered for obesity prevention and treatment (Robinson, 1999). However, there is limited evidence available to draw conclusions on the long-term efficacy of active video games for physical activity promotion (Grad, Pratt, Hester, & Short, 2009).

Examples of active video games

(Biddiss & Irwin, 2010)

• Wii dance kids
• Wii sports
• Wii fit
• EyeToy
• Dance dance revolution

Screen Time Recommendations

Sedentary behavior Guidelines for children 0-4

(ParticipACTION, 2015):

• According to the guidelines, screen time is not recommended for children under the age of 2 years old.
• For children between the ages of 2 and 4, the fewer the time, the better. But they shouldn’t get more than hour of screen time a day.
• Set limits and enforce rules to control the amount of screen time.
• Keep televisions and computers out of bedrooms.
• Take children outside and get their mind off electronics.

Sedentary behavior Guidelines for children 5 and above

(ParticipACTION, 2015):

• Limit recreational screen time to 2 hours or less. Lower amounts directly correlate with health benefits (ParticipACTION, 2015).
• Turning off the television.
• Hiding the remote so people will have to get up from their seats in order to change the channel.
• Unplug any videogames or computer games and even set a parental control to limit the amount of hours used daily.
• Limit the amount of televisions in the house, taking out any televisions from the kitchen and bedroom.
• Plan family time outside the house, like a walk in the garden.
• Playing an active game with the family or friends.
• Create a schedule and allocating times to watch television or browse the computer.
• Encourage children to visit a friend and communicate instead of texting them on their cellphone.
• Dance or move along to the music.
• Volunteer in free time instead of screen time.

Additional recommendations

(American Academy of Pediatrics, 2001)

• Monitor the shows that children are viewing. The shows should be informational, educational and nonviolent in nature.
• View television programs along with the child and discuss the content.
• Use controversial programming as a stepping-off point to initiate discussions about family values, violence, sex and sexuality, and drugs.
• Use the videocassette recorder wisely to show or record high-quality, educational programming for children.
• Support efforts to establish comprehensive media-education programs in schools.
• Support efforts to establish comprehensive media-education programs in schools.
• Change own habits so that a positive role model is created for the children (Hesketh et al., 2012).

Similarly, the Canadian Paediatric Society (CPS) recommend that most young people need to reduce their sedentary activities by 30 min per day, followed by a further reduction of 5 min per day each month until sedentary behaviours amount to no more than 90 minutes per day (Mark, Boyce, & Janssen, 2006). A further statement by the CPS in 2003 recommended limiting television to no more than 2 h per day in school-aged youth (Mark et al., 2006).

References

American Academy of Pediatrics. (2001).American Academy of Pediatrics: Children, Adolescents, and Television. Pediatrics, 107, 423 -426. doi: 10.1542/peds.107.2.423

Anderson, R. E., Crespo, C. J., Bartlett, S.J., Cheskin, L. J., Pratt, M. (1998). Relationship of physical activity and television watching with body weight and level of fatness among children: results from the Third National Health and Nutrition Examination Survey. JAMA: the journal of the American Medical Association, 279, 938-42. doi:10.1001/jama.279.12.938

Anderson, S. E., Economos, C.D., & Must, A. (2008). Active play and screen time in US children aged 4 to 11 years in relation to sociodemographic and weight status characteristics: a nationally representative cross-sectional analysis. BMC Public Health, 8,366. doi:10.1186/1471-2458-8-366

Barnett, L.M., Bangay, S, McKenzie, S, & Ridgers, N.D. (2013). Active gaming as a mechanism to promote physical activity and fundamental movement skill in children. Frontiers in Public Health, 74. doi:10.3389/fpubh.2013.00074

Berentzen, N.E., Smit, H.A., Van Rossem, L, Gehring, U, Kerkhof, M, & Postma, D.S. (2014). Screen time, adiposity and cardiometabolic markers: mediation by physical activity, not snacking, among 11 year old children. International journal of obesity, 38.10, 1317. http://dx.doi.org.ezproxy.library.ubc.ca/10.1038/ijo.2014.110

Biddiss, E., Irwin, J. (2010). Active Video Games to Promote Physical Activity in Children and Youth. Arch Pediatr Adolesc Med, 164, 664-672. Retrieved from http://www.aahf.info/pdf/youth_articles/exergamesjournalarticlepdf.pdf

