Zone’in Workshops

Reviewing the impact of technology on child development, behavior, and academic performance.

• Infants watch 2.5 hours per day of TV; toddlers watch 4.5 hours per day TV
• Elementary children use 8 hours per day of combined technologies
• 30% of children will enter kindergarten developmentally delayed
• 14.3% of Canadian, and 13% of US children, have been diagnosed with a mental illness
• 30% of children are obese
• 20% of children require special education assistance

Impact Statement

The past decade has seen an increase in personal electronic technology, with childhood TV, internet, video game, cell phone and iPod use similarly increasing.  Critical milestones for child motor and sensory development are not being met, impacting on foundation skills for literacy and academic performance.  Simultaneously there is an increasing incidence of childhood physical, psychological and behavior disorders, often accompanied by the prescription of psychotropic medication.  Media violence is now been classed as a public health risk due to causal links to child aggression.  Research regarding technology’s detrimental effects on critical milestones for child development, behavior, and academic performance are reviewed. Considerations for parents, teachers, health professionals, government, researchers and technology production corporations related to these trends are outlined.  Suggestions are made for health and education professionals regarding implementation of school based technology management programs, and an Unplug – Don’t Drug policy.

Technology Use Overview

• Throughout most of human history child engagement in rough and tumble outdoor play and imaginary games resulted in the achievement of adequate sensory, motor and attachment development required for attention and learning (Ayres J 1972, Pelligrini A 2005, Tannock M 2008).
• Elementary aged children now average 8 hours per day using a combination of technologies (TV, video games, internet, cell phones and iPods), with total amount of exposure time averaging 11 hours per day. Two thirds of children report their parents do not restrict their access to technology, and 75% of these children have TV’s in their bedrooms (Kaiser Foundation Report 2010).
• ‘Baby TV’ now occupies 2.2 hours per day for the 0-2 year old population, and television occupies 4.5 hours per day for 3-5 year olds, and 6.5 hours per day for elementary aged children and is causally linked to developmental delays (Christakis D 2007).  This situation has prompted France to ban its broadcasters from airing TV shows aimed at children under three years of age (CBC News, 2008), and Disney to offer refunds for their “Baby Einstein” DVD’s (NY Times, 2009).
• 173 research efforts going back to 1980 were analyzed and rated, showing 80% of the studies showed a link between the following negative health outcomes and media hours or content: obesity, smoking, sexual behavior, drug use, alcohol use, low academic achievement and ADHD (Nunez-Smith M 2004, Zimmerman F 2007, Hancox R 2005, Murray J 2006).
• Each hour of TV watched daily between the ages of 0 and 7 years equated to a 10% chance of attention problems by age seven years (Christakis D 2004).
• Passive and active TV watching results in irregular sleep patterns and sleep/wake transition disorders (Paavonen E 2006).
• Canadian children were granted a “D” grade for inactivity in 2008 and an “F” in 2009 by Active Healthy Kids Canada, citing TV and videogames as the primary cause (Active Healthy Kids Canada 2008 and 2009 Reports).
• TV and videogame use accounts for 60% of childhood obesity, and is now considered a North American ‘epidemic’ (Tremblay M 2005, Strauss R 2001).
• American Physician, Pediatrician, Psychiatrist and Psychologist Associations in 2001 declared media violence a Public Health Risk, stating violence is the leading cause of death in children (Committee on Public Education – Media Violence 2001).
• Based on the ways in which the parent copes with the stresses of their own technology overuse, the parent consequently might raise their children in such a way as to result in either an avoidant, ambivalent, or disorganized attachment disorder. A study conducted in Beijing, China reports that adolescents with Internet Addiction Disorder consistently rated parental rearing behaviors as being over-intrusive, punitive, and lacking in responsiveness, indicating that the influences of parenting style and family function are important factors in the development of internet dependency (Xiuquin, 2010).

