For this post I’ll share some commonplace practices that can, like screen-time, contribute to dysregulation in children. The first issue we see primarily in tweens and teens, while the second two apply to younger kids.
Here are 3 non-screen technology sources that can detune the nervous system, leading to tantrums, rages, depression, sleep disturbance, and/or anxiety:
Ear buds– screen addiction specialists are increasingly recommending to ban use of ear buds during treatment. I discovered the dysregulating effect of headphones years ago with a particularly difficult patient who was screen fasting but not improving; she finally “reset” once we got rid of the headphones. (We still allowed music via speaker.) Ear buds are even worse than headphones- they contribute to isolation and overstimulation, and because they’re wireless they’re often used non-stop. They also use bluetooth which emit EMF and are literally sitting next your child’s brain. The link to depression is also supported by research.
Remote control cars- I think of these as playing a video game but without the screen. They are highly arousing, fast paced, and kids are oten watching them without moving much. In contrast to ear buds, not every kid will have side effects from these, but for everyone I recommend avoiding use during the Reset/screen-fasting. Afterwards, assuming the child is no longer dysregulated, you can try them occasionally but mitigate their impact by doing it in a big park and having the kids take turns driving and chasing them.
Toys with buttons, sounds and/or lights – These are hard to get away from and even if you don’t buy them, some well-meaning family member will! Do not fall for the “teaches kids cause-and-effect” wording on the packaging. Cause and effect is innate, it does not need to be taught. And what it does teach is that having fun needs to be immediately rewarding and overstimulating! Toys should stimulate creativity, not entertain. Be especially mindful of these toys if your has ADHD, ASD, or any delays. They’ll undermine all your other hard work!
The common thread we see here is artificial and intense stimulation. For evolutionary reasons the brain is attracted to stimulating things, but mother nature never intended it to be able to tolerate unnatural stimulation, especially over long periods. A good rule of thumb is that anything that uses electricity – plug in or battery- can potentially dysregulate and won’t brain-build as optimally as natural play.
One of the best parts is that you can see a video of a family who did the Reset screen fasting protocol (and ended up remaining screen-free afterward, by the way!) . It’s powerful testimony.
Melanie Hempe’s talk is also super important, particularly regarding Dr Gabor Mate’s work on how parents should matter more than peers. It’s compelling and she’s an engaging speaker.
The ASD brain is uniquely vulnerable to the effects of screen time.
Does screen time make ASD worse? Functional, physiological, and social factors that make special brains more vulnerable
A growing body of research links autism and autism-related symptoms with higher amounts of electronics’ use. In fact, children with autism spectrum disorders (ASD) are uniquely vulnerable to various brain-related impacts of screen time, yet tend to be high users. These electronic “side effects” include hyperarousal and dysregulation—what I call Electronic Screen Syndrome—as well as technology addiction, to video games, internet use, video viewing (think YouTube, TikTok, cartoons), use of smartphones and social media, and so on. Parents of children with ASD or special needs also tend to lean on devices more than with typcially developing kids, to control behavior, take a break, or get things done.
But why the concern? Because a brain with autism has inherent characteristics that screen time exacerbates. In truth, these impacts in occur in all of us, but children with autism will be both more prone to experiencing negative effects and less able to recover from them; their brains are more sensitive and less resilient.
As a framework for understanding these vulnerabilities, it’s helpful to know that screen time—particularly the interactive kind—acts like a stimulant, not unlike caffeine, amphetamines, or cocaine. Also important is children with autism are often sensitive to stimulants of all kinds, whether pharmaceutical or electronic. For example, children with autism and attention issues often can’t tolerate prescribed stimulants (eg Ritalin, Concerta, Adderall, Vyvanse), a standard treatment for ADD/ADHD. Stimulants tend to make children with autism irritable, weepy, over-focused, more obsessive-compulsive, and unable to sleep. Stimulants – including screen time – can also exacerbate tics, self-injurious behaviors, aggression, skin picking, and sensory issues.
Meanwhile, in families with special needs children, there exist additional social and emotional factors that contribute to technology overuse. First, families are often dealing with highly disruptive behaviors that are quieted—at least in the short term—by handing the child a device. Second, parents are told that “playing video games is ‘normal.’ It’s something your son can do with other kids.” Third, parents are encouraged to introduce technology early and often—especially if “he’s good at computers.” Fourth, in-home and school behavior therapists often use video games, ipads, phones or specific apps as reinforcers: “It’s the only thing that works with her!” And lastly, parents and clinicians are routinely encouraged to try unproven screen-based software claiming to reduce autistic behaviors or to improve social, communication or reading skills.
Needless to say, education in this arena is sorely needed.
