043 - Is increased screen time in young kids linked to developmental or language delays? Interview with Dr. Angel Dy

Parenting in the digital age comes with its fair share of challenges, and one of the most pressing concerns for parents today is managing screen time for their children. The constant barrage of advice and opinions can be overwhelming. On one hand, you'll hear experts advocating for strict limitations on screen time, while on the other, some suggest that early exposure to screens can boost a child's intelligence. So, how do you find the right balance?

In this episode, we delve into the world of screen time and its impact on young children's development. We're fortunate to have Dr. Angel Dy, a medical doctor, early childhood development advocate, and founder of The Growing Brain Ph., who conducted extensive research on this very topic. Get insights firsthand from the study author herself!

About Dr. Angel Dy:
Dr. Angel Dy is a medical doctor and a passionate advocate for early childhood development with over a decade of experience. She holds degrees from the Ateneo School of Medicine and Public Health and completed postgraduate studies at the London School of Hygiene and Tropical Medicine and the UC Davis Mind Institute. Dr. Dy is an Assistant Professor at the AT School of Medicine and Public Health and an Assistant Head of Mental Health Sciences flagship programs. She's a certified trainer for the "Zero to Three" Growing Brain curriculum and has published academic articles on topics like screen time's impact on child development. She is widely recognized in the parenting space as The Growing Brain PH.

⭐ Our book Learning by Heart: Teach Your Child to Read, Stress-Free is now on Amazon! Click here to learn more about Dr. Victoria Nolasco's books.

⭐ Check out our FREE Discerning Parenting Toolkit and Resource Library.

⭐ Find out more about our on-demand courses to guide you through parenting challenges.

🎖️Discerning Parenting is now one of the TOP 20 PARENTING PODCASTS on Feedspot!

The Discerning Parenting Podcast is a free informational resource for parents. As a valued listener, you acknowledge that any information you get from this podcast is for your general guidance only, and ​​must never be considered a substitute for the advice provided by a doctor, therapist, or other qualified medical professionals who know your child specifically. Read our full disclaimer policy here.

Transcript

One of the biggest worries that parents have today is about screen time. And we get a lot of questions about this how much screen time is okay? What can I do to manage my child's screen time? And of course, as parents, many of us still hear people saying screen time makes kids smarter. So despite the limitations of screen time that are advocated by pediatricians.

We will hear people saying don't worry about these screen time limits. You need to introduce screen time early so that kids will be smarter. Now, today we're very, very lucky because we have a doctor who did research exactly about this topic, exactly about screen time. We'll get to hear firsthand from her.

 So, today I'm going to welcome Dr. Angel Dy. She is a medical doctor who is an early childhood development advocate and she conducted wonderful, wonderful research about screen time in young kids. 

Are there days you feel you've had it with the sleepless nights, the temper tantrums, and the constant fatigue of trying to keep up with an active baby? Does it feel like you're always working so hard as a parent, trying to do everything for your kids and family, and yet it never feels enough? We get it. You love your child more than anything, and yet parenting is also exhausting and challenging.

Especially when you're bombarded with criticism and pressure to be the perfect parent. Which, spoiler alert, does not exist. That's why we created Discerning Parenting, the podcast that helps you cut through the noise and focus on what truly matters in your parenting journey. This podcast is jam-packed with valuable insights and practical tips specifically tailored for parents of kids aged 5 and below.

So join us and discover how you can use the combined power of science, knowing your child, and your own intuition in making the best parenting decisions for you and your family.

hello and welcome Dr. Angel Dy. Thank you so much for joining us for today's episode of the Discerning Parenting podcast.

Dr. Angel Dy is a medical doctor and she is an early childhood development advocate for over 10 years. She graduated from the Ateneo School of Medicine and Public Health. With her degree in medicine and her M.B.A., she completed postgraduate studies at the London School of Hygiene and Tropical Medicine and the UC Davis Mind Institute.