Developmental Delays and Obesity

• A joint study by the BC Business Council, and University of BC researchers with Human Early Learning Partnership showing that just under 30% of BC children entering kindergarten are “developmentally vulnerable” – lacking in those basic skills they need to thrive in school and in the future.  This study, entitled A Comprehensive Policy Framework for Early Human Capital Investment in BC states “Economic analyses reveal this depletion (in human capital) will cause BC to forgo 20% GDP growth over the next 60 years, costing the provincial economy a sum of money that is 10 times the total provincial debt load.” (Kershaw P 2009)
• American Physiotherapy Association reports two-thirds of over 400 members surveyed report they’ve seen an increase in early motor delays in infants over the past six years (Jennings J 2005).
• A 2006 Canadian study reported one in six children have a developmental disability with only 55-65% of developmental disabilities are detected prior to school age entry (Hamilton S 2006).
• Data from the 1988 National Health Interview Survey reported 17% of U.S. children had a developmental disability with 6% of child population having language impairment, 8% a learning disability, 7% ADHD and 0.5% Autism with 13.2% accessing special education assistance, resulting in 1.5 times more physician visits, 3.5 times more hospital days, twice the number of lost school days and a 2.5 fold increase in the likelihood of repeating a school grade compared to a non-developmentally disabled child (Boyle C 1994).
• The past decade has seen an unprecedented rise in numbers of referrals to occupational therapists for children with disorders such as printing and reading delays, attention and learning difficulties, and significant behavior problems, which has placed the occupational therapist under considerable workload management stress (Davidson & Bressler, 2010).
• One in five toddlers have speech and language delays associated with overexposure to television, and Dr. Sally Ward recommends improving quality and quantity of communication with parents to optimize speech and language acquisition (Ward S 2004).
• In Canada 1 in 165 children have been diagnosed with Autism (Autism Society of Canada, 2010), and in the US 1 in 110 children have Autism (Autism Society, 2010).
• 9% of US children age 8-15 years meet criteria for ADHD (Rapport M 2008).
• Sensory Processing Disorder affects 1 in 20 children www.SPDFoundation.net, 2009.
• A 2006 US study reported 32% of children admitted to inpatient pediatric ward demonstrated a developmental disability (Petersen M 2006).
• In 1996, 10% of Canadian children ages 7-13 years were obese, with estimated economic costs of 1.8 billion (Tremblay M 2002).  In 2004, just eight years later, this number is 50% higher with a prevalence of obesity at fully 30% of Canadian children (Statistics Canada, 2010).
• US study reports obesity incidence in 2 to 5 year old toddlers increased from 2.1% to 5.0% in boys and 4.8% to 10.8% in girls over a 6 year period (Harvey-Berino J 2001).
• Health care providers are finding more and more children with type 2 diabetes, a disease usually diagnosed in adults aged 40 years or older (Center for Disease Control and Prevention, 2010).
• Professor Andrew Prentice told the British Association’s science festival in Leicester that due to the secondary effects of obesity on child cardiovascular systems and potential for diabetes, the 21^st century generation may be the first generation to not outlive their parents (BBC News, 2002).
• Climbing obesity rates in European countries have lead a team of child health experts to recommend placing obese children in foster care, citing that parents of obese children are negligent in some way as to have indicated that the parents have caused their child’s obesity. By neglecting to identify child technology overuse as a causal link to obesity, these experts are subjecting whole families to what might be an unnecessary and uncalled for traumatic and catastrophic event (Vilner R, 2010).
• A boy who spent an entire day kneeling down playing computer games needed hospital treatment for a blood clot in his leg (BBC News, 2004).

