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One way to look at screen time is like a diet, says one expert: It’s not just how many calories are taken in, it’s whether those calories have any ‘nutritional’ value.

Sheila Boardman

It's hard to believe that iPads have only been on the market since April, 2010. In three years, the all-in-one device has become an electronic Zelig, inserting itself seamlessly into the daily scene as though it's always been there: it's now often the newspaper on the breakfast table, the TV in the bedroom and the cash register at the coffee shop.

For parents, the iPad revolution puts a new spin on an old dilemma: How much screen time is appropriate for school-age children? When it comes to infants and toddlers, the message is at least unambiguous, even when it goes unheeded. Both the American Academy of Pediatrics and the Canadian Paediatric Society essentially discourage all "screen-based activities." The rationale is that newly developing brains need to interact with real people, not machines.

For children in school, the recommendation is two hours or less of "recreational" screen time a day – an increasingly murky distinction. At what point does playing an engaging game on an iPad in spare time become qualitatively different from using an iPad in the classroom as part of a game-based learning activity? How different is an iPad experience, health-wise, from a TV or an Xbox experience?

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The challenge for researchers is that iPads have not been around long enough to allow for meaningful studies of their impact on children. The screen time recommendations experts apply today are based on studies of children and television – an entirely passive and single-purpose device – that have also been applied to television plus video games.

Although researchers are trying to catch up, there is still very little in the way of hard data that can tell us what it means to have children growing up in a world where screens are as versatile and portable as our iDevices have now become.

In the absence of stacks of published research, then, The Globe and Mail has assembled a panel of experts to speak to their views – as scientists and as parents – about kids and screens.

DMITRI KRISTAKIS, Professor of Pediatrics at the School of Public Health, University of Washington and Seattle Children's Hospital, author of The Elephant in the Living Room, Making Television Work for Your Kids.

Content and context matters:

Not all screen time is the same – and I think that's one of the big challenges parents face. We know from decades of media research that what children watch is as important as how much they watch, and, frankly, how they watch is important as well. You can take an iPad and make it nothing more than a television, a screen like any other screen. But if you use it with as some kind of interactive educational device it's dramatically different from a television in many structural ways that we're still trying to understand.

A useful analogy is diet. We can think about a child's total amount of screen time as we think about total calories, but then we have to consider what makes up those calories, about health and diversity, like a balanced diet. Two hours of watching a violent movie is very different from two hours of playing an educational game or two hours of texting with friends, even though that can now all be done on the same device.

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But even at its best, one can have too much of a good thing because the screen time displaces other activities. I hear from a lot of parents who feel their children will be left behind if they're not using these devices. I think that's an overblown fear. Children are remarkably adaptive and very intuitive when it comes to media technology. There's no empirical reason to believe that if your young child isn't exposed to enough of it that he or she will somehow have a deficit.

Personal bottom line:

I am a parent, and at home we do have our own rules – I think it's incumbent on parents to come up with their own rules. I also happen to think the Academy's recommended limit of 2 hours a day is excessive and it's not my personal recommendation. At home, we don't allow any recreational screen time during the week. By that, I mean mindless screen time – obviously how you define "mindless" is very subjective. For example, my son, who is now 15, composes electronic music on his computer. I don't consider that to be mindless recreation. We also don't include texting as part of screen time because, for better or worse, texting has essentially become the primary mode by which school-age children talk to each other today. We count that as "phone time," if you will.

CLAIRE LEBLANC, Pediatrician at McGill University and Montreal Children's Hospital, and Chair of the Canadian Paediatric Society's committee on active living and sports medicine.

Think about what screens are doing to bodies, not just brains:

Once kids start school, a large part of their day is sedentary. Given this fact, we really do have to be concerned with how much of their time is spent on recreational screen use.

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The research that's out there tells us that high levels of sedentary behaviour are associated with lower self-worth, poor self-concept and less pro-social behavior. As well, more than two hours a day of television is associated with lower academic scores – and the outcomes get worse as the amount of viewing time grows.

I don't think we can turn the clock back and pretend that iPads and other devices don't exist. But we need to be looking at all aspects of a school-age child's day and realize that children learn better when they are physically active. If they end up spending much of their day in screen-based learning and recreational time, too, we should not be expecting that they'll end up brighter.

Personal bottom line:

I'm a grandparent now and when I was raising my son there were no guidelines on screen time. What we tried to do as parents was to make sure that there was sufficient time to get homework done and to use recreational time in part to promote physical activity, so that we had a balance. In our particular household, we had to put a limit on video games, a type of activity that young boys especially seem to gravitate towards. I'm not saying it's easy for parents, but I think we have to just look at children today and see that if we don't turn this around we're going to have kids who are a lot less healthy than we were growing up.

DAVID BICKHAM, Research Scientist at the Center on Media and Child Health, Boston Children's Hospital.

Take measured doses and be wary of parental substitutes:

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A lot of what kids experience on these new devices is old content conveyed in a new way – for example, videos which should have the same effect as television.

One of those effects is known as "attentional inertia" – basically, when you're viewing passively, the longer you've been watching the less likely you are to look away. It takes structural breaks in the content to help you interrupt that. At least with streaming video, there could be more opportunity for using structural breaks to manage screen time as compared to television. When the video is over parents can say, "Let's stop, this is done."

We also have this huge glut of apps that claim to be educational. But [we] don't really know. There's evidence that educational content can be conveyed in this way but on an app-by-app basis, no one has to prove any claims.

With younger children, we know that real-world interactions – such as those with parents and caregivers – lead to positive brain development. So there's a tendency among child health experts to say we should be relying on what we know works, at least until we know better.

Certainly there are many activities parents can do with children around mobile screens that are just like books, games and puzzles. Yet there may also be a difference: Some research on what happens when parents and children look at a story in digital form versus book form suggests parents interact with kids less around digital books. This makes sense, because the device is sort of expected to do the work. Without the device to fall back on, the parent has to drive the interaction.

Personal bottom line:

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My children are 22 months and two weeks old, so I'm still a bit new to this in my own life. I do think there are appropriate and effective ways of using screens and screen time that make a lot of sense. For example, my son doesn't watch TV but we when he was sick and in hospital we spent a lot of time watching videos of animals. As my children get older, I think their screen time will be in the form of streamed videos via DVR or a mobile device, and not as conventional television.

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