Electronic Screen Syndrome – The Effects on Children

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As parents, one of our primary responsibilities is to protect our children, but that’s become dramatically more difficult in the last twenty years. According to the results of a Pew survey, they found that 66% of respondents say that parenting is harder today than it was 20 years ago, citing technology as the reason why. 

They wrote, “Parents overall are also apprehensive about the long-term effects of smartphones on children’s development: 71% believe the widespread use of smartphones by young children might potentially result in more harm than benefits.

In addition to parents’ concerns about screen time, there are other tech-related worries that are on their minds. Majorities of parents say they are concerned about their child being the target of online predators, accessing sexually explicit content, accessing violent content online, and being bullied or harassed online.”

Obviously, those are valid concerns, and ones we should take very seriously. But, external threats aren’t the only thing to be concerned about. 

Electronic Screen Syndrome can quite literally change your child’s personality. Although varied, many of the effects of ESS can be grouped into symptoms related to mood, cognition, and behavior. The root of these symptoms appears to be linked to repeated stress on the nervous system, making self-regulation and stress management less efficient.

The result? Disorganized, disobedient, or oppositional thinking, over-excitement, delayed maturity, narrowed interests, loss of friends, lower grades, anti-social behavior, low frustration tolerance, poor short-term memory, and much, much more. 

When the increased levels of stress reach a breaking point, you’ll see dramatic mood swings, outbursts, tantrums, erratic and unpredictable behavior, addiction, and, eventually, sleep disturbances.

The Role Parents Play

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Let’s roll back the discussion a little bit and explore something very basic…children learn from their parents, right? Well, guess what… most of us grownups struggle with a serious addiction. Not only are we addicts we also play an active role in getting our children hooked, too. Our drug of choice? Technology. And, we put it right into their little hands.

From the time most children are born, they are fed a steady diet of unnatural sensory input. Studies show that when a newborn or infant is exposed to a noisy toy with a lot of lights for an extended period of time, they will become overwhelmed by the stimulation and begin to cry. 

But, you would never provide such a toy, right? Wrong. Most likely, you have more than one of these toys. They are at least twenty times the size of a newborn, and they are probably connected to a booming, vibrating, cacophony of noise commonly known as… surround sound. 

We’re talking about televisions. 

Giant, loud, bright, cell-altering technology. 

Did you know that the average household keeps the TV on for an average of 3.5 hours a day? 

Every day. 365 days a year. 

According to a survey by pewresearch.org, they found that by the time children are 4 years old, 90% of children watch TV on a daily basis, 64% use a tablet, 49% interact with a smartphone, 12% use a computer, and 9% are already using a gaming device. By the time children are 11 years old, the figures balloon. 78% have a tablet, 67% use a smartphone, 73% operate computers, and a whopping 68% use gaming devices. Every – Single – Day.

This information isn’t intended to blame or shame the parents who live these figures, but to serve as a wake-up call.

The History of Electronic Screen Syndrome

According to several sources… In 2012, Victoria L. Dunckley M.D. was the first to describe what is now called Electronic Screen Syndrome. She wrote an article in Psychology Today arguing that there was an unrecognized disorder that explained many psychiatric symptoms in children. She listed complaints that many parents can relate to:

  • “He’s revved up all the time.”
  • “He can’t focus at all and is totally defiant. Getting ready for school or bedtime is a daily nightmare.”
  • “She’s exhausted and has meltdowns even when she’s slept enough.”
  • “He flies into a rage over the slightest thing. The other kids don’t want to play with him anymore.”
  • “Her grades have gone downhill this year and we don’t know why.”

These are common complaints that can have many causes and can lead to faulty diagnoses.

Dunckley said the two most over-diagnosed conditions she sees in the pediatric population are bipolar disorder and attention-deficit/hyperactivity disorder (ADHD or ADD). 