Psychological Disorders and Psychotropic Medication

• Recent changes from a ‘categorical’ to a ‘dimensional’ model in the upcoming Diagnostic and Statistical Manual, Fifth Edition to be released in May of 2013, has opened the flood gates for increasing diagnosis of children with mental disorders, reports Dr. Allen Frances, who was chair of the DSM-IV Task Force and of the department of psychiatry at Duke University School of Medicine in North Carolina (Psychiatric Times, 2009). Dr. Francis states that this paradigm shift is premature, as there is not even one biological test ready for inclusion in the criteria sets for DSM-V. With increasing numbers of experts in the field of child psychiatry now questioning whether there even is a biological component in child mental illness (Breggin P, 2008), it seems pertinent to investigate environmental causes for the incremental rise in child mental and behavioral diagnoses.
• Recent studies document a rise in psychological disorders in children reporting increasing incidence of ADHD, autism, bipolar disorder, depression and anxiety (Zito J 2001, The Well-being of Canada’s Young Children Report 2003, Mental Health: A Report of the Surgeon General, Overview of Mental Disorders in Children, Mental Health in the United States: Prevalence of Diagnosis and Medication Treatment for ADHD, Center for Disease Control and Prevention 2003).
• 2007 mental illness statistics for children in Canada show that 14.3% of children have a diagnosed mental health disorder with anxiety disorders 6.4%, ADD or ADHD 4.8%, conduct disorders 4.2%, depressive disorders 3.5%, substance abuse 0.8%, autism spectrum disorders 0.3%, obsessive compulsive disorders 0.2%, eating disorders 0.1%, schizophrenia 0.1%, bipolar disorder <0.1% (Waddell C 2007).
• 13% of respondents ages 8 to 15 years of age who participated in the National Health and Nutrition Examination Survey reportedly met criteria for at least one of the following mental health disorders in the past year: generalized anxiety disorder, panic disorder, eating disorders, depression, ADHD, and conduct disorder (National Institute of Mental Health, 2009).
• There are no reliable, valid, or replicable studies showing genetic evidence for any psychiatric disorders, including ADHD, Autism, bipolar disorder, schizophrenia, depression or anxiety (Joseph J 2003, Baughman F 2009).
• Yet – in a study of 491 physicians in Washington D.C., almost half of the diagnoses of ADHD in their patients had been suggested first by teachers (Sax L 2003).
• Teachers have taken on the role of “disease spotters” and “sickness brokers” for ADHD, as pharmaceutical companies escalate their infiltration of the school system (Phillips C 2006).
• People who report they are not happy watch over 30% more TV hours per day than people who report they are happy (Robinson J 2008).
• Television exposure and total media exposure in adolescence are associated with increased odds of depressive symptoms in young adulthood, especially in young men (Primack B 2009).
• Behaviors associated to technology overuse may be confusing for parents, teachers and physicians, and could be easily misunderstood, possibly resulting in psychiatric diagnosis and prescription of psychotropic medication (Ruff M 2005, Diller L 1999, Welch M 2006, Mukaddes N 2000).
• Dr. David Stein reported at the International Center for the Study of Psychiatry and Psychology conference in October 2009 that 32% of children ages 0-18 years covered by Blue Cross insurance are currently on psychotropic medication (Stein D 2009).
• Between 1991 and 1995, prescriptions for psychotropic medications in the 2 – 4 year old toddler population, as well as in children and youth tripled (Zito J 2000, 2003, Mandell D 2008).  80% of this medication was prescribed by family physicians and pediatricians (Goodwin R 2001).
• 28-30% of children receiving psychotropic medication are on multiple medications, with minimal knowledge regarding drug interactions or long term toxicity (47).
• Study performed by researchers from the Government of Western Australia, Department of Health, report reduced academic performance and increased risk of heart malfunction in children who receive ADHD medication. “We found that stimulant medication did not significantly improve a child’s level of depression, self perception or social functioning and they were more likely to be performing below their age level at school by a factor of 10.5 times.” Prof Landau said the study also suggested that a child’s heart function may be affected by long-term stimulant use and may remain affected even after stopping medication (Raine ADHD Study).
• A comparative study of children diagnosed with ADHD who were on stimulant medication showed a 10% decrease in growth rate when contrasted with children diagnosed with ADHD who were not receiving stimulant medication (Swanson, Elliot, Greenhill, Wigal Arnold & Vitiello, 2007).
• Limited high quality evidence guiding appropriate dosing and inexperience in documentation of long term effects of these prescriptions in children may mean that these children undergo unquantified risks (dosReis S 2005, Rosack J 2003, Kirsch I 2004, Thomas C 2006).
• Dr. Peter Breggin reported at the International Center for the Study of Psychiatry and Psychology conference in October 2009 that ADHD medication causes permanent neurotransmitter changes due to receptor down regulation, resulting in depletion of the transmitter the drug was originally designed to increase.  New psychotropic medication molecular structure has added fluoride and chloride ions to improve long acting ability, which are proven to be toxic with long term (> 4 months) administration to cell mitochondria causing eventual cell death.  ADHD medication results in growth retardation and 20% brain shrinkage, appetite loss, 50% depression, 50% Obsessive Compulsive Disorder, Tardive Dyskinesthesia, and alcohol and cocaine abuse. Psychotropic medication decreases spontaneity and increases obsessive compulsive disorder, two traits which are ALWAYS interpreted as “improvement” by the educational system (Breggin P 2008).
• Research regarding stimulant medication with children is rife with conflict.  Studies have low validity and reliability ratings, and findings can rarely be replicated.  Clinical trials are generally small in sample size (30-40 children), and on children older than FDA approved regulations, resulting in prevalent “off label” prescribing.  Clinical trials are conducted for no longer than 4-8 week periods, which is insufficient to document any toxicological side effects, and authors state “Neither the long-term effectiveness nor the long-term safety of stimulant medications has ever been demonstrated”. (Jensen P 2002)
• Three year follow-up of treated ADHD subjects showed increases in heart rate, and/or systolic and diastolic blood pressure in 20% of children taking stimulants for ADHD (Winterstein A 2009).