She's an assistant professor at the AT School of Medicine and Public Health, and she's also the assistant head of the Mental Health Sciences flagship programs. She's a certified trainer under zero to three for the growing brain curriculum, and she is a provider of several interventions that will help young kids in their development. She's published several academic journal articles, including the one about screen time that we'll be talking about today. And she's also written neuroscience and research-informed parenting materials. And if you're following the parenting space, you may know her as the Growing Brain PH.

She's the founder of Growing Brain PH, and she advocates for early intervention, infant and toddler mental health, and supporting the parent-child dyad for optimizing growth and development during the early years. So, Dr. Angel, it's so wonderful to have you here today. I know that you have a very busy schedule and this is something we've been wanting to do for months.

So finally, you're here. Hi, Dr. Toyang, I'm, I'm honored to be invited to be here and to share what might be helpful to the community. Yeah. So could you tell us more about your research about screen time? Yeah. Well, maybe I can start off by letting you know why I did it. Yeah. Because I think when the study was conducted in 2021, it was smack dab in the middle of the ongoing pandemic.

In the clinic, I would get a lot of parents who are concerned about language development, specific language development, and social skills of their children. And because it's medical doctors, we tend to ask a lot of history, medical history, developmental history, what's going on at home.

And the first thing that they'll really tell me, and they know this parents are very aware. Doc, I think it's because we do a lot of screen time, right? They'll outright say it's screen time. They'll let you know all the shows that they've watched. And I think part of the reason why they do that is because they're trying to find out, am I watching, am I letting them watch the right things?

Because as you mentioned, some parents really feel that gadgets teach our children. And they're not 100 percent wrong, but it made me curious how much of that effect was happening in our kids during the pandemic time because of the restrictions. We literally told the parents that they could not take their kids out.

And so we had no other choice. They had no other choice but to think of things that would happen within the home. And so that kind of triggered doing the study. So the study then targeted two to three-year-old children.  Because that was the age group and because it's also the age group I see in the clinic and just wanting to see what their skills and not just language, social skills, play skills, and interpersonal relationship skills, those became the targets of the study that we conducted.

Wow, that is so interesting. So I know if you're listening to this episode, you're excited to find out what were the findings of this. research. So you told us already who were the ones who joined. So these were those who were two and three years old, right in the middle of the pandemic. And these were kids who tended to be stuck at home.

So they may have had more exposure and screen time. So could you tell me what were the findings of the research? Yeah, it was so interesting because we really just wanted to get about 280 kids and the statistics standpoint so that the research has sense and meaning to the scientific world. 280 was what was required.

We actually got an overwhelming response of 400 plus, so about 419 kids. So one of the things we wanted to see is how many Okay. kids were able to follow the recommendations of our pediatricians, which is no more than one hour a day for that age group. And oh my goodness, Dr. Toyang, we couldn't get enough because only, it didn't even reach a hundred, only 99 kids of the 419 could do one hour or less.

Everyone else was doing more than that. And so that made me curious, oh my goodness, am I going to see Crazy results? And so what we did notice there are a lot of findings, but in terms of development, we were able to account for drops in language development in children who were watching more than two hours of screen time.

Right, so two hours became the mark where we would see a drop like you when you look at a graph, you sometimes you'll see a graph and you'll see okay it's in the average and then you, you see it dip, you really, you literally notice that both. Expressive, meaning what they can say, and express, and that's through gestures, words, and what they receive, or receptive language, what they understood, both went down.

And so, and this is over 400 kids, so it's not just a fluke, right? So, yeah, that's true. One of the major findings is that  Which, which provides evidence of what our pediatricians are trying to express to our kids, and to our parents to try to limit the amount of screen that we give to our kids. Yeah, so that's very interesting.

Now, sometimes when somebody shares. research findings like this one, like there is a drop in language skills at a certain point when you give beyond a certain amount of screen time, there are people who are going to protest something like, oh, it wasn't an experiment, but you know what, Dr. Angel, I don't think it's I don't think we'll really be able to conduct an experiment like can you actually tell, you know, divide these parents into two groups and then tell them, okay, you give your kids two hours of screen time, you give your kids three hours of screen time, you know, we can't, we can't do that.