11 reasons children with autism are extra vulnerable to screen time effects and tech addiction
1. Children with autism tend to have low melatonin and sleep disturbances [1] and screen time suppresses melatonin and disrupts sleep. [2] Aside from regulating sleep and the body clock, melatonin also helps modulate hormones and brain chemistry, balances the immune system, and keeps inflammation at bay.
2. Children with autism are prone to arousal regulation issues, manifesting in an exaggerated stress response, emotional dysregulation, or a tendency to be over or under-stimulated[3]; screen time increases acute and chronic stress, induces hyperarousal, causes emotional dysregulation, and produces overstimulation. [4]
3. Autism is associated with inflammation of the nervous system [5] and screen time may increase inflammation by a variety of mechanisms including increased stress hormones, suppressed melatonin, and non-restorative sleep. [6] Light-at-night from screens also suppresses REM sleep, a phase during which the brain “cleans house.” [7]
4. The autistic brain tends to be underconnected—less integrated and more compartmentalized [8]—and screen time hinders whole-brain integration and healthy development of the frontal lobe.[9] In fact, in tech addiction brain scan studies reveal reduced connectivity (via reduced white matter) and atrophy of gray matter in the frontal lobe. [10]
5. Children with autism have social and communication deficits, such as impaired eye contact, difficulty reading facial expressions and body language, low empathy, and impaired communication [11]; screen time hinders development of these exact same skills—even in children and teens who don’t have autism. [12] Screen time appears to directly compete with social rewards, including eye contact—a factor essential for brain development. [13] Lastly, screen viewing and even background TV has been shown to delay language acquisition. [14]
6. Children with autism are prone to anxiety [15]—including obsessive-compulsive traits, social anxiety—and screen time is associated with increased risk for OCD and social anxiety [16] while contributing to high arousal and poor coping skills. [17] Additionally, anxiety in autism has been linked to abnormalities in serotonin synthesis and amygdala activity [18] and both serotonin regulation and amygdala changes have been implicated in screen time. [19]
7. Children with autism frequently have sensory and motor integration issues [20] as well as tics; screen time has been linked to sensori-motor delays and worsening of sensory processing [21], and can precipitate or worsen vocal and motor tics due to dopamine release.
8. Individuals with autism are typically highly attracted to screen-based technology and are not only at increased risk for developing video game and other technology addictions, but are more likely to exhibit symptoms with smaller amounts of exposure. [22] Male teens and young adults with ASD are also at high risk for porn addiction, due to a combination of social deficits, isolation, and excessive computer time, and may develop romantic delusions or obsessions fueled by being accustomed to immediate gratification and a lack of practicing in the real world. At the same time, dopamine released by screen interaction reinforces these obsessive “loops.”
9. Children with autism tend to have a fragile attention system, poor executive functioning, and “reduced bandwidth” when processing information [23]; screen time likewise fractures attention, depletes mental reserves, and impairs executive functioning. [24]
10. Children with autism may be more sensitive to EMFs (electromagnetic fields) emitted from wireless communications (e.g. WiFi and cell phone frequencies) as well as from the electronic devices themselves. [25] At the cellular, molecular, and atomic level, the pathology seen in autism mirrors the effects demonstrated in research on the biological impacts of EMFs. Heightened sensitivity to EMFs may be due to (and may worsen) immune abnormalities and problems with barrier integrity in the gut and/or the brain.
11. Children with autism are at higher risk for psychiatric disorders of all kinds, including mood and anxiety disorders, ADHD, tics and psychosis. [26] Likewise, higher amounts of total screen time are associated with higher levels of psychiatric disturbances, including mood and anxiety disorders, ADHD, tics and psychosis. [27] Regarding psychosis, young people with ASD who engage in daily screen time may experience hallucinations, paranoia, dissociation, and loss of reality-testing. More often than not, however, these scary symptoms resolve or greatly diminish once devices are removed and don’t require antipsychotic medication.
An informed approach to address device use and optimize the ASD brain
In addition to the above, screen time replaces the very things we know to be critical to brain development: bonding, movement, eye contact, face-to-face verbal interactions, loving touch, exercise, free play, and exposure to nature and the outdoors. Reduced exposure to these factors negatively impact brain integration, IQ, and resilience in all children. This also means that parental use of devices, which diminishes eye contact, speech, and face to face communication, contributes to this risk.
In my own experience in working with children and adults with autism, screen time can precipitate regression (loss of language or of social or adaptive living skills), exacerbate repetitive behaviors, further restrict interests, and trigger aggressive and self-injurious behaviors. I’ve even seen regression occur when a communication device is introduced, often when the parents are told to encourage “play” on the device so the child can “get used to it.” The proliferation of the iPad and smartphones has produced more problems and setbacks in my practice than any other single factor.