• Health Canada warns that Atomoxetine (Strattera), a drug commonly used to treat ADHD disorder in children, has been linked to 189 reported adverse reactions as of December 31, 2007, including 55 suicide attempts of which 43 were among children between the ages of 6 and 17 (CBC News 2008).
• Two world-renowned Harvard child psychiatrists Dr. Joseph Biederman and Dr. Thomas Spencer, whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children, found in a 2006 study increased prevalence of adult ADHD and call for increased detection and treatment (Kessler R 2006).  Senator Charles E. Grassley implicated these same researchers in payments of $1.6 million of unreported income from pharmaceutical corporations over a 6 year period (New York Times 2008).
• Although “off label” marketing of psychotropic medication and suppression of negative results of drug trials are illegal, they are widely accepted practices by pharmaceutical companies (Bass A 2008). Researcher concerns regarding the correlation between stimulant use and cardiovascular risk in children, (Vitiello, B. & Towbin, K. 2009), indicates immediate attention be directed to nonpharmalogical behavior interventions for the treatment of child behavior and learning disorders.
• Child behavior diagnoses and subsequent use of psychotropic medication may be a result of technology overuse, resulting in the development of a novel “Unplug – Don’t Drug” policy initiative and routine technology screening (Rowan C 2010).
• School management difficulties with increasing numbers of aggressive children, is resulting in the rising use of physical and chemical restraints (Irwin M 2009), as well as the rising use of seclusion rooms (Vancouver Sun 2010).
• A systematic review of children with autism and physical exercise showed decreases in stereotypy, aggression, off-task behavior, and elopement (Lang, 2010).
• Studies have shown that access to “green space” for 20 minutes per day significantly reduced ADHD symptoms, yet drug use continues to climb.  Inner city children suffer from ADHD at three times the rate of children in rural areas (Kuo F 2004).

