The past decade has seen an increase in personal use of electronic technology, with childhood television and video game use similarly increasing. Critical milestones for child motor and sensory development are not being met. Simultaneously, there is an increasing incidence of childhood physical, psychological, and behavior disorders, often accompanied by the prescription of psychotropic medication. One in six children exhibit signs of poor health, mental stress, or problems at school. Exposure to an average of 8 hours per day of various forms of technology use has resulted in a physically sedentary yet chaotically stressed existence for Canadian children. The detrimental effects of technology use on critical milestones for child development are reviewed. This commentary by a pediatric occupational therapist outlines issues of concern for parents, family physicians, and pediatricians related to these trends and offers a novel treatment approach: Unplug - Don't Drug.
Keywords: developmental delay; child behavior management; technology addictions; overmedication of children; balanced technology management
A 7-year-old boy was brought to his family physician's office by his mother at the urging of his school. In attendance was his four 4-year-old sister. Discussion with the boy's mother indicated that although his reading was at age level, the boy apparently had great difficulty producing school work and listening or paying attention in class and was reportedly "disruptive" and "aggressive." The mother stated that her son had few friends, preferring instead to spend his time alone in his room watching television or playing video games. Initial assessment indicated that the son appeared pale with dark circles under his eyes, slightly obese, lethargic, and noncommunicative. Following a short period of questioning, the son became confrontational and combative with both the physician and his mother, abruptly leaving the physician's office and returning to the waiting room. As the mother began to apologize for her son's behavior, the physician began to take notice of the boy's 4-year-old sister, who was positioned behind the mother. When questioned regarding her daughter's health, the mother responded that the daughter frequently became upset and demonstrated high anxiety when experiencing normal everyday events. The mother went on to report that her daughter woke frequently in the night "screaming," was overly sensitive to noise and light, and appeared to be "hooked" on cartoons- watching up to 6 hours per day.
CHILD HEALTH AND ACADEMIC PERFORMANCE
It wasn't all that long ago that children were brought to their family physicians for fractures or lacerations sustained from falling out of trees or off bicycles. Today's office visits are different. Physicians are now assessing and treating a variety of physical, psychological, and behavioral disorders in children that appear to be escalating at an alarming rate. One in six Canadian children have a diagnosed developmental disability (Hamilton, 2006), one in six are obese (Canadian Institute of Health Research, 2004), and 14.3% have a diagnosed psychiatric disorder (Waddell Hua, Garland, DeV, & McEwan, 2007). School-based occupational therapists observe increasing referrals of students to family physicians by their teachers for either attention impairments or learning difficulties. Subsequent child behaviors associated with these problems may be confusing for parents and teachers as well as the medical community and could be easily misunderstood, possibly resulting in psychiatric diagnosis and prescription of psychotropic medication (Mandell et al., 2008; Mukaddes, Bilge, Alyanak, & Kora, 2000; Ruff 2005). Between 1991 and 1995, prescriptions for psychotropic medications in the 2- to 4-year-old toddler population, as well as in children and youth, tripled (dosReis et al., 2005; Goodwin, Gould, Blanco, & Olfson, 2001; Zito et al. …