So, what you do is you statistically control for them you use statistics to control for these other confounding factors. So that means if you saw that drop and you said it was really a significant drop it was a statistically significant drop. Then, there really is a correlation, there really is an association between excess screen time and a drop in language skills.

Yeah, and maybe. I get really excited about talking about numbers, but that's the nerd side of me, I think maybe to support our family, families who may be listening about it is I can see and understand how difficult it is to stick to the two-hour limit or the one hour limit, even part of what we try to do, or I tried to to do.

Incorporate into the research study was to try to understand where it was coming from. So not just the numbers and knowing that the language dropped. I think it was also nice because part of the research was trying to understand the perceptions of the family members on why they were using certain screens.

And one of the things that I thought was nice to see was parents are aware. That there are difficult behaviors when their Children are using the screen there was about 60 to 70 percent of parents said yes, my child did have difficult behaviors, but on the flip side. Parents do recognize that there are some screens that can be educational.

So there's another 50 to 60 percent depending on it. Some will say language. Some will say mathematics. Some will say reading. And these are skills are trying to get their Children to learn. But it, it adds on to sometimes it's because it's also what is told to them. I think that's one of the things that I kind of want to point out also I think our parents need to educate themselves also on how to choose the right materials that match their goal for their child.

So what I took away from those numbers was These parents have good intentions. They want their child to learn they have a goal. Mom or dad will not want their child to be able to read or do math early if they could if a game told them that the child would be able to. And so sometimes it's being educated in that regard that perhaps letters and numbers aren't.

The way to read for a child who's two years old. And so exactly in early childhood, it's really all about interactive communication, and not about memorizing letters and numbers and shapes which are Yeah. If we look at YouTube or screen time, we really see the titles, like help your child learn this, help your child learn that.

So, as a parent, you're going to see that, you're going to say, oh, I want that for my child. So, there's some pressure on parents to give their kids the screen time. I remember, I actually get a lot of parents who would tell me something like, I wanted 6 or 8 or 12 months. I gave him the screen so that he could learn, and actually, at first, he didn't want to, he preferred crawling around overlooking that screen, but eventually, he became more and more attached, and until now it's difficult to get him off.

I hear that story time and again. So if you're a parent listening to this and you have a six or an eight-month-old who hasn't been exposed to screen time, And you're feeling the pressure around you. People are saying,  how are they going to learn? They're going to be behind.

Well, this episode is going to give you the confidence that no, your child is not going to be behind and there is research evidence for it. So Dr. Angel, can you also tell us,  in your research, that you also looked into the effects on other skills as well, not just language skills?

Could you also tell us about the other effects of screen time? Yeah. So there were three other domains that we looked at in the paper, it calls it personal skills, interpersonal relationships, and play and leisure. So those three, I wanted to look into those three because personal skills mean what can you do for yourself?

Your activities of daily living. Can you eat on your own? Do you toilet on your own? Do you still wear a diaper and so on? Yeah, this is also a huge concern for parents. I want my child to be more independent and it's also a huge load of a parent's work if their kids are able to do these things for themselves.

Yeah. And then so there's that one, right? The, the, the individual skills, and then there are interpersonal relationships, meaning how do you develop friends? How do you interact with somebody else or the parent which is what they're supposed to be doing in the first couple of years before, they have peers?

And then the last one is play and leisure, but it's not about how you play with a toy, which is, I think what I'd like to highlight. When we look at children's screens and evaluate them, we're actually not looking at how well they use a toy, especially for the younger age. So if some of your listeners may have even joined this study, if they recall answering the questions there, it was about how you play with another person.

So it's a lot of it is about interpersonal relationships. And so you asked about the findings. The findings show that the skills level for these three also drops, but not until the child is excessively using screen time for four to five hours. But I think more than that, it makes sense, right? If you're spending four to five hours of most likely a 12-hour waking time, you have much less time to learn the skills that take.