Missing Critical Factors for Child Development

• In primitive times, human beings engaged in physical labor, and sensory stimulation was natural and simple.  Rapid advances in technology and transportation have resulted in a physically sedentary society with high frequency, duration and intensity of sensory stimuli (Nelson M 2006).
• These environmental changes are faster than human being’s ability to adapt and evolve.  Children who immerse themselves in virtual reality may exhibit signs of sensory deprivation, as they become disconnected from the world of physical play and meaningful interactions (Tannock M 2008).
• Canadian parents spend an average 3.5 minutes per week participating in meaningful conversation with their children (Turcotte M 2006).
• Overuse of TV and video games may result in children lacking essential connection with themselves, others and nature.  Child now fear nature, limiting outdoor play which is essential for achieving sensory and motor development (Louv R 2005).
• Three critical factors for healthy physical and psychological child development are movement, touch and connection to other humans (Insel R 2001, Korkman M 2001).
• Developing children require 3-4 hours per day of active rough and tumble play to achieve adequate stimulation to the vestibular, proprioceptive and tactile sensory systems (National Association for Sport and Physical Education 2002).  This type of sensory input ensures normal development of posture, bilateral coordination and optimal arousal states necessary for attainment of printing and reading literacy (Schaff R 2007, Braswell J 2006, Rine R, 2004).
• Scottish study reports toddlers aged 3 years engaged in only 20 minutes per day of moderate to vigorous physical activity, which correlated with a decline in total energy expenditure and sedentary behavior.  Study identifies TV, video games, strollers as “culprits” (Reilly J 2004).
• Infants with low tone, toddlers failing to reach motor milestones, and children who are unable to pay attention or achieve basic foundation skills for literacy, are frequent visitors to pediatric physiotherapy and occupational therapy clinics. Infant flat head has increased 600% in the past 5 years (Jennings J 2005).
• The ability of the 21^st century child to socialize with both adults and peers is deteriorating at a rapid pace. Sally Ward, a professor of speech and language pathology reported in her book “Baby Talk “ that one in five toddlers demonstrate speech and language delays (Ward S 2004).
• Dimitri Christakis, pediatric researcher at Children’s Hospital and Regional Medical Center in Seattle, reports that children learn language skills largely from verbal interactions with their parents. In his recent 2009 study where he used digital recorders on both parents and children in their homes, Dr. Christakis found that adults typically utter approximately 941 words per hour, yet these adult words are almost completely eliminated when television is audible to the child. Dr. Christakis found that each hour of audible television was associated with significant reductions in child vocalizations, vocalization duration, and conversational turns. On average, each additional hour of television exposure was also associated with a decrease of 770 words the child heard from an adult during the recording session. Since 30 percent of American households now report having the television always on, even when no one is watching, researchers report these findings have grave implications for language acquisition and therefore perhaps even early brain development (Christakis, 2009).
• Injury accounts for 40% of all childhood death, but – environmental modifications reduce 50-75% of injuries and therefore playgrounds can be designed to be safe (Howard A 2010).
• Canadian Standards Association (www.csa.ca) sets rules for playgrounds and if followed, halves the injury rate. Safe Kids Canada (www.safekidscanada.ca) has a number of resources and information (Howard A 2005).
• U.S. Consumer Product Safety Commission has published detailed guidelines for playground safety, which specifically address requirements for raised play platforms and protective playground surfaces. CPSC has produced a handbook for public playgrounds and a playground safety checklist (U.S. Consumer Product Safety Commission).
• Risk factors for severe playground injuries are associated with falls from playground equipment. Majority of playground injuries are sustained when falling from heights greater than 1.5 meters onto inadequate falling surface (MacArthur C 2000).
• The use of safety restraint devices such as infant bucket seats and toddler carrying packs and strollers, have further limited movement, touch and connection, as have TV and videogames.
• A comparative study of two different types of neonatal infant care: the use of a ‘kangaroo care’ where the infant was carried in a pouch-type device at all times by the caregiver optimizing skin-to-skin contact, and the use of traditional incubators concluded that kangaroo care had a significant positive impact on the infant’s perceptual-cognitive and motor development and on the parenting process, and speculated that kangaroo care has both a direct impact on infant development by contributing to neurophysiological organization and an indirect effect by improving parental mood, perceptions, and interactive behavior (Feldman, R 2002).
• Adequate tactile stimulation is integral to optimizing infant and child development, and subsequently many factors can cause abnormal development of the tactile system. Dr. Ann Bigelow, pediatric researcher at St. Francis Xavier University, Nova Scotia found that skin-to-skin tactile stimulation between mother and infant was shown to reduce gurgitation, improve sleep, and improve overall growth, as well as enhance infants’ sensitivity to their mother which accelerates knowledge about, and expectations for, her behavior (Bigelow, 2006).
• The ability of a child to adapt to sensory responses in their environments emerges early in life as a protective and discriminative mechanism, and as children grow they typically become better at tolerating uncomfortable sensory stimuli by applying strategies to self regulate. Sensory over-responsivity reflects a failure to achieve a balance between sensitization and habituation, and can affect many aspects of a child’s life in both home and school settings. A study long term study looked at infants with sensory over-responsivity when they entered the school system and found that early sensitivities were associated with sensory over-reactivity status at school-age (Ben-Sasson, 2010).
• Study investigating sensory over-responsivity in children with ADHD shows substantiated links between sensory over-responsivity and anxiety, in both typical and ADHD children. Results suggest that ADHD should be considered in conjunction with anxiety and sensory responsivity; both may be related to bottom-up processing differences, and deficits in prefrontal cortex/hippocampal synaptic gating (Lane, S 2010).
• Sixty nine percent of the boys with ADHD were categorized as tactile defensive (Parush 2007).
• Following touch therapy, children with Autism showed decreased touch aversion, off task behavior, orientation to irrelevant sounds, and stereotypic behaviors compared to a control group of children with Autism who sat on researcher’s lap and were read a book. The touch therapy group also improved more than the control group in stereotypic behaviors and orientation to irrelevant sounds. The authors suggest the effectiveness of touch therapy might be related to changes in vagal tone and/or EEG patterns (Field T 1997).
• Children with photosensitivity have increased risk of epilepsy when using video games or other high speed visual technologies (Singh R 2004 and Kasteleijn-Nolst Trenite DG 2002). Children with Autism frequently exhibit photosensitivity (Baron-Cohen S 2010).
• Many of today’s parents perceive outdoor play is ‘unsafe’, even though most crimes against children are instigated by family members (Burdette H 2005), limiting essential developmental components usually attained in outdoor rough and tumble play.
• Dr. Montagu reports that when children lack touch and human connection, they may respond by ‘turning in’ (anxiety, depression) or ‘turning out’ (aggression) (Montagu A 1972).

