Screen use by children aged under 5

Who uses screens with children, and how they use them, matters. Responsive interaction between parents and children when using screens can prevent harms and promote development for young children The way that screens are used is key to the way in which they influence health and development in early childhood. What young children are viewing (including whether it is suitable for developing brains by being slow-paced, repetitive and predictable) and the quality of interaction between parents and those young children during screen use, is crucial to determining whether it has a positive or negative effect on child health and development. Some evidence has linked large amounts of screen time with negative effects on children's health and development, including on social, emotional, language and brain development, sleep, eyesight and healthy weight. Screen use becomes particularly problematic when it crowds out sleep, physical activity, parent-child interaction, creative play, household routines, real-world exploration or learning. Lengthy periods of non-interactive, receptive watching are unlikely to benefit young children and are likely to harm development by crowding out these important activities. These harms can be avoided. A child viewing screen content together with an adult (co-viewing) – meaning adults talking, responding to children’s interests, asking questions, taking turns, and engaging with the content - improves language and thinking skills, and reduces the risks seen with solo and non-interactive receptive screen use. We discuss the evidence in sections 4B and 4C of this report. We recommend government includes the following messages in its guidance to parents:

• Interact with your child when they are using screens – for example by asking your child questions or responding to what is taking place on the screen – e.g., think about how you read a book with your child.
• Choose activities that involve interactions and family connection as those can support learning and family bonding – for example, video calls with relatives, looking through family photos and videos together, and reading e-books together.
• Ensure screen use in young children is balanced by other healthy activities away from screens, such as time interacting with parents and other adults and time in creative play either alone or with other children.
• Protect your child’s sleep:

o Ensure your child sleeps the World Health Organisation (WHO) recommended amount: at least 11-14 hours for children one to two years of age and 10-13 hours for three to four-year-olds (Guidelines on Physical Activity, Sedentary Behaviour, and Sleep for Children under 5 Years of Age, 2019). o Have screen-free bedrooms and do not allow screen use in the hour running up to bedtime.

• Ensure your child gets enough physical activity (Davies S.C., Atherton F., et al., 2019). The UK Chief Medical Officers (CMOs) recommend three hours a day of physical activity including play for children under five years.
• Adopt screen-free periods of the day, such as mealtimes, as these are important opportunities for social interaction.

Time matters: parents should remain cautious about screen use in the under-fives The evidence on time thresholds for screen use in the early years is very limited. However, the precautionary principle suggests parents should limit screen use to guard against potential harms, such as where time spent on screens displaces or crowds out healthy social interactions, sleep and physical activity. We discuss the evidence in sections 4A, 4G and 4H of this report. We recommend government includes the following messages in its guidance to parents:

• Under two – avoid screentime except for shared activities that support family bonding and learning. These activities could include video calling to relatives, reviewing family photo albums or reading e-books with parents or siblings.
• Two to five-year-olds – keep screen time to no more than an hour a day, ideally through short chunks (30 minutes or less) and not during mealtimes or near to bedtime. Keep solo screen use to a minimum. Note that these limits do not apply to screen-based assistive technologies for children with SEND. These technologies have particular benefits for some children with SEND in improving their quality of life, for example by helping with mobility and communication.

What children are watching is important What children are viewing also matters in determining whether screen use brings harms or benefits. Well-designed content and interactive activities that are appropriate for the child’s age can support young children’s language development, problem solving, memory, and early literacy. This is particularly true when activities are shared with a parent or other supportive adult or older sibling. Fast-paced short-form videos raise particular concerns, with suggestions that rapidly changing, highly stimulating content may affect children’s attention and excitement. Evidence is limited, so a precautionary approach suggests avoiding short-form videos and fast-paced content for young children – and limiting screen use to more child-appropriate slow-paced, repetitive and predictable content. We discuss the evidence in section 4C of this report. We recommend government includes the following messages in its guidance to parents:

• Young children need time to process information, so choose content that is slower- paced than the equivalent for older viewers. Content should focus on faces, have limited movement, simple backgrounds and use repetition.
• Parents should try to avoid children spending lengthy periods of simple receptive watching, flipping or scrolling through content by themselves. This is unlikely to benefit young children and is likely to harm development by displacing play, interaction with parents, sleep and physical activity.
• Parents should seek out suitable slow-paced content and to try to avoid fast-paced screen content, rapid speech or multiple characters talking at once, such as short videos where the sounds and images change constantly. This type of content can have an adverse effect on children’s social and emotional development and on their self-regulation.
• Wherever possible, parents should try to avoid having the TV or other screens running in the background as they can distract young children’s attention from playful, fun and learning activities. Fast-paced vs slow-paced content Content which is fast-paced in terms of its auditory, visual and narrative content can be over-stimulating for under-fives and is associated with behavioural problems. Fast-paced visual content includes frequent scene cuts, camera pans, vivid/bright colours and characters and objects moving on-screen. Good visual composition should include slow, static shots with limited movement. Fast-paced auditory content includes rapid speech, multiple characters talking at once, and dense or complex backing tracks. Young brains struggle to separate speech from background noise, so character speech presented against a backdrop of silence is easier for young brains to process. Fast-paced narrative includes complex, multi-layered stories, short conversations with frequent changes of topic, frequent scene changes and a large number of different characters. Good quality content may contain repeated sequences and narrative elements that reoccur across episodes – such as a character having an ‘entry’ song, songs with a repeated chorus, the same sequence of events occurring repeatedly in different contexts or retelling a story to summarise it just after it’s happened. Together, slow pacing and repetition help to build understanding in younger viewers. 9

Safety is paramount Online, as in real life, protecting children from harm is parents’ main concern. Safety concerns can arise from the risks of seeing inappropriate content and of engaging with inappropriate adults or because of data privacy and protection issues. Technology is evolving very rapidly, and artificial intelligence (AI) is now being included in a number of apps, toys and chatbots recommended for young children, raising safety concerns. We discuss safety and the evidence around safe use of screens in sections 1 and 4C of this report. We recommend government includes the following messages in its guidance to parents:

• Use parental controls that restrict content on any screen devices used by young children. In many cases these controls enable parents to set them according to the age of their children (e.g. under five). However, parents should be aware that these controls are not infallible, and we recommend parental supervision of screen use in under-fives. See https://kidsonlinesafety.campaign.gov.uk/parental-controls/
• Ensure that young children don’t have social media accounts.
• Be aware of the risks of giving an adult’s phone to a young child. This risks them seeing content not meant for under-fives. If parents do give young children their phone, watch it with them.
• Parents should not let young children use AI tools, toys or chatbots (even those aimed at young children) until the present state of knowledge improves.

Think about your own screen and media use Parents remain the strongest influence on their young children, and the way parents use their phones and other screen-based devices in the presence of young children strongly influences their children’s use. As noted previously, parental interaction with children using screens can promote development but there is growing evidence that parental use in front of young children could negatively impact upon their development or health. However, occasional short periods of use may be necessary for many parents and are very unlikely to be harmful. We discuss the evidence in section 4D of this report. We recommend government includes the following messages in its guidance to parents:

• Carefully consider how you can limit use of your own devices in front of young children.
• Consider adopting screen-free periods of the day for all family members, such as mealtimes and for an hour before children go to bed. 10

Providing guidance and support for parents In conducting this review, we noted a number of limitations in the information for parents on what constitutes quality online materials for young children (see section 4B, for example). We recommend government provides further guidance and support for parents in:

• Identifying good quality online educational materials for young children; and
• Using AI-enabled tools or toys for children.

Digital screens are everywhere in modern life and bring new challenges for parents and carers; yet balancing negatives and positives in children’s lives is familiar to parents Parents and carers of children under five years of age are confronted with a new set of challenges about their children using digital technology. These challenges are constantly changing as technology evolves. Parents know their children better than anyone else and recognise that children need love, security and their guidance and support to thrive. They know children need protection from harms, enriching experiences to learn; and social interaction, play and exercise to become socially and physically skilled. They notice when children become overly fixated on one thing to the exclusion of others, or overly excited or tired, and intervene to restore a sense of equilibrium and balance. They know that children need routines and good habits and how to foster those routines and habits. These skills and instincts that parents have used routinely for generations apply to the digital world just as much as they do to everyday life. Evidence on the positives and negatives of screen use and the challenges for parents is discussed throughout section 4 of this report. We recommend government includes the following message in its guidance to parents:

• Parents should trust their instincts as they make decisions about what is best for their child and for their particular circumstances. However, we recognise that in an ever-changing technological world, trusted and evidence-based information can help parents make informed choices that reflect both their values and their child’s needs.