Is Screen Time Bad for Children’s Mental Health?

Many parents are concerned about how much time their children spend on cellphones, Xboxes and other digital media. Some experts say they should be: There is a growing body of research showing an association between unhappiness and the time adolescents spend on digital media.

What is less clear is whether screen time is causing mental-health problems or if children with worse mental health spend more time with digital media.

To assess the research, we went to Jean Twenge, author of the book “iGen: Why Today’s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy—and Completely Unprepared for Adulthood—and What That Means for the Rest of Us”; Michael Rich, founder and director of the Center on Media and Child Health in Boston and an associate professor at Harvard Medical School; and Cara Booker, research fellow and acting graduate director at the University of Essex in the U.K., who has studied the effects of social-media use on children and adolescents.

Edited excerpts follow:

WSJ: What does the evidence tell us about the links between screen time and children’s mental health?

DR. RICH: Perhaps the question should be whether screen use can be problematic for mental health. In an era when educational technology has deeply penetrated our schools—even preschoolers are handed tablets now—there are screens in all public places, and virtually everyone has interactive screen media at home and in their pockets, the concept of screen time as something that could be controlled is obsolete.

With one exception, screen time is less important to mental health than screen content and the context in which it is consumed and created. It is what children and adolescents are exposed to and encouraged to do with screens that helps or harms.

Where screen time becomes an issue is when it is displacing more productive or meaningful activities. For some young people, screen time can become compulsive, taking up more of their waking hours until they are functionally impaired. My colleagues and I describe this as Problematic Interactive Media Use, or PIMU, and over the past five years, we have seen a dramatic increase in young people whose gaming, social media, pornography or information-bingeing has resulted in sleep deprivation, school failure, relationship problems, anxiety and depression. As a result, we have founded a clinic at Boston Children’s Hospital for children and adolescents with PIMU and other media-related disorders.

DR. BOOKER: Most of the research that I focus on looks at social-media use and mental health, and unfortunately the findings are mixed. There are some studies that find either positive or no effects of social media. Others find negative effects. Much of this debate surrounds the question of time versus content. Some studies look at time and find negative effects, while others examine content and find lesser effects.

DR. TWENGE: Several large studies show that use of digital media beyond two hours a day of free time, and especially beyond four hours a day, is correlated with more depression and unhappiness in teens. Several longitudinal studies show this, as well, with children, teens, and young adults who spend more time on digital media later showing more mental-health issues. Sheer amount of time with screens, not just content, does matter, probably because those higher levels of use are enough to displace time spent on more beneficial experiences such as face-to-face interaction. It also is well-documented that digital media can displace or disrupt sleep; that alone could explain the link with compromised well-being.

Many of the mixed findings in the field are explained by two factors. First, some find links between positive experiences online and positive well-being, which isn’t surprising and isn’t the same thing as time spent online. Second, most studies don’t control for level of face-to-face social interaction. The same teens who spend more time with their friends in person are often those who are active on social media, so if that isn’t controlled for it can wash out the effect on well-being. We found, for example, that the most unhappy teens were those who spent more time than average with digital media and less time than average on face-to-face social interaction.

WSJ: What are the main weaknesses of the research so far?

DR. BOOKER: We haven’t fully explored the mechanisms through which screen use and children’s mental health are related. As has been mentioned, sleep is a large part of it. But there are other factors such as self-esteem, cyberbullying, body image, etc. that haven’t been fully addressed. I also don’t think that we have explored gender, cohort or ethnic differences enough and whether those exist. For example, in my research we found a relationship between social-media use and mental health among girls but not boys. [Ten-year old girls who used more social media were at higher risk of poorer well-being by age 15, according to Dr. Booker’s analysis of the Understanding Youth survey of 9,859 10- to 15-year-olds, 49% of whom were female.]

Is screen time just displacing any activity or specific ones that may lead to worse well-being? Also, if we are going on the broader topic of screen time, how do these interact with each other to affect mental health? Many young people multitask and use more than one screen to do different things. Is this substantially worse than those only using one screen at a time?

One of the hardest questions to answer is does screen time affect children’s mental health, or do children with varying levels of mental health interact with screens differently?