As stressful and devastating as these experiences can be, so can methodical elimination of screens be exciting and inspiring. Being screen-free can enhance eye contact and language, increase flexibility in thinking and behavior, expand interests, improve emotional regulation and ability to stay on task, induce more restorative sleep, and reduce anxiety and meltdowns.
Because the idea of eliminating screens can seem overwhelming, I typically recommend parents do a four week “electronic fast” (aka screen fast or tech fast) as an experiment so they can get a taste of what the intervention can do. Families track two to three problematic areas to provide objective evidence, and are encouraged to document behaviors (such as screen time tantrums and how the child plays). Even a few short weeks can produce improvements that can be significant enough for the family to decide to continue with screen elimination, in which case the benefits will continue to build on one another.
Will the child still have autism? Yes, but it’s practically guaranteed that they will feel, focus, sleep, behave, and function better. And intriguingly, anecdotal evidence suggests this simple intervention may be powerful enough to prevent, arrest or in some cases even reverse the autism process if caught early enough; pilot studies testing this intervention more formally are forthcoming. (Case studies illustrating these phenomena will be the subject of a future post.)
When parents really grasp the science of what happens in the brain when children interact with screen devices—and understand how these things specifically impact autism—they are much better able to restrict screens appropriately and are less swayed by social pressures. They “see” how screen time translates into certain symptoms in their child, they prioritize brain-health over being tech-savvy, and appreciate that every minute spent on a screen is a tradeoff.
This article was adapted from a post originally published on Dr Dunckley’s Mental Wealth blog on PsychologyToday.com
[2] Shigekazu Higuchi et al., “Effects of Vdt Tasks with a Bright Display at Night on Melatonin, Core Temperature, Heart Rate, and Sleepiness,” Journal of Applied Physiology (Bethesda, Md.: 1985) 94, no. 5 (May 2003): 1773–76.
[3] Matthew S. Goodwin et al., “Cardiovascular Arousal in Individuals with Autism,” Focus on Autism and Other Developmental Disabilities 21, no. 2 (2006): 100–123; BA Corbett and D Simon, “Adolescence, Stress and Cortisol in Autism Spectrum Disorders.,” OA Autism 1, no. 1 (March 1, 2013): 1–6.
[4] Marjut Wallenius, “Salivary Cortisol in Relation to the Use of Information and Communication Technology (ICT) in School-Aged Children,” Psychology 1, no. 2 (2010): 88–95; Amy E. Mark and Ian Janssen, “Relationship between Screen Time and Metabolic Syndrome in Adolescents,” Journal of Public Health 30, no. 2 (June 1, 2008): 153–60; Gary S. Goldfield et al., “Video Game Playing Is Independently Associated with Blood Pressure and Lipids in Overweight and Obese Adolescents,” ed. Philippe Rouet, PLoS ONE 6, no. 11 (November 1, 2011): e26643.
[5] Theoharis C. Theoharides, Shahrzad Asadi, and Arti B. Patel, “Focal Brain Inflammation and Autism,” Journal of Neuroinflammation 10, no. 1 (2013): 46.
[6] Z. Ranjbaran et al., “The Relevance of Sleep Abnormalities to Chronic Inflammatory Conditions,” Inflammation Research: Official Journal of the European Histamine Research Society … [et Al.] 56, no. 2 (February 2007): 51–57.
[7] Christian Cajochen et al., “Evening Exposure to a Light-Emitting Diodes (Led)-Backlit Computer Screen Affects Circadian Physiology and Cognitive Performance,” Journal of Applied Physiology (Bethesda, Md.: 1985) 110, no. 5 (May 2011): 1432–38.
[8] Marcel Adam Just, Timothy A. Keller, and Rajesh K. Kana, “A Theory of Autism Based on Frontal-Posterior Underconnectivity,” Development and Brain Systems in Autism, 2013, 35–63.
[9] Cris Rowan, “Unplug—Don’t Drug: A Critical Look at the Influence of Technology on Child Behavior With an Alternative Way of Responding Other Than Evaluation and Drugging,” Ethical Human Psychology and Psychiatry 12, no. 1 (April 1, 2010): 60–68; Victoria Dunckley, “Gray Matters: Too Much Screen Time Damages the Brain,” Psychology Today, Mental Wealth, (February 27, 2014), http://www.psychologytoday.com/blog/mental-wealth/201402/gray-matters-t….
[10] Chuan-Bo Weng et al., “Gray Matter and White Matter Abnormalities in Online Game Addiction,” European Journal of Radiology 82, no. 8 (August 2013): 1308–12.
[11] R. Adolphs, L. Sears, and J. Piven, “Abnormal Processing of Social Information from Faces in Autism,” Journal of Cognitive Neuroscience 13, no. 2 (February 15, 2001): 232–40.