Overdiagnosis leads to inappropriate treatment with psychotropic drugs that have side effects. She wondered if the true cause of these misdiagnosed symptoms might be environmental. Seek and ye shall find. Sure enough, Dunckley found one: “the unnaturally stimulating nature of an electronic screen, irrespective of the content it brings.” She called it “Electronic Screen Syndrome” or ESS, alleging that too much screen time could cause mental health issues or exacerbate pre-existing ones.

Characteristics of ESS in Children

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Dunckley says ESS is a disorder of dysregulation, the inability to modulate one’s mood, attention, or level of arousal. She says interacting with screen devices over-stimulates the child and shifts the nervous system into fight-or-flight mode. The response can be immediate, as with action games, or more subtle, as in repeated texting.

A child diagnosed with ESS exhibits symptoms such as irritability, depression, tantrums, low frustration tolerance, poor sportsmanship, poor eye contact, insomnia, poor short-term memory, and learning difficulties. Dunckley claims that ESS can mimic virtually any mental health disorder.

Although defining the syndrome and naming criteria is a work in progress, here are some general characterizations of ESS:

  • The child exhibits symptoms related to mood, anxiety, cognition, behavior, or social interactions that cause significant impairment in school, at home, or with peers. Typical signs/symptoms mimic chronic stress and include irritable, depressed or labile mood, excessive tantrums, low frustration tolerance, poor self-regulation, disorganized behavior, oppositional-defiant behaviors, poor sportsmanship, social immaturity, poor eye contact, insomnia/non-restorative sleep, learning difficulties, and poor short-term memory.
  • ESS may occur in the absence or presence of other psychiatric, neurological, behavioral, or learning disorders, and can mimic or exacerbate virtually any mental health-related disorder.
  • Symptoms markedly improve or resolve with strict removal of electronic media (an “electronic fast”); three- to four-week electronic fasts are often sufficient but longer fasts may be required in severe cases.
  • Symptoms may return with the re-introduction of electronic media following a fast, depending on a variety of factors. Some children can tolerate moderation after a fast, while others seem to relapse immediately if re-exposed.
  • Vulnerability factors exist and include: male gender, pre-existing psychiatric, neurodevelopmental, learning, or behavior disorders, co-existing stressors, and total lifetime electronic media exposure. At particular risk may be boys with ADHD and/or autism spectrum disorders.

Quiz: Is Your Child Overstimulated from Too Much Screen Time?

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In a brilliant article that Dunckley contributed to Psychology Today in 2017, she wrote, “Long before addiction sets in, a child’s sensitive nervous system can become overstimulated and hyperaroused from moderate but regular amounts of screen time. This causes the brain to be in a state of chronic stress and effectively short-circuits the frontal lobe, creating a host of symptoms that mimic or exacerbate mental health, learning, and behavioral disorders.

The first step in addressing this state — what I call Electronic Screen Syndrome (ESS) — is recognizing the signs.

This is important because traditionally when experts discuss red flags for problematic screen time, they focus on addictive behaviors, many of which are readily apparent. In contrast, this quiz is designed to help parents see the not-so-obvious ways in which screen time might be impacting a child’s or teen‘s behavior in a negative way.

Place a checkmark next to each question that applies to your child.