Several repetitions to learn to pull up and down your pants have to happen several times before you understand that this is how far or how hard I have to pull or push it so that it covers my butt, right? So there's that kind of skill or just getting a spoon being able to scoop and putting it in our mouths.

Let's say I know this wasn't a question in the study, but A lot of people will use the screen to pacify a child so that they can be fed a lot easier and not to judge anyone, but it kind of tells you that the child, therefore, doesn't learn to pick up a spoon scoop and put it in their mouths.

There are several reasons for this.  Our parents are busy during the pandemic. People were working from home. Even now you're no longer in the pandemic. You want to finish a little faster and you kind of want them to be a little bit more neat. And I think that's cultural for us. We don't like messy, but children don't learn to become clean until they are done being messy.

So Again, it comes from repetition and work. And so if we have continuous exposure to screen or using screen to pacify so that you can get more bites in and faster or, or they don't notice that they've eaten two bowls of food because we like to feed our kids a lot, then they don't learn the skills that make them more independent as well.

That is so true, Dr. Angel. And this age is a critical time for brain development. The first two or three years of life. That is when the brain connections are going to form, and this has also been shown in other research, that if they are deprived of this interactive communication, human interaction because they're supposed to be interacting with other people at this time, and that is how the social brain forms.

That is how they learn to regulate. That is how they learn interactive communication. That is how they learn how to use language in everyday life by interacting with other people. And if they miss this crucial period, it's going to be very difficult for them to catch up later on. And that's what we always tell parents.

During the early years, Your priority is really to learn social interaction because memorizing the numbers, memorizing the letters, all of that can come later on. If your child doesn't learn it in the first three years of life, later on, they're going to learn it. So all those things that they're supposed to learn, quote-unquote, in the educational videos, if you wait until they're older before they learn it, they will still learn it.

But if they miss this time interacting with other people because we gave them the screens, then we're never going to get that time back. And I think that is what your study shows and other research like it also. Yeah, and I like how you highlight the educational videos because there are several studies like those of Radesky.

These are researchers who really try to understand how infants and toddlers understand the use of screen media. And I really appreciate one of the studies that they did was they went through the app store. The Google Play in the App Store, and they tried to review the materials that were there because some parents will try to use those as a guide, right?

It would say there it's for baby learning, for infant learning, and out of the top 100 that they saw being downloaded, I think not more than 10 percent were even appropriate for children. Exactly. For that age, so I go back to, I don't know if anybody who's in marketing is hearing this, but it also speaks to those who create the materials because our parents have, are drawn to the marketing or the appeal of, the learning activity.

And so if you look up the top 100 in the first 80 tell you ABCs. Yes. Parents are going to think that you need ABCs at one and two years old. Exactly, Dr. Angel. And that is why we're here at the Discerning Parenting podcast. Being a discerning parent is about knowing how to make decisions that are right for you and your family and your child as a parent.

So I hope that listening to this, will help make us more discerning. Because I understand for parents, the pressure is all around us. And I know it pops up all the time on my Facebook feed. I always see all these apps that will say make your baby smarter, make your toddler smarter. Get this app and then your toddler will learn to read in 30 days.

And parents do get pressured by these things and they're not And they're not even, they will say that they're backed by research. And sometimes I actually click on them, either I don't see the research, Or what does the research say? The research will say the first three years are critical for brain development.

It's the only research that they say, but that is not how to make the most out of the first three years. So it's a very misleading use of research.  What tips do you have for parents, especially for busy parents where sometimes we do really need the gadgets to help us maybe to give us a chance to cook dinner or to do some.

finish some of our own work. Any advice that you saw the parents in your research? Well, I think the number one takeaway is it's actually letting us know that it doesn't have to be zero. The use of screen time doesn't have to be zero, so maybe I'll go first with the recommendation of our pediatricians both AAP, the American Academy of Pediatrics, and PPS, the Philippine Pediatric Society, which recommends no more than an hour.