DR. RICH: Mental illnesses are diverse, affect different individuals in different ways, and in most cases result from the influences of many factors from genetics to environment to events in the individual’s life. If we don’t measure many factors affecting the individual, we are missing many pieces of the puzzle. This is exactly why the data are mixed.

Jean is right, there are correlations between screen time and adverse mental-health outcomes. What we don’t know is whether screen time or screen use contributes to those outcomes, whether they are the result of abnormal psychology, or are an indicator of dysfunction.

DR. TWENGE: We definitely need more studies that measure face-to-face social interaction—that is a crucial moderator for well-being effects.

Although existing studies have been able to control for gender, ethnicity, and socioeconomic status, it would be really useful to know if both digital media use and low well-being were linked to a certain type of parenting style, or not.

Most important, we need more experimental random-assignment studies to determine causality (does screen time cause low well-being, or does low well-being cause screen time?).

Overall, though, doing experiments will be difficult. I got interested in tech and well-being in the first place because iGen (those born after 1995) are the first generation to grow up with smartphones and are also much more likely than teens five to 10 years ago to be unhappy and depressed. It isn’t possible to show a connection between these two things experimentally because you can’t randomly assign people to grow up at different times. Experiments can be done, but they don’t capture the whole of the generation’s experience.

If, for example, you did an experiment where you asked iGen teens and young adults to lower their digital media use [vs. not], they might feel withdrawal that could actually lower well-being. This type of experiment also won’t capture the experience of teens who limit their own digital media use but are surrounded by teens who don’t—so even if they wanted to interact face-to-face they have no one to do that with.

WSJ: In terms of mental health, how does social-media use compare to playing computer games or, say, Instagram to Snapchat?

DR. TWENGE: At least in the large data sets I’m familiar with, large amounts of time spent on any digital-media platform are linked to more unhappiness and depression. There’s some variation in the size of the correlations for social media vs. gaming vs. texting, but not much.

DR. BOOKER: I think that with the advancement of computer games, an element of social media is included as many players can play together at the same time and communicate, and gamers are some of the most popular vloggers on YouTube.


Another weakness of current research is that we haven’t been able to look at differences between sites, partly due to rapid changes in what is popular among young people and partly because young people often have profiles on many sites and use them in conjunction with each other. Perhaps one question of interest is do they have different friends/contacts on the different sites and if so, are some mainly face-to-face friends and the others not?

DR. RICH: It is the type of site and the type of kid that matters. We are seeing that gaming PIMU is more prevalent in boys, social-media PIMU more prevalent in girls, and that both problematic pornography use and information-bingeing [watching endless videos, etc.] are pretty evenly split gender-wise.

One study found that use of ephemeral social media like Snapchat was correlated with greater happiness, while more lasting social-media use has been linked to higher rates of anxiety and depression.


WSJ: Do screens and social media affect girls differently? And what differences have we seen among age groups?

DR. BOOKER: My research showed that girls who interacted more with social media at a young age (10 years old) had worse well-being by the age of 15 than young girls who interacted less.

DR. RICH: There are distinct differences between boys and girls, particularly in regard to gaming and social media. This is in part biology and in part socialization. Boys compete by seeking to prevail, girls by seeking acceptance. Boys can get immersed in gaming because no matter how well they do the games are designed so that they can always do better—and there is always someone, somewhere in the world, who can best them. Girls seek acceptance in a competitive way on social media, which can contribute to anxiety because there is always someone who takes better vacations, has nicer outfits or a better-looking boyfriend.

Age differences are significant because of the dramatic changes in neurodevelopment that occur throughout childhood into adolescence into adulthood. Cognitive psychology shows that children under the age of about 7 cannot recognize persuasive intent or reliably distinguish fantasy from reality. What does that mean for screen use?

Executive functions such as impulse control, future thinking, and what we used to call the superego or conscience don’t fully develop until the mid- to late 20s. This is why kids get into trouble with sexting, cyberbullying or documenting their own misdeeds.

WSJ: Are there positive aspects to social media?