Academic Performance

• Students with greater than 15 minutes per day of recess had teacher reports of better classroom behavior.  30% of 3^rd graders had little or no recess (< 15 minutes per day) and 40% of schools surveyed had cut back at least one daily recess period. Since the 1970’s, children have lost 12 hours per week in free time (Barros R 2009).
• There is a positive correlation between physical activity and seven categories of cognitive performance: perceptual skills, intelligence quotient, achievement, verbal tests, math tests, developmental level, and academic readiness.  Studies show that a reduction of 240 minutes per week of academic class time, replaced with increased time for PE, led to higher math scores.  Adding PE time alone does not improve grades, it’s vigorous exercise that improves cognition e.g. climbing walls, exercise bikes, tread mills, dancing (Ratey J 2008).
• In 1994 and 2003, comparative literacy studies of Canada, Germany, the Netherlands, Poland, Sweden, Switzerland and the United States were completed covering four literacy domains – prose (reading and  understanding text information e.g. stories, editorials), document (locating text information e.g. maps, schedules), and numeracy (understanding math embedded in text e.g. weather and loan interest charts) and problem solving. Participants were ranked on five levels, with level one being the lowest.  15% of Canadians scored in level one, and only 50% reached level three.  Canadians scored in the middle of the pack, and results were the same for 1994 and 2003 (Sloat E 2000).
• More than eight million students in grades 4-12 read below grade level, and while they can decode, they cannot comprehend what they read.   Between 1971 and 2004, the reading level of America’s 17 year olds showed no improvement at all.  40% of high school graduates lack the literacy skills employers seek.  Early exposure to print is largest predictor of reading ability (National Center for Education Statistics 2005).
• Literacy is defined as competency in handwriting, reading and communication skill. A foundation in spoken language competence in the early years, is important for the successful achievement of literacy, academic and social competence. Printing is a precursor to reading and speech fluency, and poor handwriting skill is related to language disorders.  Motor planning required for automatic letter production when printing “maps” the sensorimotor cortex for eventual visual letter recognition for reading, and word finding for oral sentence production (Shanahan T 2007, Goldberg E 1999, Tomblin B 2006).
• A US study by Steven Graham reports that 90% of US primary school teachers college education did not adequately prepare them to provide lessons in penmanship, and therefore do not devote much time to teaching printing. Teachers spend an average 14 minutes per day teaching handwriting, far less than the 45 minutes per day spent in the 60’s and 70’s, and slightly less than the 15 minutes per day mandated in the 80’s. Textbooks offer less information on teaching printing, and universities have less instruction. Handwriting teaching methods and methods for student evaluation are inconsistent and non-standardized. 100% of the 169 primary teachers who participated in this study reported they thought printing should be taught as a separate subject (Graham S 2008).
• Another study by Graham documents that in 1996 70% of teachers indicated that handwriting was “not as good as it should be”, and expressed concern regarding the “downward plunge in the standards of handwriting legibility required of elementary school children”. Authors also state that students who have difficulty with automaticity of writing, thus achieving poor quality and quantity of written output, results in avoidance and minimization of the writing process. Authors state that for beginning writers, both visual and verbal modeling appears to be the most effective means of introducing a letter prior to practice i.e. the teacher demonstrates how a letter is made while describing how it is formed (Graham S et al 1993). Graham goes on to report in 2000 study how poor ability to produce quality and quantity of written output can result in a long term disability in written expression (Graham S et al 2000).
• In Steven Graham’s 2006 book Handbook of Handwriting Research, this meta-analysis concludes that printing strategy instruction is effective in improving student’s writing performance in the areas of quality, elements, length, and revisions, with results maintained over time and generalized to new tasks and situations.
• Steven Graham’s 2007 book Best Practices in Handwriting Instruction draws the correlation between poor printing and subsequent difficulty with spelling, sentence composition, math, science and any subject requiring printing skill. Graham states “Failure to develop legible and automatic letter and word formation interferes with content in writing.” and “Because of the excessive labor and unattractive results involved in such writing, students are more likely to avoid or minimize the process when possible”. Graham instructs that for beginners, both visual and verbal modeling is the most effective means of introducing a letter prior to practice.
• Yet – whole school districts are moving rapidly toward both virtual teaching and virtual therapy.  Referred to as the “$100 curriculum in a box”, TeacherMates and XO’s are replacing teaching, referencing the teacher as a “moderator” (Fast Company, April 2010).
• Rowan, C. 2007. Children who cannot print are essentially illiterate.  Teacher misperception that the computer will replace the need to print, is unfounded and shortsighted.  Slow printing speed resulting from inadequate teaching of letter and number formation, impacts on every subject and is the leading cause of illiteracy (Rowan C 2007.
• Comparative study of digital (screen) reading vs. print reading reports the following problems with screen reading:
  • Attention: clicking and scrolling disrupt attention and disturb mental appreciation
  • Comprehension: reader lacks both completeness and constituent parts
  • Memory: change in physical surroundings has a negative effect on memory
  • Learning: doesn’t allow required time and mental exertion
  • Meaning:  isn’t a physical dimension, loss of totality

Mangen Quote: “The digital hypertext technology and its use of multimedia are not open      to the experience of a fictional universe where the experience consists of creating you           own mental images.  The reader gets distracted by the opportunities for doing something      else” (Mangen A 2008).

