Introduction
The increased access to emerging innovative multimedia devices (e.g., smartphones and tablets, video gaming gadgets) has led to a rapid rise in screen time in children. Yet, invariably, television watching starts at a very young age, much earlier before these kinds of exposure.1 According to the American Academy of Pediatrics, children should watch no more than two hours of TV daily. Whereas, a recent analysis indicate that over 35% of teenagers watch TV for three hours and above.2 Children’s screen time has shown a similar trend globally and is rising continuously. According to the latest research, kids of this era devote up to 8 hours each day to social media, with sleep accounting for additional time. It might be because electronic devices have become part of the child-rearing process over the last ten years and are the most readily available media type at home and the easiest to use. Also, most guardians(78%) have no concerns or objections to their kids devoting more time to electronic gadgets. About 41% of parents provide a tablet or smartphone when socializing to keep their children engaged and busy.3, 4 India has one of the youngest demographics in the world and has a disproportionately large number of young adolescents. In this age of advancing technology, Indian kids are being given access to all kinds of media at a very early age. These days, it is not unusual to witness pre-schoolers absorbed in electronic games or watching clips on tablets or smartphones.5 Six out of ten children between the ages of nine and seventeen spend more than three hours daily on social media or gaming websites. Based on a 2022 national survey, about 49% of parents of children in the age group of 9 to 13 years living in metropolitan cities stated that their children spend over three hours daily on social media, movies, and games. In the same study, around 11% of parents did not know how much time their kids spend on online platforms.6
Harmful Effects of Increased Screen Time and Social Media on Children
The widespread sedentary lifestyle associated with increased screen time has raised alarm bells among parents, medical professionals, teachers, and researchers. Several studies have documented the negative consequences of kids' involvement in non-educational social media activities on their unfavourable food consumption, cognitive issues, aggressiveness, and sleeping patterns. Also, excessive screen time in childhood is associated with behavioural problems, increased irritability and increased anxiety, lower fitness, and lower self-esteem in children.1, 3, 4 Researchers have reported a significant relationship between the amount of electronic media usage and anxiety and behavioural management problems in younger children, especially in 3- to 6-year-olds. A study reported that the children with severe anxiety and behavioural management issues during dental appointments were significantly involved in higher amounts of social media exposure like watching TV, playing e-games, and surfing the Internet.7 Quality of Media exposure can also elicit strong emotions in children. Youngsters respond strongly to emotionally sensitive media content, which can significantly affect their psychological behaviour. Media glorifying unnecessary violent activities is considered a risk factor for aggressiveness, behavioural abnormalities, and anxiety-related disorders leading to the development of dental anxiety (DA) and behaviour management problems (BMP). Also, observing the actions of others can result in hostility, desensitisation to aggression, and an array of behaviours. It can be interpreted by Bandura’s social learning theory, which asserts that learning depends on reactions to environmental stimuli. According to this concept, extensive media exposure provides a negative perspective to children, resulting in unfavourable consequences.8 There is evidence that screen time may also increase the chance of adverse psychological ill-effects such as depression since it replaces the time for outdoor activities, sleep, social interactions, and possibilities for learning that help promote a healthy personality. The fast-paced and powerful audio-visual effects caused by television and other screens might also hinder self-control processes and raise excitement levels, resulting in apathy and aggression.9 Research has shown that kids who devote two or more hours a day to screen, or three hours a day, are more likely to have behavioural issues and acquire vocabulary less effectively than kids who use screens for less than an hour daily.10 These findings suggest the importance of monitoring and regulating screen time for young children to mitigate potential adverse effects on their development and behaviour.
Solutions and Recommendations
Screens have become a standard in households and are being incorporated into teaching systems more often, especially following widespread reliance on online interactions during the COVID-19 pandemic. It is crucial to inform parents of younger children, especially those below three years, about the possible threats linked to excessive screen time in an inappropriate setting.1, 3, 4 Parents should direct their children’s television use to maximize its potential benefits. They may need to be counselled to make more effort to guide their kids towards instructional television and/or limit their total television viewing time if initial TV watching has an overall negative influence.1 The American Academy of Pediatrics (AAP) coined the phrase "healthy media diet," which advocates for moderation in screen time and a daily allowance of more educative and less potentially dangerous information while taking the viewer's age into consideration.8 The Centers for Disease Control and Prevention (CDC) and other organizations/evidence have suggested that the lack of TVs in bedrooms and parental controls on screen time are two effective ways to reduce screen exposure. Ideally, the recommended daily maximum screen time is less than one hour for children aged three to seven years, one hour for seven to twelve years, 1.5 hours for those aged twelve to fifteen, and two hours for those aged sixteen and beyond.2 However, children frequently fail to adhere to these recommendations. Most of the parents in an Indian survey felt that the age of creating an account on social media should be raised from 13 to 15 years. Additionally, lawmakers must ensure that social media services are subject to legislation that includes the necessary safeguards to ensure that no account is created with or without consent by minors below the age of 15 years.11
On social networking sites, children are also exposed to risks such as dangerous viral trends, online predators, identity theft, breach of personal information, cyberbullying, and blackmail. The reports of attempted theft of online accounts are higher among Indian children when compared to other countries. Parents are also concerned that their children may be susceptible to divulging private details to unknown individuals. One of the main reasons parents want controlled access to media for their children is the numerous instances of online gaming addiction inspiring violence and negatively influencing their development.5, 6
Conclusion
Excessive exposure to electronic screens and social media content can cause dental anxiety and abnormal behaviour in pediatric dental patients. Limiting a child's screen time is thus something to think about. For many parents, this is something new to handle. It requires time and energy and can be challenging for parents who work while managing children and domestic chores side by side.
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