DR. RICH: Absolutely! I believe that social media used in a healthy balance with face-to-face human interaction and other real-life activities and used as a tool with which to be authentic, human and vulnerable, rather than as a self-marketing tool, can be an instrument of peace. When a young person who has been connecting with a young person in another country is asked to take up arms against him or her, I believe that he or she is less likely to do so.

DR. TWENGE: I think social media can be positive, but it often isn’t. Social media is the most positive when people use it to set up face-to-face social interaction and to organize social movements.

WSJ: Is there enough firm evidence of risk from too much screen time that parents, schools and health-care professionals should act?

DR. RICH: Again, I think it is screen use rather than screen time that is the issue, until the screen time displaces sleep, homework, or healthy relationships with family and friends. That said, we should teach our children that these devices and apps are tools to be used in mindful, healthy and balanced ways. We should observe our children, patients, students and ourselves and, if we detect impairment or dysfunction, act to correct it.

DR. BOOKER: Current evidence suggests there is a relationship between increased screen time and poorer mental health. However, this doesn’t mean we can just say use less. As both Rich and Jean say, poorer mental health in young people isn’t only caused by screens, and a reduction in screen time may not have any impact on mental health. Screen behaviors are also important. This is a multifaceted issue that will need to be addressed through multiple avenues.

Some of the things we can do in the immediate future are increase digital literacy among young people and have parents model good practice with screen use.

DR. TWENGE: I do think that limiting digital media time can be beneficial, especially if it’s cutting down excessive use. The research points to a limit of 2 hours a day or less of leisure time spent on digital media. It’s also very clear that phones and sleep aren’t a good combination, so phones should be shut down at least 30 minutes before bedtime.


Should Parents Post Photos of Their Children on Social Media?


Those in favor say it’s a great way to help build a community. Others say sharing violates children’s privacy and may have long-term consequences.
A parent on average will post almost 1,000 photos of a child online before the child turns 5, a recent survey found.
A parent on average will post almost 1,000 photos of a child online before the child turns 5, a recent survey found.

It’s a question any social-media user faces after snapping a great photo: Should I post this? Or it going to come back to haunt me?
The questions get doubly complex when they involve people’s children. A parent on average will post almost 1,000 photos of a child online before the child turns 5, according to a recent survey. Many parents don’t ask children’s permission before posting, and many have never checked their privacy settings—even though photos often contain data about where they were taken.

That leads many privacy advocates to urge restraint on parents. The risks of putting your child in danger now, or embarrassing them later, are too big to ignore, these critics say. The best course is to keep their photos off the Internet.

But some parents strongly argue for posting photographs of children. It’s a way to strengthen an online social circle, they say, and connect with people you didn’t know before. What’s more, children are going to end up on social media eventually, they say, and parents can set a good example for them by being careful about what photos they post and asking permission when children are old enough to consent.

Lauren Apfel, a writer and mother of four (including twins) and founder and executive editor of Motherwell magazine, makes the case for sharing photos. Arguing the case against sharing is Morgan G. Ames, a postdoctoral scholar at the Center for Science, Technology, Medicine, and Society and a fellow at the Center for Technology, Society and Policy at the University of California, BerkeleyYES: In an Isolated Age, It’s a Great Way to Help Build a Community

By Lauren Apfel

Sharing photos of your children online can be a rewarding experience and a way to connect with other parents. But you must be prepared to be responsible about what you post.

The big reason to share is to build community. Raising children is a more isolated endeavor than ever before. I live, for example, thousands of miles from my family. In this atmosphere of modern parenthood, we all struggle to make it through the day, and the Internet has become an incredible source of support. In the early years of mothering twins, one of the things that brought me the most happiness was posting pictures of them on Facebook. Sharing those photos and engaging with an online community was a lifeline.
Many people fear those pictures will spread further than intended. To me, that’s part of the joy of it. My work as a writer has helped me create a community on social media, and the images I post of my children allow me to engage with a range of “friends” I wouldn’t necessarily include on a tailored list. I delight in seeing their photos, too. You don’t know whom a picture will touch, what connection will be made. Unexpected people have seen my pictures and commented on how much they enjoyed them or could relate to them.

