Reducing Kids' TV Time: What Works?

By Kathleen Doheny
WebMD Health News

Reviewed by Louise Chang, MD

Nov. 5, 2012 -- Counseling parents on the health risks of too much TV time for their toddlers doesn't seem to help break the TV habit.

Researchers thought that educating parents about the dangers of excess screen time, with suggestions on how to reduce it, would work.

But in a new study, it didn't, although the counseling did lead to another important behavior change.

"We did find we could reduce the number of meals eaten in front of the screen," says researcher Catherine S. Birken, MD. Birken is a pediatrician at the Hospital for Sick Children and assistant professor of pediatrics at the University of Toronto.

"That's important, because some research is showing the relationship between screen time and obesity is strongly mediated by what you eat while watching TV," she says.

The study results ''may be depressing but it's not surprising," says Dimitri Christakis, MD, MPH, director of the Center of Child Health, Behavior, and Development at Seattle Children's Hospital Research Institute. He reviewed the study findings for WebMD.

"The majority of American parents already feel bad or guilty about the amount of TV their kids are watching, but they aren't doing anything about it," he says.

The study is published in Pediatrics.

Too Much Screen Time: What's the Problem?

The researchers define screen time as time spent watching TV, videos, and DVDs, and also playing video or computer games. Too much screen time is linked with obesity, delayed language development, aggressive behavior, and other problems, the researchers note.

Screen times have risen in recent years. The average preschooler now gets about four hours a day, according to a recent study by Christakis.

The American Academy of Pediatrics strongly discourages television viewing for children ages 2 or younger. For older children, it advises no more than one to two hours a day of educational, nonviolent programs.

Reducing Screen Time: Study Details

Birken's team decided to test whether counseling parents of 3-year-olds who came to a pediatric practice in Toronto could help them reduce their kids' screen time.

They randomly assigned 160 children and their parents to a counseling group or a comparison group.

In the counseling group, parents got a 10-minute session on how to reduce screen time. "We talked briefly about the health impacts of screen time," Birken says.

"We made suggestions about removing the TV from the child's bedroom, turning TV off during meals, and gave ideas about how to budget screen time," she says.

The comparison group got information about safe media use and television rating systems.

A year later, Birken asked the parents to report on their children's screen time. In all, 132 children finished the one-year study.

No screen time differences were found between groups. At the start of the study, the average of both groups was under the suggested two-hour-a-day maximum. But some watched much more.

At the start, the counseled group watched about 94 minutes a day. The comparison group watched 104 on weekdays. At the end, the counseled group was watching 85 minutes and the comparison group 89 -- not a substantial difference.

On average, children in both groups ate 1.9 meals a day in front of the television at the start of the study.

A year later, there was no change in the comparison group. The counseled group ate 1.6 meals a day in front of the screen.

Children's Screen Time Study: Perspective

The intervention may have been too brief to work, Christakis says.

In his studies, he has found that more intensive interventions do reduce screen time, but just slightly.

However, the finding that the kids in the counseled group ate slightly fewer meals in front of the television is worth noting, Christakis says.

TV viewing promotes obesity, he says, ''not because of being [inactive], but because it promotes unhealthy eating."

Triggered by commercials for food and by habit, TV viewers are likely to grab a bag of chips or other high-fat foods, he says.

Parents who want to reduce screen time for their children should first develop a strategic plan, he says.

Decide what you want your child to get out of TV and other viewing. Then select shows and games that meet that goal, he says.

Parents often tell Christakis they depend on television or other screen time activity to take a break and get tasks done, such as making dinner.

He suggests figuring out exactly how much time you need, then picking a high-quality program for the kids to watch.

"If you need 30 minutes to make dinner, find a high-quality 30-minute program," he says."Don't put in the 90-minute feature-length movie your kids have seen many times."

Parents who want their kids to watch less TV should watch less themselves, Birken says.

In a previous study, she found that children's screen time reflects parents' screen time.


Some children are overweight because they have big bones. See Answer

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SOURCES: Catherine S. Birken, MD, Hospital for Sick Children; assistant professor of pediatrics, University of Toronto. Dimitri A. Christakis, MD, MPH, George Adkins Professor of Pediatrics, University of Washington; director, Center for Child Health, Behavior, and Development, Seattle Children's Research Institute. Birken, C. Pediatrics, Nov. 5, 2012. American Academy of Pediatrics: "Where We Stand: TV Viewing Time." Tandon, P. Journal of Pediatrics, February 2011.

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