free open ended play to combat ADHD and screen time | WHO (World Health Organisation)

i recently spent a weekend visiting my two-year-old nephew for the first time. while it was an absolute pleasure to meet this cutie patootie, who has since then stolen my heart, something about that interaction left me worried.

these were some symptoms i noticed: 

1. he was on his ipad most of his free time – he would have it with him through each meal time, and then through large parts of the rest of the day (when he wasn’t in play group or classes)

2. when he was watching his screen, he was riveted. he would not connect with anyone else. absolutely not. not with anybody, and not for any reason. if someone was trying to get his attention, he would simply not respond.

3. when he was not on his screen, he was typically running around manically – while this was very cute (he was pretending to be super man, spider man etc.), no one was able to hold his attention for more than a few seconds

was this classic ADHD? already?

psychology today lists the symptoms of ADHD as (i) inattention and (ii) hyperactivity/impulsivity.

problems of inattention include difficulty sustaining attention, easily becoming distracted, and not paying attention to details or instructions. my little nephew was all this and more.

screen time has been linked to ADHD

JAMA, the journal of the american medical association, recently published a longitudinal cohort study (studying the same group of people over a number of years) investigating whether use of new technologies leads, over time, to an increase in symptoms of ADHD. the study found that the risk of developing ADHD symptoms more than doubled with high use of screens.

in another study by plos onel, preschool children exposed to at least two hours of screen time each day were SIX times more likely to struggle with inattention and behaviour problems compared to other pre-schoolers who were given only 30 minutes or less. the study concluded that children exposed to 2 or more hours of screen time per day were EIGHT times more likely to meet the criteria for ADHD.

what should we do?

the WHO (World Health Organisation) recently published guidelines for screen time and physical play for children:

Dr Juana Willumsen says “what we really need to do is bring back play for children. this is about making the shift from sedentary time to playtime, while protecting sleep.”

infants (less than 1 year) should:

• be physically active several times a day in a variety of ways, particularly through interactive floor-based play; more is better.
• for those not yet mobile, this includes at least 30 minutes in prone position (tummy time) spread throughout the day while awake.
• not be restrained for more than 1 hour at a time (e.g. prams/strollers, high chairs, or strapped on a caregiver’s back). screen time is not recommended.
• when sedentary, engaging in reading and storytelling with a caregiver is encouraged.

children 1-2 years of age should:

• spend at least 180 minutes in a variety of types of physical activities at any intensity, including moderate-to-vigorous-intensity physical activity, spread throughout the day; more is better.
• not be restrained for more than 1 hour at a time (e.g., prams/strollers, high chairs, or strapped on a caregiver’s back) or sit for extended periods of time.
• for 1-year-olds, sedentary screen time (such as watching tv or videos, playing computer games) is not recommended.
• for those aged 2 years, sedentary screen time should be no more than 1 hour; less is better.
• when sedentary, engaging in reading and storytelling with a caregiver is encouraged.

children 3-4 years of age should:

• spend at least 180 minutes in a variety of types of physical activities at any intensity, of which at least 60 minutes is moderate- to vigorous intensity physical activity, spread throughout the day; more is better.
• not be restrained for more than 1 hour at a time (e.g., prams/strollers) or sit for extended periods of time.
• sedentary screen time should be no more than 1 hour; less is better.
• when sedentary, engaging in reading and storytelling with a caregiver is encouraged.

while these directions are good and important, given that screens are everywhere and our own usage of screens (and therefore model behaviour) is at an all time high, it is very difficult to implement these sorts of guidelines at home.

so here are some thoughts for making it easier:

one. watch your own behaviour. 

there have been so many instances of children clamouring to get the parents attention – at a restaurant, at the airport, in the car/train – but the parents simply have not noticed because they’re too involved with their own screens. we’re the role models for our children… and if we’re addicted, they will be too.

if you institute “rules” around screen time – no screen time at meal times, no screen time post 9pm etc. – make sure you follow them too…

two. create an exciting enough alternative

kids are kids! at the end of the day, if the screen is the most exciting thing in the house, that’s where they would want to be all day. you need to create a space for them – outdoors or indoors – which is compelling enough for them to want to play in.

this means it should be full of materials that invite “play”, that ignite their imaginations.

it’s not just about the materials though, it is about helping them enter the world of imaginative pretend play - children spontaneously enter imaginative play, but sometimes (like any of us) they need inspiration – for some children, the most open ended of materials can inspire their imagination, for others they need forms they can relate with like cars, figurines and dolls, others need stories from where they can take off!

so get to know your child and figure out what works to inspire their imagination.