  1. Does your child seem revved up much of the time?
  2. Does your child have meltdowns over minor frustrations?
  3. Does your child have full-blown rages?
  4. Has your child become increasingly oppositional, defiant, or disorganized?
  5. Does your child become irritable when told it’s time to stop playing video games or to get off the computer?
  6. Do you ever notice your child’s pupils are dilated after using electronics?
  7. Does your child have a hard time making eye contact after screen time or in general?
  8. Would you describe your child as being attracted to screens “like a moth to a flame”?
  9. Do you ever feel your child is not as happy as he or she should be or is not enjoying activities as much as he or she used to?
  10. Does your child have trouble making or keeping friends because of immature behavior?
  11. Do you worry that your child’s interests have narrowed recently, or that interests mostly revolve around screens? Do you feel his or her thirst for knowledge and natural curiosity has been dampened?
  12. Are your child’s grades falling, or is he or she not performing academically up to his or her potential — and no one is certain why?
  13. Have teachers, pediatricians, or therapists suggested your child might have bipolar disorder, depression, ADHD, an anxiety disorder, or even psychosis, and there’s no family history of the disorder?
  14. Have multiple practitioners given your child differing or conflicting diagnoses? Have you been told your child needs medication, but this doesn’t feel right to you?
  15. Does your child have a preexisting condition, like autism or ADHD, whose symptoms seem to get worse after screen time?
  16. Does your child seem “wired and tired” — exhausted but can’t sleep, or sleeps but doesn’t feel rested?
  17. Does your child seem unmotivated and have poor attention to detail?
  18. Would you describe your child as being stressed, despite few identifiable stressors?
  19. Is your child receiving services in school that don’t seem to be helping?
  20. Do you and your child argue over screens (limits, timing, content, activities, getting a new device, etc.) on a regular basis?
  21. Does your child lie about screen use, “cheat” when on restriction, or take their device to bed with them?
  22. Is your child a “sore loser” or hyper-competitive when playing games or sports, to the point where it affects peer relationships or enjoyment of the activity itself?
  23. Does your child prefer socializing online over face-to-face interactions?
  24. Do you avoid setting screen time limits because you fear your child’s reaction, you’re too exhausted, or because you’d feel guilty doing so?
  25. Do you avoid spending time with your child because you predict it won’t be enjoyable or because you harbor negative feelings toward your child?

Scoring:

Overall points: Count the number of checked boxes. The more questions that resonate with your family’s situation the higher the likelihood that screen time is affecting your child’s nervous system—ESS. At the same time, a higher score reflects risk for tech addiction—even if the amount of screen time is “average” or even less than your child’s peers.

1-5 points: Some risk for ESS. Your child has some difficulties whose primary underlying cause may or may not be related to screen use. However, all mental health, learning, and behavior issues will improve when screen time is properly addressed. This is similar to how restoring sleep tends to have a panacea-like effect on mental conditions across the board.

5-12 points: Moderate risk for ESS. Your child has some significant difficulties, likely in more than one area (school, home, or in relationships). There’s a good chance that your child may remain “stuck” or see limited improvements if ESS and screen time are not addressed. On the other hand, if you’re catching ESS early and aren’t too stressed yourself, now would be a good time to nip it in the bud.

13 or more: High risk for ESS. If you’ve answered “yes” to more than half the questions above, it is highly likely your child has Electronic Screen Syndrome and may also be at risk for technology addiction. Many, many families fall into this category. You may feel you’re in crisis mode, all the time. Fear not—being in this state can be highly motivating, and you’re likely to see more dramatic and even “life-changing” benefits when ESS is reversed.

Specific problematic areas: In contrast to the overall score, this section can help flesh out specific challenges your child may be experiencing. In turn, this can help you choose areas in which to track progress.

Hyperarousal/overstimulation: Virtually all these questions relate directly or indirectly to hyperarousal, but in regards to physiological arousal look to items 1-7, 10, 16-18, and 22.

Mood: Items 9, 11, 13, 17, and 22.

Cognition/Focus: Items 4, 11-15, 17 and 19.

Behavior/social skills: Items 4, 7, 10, 20, 22, and 23.

Attachment: Items 7, 9, 10, 20, 21, 24 and 25.

Addiction: Items 5, 8, 9, 11, 12, 20, and 21, 23 and 24.

Misdiagnosis: Items 12-15, and 19. Since ESS can mimic or exacerbate psychiatric disorders, its presence is commonly missed. The presence of ESS doesn’t rule out other underlying conditions, but it will virtually always make other issues worse. Further, when ESS is left untreated the underlying disorders become harder (if not impossible) to address.

Electronic Screen Syndrome – Summary

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In general, ESS is marked by high levels of arousal (hyperarousal, or being “revved up”) and an inability to regulate emotions and stress levels (dysregulation).