[12] Yalda T. Uhls et al., “Five Days at Outdoor Education Camp without Screens Improves Preteen Skills with Nonverbal Emotion Cues,” Computers in Human Behavior 39, no. 0 (October 2014): 387–92; Roy Pea et al., “Media Use, Face-to-Face Communication, Media Multitasking, and Social Well-Being among 8- to 12-Year-Old Girls,” Developmental Psychology 48, no. 2 (March 2012): 327–36.
[13] Karen Frankel Heffler and Leonard M. Oestreicher, “Causation Model of Autism: Audiovisual Brain Specialization in Infancy Competes with Social Brain Networks,” Medical Hypotheses 91 (June 2016): 114–22.
[14] Weerasak Chonchaiya and Chandhita Pruksananonda, “Television Viewing Associates with Delayed Language Development,” Acta Pædiatrica 97, no. 7 (2008): 977–82.
[15] Susan W. White et al., “Anxiety in Children and Adolescents with Autism Spectrum Disorders,” Clinical Psychology Review 29, no. 3 (April 2009): 216–29.
[16] Jee Hyun Ha et al., “Depression and Internet Addiction in Adolescents,” Psychopathology 40, no. 6 (2007): 424–30; Pea et al., “Media Use, Face-to-Face Communication, Media Multitasking, and Social Well-Being among 8- to 12-Year-Old Girls.”
[18] D. C. Chugani et al., “Developmental Changes in Brain Serotonin Synthesis Capacity in Autistic and Nonautistic Children,” Annals of Neurology 45, no. 3 (March 1999): 287–95; Adolphs, Sears, and Piven, “Abnormal Processing of Social Information from Faces in Autism.”
[19] Jun Kohyama, “Neurochemical and Neuropharmacological Aspects of Circadian Disruptions: An Introduction to Asynchronization,” Current Neuropharmacology 9, no. 2 (2011): 330; Klaus Mathiak and René Weber, “Toward Brain Correlates of Natural Behavior: fMRI during Violent Video Games,” Human Brain Mapping 27, no. 12 (December 2006): 948–56.
[20] Geraldine Dawson and Renee Watling, “Interventions to Facilitate Auditory, Visual, and Motor Integration in Autism: A Review of the Evidence,” Journal of Autism and Developmental Disorders 30, no. 5 (2000): 415–421.
[22] Micah O. Mazurek and Christopher R. Engelhardt, “Video Game Use and Problem Behaviors in Boys with Autism Spectrum Disorders,” Research in Autism Spectrum Disorders 7, no. 2 (February 2013): 316–24; Micah O Mazurek and Colleen Wenstrup, “Television, Video Game and Social Media Use Among Children with Asd and Typically Developing Siblings,” Journal of Autism and Developmental Disorders 43, no. 6 (June 2013): 1258–71.
[23] Just, Keller, and Kana, “A Theory of Autism Based on Frontal-Posterior Underconnectivity.”
[24] Edward L Swing et al., “Television and Video Game Exposure and the Development of Attention Problems,” Pediatrics 126, no. 2 (August 2010): 214–21; Robert M. Pressman et al., “Examining the Interface of Family and Personal Traits, Media, and Academic Imperatives Using the Learning Habit Study,” The American Journal of Family Therapy 42, no. 5 (October 20, 2014): 347–63; Angeline S Lillard and Jennifer Peterson, “The Immediate Impact of Different Types of Television on Young Children’s Executive Function,” Pediatrics 128, no. 4 (October 2011): 644–49.
[25] Martha R. Herbert and Cindy Sage, “Autism and EMF? Plausibility of a Pathophysiological Link – Part I,” Pathophysiology: The Official Journal of the International Society for Pathophysiology / ISP 20, no. 3 (June 2013): 191–209.
[26] Cecilia Belardinelli and Mahreen Raza, “Comorbid Behavioral Problems and Psychiatric Disorders in Autism Spectrum Disorders,” Journal of Childhood & Developmental Disorders 2, no. 2 (2016).
[27] Goran Mihajlović et al., “Excessive Internet Use and Depressive Disorders,” Psychiatria Danubina 20, no. 1 (March 2008): 6–15; Ju-Yu Yen et al., “The Comorbid Psychiatric Symptoms of Internet Addiction: Attention Deficit and Hyperactivity Disorder (ADHD), Depression, Social Phobia, and Hostility,” The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine 41, no. 1 (July 2007): 93–98; J Lee, K Lee, and T Choi, “The Effects of Smartphone and Internet/Computer Addiction on Adolescent Psychopathology.” (166th Annual Meeting of the American Psychiatric Association, San Francisco, CA, 2013), http://www.psychcongress.com/article/smartphone-addiction-linked-increa…-.