• Every additional hour of TV exposure at 29 mo. Corresponded to 6% unit decrease in classroom engagement, 7% unit decrease in math achievement, 10% unit increase in victimization by classmates, 13% decrease in time spent doing physical activity, and 10% higher consumption of soft drinks and snacks (Pagani L 2010).
• ADHD should be re-termed “attention inconsistency”, as these children have episodic attention ability.  Attention Restorative Theory has three tenants: 1) attention ability is subject to fatigue and restoration 2) voluntary and interesting tasks are less fatiguing than involuntary and uninteresting tasks 3) attention ability is subject to environment modifications (Kaplan S 1995).
• Each hour of TV watched daily between the ages of 0 and 7 years equated to a 10% chance of attention problems by age seven years (Christakis D 2004).
• Viewing TV and playing video games each are associated with increased subsequent attention problems in childhood (Swing, 2010).
• Passive and active TV watching results in irregular sleep patterns and sleep/wake transition disorders (Paavonen E 2006).
• Dyslexia can be artificially induced by teaching whole word method reading, and cured by teaching phonic reading (Blumenfeld S 1995).
• Exposure to “green space” results in a significant reduction in ADHD, in both areas of impulse control and attention ability.  Nature not only has attention restorative benefits, but also activates all the senses to enhance multi-sensory learning ability (Faber-Taylor A 2001, Kuo F 2004).

Declining Empathy, Media Violence and Aggression

• A 2010 University of Michigan study shows today’s college students are 40-per-cent less empathetic than those of the 1980s and 1990s determined by an analysis of the past 30 years of students who participated in the Davis Interpersonal Reactivity Index which looked at empathic concern, emotional response to the distress of others, and “perspective-taking” or the ability to imagine another person’s perspective. This study cites the influx of callous reality television shows and the growth of social networking and texting as causal factors for the decline in empathy in today’s young people (Globe and Mail, 2010).
• Violent media is a public health threat. A review of 50 years of research on the impact of violence in TV, movies, videogames and internet concludes that watching media violence significantly increases the risk that a viewer or videogame player will behave aggressively in both the short and the long term. 60% of TV programs contain violence and 40% contain heavy violence.  Most videogames contain violence.  Video game ratings are a poor indicator of content and constitute conflict of interest, as the rating process is performed by the video game industry.  Authors state the impact of violent electronic media on public health is second only to the impact of cigarette smoking on lung cancer (Huesmann L 2007).
• In the short term, media violence can increase aggression by priming aggressive thoughts and decision processes increasing physiological arousal, and triggering a tendency to imitate observed behaviors.  In the long-term, repeated exposure can produce lasting increases in aggressive thought patterns and aggression-supporting beliefs about social behaviors, and can reduce individuals normal negative emotional responses to violence (Anderson C 2003).
• Studies regarding the effects of violent video games on children found even violent cartoons increased aggression in 9-12 year old children.  Violence is defined as doing intentional harm to another, not how graphic or gory the game is.  Increased exposure to violent videogames results in more pro-violent attitudes, hostile personalities, less forgiveness, belief that violence is typical, and causes children to behave more aggressively in their every day life (Anderson C 2007).
• Young children are most vulnerable to media violence as they are more impressionable, can’t distinguish between fantasy and reality, cannot discern motives for violence, and learn by observing and imitating (Buchanan A 2002).
• Recent incidents of growing child aggression against other children and school staff members have been reported in the press to have doubled in the Vancouver School District in the past three years (Vancouver Sun, 2010). School management difficulties with increasing numbers of aggressive children, is resulting in the rising use of physical and chemical restraints (Gaskin, 2007; Muralidharan & Fenton, 2009), as well as a rising use of seclusion rooms (Vancouver Sun 2010; Muralidharan & Fenton, 2009).
• Tyrone Spellman, 27, played long hours on his Xbox, so when his 17-month-old daughter pulled on some cords and tipped the Xbox to the ground, breaking it, he become completely enraged.  He struck her with such force that it “cracked her skull several times.”  The autopsy too, revealed a broken arm that was at least two weeks old which social workers had failed to identify previously (CBS News, 2008).

Cyberbullying

• Survey of 3,767 grade 6, 7, 8 students who attended six schools in the US found 11% had been electronically bullied and 4% indicated they had bullied a victim in the past month.  Half of the electronic bully victims reported not knowing the perpetrator’s identity (Kowalski R 2007).
• Youth who reported being harasses online were 8 times more likely to carry a weapon to school in the past 30 days (Ybarra M 2007).
• While online cyberbullying occurs off campus, resulting altercations happen on site (Willard N 2007).
• Internet bullying is correlated with school behavior problems, and media literacy programs may mitigate the negative effects of electronic media on youth (Worthen M 2007).

Technology Addiction Prevalence

• A German nationwide survey in 2007 and 2008 of 44,610 ninth graders indicates that 3% of male and 0.3% of female students were diagnosed as Video Game Dependent accompanied by increased levels of psychological and social stress in the form of lower school achievement, increased truancy, reduced sleep time, limited leisure activities, and increased thoughts of committing suicide (Rehbein, Kleimann & Mobie, 2010).