Symptoms vary and can mimic virtually any psychiatric or learning disorder and many neurological disorders. However, a classic presentation of ESS is irritable mood, poor focus or disorganization, low frustration tolerance, and problematic behaviors such as argumentativeness or poor eye contact. A depressed or anxious mood is also common.

You might notice that the quiz questions cover a wide variety of dysfunction, but they all represent scenarios that can occur when a child starts operating from a more primitive part of the brain—which is what happens when children get more screen time than the nervous system can handle.

Now what?

The presence of ESS is good news—because whenever we can identify a culprit, we can point to an avenue of treatment. (Compare this to going in circles because you don’t know what’s going on and you’re wasting time/energy/money trying to figure it all out.)

Importantly, it doesn’t matter if there are underlying diagnoses or stressors contributing to the child’s symptoms; indeed these factors only make the child more vulnerable to overstimulation. And though screens may seem so ubiquitous that they’re impossible to control, the truth is that with education, support, and a concrete plan, parents can take back control, turn ESS around, and boost the quality of life for not just their child but the entire family.

The keys to success lie in grasping the physiology and dynamics behind screens and the nervous system as well as understanding how to systematically reset and resynchronize a child’s brain. This is achieved with a strict, extended electronic fast (aka a tech fast or screen fast) of at least three weeks (sometimes longer) duration.

Though the thought of this might seem overwhelming, most parents find the fast easier than they imagined it would be. Once the child’s nervous system is reset to its natural baseline, parents can either continue being (mostly) screen-free, or they can methodically determine how much screen time the child can tolerate without triggering symptoms or dysfunction.

Why not just cut back, you ask? Because screen exposure has potent biological effects including overactivation of the brain’s reward pathways, desynchronization of the body clock, sensory overload, the release of stress hormones, and electrical excitability. These systems tend to stay in a disorganized state without the complete removal of the offending agents. Removing screen stimulation allows the brain to get deep rest, resynchronize the clock, rebalance brain chemistry and hormones, quiet overactive pathways, and restore mental energy.

In short, recognizing and addressing overstimulation and ESS from screen time can have a profound impact on mood, focus, and behavior in children, teens—and even young adults—in a matter of weeks, while restoring peace and harmony in the home.”

Reversing the Effects of ESS – A 4-Week Plan

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In excerpts from a brilliant article (It’s worth reading in its entirety!) by Linda Graham, she wrote, “The Four-Week Reset Program is typically one week of planning and three weeks of an electronic fast. Dr. Dunckley’s instructions are very clear, comprehensive, and [filled with] guidance about dealing with resistance (or sabotage).

During the week before the fast, go through your closets, borrow from friends, and buy whatever toys, games, puzzles, drawing pads, magazines, and activities you think your child might find interesting. Your child will become interested in these things again once the electronics are gone. 

Legos, books, models, jewelry-making, art, comic books, and so on are all helpful to have around. Checkers, chess, backgammon, card games, and dominoes are terrific. Anything kids can build or make with their hands is good. Also, anything that provides kinesthetic input, like working with lay, playing marbles, juggling, arranging sand trays, and anything that promotes physical movement, such as a swing or trampoline.

Week 1: Unplug in Order to Rest

“Removing the bright screen helps initiate a resynchronization of the circadian rhythms, allowing melatonin, the sleep hormone, to be secreted earlier in the evening and in larger amounts. Melatonin is also a powerful antioxidant in the nervous system – one of the most potent actually – helping mitigate chronic stress-related damage caused by inflammation. Melatonin is also the precursor to the brain chemical serotonin, which keeps us calm and happy.

“Thus brain chemistry and hormones enjoy an immediate shift toward normalization once melatonin is no longer suppressed. Likewise, dopamine is no longer forced into a “surge and deplete” pattern, which serves to improve mood and attention span. Upon the removal of unnatural and intense sensory and psychological stimulation, the nervous system will seek out more balanced stimulation through physical interactions with the environment. The brain has taken shelter from the storm, and instead of being in a protective state of reacting and defending, it shifts to a proactive mode and begins to self-organize.