I know there is much concern about the potential dangers in sharing pictures of children: catfishing, identity theft or projected scenarios where our bundles of joy are judged by future employers because of a virtual fingerprint they did not create. But none of this bothers me. My children are my children because of the choices I make about them. They were born to parents who believe that the benefits of sharing photos of them online outweigh the risks—this is their lot, and it has been a constant, familiar part of their upbringing, one with which they seem innately comfortable.

I don’t actively avoid unintended negative consequences, because I don’t fear them per se and certainly not enough to stop posting. If problematic unintended consequences did arise because of a photograph I posted, I would deal with them on an ad hoc basis.

I will not share photos that I think are tasteless or inappropriate, or that I feel mock my children in any way. Nor will I share photos that my older children have expressly asked me not to (and, with my 10-year-old and 8-year-old, I tend to request permission).

What Twitter and Facebook Said
We asked readers on social networks if it’s a good idea for parents to post photos of their children on social media. Here’s what we heard.
As critics of sharing photographs argue, there might well be much about the effects of the Internet we don’t yet know. There are always unpredictable repercussions when it comes to new technologies—but there are always new solutions. Instead of fearing the unknown, we should be embracing the digital world and all it has to offer by interacting with it in a civilized, dignified way. Parenting (indeed, life!) is hard enough without letting vague and unsubstantiated concerns for the future dictate present-day decisions.

My oldest son will soon be entering the brave new world of social media. The same way our children are the first to grow up immersed in screens, so too are they the first to be raised in the age of online parenting. We should be using our own forays into the Internet as an opportunity: Parenting is nothing if not setting a good example.

When my son follows the winding trail of my online history, I know what he will find: a mother who prioritizes posting photos of herself and others respectfully, moderately and tactfully. And this is exactly what I will expect from him.

Ms. Apfel is a writer and mother of four (including twins). She is co-founder and executive editor of Motherwell magazine. She can be reached at

NO: They Violate Privacy, and Without a Child Giving Consent

By Morgan G. Ames

Facebook seems to be full of friends’ adorable babies and precocious children. But a healthy proportion of parents—myself included—have decided that sharing photos carries too many risks for their children.

Why do we opt out? And what issues should parents consider when posting pictures of their children online?

My own reasons center on privacy and consent. In the early days of the Web, those few with an online presence often felt that they were protected by security through obscurity. But in today’s world, data mining is big business. Much of our content is hosted on sites where we may not only lack control over what happens to it, but where it is aggressively used in aggregation and profiling.
The pictures parents post may follow children from birth to death as their data profiles are sold and resold to marketers. They can reinforce prejudices and barriers as marketers decide what sort of person someone is, what kinds of content will be marketed to them, and even what kinds of loans they might be worthy of based on their past. And there are likely long-term implications of these data profiles that we don’t yet understand.

It can also be difficult for parents to keep in mind just who their actual audience is. They may be targeting grandparents in their posts, but on many sites, including Facebook, sharing to one’s whole network is the default that many never change, and photos are visible years in the future. It can also be hard to control re-sharing, so that photos that people think are private can eventually take on a life of their own.

These issues are thorny enough when deciding to post pictures of ourselves online—in fact, research shows that adults are sharing less personal content on social-networking sites (much to Facebook’s chagrin!). They may be compounded for children.
Some people who share photos say they are building an online community. Indeed, there are definitely benefits to creating such support structures of parents. But the benefits to children are less clear, and the risks are high enough that I would encourage parents to think about posting a few paragraphs of text instead of a photograph.

It’s also true, as some people who share argue, that information will end up online eventually. But rather than use that fact as a reason to post photographs of our own, we should take it as a warning to be even more cognizant of the information about us and our children that ends up online.

Finally, there’s the crucial issue of consent. Children are rarely given the opportunity to agree to having pictures of themselves shared online by others, and they may not fully understand what they are consenting to. Children also often don’t have control over how they are portrayed when others are posting. They may not understand how that embarrassingly cute photo of them that parents adore might come back to haunt them years later when bullies or future employers or bitter ex-lovers unearth it.

This isn’t to say youth don’t make missteps when managing their own online identities. But allowing them to create those identities themselves, rather than contending with something their parents have already crafted for them, could be an important part of developing independence while maintaining trust.