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Meet Dr Álvaro Bilbao, author of Understanding Your Child's Brain

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Dr Bilbao has published Understanding Your Child's Brain, which recommends parents ration or not allow screen time for children under six. He says devices with screens should ‘find their way into the child's hands gradually’ once they have developed emotionally and intellectually.
Dr Álvaro Bilbao
Dr Álvaro Bilbao

WHEN DID CHILDREN’S SCREEN USE BECOME OF INTEREST TO YOU?

I started to warn about screen use with children in 2012. In my experience as a neuropsychologist in brain injury rehabilitation, I’m aware of many different studies that demonstrate that computer-based rehabilitation for adults and children with intellectual disabilities has no beneficial effect. The reasons lie in the nature of human learning. We are designed to learn through human interaction. A recent study showed how brain connectivity reduces when children play with video games and increases when they are reading a book or playing with peers.

WHY DO YOU RECOMMEND RATIONING OR NO SCREEN TIME FOR CHILDREN UNDER SIX?

There are quite a lot of studies that show how screen time in pre-schoolers is associated with three main difficulties during childhood: deficits in attention span and sustained attention, and a higher prevalence of ADHD; difficulties in social interaction and a higher prevalence of autism spectrum disorders; and difficulties in executive control and higher prevalence of behavioural problems.

The American Pediatric Association recommends no devices for children under 18 months, while the Canadian Pediatric Association recommends no devices for children younger than two years old. I recommend age six because that is a crucial age in the development of certain areas of the brain – specifically, striatum – that are highly associated with the development of motivation, self-control and attention.

In my clinical practice I have seen over and over that children who love drawing or playing with regular toys start to lose interest in that kind of play when devices are given to them. Devices such as videogames, iPads or smartphones have a such rapid and intense interaction that any other stimulus becomes dull and boring for the developing brain.

HAS IT BECOME ACCEPTABLE FOR PARENTS TO GIVE CHILDREN DEVICES TO ENTERTAIN THEM?

I feel that all of us as a society have normalised the non-stop use of electronic devices in our lives. However, it is very likely we are not happier now than we were before 2009, when most people bought their first smartphone. Smartphones are very engaging but can create a certain amount of anxiety and can be addictive.

DO YOU THINK THERE IS A POSITIVE USE OF SCREENS FOR YOUNG CHILDREN?

Yes! It is great that children can use screens in order to learn and for entertainment. I do not think it is positive before the age of six, but we recommend children use technology in many different ways. For example, studies have shown that if children watch a movie about the Roman empire before studying the subject at school, learning will be easier for them. I love having children learn robotics or programming. My two girls, now nine and ten, watch YouTube videos and learn dance routines. We have family movie night every Friday and they watch TV when they have finished their homework and other duties. I would say we are a normal family, but we have clear rules about screen time.

WHAT ABOUT FOR CHILDREN WITH SPECIAL EDUCATIONAL NEEDS AND DISABILITIES?

Clinicians and special education teachers use these types of devices on a daily basis for children with hearing disabilities, autism and many other developmental disorders. I am using my computer to answer this interview, and we use technology on a daily basis. There is nothing wrong with technology. The problem starts when we use technology to entertain children whose brains are meant to learn through jumping, crawling, running, climbing trees, using their hands to put together Lego and mould playdough, or learn social skills through social interaction and face-to-face conversations. The first six years are precious, and taking time from doing all that wonderful stuff is not the most intelligent choice. I am a parent of three and I work with families on a daily basis. Real-life parenting includes sitting your three-year-old in front of the television for 15 minutes while bathing their newborn sibling. But children under six (or older) should not spend the afternoons playing with an electronic device or wait at the restaurant table watching Peppa Pig.

IS IT DIFFICULT FOR ADULTS TO LIMIT CHILDREN’S SCREEN USE WHEN THEY ARE MODELLING THIS BEHAVIOUR THEMSELVES?

That is the greatest handicap we might have. We have not set a good example. Children learn to yell if they watch parents yell. However, children also perfectly understand that adults can drive cars while they cannot drive cars. I believe we should just delay the age of electronic device usage until they are mature enough.

WOULD YOU SUGGEST CHILDCARE SETTINGS OPT AGAINST USING SCREENS WITH THE CHILDREN IN THEIR CARE?

Studies have shown that children learn best from physical books. University students learn better when taking notes on pen and paper than using a computer. However, we must understand times are changing. I would never recommend a school that uses traditional books to switch to computer-based books, but I have not recommended ever going back to the paper book when schools have started to use them. Screens in childcare settings are a good opportunity to teach children to be responsible with the time they spend on these devices.

One thing that most people find interesting is that many Silicon Valley CEOs send their children to a school where there is no usage of electronic devices. When presenting the iPad, Steve Jobs said his kids did not have a favourite iPad game because they had not used the device yet. He stated: ‘We limit how much technology our kids use at home.’ His children were 16 and 13 at the time of the interview in 2011.