Could your child be overstimulated from too much screen time? Take this quiz to find out
*Originally posted on Dr dunckley’s Mental Wealth blog on Psychology Today.
How much screen time is “too much”? How does one know? Blanket guidelines, such as those provided by the American Academy of Pediatrics, do not address individual needs and sensitivities. This quiz can help determine whether your child may be experiencing screen time impacts – aka “digital side effects”- from using electronic devices, which can occur even when a child has limited (but regular) screen use.
Recognizing Electronic Screen Syndrome
Thankfully, there is now a growing awareness regarding technology addiction. But well 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.
Electronic Screen Syndrome Quiz:
Place a checkmark next to each question that applies to your child.
Does your child seem revved up much of the time?
Does your child have meltdowns over minor frustrations?
Does your child have full-blown rages?
Has your child become increasingly oppositional, defiant, or disorganized?
Does your child become irritable when told it’s time to stop playing video games or to get off the computer?
Do you ever notice your child’s pupils are dilated after using electronics?
Does your child have a hard time making eye contact after screen time or in general?
Would you describe your child as being attracted to screens “like a moth to a flame”?
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?
Does your child have trouble making or keeping friends because of immature behavior?
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?
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?
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?
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?
Does your child have a preexisting condition, like autism or ADHD, whose symptoms seem to get worse after screen time?
Does your child seem “wired and tired” — exhausted but can’t sleep, or sleeps but doesn’t feel rested?
Does your child seem unmotivated and have poor attention to detail?
Would you describe your child as being stressed, despite few identifiable stressors?
Is your child receiving services in school that don’t seem to be helping?
Do you and your child argue over screens (limits, timing, content, activities, getting a new device, etc.) on a regular basis?
Does your child lie about screen use, “cheat” when on restriction, or take their device to bed with them?
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?
Does your child prefer socializing online over face-to-face interactions?
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?
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?
Quiz Scoring:
Overall points: Count the number of checked boxes/items endorsed. Needless to say, 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 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 if you decide to try the screen fasting protocol.
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 dysregulation: 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 them worse. Further, when ESS is left untreated the underlying disorders become harder (if not impossible) to address.
Electronic Screen Syndrome characteristics
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. Depressed or anxious mood is also common.
You might notice that the quiz questions above 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 quality of life for not just your child but the entire family.
Screen fasting provides relief and clarity, and helps form new habits
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, release of stress hormones, and electrical excitability. These systems tend to stay in a disorganized state without 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.
At the same time, the child’s play changes naturally, to being more physical, social, and creative. Instead of being bombarded by electronic stimulation while “waiting for the next fix” in between screen sessions, the child forms new habits and new routines, for example going directly outside after school, and reading or wanting to be read to in the evenings. Family dynamics change too, as members talk more, listen better, make more eye contact, and even laugh and smile more.
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.
Victoria L. Dunckley, M.D. is an integrative child, adolescent and adult psychiatrist, the author of Reset Your Child’s Brain, and an expert on the effects of screen-time on the developing nervous system.
Lessons from Big Tobacco can shed light on
industries like Ed Tech
“Back then, we didn’t know it was bad for you.”
If we first keep in mind that technology is an industry — with associated corporations beholden to shareholders, not the general public — we can begin to build the framework needed to change how we view and use technology. We need to be conscious of the fact that, ultimately, corporations and even small businesses are driven by profits, not good will.
This is not a bad thing in and of itself; the tech industry — with its related Ed-Tech, entertainment, communications, information, and medical components — creates an enormous number of jobs and helps drive the economy as a whole. But financial incentive does need to be considered. Indeed, it can become a bad thing if messages conceived to drive profits impact health and education.
With the tobacco industry, this kind of realization — that the industry was motivated by profit, not scientific truth — is what helped shift attitudes toward smoking, since it allowed the dangers of smoking to be brought to light and helped the public and health agencies to appreciate that “evidence” denying these dangers was being manufactured. As such, let’s look at a page from the tobacco story.
Early tobacco warnings regarding health risks were undermined by a powerful industry whose strategy was to create doubt and confusion. They accomplished this by repeatedly sending the message to the public (via the popular press) that there was a lack of consensus about whether or not smoking caused health risks, and by funding “research” at respected institutions with hand-picked unscrupulous researchers whose findings were communicated to Congress.1
Other strategies included aggressive marketing to younger and younger consumers — thereby acquiring addicted lifelong customers — and manufacturing “healthy” (filtered) cigarettes, while simultaneously altering cigarette composition to make them more addictive. Tobacco marketers decried government regulation proposals as both a violation of personal freedom and a belittling of one’s capacity to be responsible for one’s own health. Since then, we’ve seen many of these same arguments and marketing tactics being used in various industries, including the chemical and food and beverage industries.2
The technology industry uses these tactics, too — masterfully. For starters, concerns about screen-time affecting attention and brain development are held at bay by industry-funded research claiming the opposite. The mountain of evidence of screen-time’s harmful effects on cognition appears to be the same size as the evidence for “positive” studies, but only because the peddlers of the studies on positive findings have mountains of money to publicize them. In reality, there is probably a 20:1 ratio of negative to positive studies, and it’s probably higher than that if you exclude non-biased research.