The research does say that hours is where the language drops off and knowing that the majority of our parents don't even make it to the one hour. I think the 1 to 2 hours is a safe enough number to follow in terms of screen time. So if we're talking about needing it to maybe go to the bathroom, maybe get your house cleaned, perhaps get that into smaller chunks of time for the screen as a distraction, that should be okay.

As an advocate, this would be this would be for kids who are around two years and up because below 18 months, they really recommend this when the recommendation is for zero screen time and then for 18 months, to two years. Then maybe there can be some amount of screen time that is carefully selected and that you watch together with them.

There is research evidence for these recommendations, which I talk about in my two books, one about toddler talking and another about toddler behavior, which we will link to in the show notes. And of course, we'll also link Dr. Angel's research in the show notes. Yeah, thank you for pointing that out because just remember that the research was for two to three years old in the years below.

So 18 to two years old. Actually, they were just encouraging video calls. So encouragement of video calls just highlights the social interaction of the use of that gadget for that younger age group. And so maybe to add as an addendum to the two hours that you do watch, the best way is also to co-view.

And it's not something we've talked about yet, but co-viewing actually Made language skills better than those who didn't co-view. And when we say Kobe, what does that mean? It's literally having someone watching with you so that it's not passive-watching. It's actually having someone who may explain to me add on to what they heard.

Or what I'm thinking about is those shows like Dora the Explorer will ask a question. And then I'm imagining a parent having their child respond or helping the child have a response to the questions. comes a more interactive show. So that goes beyond the scope of the research study. But just coming from our field of work, I think it's more than just knowing the number or amount of time that you watch the screen.

It's how they watch the screen. And then one of the things that I advise patients in the clinic is that. Maybe you can't, you can break up the two hours rather than sitting two hours straight because that does affect brain development and that's chemicals in the brain. And that could be a whole different conversation.

Maybe it can be in smaller chunks, 15 minutes at a time. So that it's not, you're not just sitting and staring at the screen for long periods because that's also not how Children will learn. They may look like they're being well-behaved and have good attention, but that's not attention. That's almost what we call this.

An addiction. They can't get away from it so they just kind of stare and you can't even call their names. And so that's a problem. If you're seeing that with your child who's watching, that is already a problem. So that might signify that you need to lessen the amount of time that you're, you're allowing your kids to watch.

And so Dr. Doyle, you mentioned earlier about discerning Okay. You also need to be able to discern what is a good enough time for your child. So if you are a parent who notices that your child misbehaves with too much screen use already, I will not wait for two hours just because Dr. Angel said two hours is not right.

Maybe my child is on the one hour. Maybe even 30 minutes. And so we got to discern for our child's individual differences. Yeah. And we do see that Dr. Angel, we do see kids that with just one episode of a 20-minute show, there's really something different already about their behavior. Yeah. So it's being curious.

I like to call it being curious about how your child might be reacting or behaving based on the show and not just relying on that the show is of good quality. It also needs to match the quality. The quality needs to match the learning style of your child. And of course, there are two. So that learning style will continue to change.

So we have to continue to learn What they're able to do as well which is why if you'll notice the recommendations for screen time actually change also as kids get older, right? So after five that actually shifts that you don't have to co-view with them forever.  Right? We don't co-view anymore unless we're doing family movie nights and such.

Yeah, because especially in early childhood, they really have a hard time learning from screens. I mean, they can learn, like they see one cartoon character pushing another. They can certainly imitate that action. But if you're looking at what you want them to learn from an educational video, it's going to be a huge challenge if we do not help them translate what they see to the everyday world.

And when you're growing brain advocacy, I know you also advocate a lot of play and screen-free activities. So could you tell us more about that too, as an alternative to screen time? Actually my favorite recommendation for families, I literally write it on a prescription play with your child six to eight times a day for 10 to 15 minutes each time.