• A Harris Interactive Poll in the US release in April 2007 found that 8.5% of youth gamers could be classified as “pathological” or “clinically addicted” to playing video games.  A British survey of gamers indicated 12% reported being “addicted”. 2.4 % of South Korea from ages 9 – 39 have video game addiction according to a government funded survey.  Another 10.2% were found to be borderline cases at risk of addiction.  Addiction was defined as an obsession with playing electronic games to the point of sleep deprivation, disruption of daily life and a loosening grip on reality, depression and with drawl when not playing.  10 South Koreans died in 2005 from disruption in blood circulation caused by prolonged use.  S. Korea has government funded counseling and clinics for gamers. Most addictive video games are the MMORPG’s massively multiplayer online role playing games (Washington Post 2006).
• Difficulty identifying feelings, higher dissociative experiences, lower self esteem, and higher impulse dysregulation were associated with higher incidence of internet addiction (DeBerardis D 2008).
• ADHD was the most associated symptom of Internet Addiction, followed by impulsivity (Yen J 2008).
• Internet addicts are lonelier and have lower self-esteem and poorer social skills than moderate users (Ghassemzadeh L 2008).
• Video game addiction can be statistically predicted on measures of hostility and poor academic achievement (Shao-I C 2004).  12% of boys and 8% of girl video game players exhibit pathological patterns of play, and fit the DSM IV category of addiction.  Study also showed that pathological gamers are twice as likely to have ADD or ADHD (Gentile D 2009).
• An internet-obsessed Korean couple allegedly allowed their infant daughter to starve to death while they cared for their virtual child (Telegraph, UK, 2010).
• Xiao Yi was thirteen when he threw himself from the top of a twenty-four story tower block in his home town, leaving notes that spoke of his addiction and his hope of being reunited with fellow cyber-players in heaven. The suicide notes were written through the eyes of a gaming character (Play TM News, 2005).

Costs of Child Technology Overuse to the Canadian Health and Education Sectors

• Extrapolation from previously cited research indicates estimated annual costs to the Canadian health care system to support children with developmental disabilities, psychiatric and behavioral disorders are $9.3 billion, obesity are $3 billion and medication costs are $0.3 billion, totaling $12.5 billion. 
• Estimated annual costs to the Canadian education system for failing literacy are $10 billion, and educational support of children with developmental disabilities are $13 billion, totaling $23 billion. 
• In summary, the total annual costs to the Canadian health and education sectors to address problems that strongly correlate with child technology addictions are $35.5 billion.

Considerations and Recommendations

• In 2001 the American Academy of Pediatrics issued a policy statement recommending that children less than two years of age should not watch any TV or videogames (Children, adolescents and television. Committee on Public Education, AAP 2001), and further recommended that children older than two should restrict usage to one hour per day if they have any physical, mental or social problems, and two hours per day maximum if they don’t (Children, adolescents and advertising. Committee on Communications, AAP 2006).
• Further evidence suggests some parents may have technology addictions (Horvath C 2004), and Adult Internet Addiction has been proposed for inclusion in the Diagnostic and Statistical Manual 5th Edition (Block J 2008).
• Mounting research evidence suggests that childhood is the optimal time to influence determinants of social and emotional wellbeing (Willms J 2002), with recent research demonstrating that prevention programs in childhood can reduce the prevalence of mental disorders, while also addressing causal factors.  For example targeted parent training within disadvantaged families can significantly reduce subsequent prevalence of behavior disorders in children, while also improving educational and social outcomes (Waddell C 2007).
• These facts support implementation of school based technology management programs, teaching children how to balance activities they need to grow and succeed, with technology use.  A randomized controlled trial of a 6-month classroom curriculum to reduce TV and video game use resulted in not only statistically significant reduction in technology use, but also showed relative decreases in obesity (Robinson R 1999).
• With researchers advocating for increased services for children to address increasing prevalence of child mental health disorders (McEwan K 2007), and solid evidence that many of these disorders may be related to technology overuse, it seems warranted that the medical profession may want to consider an Unplug – Don’t Drug policy where prior to costly diagnosis and medication of child behavior, the child and family undergo a three month technology unplug trial.  Alternatively, the medical profession may consider routine technology usage histories for all their clients.

Biography

Cris Rowan is a well known speaker on the topic of the impact of technology on child development and academic performance, providing over 200 workshops to health and education professionals throughout North America.  Cris has BSc’s in occupational therapy and biology, and is a SIPT certified sensory specialist.  Cris is CEO of Zone’in Programs Inc. offering products, workshops, training and consultative services to reverse the effects of technology on child development.  Cris is author of the following policy initiatives: Unplug – Don’t Drug, Creating Sustainable Futures and Linking Corporations to Communities. Cris’s forthcoming book Virtual Child – The terrifying truth about what technology does to children will released in October, 2010.

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