This leads to:

  • A return to healthier, more imaginative, and more physical forms of play as creative energy returns
  • Improved mood and less extreme or less frequent meltdowns as dopamine and serotonin regulation begin to normalize
  • Improved compliance and less oppositional-defiant behavior as the brain moves away from the protective-defensive mode

“It’s important to track changes in the target areas of difficulty and to fill in any gaps in alternative and family activities that provide nourishment in place of the screens.”

Week 2: Allow Your Child’s Brain Deep Rest for Rejuvenation

“By the second week, your child’s brain chemistry and biorhythms are a lot closer to normalizing, thanks to deeper sleep and reduced exposure to unnatural stimulation. Brain waves become more coherent and less erratic, and stress hormones diminish. Fight-or-flight symptoms or reactions may still be present, but these should start to ebb.

In week 2 you can expect:

  • Deeper and more restful sleep
  • Earlier bedtime or less resistance to bedtime and more energy upon awakening
  • Continued improvement in mood swings and meltdowns
  • Better organized behavior (child gets ready for school more easily, keeps better track of belongings or schedule)
  • Improved impulse control, “cause-and-effect” thinking, and attention due to improved frontal lobe function
  • Less arguing and negotiating about returning screen devices
  • Increased spontaneous play and use of imagination

“Continue to track changes in target areas, review and revise the schedule of alternate and family activities as needed, check in with everyone in the family, is everyone getting enough support?”

Week 3: Reset the Nervous System, Heal and Reclaim the Brain

“By now, biorhythms, and brain chemistry may be close to normalizing, and as healing continues, stress and sleep hormones rebalance and promote calmness rather than hyperarousal. From the cell to the entire brain, oxidative stress and inflammation lessen, due to reduced stress load, and hormones will start to rebalance. As your child moves out of a state of chronic stress, the brain’s energy is freed up to do other things – like learning new concepts ad processing emotions.

“In week 3, your child may experience or display:

  • Dampened stress response and improved coping due to ongoing deep rest
  • Reduced signs of anxiety, like nail biting, nightmares, headaches, or stomachaches
  • Heightened curiosity and improved retention of new information
  • Better manners and a more respectful attitude

“A “virtuous circle” of improvement begins, in which better rest begets better mood and attention, which begets improved self-image, which begets better sleep, and so on.

“Continue to track changes in areas of difficulty; notice changes in other areas as well; notice all positive changes in mood, behaviors, and cognitive functioning. Journal your impressions of the entire fast as preparation for plans for “after.”

“As for yourself, the fast will likely feel much easier to manage at this point. Your own stress levels will likely be significantly lower in general. Particularly if you’ve reduced your own screen time, you may feel an enhanced sense of being “in the moment” with your child.”

In the remaining chapters of Reset Your Child’s Brain, Dr. Dunckley troubleshoots some of the most common saboteurs of the fast – failure to track improvements in behaviors, overlooking “hidden” devices, ending the fast too soon (some children may require more than 3 weeks to reset their brains), doubting the efficacy of the fast, softening the rules, providing/receiving too little support, not giving one’s self permission to buck the culture and do the fast. 

She offers “house rules” for continuing or modifying the fast after the fast is over. She pays special attention to the encroachment of screen-time and the disappearance of developmental support in our modern education system.

And answers the question “Does screen-time affect adults as well?” with a resounding yes! “As an adult, you need to be able to do two things regarding screens: tolerate and moderate. We all have a screen-time “dose” we can tolerate without experiencing any negative side effects, though determining when this threshold has been crossed in adults may be more difficult than it is in children. 

Many adults don’t notice immediate effects, making it harder to appreciate a link between screen habits and health or functioning. Some red flags that electronics may be impacting you may include an inability to relax or feel rested in spite of getting enough sleep, an inability to follow through on commitments, and feeling as though you can’t get anything done.”

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