Other health concerns are equally discounted or are quieted by a new spin: just as “safe” cigarettes were made, “healthy” video games and “educational” software are made; worry that screen-time makes us lazy is met with arguments about the stimulating effects of “interactive” screen-time; and concerns about technology making us disconnected and lonely are fought with reassurances that the Internet and social media “connect us all.” Meanwhile, video game designers purposely hook players into games that never end, and electronics advertisers market to younger and younger children, who then become dependent on devices for the rest of their lives. Perhaps most disturbing of all is that the infusion of technology into public education has created an ongoing “need” for more equipment and more products, making schools themselves dependent on the tech industry.3
Then there are the parallels regarding “personal choice” tactics. People — and especially Americans — don’t like their freedom being restricted. But how free to choose is a child who has become addicted to technology before his or her brain has finished developing, making the addiction a much bigger beast to tame? We adults determine the environment our children grow up in — but children have no choice.
When suggestions are made to limit children’s screen-time, we are reminded that this threatens our personal freedom, that Americans do not want the government in their living rooms telling them what to do. Yet ironically, at the same time, our children are being forced into using technology in public schools — largely because of government mandates and programs such as the Common Core and Race To The Top— whether they like it or not, whether it brings inherent health risks or not, and whether it helps them or not. On top of that, our children’s data is being mined in the name of education, but in reality it’s used and sold many times over to make more profit. Are Big Tech companies really benevolent, really free of conflict of interest, when they “donate” equipment and software in exchange for contracts to use their technology? With taxpayer dollars, no less?
When tech corporations play to our emotions by selling the promise of individualized education adapting to each child’s specific needs, or of creating “readiness for succeeding in today’s world,” they create an atmosphere that makes us feel we can’t possibly survive without them. This is despite evidence that the majority of kids — with and without special needs — are hurt and not helped by tech in the classroom.4 Since when are evidenced-based methods of learning no longer the gold standard?
While contemplating these issues might make us uncomfortable, it’s important to be conscious of them and to remember how powerful and sophisticated marketing tactics are these days. Be clear about the fact that politicians, governing bodies, and corporations don’t always (or perhaps even usually) have our best interests in mind; that’s just the reality of it. Ultimately, no one cares about your children more than you do. But that doesn’t mean you’re powerless; it just means you have to make decisions about your child’s future consciously, take advice regarding the “benefits” of technology with a grain of salt, and make healthy informed choices where you can.
In fact, by doing so, you help others to do the same — which takes power away from deceptive practices, and brings truth to light. The benefits of technology can still be realized, but the health impact of screen-based technology needs to be taken much more seriously, particularly when it comes to our most vulnerable citizens — our children. At the same time, we need to be realistic about what technology can and cannot do, and always be on the lookout for wishful thinking clouding our judgment.
In one of the lecture halls of my medical school, old black-and-white photographs line the walls, depicting a history of the hospital and its physicians. One of them shows several physicians standing outside a patient’s room smoking cigarettes during what is presumably the doctors’ morning rounds. Everyone got a kick out of this photo — how ironic it was!
My hope is that eventually we’ll have this same kind of feeling about present-day screen-time practices. We’ll see how ironic it is to teach children with methods that impair concentration and creativity, to exercise them with mediums linked to obesity, or to parent them with devices that induce temper tantrums. It simply doesn’t make sense.
Someday, when we see an old picture of kids sitting motionless and glued to their iPads instead of playing, we’ll shudder and make the same remark previous generations did about how everyone used to smoke: “Back then, we didn’t know it was bad for you.”
1 Naomi Oreskes and Erik M. Conway, Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming (New York: Bloomsbury Press, 2010).
2 Kelly D. Brownell and Kenneth E. Warner, “The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food?” Milbank Quarterly 87, no. 1 (March 2009): 259–94, doi:10.1111/j.1468-0009.2009.00555.x.
