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The internet and our children’s health

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The use of the internet and its impact on the health of children and young people is a fairly recent addition to the Public Health and Child & Youth Health Committee’s agenda.

During a recent meeting we were pleased to have as a guest speaker Dr Kate Highfield of Macquarie University, who is an expert on the issue. Her presentation was very informative and affirmed that the internet and its associated activity is having an increasing impact on the health of the next generation.

There is little doubt that technology has had a monumental impact on all our daily lives. Many carry with us three or four internet-enabled devices, and spend many hours each day communicating with colleagues, friends and family using them.

Internet-enabled devices have become an essential part of our workplaces, education institutions and our home lives. 

They are also changing childhood quite dramatically.

Today’s children, sometimes referred to as the iPad generation, have access to unprecedented amounts of interactive and engaging forms of technology.

While this exposure will equip children with skills for the future, there is increasing concern that there may be some potentially negative implications for health and development if use is not moderated.

According to research undertaken by Nielson (2013), Australian children are the largest users of social media in the world.

Issues such as cyber bullying are topical and very much in the news and in talk back radio discussions.

However, a focus solely on adolescents and their interactions with technology may be far too late.

Dr Highfield suggested the focus should be on children younger than five years, and perhaps even children younger than three years, where technology devices are often used as a form of ‘digital pacifier’.

Constant use of technology displaces important activities such as active play and social interaction, and there are concerns about reduced motor skills, postural anomalies, eyesight problems (due to back-lit screens), disrupted sleep patterns and reduced attention levels.

These younger years are crucial for the development of the brain, as well as social, interpersonal and language skills.

This is not to suggest that technology is all bad.

Quality educational games and apps are available, and computing skills are an essential part of all our futures.

Games that encourage play with parents and other caring adults can be a very positive experience for children.

Nonetheless, excessive amounts of solo time on devices may increase social isolation and reduce social skills. 

Dr Highfield told the Committee that some primary schools have recently had to provide toys in the playground in order to assist their kindergarten students to interact with one another.

Along with problematic impacts on socialisation, many games and apps aimed at children have unnecessary references to gambling, while others promote unrealistic physical images that can contribute to the development of poor body image among younger girls and boys.

Children are also exposed to large volumes of advertising online, and other content that is unsuitable for children can be only a click away, or may be delivered to their screen inadvertently by the unexpected outcome of a Google search.

So far in Australia there have been few recommendations made about the use children make of technology.

The recently renewed National Physical Activity Guidelines make reference to sedentary behaviour (including screen time) and the need to limit this to two hours a day in children older than five years, and one hour for children aged between two to five years, (with a recommendation of no exposure for children aged less than two years).

These recommendations may be easily dismissed by parents because they are made solely in the context of physical activity.

The recommendations do not make a distinction between more active and educational forms of screen time and passive screen time, such as watching television. 

This leads us to the issue of screen time in the educational setting.

Laptops and tablets are common educational tools, with many children engaging in computer-based learning as part of their education experience.

Understandably, curriculum policies tend to highlight the benefits of technology rather than any potentially negative impacts. 

Dr Highfield made it clear that many parents are uncertain how to manage the time spent on the internet, social media and using technology devices within their families, and she and her colleagues are regularly contacted by parents who are desperately seeking assistance. Many parents have problems regulating their own use of technology.

As yet there is no definitive evidence about levels of exposure that are excessive, but exposure should be considered in the context of both time and quality.

As with many areas in public health, the precautionary principle provides us with guidance about the need for caution.

In practical terms, a recent survey of 800 general practitioners found that more than half had concerns about overuse of media and obesity among their patients, and most did not feel confident in identifying appropriate referrals for the problematic use of technology such as the internet.

The Public Health and Child & Youth Health Committee has agreed that this area warrants continued attention from the AMA.

A policy motion around internet use among children and young people will be put to the upcoming meeting of Federal Council.

We recognise that it is impractical to actively prevent children from using technology, but Committee members agreed that, as medical professionals, we should be promoting a message of balance and seek to assist children to engage with technology in the safest possible way.

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