Spending long hours on phones and tablets can lead children to experience disrupted sleep, reduced movement, weight gain, poorer concentration and mood changes; its potential effects are not limited to eye strain.
Academy broadens assessment of screen-related risks
The scale of the impact is determined by the duration, type and timing of use, as well as the basic needs for a child’s development that screens may displace, such as sleep, play, physical activity and social interaction. In its updated 2026 policy, the American Academy of Pediatrics stresses that dealing with digital media should not be limited to counting the number of hours a child spends in front of a screen.
It calls for consideration of the nature of the content, how digital platforms are designed, the circumstances surrounding their use and the extent to which use affects activities essential to a child’s health and development. Dr Rita Khalil, a paediatrician at Al Fardan Medical Hospital and Northwestern Medicine in Qatar, says some behavioural changes may alert parents to excessive screen use by their child.
The main signs include temper tantrums, constantly thinking about electronic games and losing interest in traditional play. Khalil adds that excessive device use may be accompanied by declining concentration and attention, impaired memory, and lower levels of homework completion and academic performance.
A tendency towards isolation and problems in social relationships may also emerge, making the impact of use extend into the child’s daily life rather than being linked only to the time spent in front of a device. The child may also complain of physical symptoms such as headaches and red eyes, signs that warrant attention to the duration and nature of device use.
Screens affect sleep, movement and weight
Khalil explains that screens may delay a child’s bedtime and make it more difficult to wake up in the morning. They may also cause daytime drowsiness, which can negatively affect the child’s ability to learn and concentrate. Excessive use reduces the time available for physical activity, as long hours on electronic devices replace movement and play.
This may contribute to weight gain and obesity, along with associated health and metabolic problems, including insulin resistance, particularly when sitting in front of a screen becomes a dominant part of the child’s daily routine. To reduce these risks, Khalil stresses that devices should be banned for at least the hour before bedtime.
She also recommends maintaining an appropriate distance between the child and the screen, paying attention to body posture and adjusting the surrounding lighting during use, which can help reduce the strain associated with sitting in front of devices for long periods. Not all forms of digital content have the same impact; spending long hours playing electronic games differs from using devices for learning or reading.
Khalil explains that the impact is linked to the duration, type and timing of use, and that more time in front of screens increases the likelihood of eye strain, headaches and reduced movement. Prolonged use of electronic games may affect attention, mood and sleep differently from educational use.
For this reason, not all screen time should be categorised in the same way. It is necessary to consider what the child is doing on the device, the circumstances in which it is being used and whether its use is displacing other essential activities. Research findings support the importance of assessing the context of use, rather than the number of hours alone.
Study links context of use to child development
A systematic review and meta-analysis published in JAMA Pediatrics included 100 studies and 176,742 children under the age of six. They concluded that the context in which screens are used is linked to different outcomes in children’s development. The researchers found that viewing content unsuitable for a child’s age was associated with poorer psychological and social outcomes, while screen use with a parent’s participation was associated with better cognitive outcomes.
These findings highlight the importance of choosing content suited to the child’s age and participating during viewing, rather than leaving the child alone with devices for long periods. Recommendations on screen time vary according to a child’s age and needs. According to the World Health Organisation, infants under one year of age should not be exposed to screens.
The organisation also recommends that one-year-old children spend no time in front of a screen during sedentary periods. For children aged between 2 and 4, it recommends that screen time should not exceed one hour a day, stressing that less is better for health and development.
These recommendations cover activities the child undertakes while seated, such as watching television and videos and playing computer games. The potential impact is not limited to devices the child watches directly; a television playing in the background may also have an effect even when the child is not watching it.
A review published in JAMA Pediatrics found that exposure to background television was associated with poorer cognitive outcomes among children under six, as an open screen during play can attract and distract the child’s attention from the activity. For school-age children and adolescents, the American Academy of Pediatrics does not set a single time limit suitable for everyone because there is insufficient evidence to support one limit for these age groups.
Different recommendations according to the child’s age and actual individual needs?
Instead, the academy recommends assessing the quality of use and whether there is a balance between screens and sleep, physical activity, play, reading, learning and interaction with the family. A child becoming angry when parents ask them to stop an electronic game or put down the phone does not necessarily mean they have gaming disorder.
The World Health Organisation says the disorder is characterised by three main features: impaired control over gaming, giving it increasing priority over other activities and interests, and continuing to play despite the resulting negative consequences. Diagnosing gaming disorder requires the behavioural pattern to be severe enough to cause marked deterioration in important areas of the child’s life, such as family and social relationships or academic performance.
The pattern should also usually persist for at least 12 months, rather than being based on a passing reaction or a single disagreement over switching off a device. Seeking an assessment from a doctor or a psychologist specialising in children and adolescents is appropriate when screen use clearly and persistently affects a child’s studies, relationships or daily activities.
The same applies when a family finds it difficult to control use despite setting clear rules and limits and trying to follow them. Khalil stresses that protecting children from excessive use begins at home by setting clear times for electronic devices and sticking to them.
She recommends encouraging physical activity, free play and reading, and involving children in daily activities and chores so that digital devices do not become their main way of filling their free time. The paediatrician stresses the importance of parents providing a practical model of balanced screen use, so that the rules are not imposed only on younger family members.
This means incorporating digital boundaries into the family’s daily lifestyle while preserving enough time for sleep, movement, reading, learning and communication among family members.