4. OECD, 2015. “Students, Computers and Learning: Making the Connection,” OECD Publishing, Paris. http://dx.doi.org/10.1787/9789264239555-en; Colleen Cordes and Edward Miller, “Fool’s Gold: A Critical Look at Computers in Childhood.” (Alliance for Childhood, 2000), http://allianceforchildhood.org/fools_gold; Aric Sigman, “Does Not Compute, Revisited: Screen Technology in Early Years Education,” in Too Much, Too Soon, 2011, 265–89; Anne Mangen, Bente R. Walgermo, and Kolbjørn Brønnick, “Reading Linear Texts on Paper versus Computer Screen: Effects on Reading Comprehension,” International Journal of Educational Research 58 (January 2013): 61–68; Pam A. Mueller and Daniel M. Oppenheimer, “The Pen Is Mightier Than the Keyboard: Advantages of Longhand Over Laptop Note Taking,” Psychological Science, April 23, 2014; Cris Rowan, “10 Reasons Why Handheld Devices Should Be Banned for Children Under the Age of 12,” Huffington Post, March 6, 2014,http://www.huffingtonpost.com/cris-rowan/10-reasons-why-handheld-devices….
6 ways electronics use can make children angry, depressed, and unmotivated
Children or teens who are “revved up” and prone to rages or—alternatively—who are depressed and apathetic have become disturbingly commonplace. Chronically irritable children are often in a state of abnormally high arousal, and may seem “wired and tired.” That is, they’re agitated but exhausted. Because chronically high arousal levels impact memory and the ability to relate, these kids are also likely to struggle academically and socially.
At some point, a child with these symptoms may be given a mental-health diagnosis such as major depression, bipolar disorder, or ADHD, and offered corresponding treatments, including therapy and medication. But often these treatments don’t work very well, and the downward spiral continues.
What’s happening?
Both parents and clinicians may be “barking up the wrong tree.” That is, they’re trying to treat what lookslike a textbook case of mental disorder, but failing to rule out and address the most common environmental cause of such symptoms—everyday use of electronics. Time and again, I’ve realized that regardless of whether there exists any “true” underlying diagnoses, successfully treating a child with mood dysregulation today requires methodically eliminating all electronics use for several weeks—an “electronic fast” —to allow the nervous system to “reset.”
If done correctly, this intervention can produce deeper sleep, a brighter and more even mood, better focus and organization, and an increase in physical activity. The ability to tolerate stress improves, so meltdowns diminish in both frequency and severity. The child begins to enjoy the things they used to, is more drawn to nature, and imaginary or creative play returns. In teens and young adults, an increase in self-directed behavior is observed—the exact opposite of apathy and hopelessness.
It’s a beautiful thing.
At the same time, the electronic fast reduces or eliminates the need for medication while rendering other treatments more effective. Improved sleep, more exercise, and more face-to-face contact with others compound the benefits—an upward spiral! After the fast, once the brain is reset, the parent can carefully determine how much if any electronics use the child can tolerate without symptoms returning.
Restricting electronics may not solve everything, but it’s often the missing link in treatment when kids are stuck.
Children’s brains are much more sensitive to electronics use than most of us realize. In fact, contrary to popular belief, it doesn’t take much electronic stimulation to throw a sensitive and still-developing brain off track. Also, many parents mistakenly believe that interactive screen-time—Internet or social media use, texting, emailing, and gaming—isn’t harmful, especially compared to passive screen time like watching TV. In fact, interactive screen time is more likely to cause sleep, mood, and cognitive issues, because it’s more likely to cause hyperarousal and compulsive use.
Here’s a look at six physiological mechanisms that explain electronics’ tendency to produce mood disturbance:
Because light from screen devices mimics daytime, it suppresses melatonin, a sleep signal released by darkness. Just minutes of screen stimulation can delay melatonin release by several hours and desynchronize the body clock. Once the body clock is disrupted, all sorts of other unhealthy reactions occur, such as hormone imbalance and brain inflammation. Plus, high arousal doesn’t permit deep sleep, and deep sleep is how we heal.
Many children are “hooked” on electronics, and in fact gaming releases so much dopamine—the “feel-good” chemical—that on a brain scan it looks the same as cocaine use. But when reward pathways are overused, they become less sensitive, and more and more stimulation is needed to experience pleasure. Meanwhile, dopamine is also critical for focus and motivation, so needless to say, even small changes in dopamine sensitivity can wreak havoc on how well a child feels and functions.
Both acute stress (fight-or-flight) and chronic stress produce changes in brain chemistry and hormones that can increase irritability. Indeed, cortisol, the chronic stress hormone, seems to be both a cause and an effect of depression—creating a vicious cycle. Additionally, both hyperarousal and addiction pathways suppress the brain’s frontal lobe, the area where mood regulation actually takes place.
Experts say that what’s often behind explosive and aggressive behavior is poor focus. When attention suffers, so does the ability to process one’s internal and external environment, so little demands become big ones. By depleting mental energy with high visual and cognitive input, screen time contributes to low reserves. One way to temporarily “boost” depleted reserves is to become angry, so meltdowns actually become a coping mechanism.