Carson, V., Spence, J. C., Cutumisu, N., & Cargill L. (2010) Association between neighborhood socioeconomic status and screen time among pre-school children: a cross-sectional study. BMC Public Health, 10,367. doi:10.1186/1471-2458-10-367

Dipardo, M. (2015, January 13). ParticipACTION campaign pushes play time, not screen time. Retrieved from http://www.marketingmag.ca/brands/participaction-campaign-pushes-play-time-not-screen-time-134777

Graf, D. L., Pratt, L.V., Hester, C.N., Short, K.R. (2009). Playing Active Video Games Increases Energy Expenditure in Children. Official journal of the American Academy of Pediatrics, 124, 534-540. doi: 10.1542/peds.2008-2851

Hancox, R. J., Milne, B.J., & Poulton, R. (2004). Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. The Lancet, 364, 226-227. http://dx.doi.org.ezproxy.library.ubc.ca/10.1038/ijo.2014.110

Harrison, M., Burns, C. F, McGuinness, M, Heslin, J, & Murphy, N.M. (2006). Influence of a health education intervention on physical activity and screen time in primary school children: ‘Switch Off–Get Active’. Journal of Science and Medicine, 9, 288-294. http://dx.doi.org.ezproxy.library.ubc.ca/10.1016/j.jsams.2006.06.012

Hesketh, K.D., Hinkley, T., & Campbell, K.J. (2012). Children’s physical activity and screen time: qualitative comparison of views of parents of infants and preschool children. International Journal of Behavioral Nutrition and Physical Activity,9,152. doi:10.1186/1479-5868-9-152

Jago, R, Stamatakis, E, Gama, Carvalhal, I.M., Nogueira, H, Rosado, V, & Padez, C. (2012). Parent and child screen-viewing time and home media environment. American journal of preventive medicine, 43, 150-152. http://dx.doi.org.ezproxy.library.ubc.ca/10.1016/j.amepre.2012.04.012

Langer, S.L., Crain, A.L., Senso, M.M., Levy, R.L., & Sherwood, N.E. (2014). Predicting child physical activity and screen time: parental support for physical activity and general parenting styles. Journal of Pediatric psychology, 39, 633-642. doi: 10.1093/jpepsy/jsu021

Mark, A.E., Boyce, W.F., & Janssen, I. (2006). Television viewing, computer use and total screen time in Canadian youth. Paediatric Child Health. ; 11:9, 595–599. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528654/?tool=pmcentrez

Mears, D & Hansen, L. (2013). Technologies in physical education article #5 in a 6 part series: active gaming: definitions, options and implementation. Strategies: A Journal for Physical and Sport Educators, 23, 26-29. DOI http://www.tandfonline.com/action/showCitFormats?doi=10.1080/08924562.2009.10590864

Moffat, P. (2014). Screen time: how much is healthy for children? Community practitioner: the journal of the community practitioners’ & health visitors’ association, 87, 16. Retrieved from http://go.galegroup.com.ezproxy.library.ubc.ca/ps/i.do?id=GALE%7CA394685501&v=2.1&u=ubcolumbia&it=r&p=HRCA&sw=w&asid=bbc01d1a6dc54c3a1968d988f060ecfe

ParticipACTION. (2015). Make room for play. Retrieved from http://www.participaction.com/make-room-for-play-2/

Robinson, T. N. (1999). Reducing Children's Television Viewing to Prevent Obesity. The journal of American medical association, 282, 1561-156. doi:10.1001/jama.282.16.1561

Salmon, J., Ball, K., Crawford, D., Booth, M., Teleford, A., Hume, C.,Jolley, D., & Worsley, A. (2005). Reducing sedentary behaviour and increasing physical activity among 10-year-old children: overview and process evaluation of the ‘Switch-Play’ intervention. Health Promotion International, 20:1, 7-17. doi: 10.1093/heapro/dah502

Statistics Canada. (2014). Health Reports. Retrieved from http://www.statcan.gc.ca/pub/82-003-x/2008002/article/10600/5202425-eng.html

Temple, J.L., Giacomelli, A.M., Kent, K.M, Roemmich, J.N., & Epstein, L.H. (2007). Television watching increases motivated responding for food and energy intake in children. The American Society for Clinical Nutrition, 85:2, 355-361. Retrieved from http://ajcn.nutrition.org.ezproxy.library.ubc.ca/content/85/2/355.full