If you bring that is a very nice prescription. It's recommended to pediatricians already. The American Academy of Pediatrics went out and said, Pediatricians, you need to prescribe play to your parents because our kids just don't get enough interactive play. That's playing with somebody else. They may not get enough active play and movement.

So that's a wonderful prescription, Dr. Angel. Yeah. And it's science back. So you mentioned before I'm actually a DIR.  Professional, meaning we advocate and teach and help families on what it means to be interactive play. And in that advocacy, we actually, we actually need the six to eight times if it's not yet being done to happen, because some, unlike before we had big families, we had kids who just had many exposures, social exposures, and if they didn't get it  We try to introduce it more purposively by saying the 68 times and notice that we don't say that it has to be very long.

So if 10 to 15 or even up to 20 minutes, because their child's attention isn't going to be that long either. And so if your interactive play can be in the form of, I'm just going to be playful with you as we eat. During mealtimes when we're trying to feed you, choosing the food, being playful, which one do you want to eat?

Or is that yummy? Is that sticky? Oh, you know, that one is so soft. And depending on how you want to have a conversation, that's playful already. So if you're eating three times a day, three of the six is already out, you just need to think about three to four more activities that you can be involved in.

doing together that is playful and interactive as well. That's wonderful, Dr. Angel. Thank you for bringing that up. And thank you for showing our listeners that play doesn't have to be so complicated. Because if you look at the internet, it feels like play has become really complicated. You have to have all of these materials, you have to follow all of these steps.

And I feel that a lot of them may have to do with marketing also, just like the apps. And that's why play has gotten so complicated when actually all you need is the parent and the child and that connection and that interaction. So Dr. Angel, where can parents go if they want to find out more about you and your work and your advocacy and also more tips?

I know you have a lot of wonderful tips for parents. Yeah, well, I do have my social media pages. As you mentioned, it's the growing brain pH. It has an equivalent website. I do manage them myself. So they are updated based on my availability to update them. But it's really been an advocacy to basically share with others what I've seen has been a concern with other parents.

So if you'd like to read articles, if you'd like to look at posts that are there, you can certainly visit the social media pages. So on Facebook, on Instagram, even on YouTube, on occasion, I'm there, and then the website, of course. If you would like to. have a consultation that's also an availability to parents.

So I do parent coaching.  I'm working with other clinicians to get them to also be more skilled in terms of helping our families. So that is something that the Growing Brain PH is trying to advocate for. So beyond me being behind the page, I actually have a team of clinicians who are helping me with this advocacy as well.

Wow, that's wonderful, Dr. Angel, and that's really very much needed. If you want to learn more about screen time, how it affects language development and behavior, and what we can do about it as parents, check out also my books, Toddler Talking, Boost Your Child's Language and Brain Development in Three Easy Steps.

And my newer book, The Discerning Parents Guide to Toddler Behavior from Power Struggles to Connection. And in both of those books, I included a chapter that reviewed the evidence about screen time. In fact, the book about toddler behavior includes also Dr. Angel's research. It also has practical tips for parents, which include a lot of the things that we said today, as well as other tips to help you if you want to.

For example, How do you choose screen media for your child? And it's not the top results on YouTube. It can be very far from the top results. And also, how we can manage screen time as busy parents. So we'll link to the books in the show notes. You also check out our website, discerningparenting. com.

So thank you so much. Dr. Angel, any last words for our parents before we end the episode?  I just have to agree with being able to discern because in terms of screen media, not all screen media is created equal, but we can equip ourselves to be able to make good choices. Because I know our parents are good-intentioned as well.

Thank you for listening. And thank you for having me, Dr. Toyang.  📍 Thank you, Dr. Angel. Thank you to everyone who has listened. So feel free to share this episode with other people. Maybe you want to share them with other parents or if there are people who are trying to decide about screen media and to discern how to best use screen media for their kids, feel free to share this episode with them.

So thank you so much, and we'll see you again on the next episode of the Discerning Parenting podcast, where it's our mission to help you discern how to make good parenting decisions. Bye!