Source: Chubykin Arkady/Shutterstock
6. Screen-time reduces physical activity levels and exposure to “green time.”
In today’s world, it may seem crazy to restrict electronics so drastically. But when kids are struggling, we’re not doing them any favors by leaving electronics in place and hoping they can wind down by using electronics in “moderation.” It just doesn’t work. In contrast, by allowing the nervous system to return to a more natural state with a strict fast, we can take the first step in helping a child become calmer, stronger, and happier.
I’m excited to announce I’m joining forces with an alternative healing center called the Centre for Life, located in Los Angeles in the Marina Del Rey area. The new office is conveniently located near West LA, Venice, Culver City, and Santa Monica just off the 90W from the 405 freeway.
The Centre was opened by homeopath Avghi Constantinides and is serviced by acupuncturists, psychiatrists, a pediatrician, naturopaths, and hypnotherapists. To better serve my patients with a holistic approach, I’ve begun preparing for an additional board specialty in integrative medicine (American Board of Integrative Holistic Medicine). Working closely with other alternative health practitioners allows me to both further my education and refer patients for consultation in a convenient manner.
New Services: Along with micronutrient testing, I’ll now be offering neurotransmitter testing, food and chemical sensitivity testing, and hormonal and metabolic panels. These tests help individualize supplement regimens, optimize treatment, and minimize psychotropic medication use.
“I hear voices at night, and sometimes I think someone’s outside my window,” the 19-year-old young man informed me. “I know no one’s really there, but it’s still scary.”
In my practice in the past six months, no less than 5 youths have reported psychotic symptoms that were attributed to, or exacerbated by, electronic screens. As per my protocol, I always get an “e-screen” history:
video games
computer/internet use
cell phone use (talking, texting, streaming, and internet).
Not surprisingly, all five of these patients, ranging from 15-22 years old, were “plugged in” for six or more hours each day. Three were female and two male. After discussing e-screens’ toxic influence on the brain, I recommended to each of these patients that they forego all electronic screens for at least 4 weeks.
The three females all decided to go “cold turkey ” and gave up their games, laptops, and phones. All three saw their symptoms resolve completely within a month. Of the two males, one cut down use significantly and his hallucinations disappeared; his paranoia remained but was less severe and caused less dysfunction. The other male turned out to be severely addicted to the internet and video games and flat out refused to change his habits at all (a subject for another article entirely! Needless to say he continues to suffer from psychosis).
Importantly, the therapeutic effects were achieved without using medication! This is a big deal, because medications used to treat psychotic symptoms are heavy duty, and have serious side effects, such as weight gain, hormone dysfunction, and movement disorders.
Electronic screens, particularly interactive ones (as opposed to passive ones, like television), increase dopamine in the reward center of the brain. This effect has been demonstrated by brain scan (Koepp, 1998: http://www.nrc-iol.org/cores/mialab/fijc/Files/2002/120402_Koepp_Nature_1998.pdf ) Dopamine is the “feel good” chemical, but is also related to stress, addiction, anxiety, mood, and attention. Perhaps more disturbing, dopamine excess in certain parts of the brain can lead to psychotic symptoms-voices, delusions, paranoia, or confusion.
Psychosis is defined by abnormal thinking. This can involve thought content, such as hallucinations, delusions, or paranoia, or thought process (highly disorganized thinking, or feeling thoughts are “blocked”). It is typically attributed to the severely mentally ill, like schizophrenics, but can also be seen in “normal” people under extreme stress. Children in particular are more likely to hallucinate when traumatized, sleep-deprived, or over-stimulated. E-screens cause or mimic all three of these states!
Take home point: Children, teens, and young adults who have unexplained hallucinations or delusions should have ALL electronic screens removed for at least 3 weeks, as part of the diagnostic process. This includes cell phones, as texting, media viewing, and internet use can quickly rack up hours. Virtually all teens and many young adults do not yet have the impulse control to moderate their own usage, and this is why the parent must physically remove these devices. While this may seem extreme, drastic times cause for drastic measures. Psychosis–and treatment thereof–is serious and has long-lasting effects.
As psychiatric disorders in young people continue to explode, and evidence mounts about the toxic effects of e-screens on the developing brain, parents and clinicians would be prudent to remove this offending environmental trigger from the child’s life, as part of the diagnosis and as one “arm” of the treatment plan.
When you start to feel conflicted about removing screens-they are so ingrained in our lives, after all-this is what I tell my patients and their parents: “You will never regret removing video games and computer use, but you may sorely regret leaving them in place. “
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Children or teens who are “revved up” and prone to rages or—alternatively—who are depressed and apathetic have become disturbingly commonplace. Chronically irritable children are often in a state of abnormally high arousal, and may seem 
