Juliana Sanchez, 5, and her brother, Francisco Sanchez Jr., 2, watch children's programming on YouTube on their parent's cell phones at their home in Mountain House, Calif. 

Nine-year-old Ella Sprague reads three levels above her grade. She likes books and often reads to her parents, Rosie and Rylan Sprague of Spearfish.

The Spragues know it’s important to engage their children in educational activities like reading, and in a time of technological advancement, they monitor their children’s screen time and engage them in other activities.

“We’re really big on reading. Our number one thing we do with our children is read to them, or for our oldest daughter, have her read to us,” Rosie Sprague said. “We also play a lot of board games and put puzzles together.”

The Spragues also have a 2-year-old son, Nels. The family sets boundaries to when and how often their children can use electronic devices including TVs, iPads and computers.

“During the weekdays they probably watch about an hour a day of television, usually right after school,” Rosie Sprague said. “My daughter is the only one to use the iPad and she is usually on it for approximately 30 minutes a day.”

The Spragues limitations on screen time are something area pediatricians stress is important to a child’s development.

“When we think about screen time, it’s not about what the screen is doing to them in the moment, but what else could children be doing with their time,” said Dr. Tara Ulmer, pediatrician with Spearfish Regional Medical Clinic. “They are missing out on interactive time with their families and physical activity — running, jumping and playing. When we get kids in front of screens, it’s hard to pull them away.

Ulmer, along with Dr. Greg Anderson, pediatrician at Black Hills Pediatrics and Neonatology in Rapid City, said there is a direct correlation between the amount of time children spend on electronic devices and obesity, sleep deprivation and aggressive behavior.

“Some kids are watching eight to 10 hours of TV a day. It becomes the question which is the cart and which is the horse; is it TV or a lack of supervision for 10 hours a day,” Anderson said.

The more screen time children are exposed to, the higher risk of childhood obesity, Ulmer said.

“If you’re just sitting on the sofa, you’re fidgeting, but if you’re watching TV, you move less. You’re in a zone, kind of like a coma,” Anderson added.

Having a television or iPad on at night when a child is trying to sleep greatly affects the sleep cycle, as well. It affects their circadian rhythm, or the natural sleeping cycle.

“Hormones change when you’re awake and asleep,” Ulmer said. “That input comes from light exposure. When it’s light your body tends to be awake; when it’s dark, your body produces hormones that make you sleepy.”

The light from a television or other electronic device makes the body think it’s daytime and will not produce the necessary hormones to make a child tired, she added.

In addition to the risk of childhood obesity and sleep deprivation, increased screen time also leads to more aggressive behavior.

“It’s the negative things they are being exposed to during screen time, but it’s also because they aren’t learning to negotiate with their peers and other vital social skills,” Ulmer said. “You can watch those skills while watching TV, but it’s a huge difference between watching someone on TV and having that interaction with your peers.”

Anderson and Ulmer recommend less than two hours of screen time a day for children. That includes iPads, iPhones, television and other electronic devices.

“Even with shows and online games that are educational, they are better learning by hands on activities,” Anderson said. “No matter how interactive something is on the screen, it’s not the same as in real life.”

Many children learn early on how to unlock iPads and play games. However, for children younger than 2, Anderson recommends no television or screen time.

“No TV, no tablets, no iPhones,” he said. “There is nothing redeeming for a kid under 2 to watch TV. Even shows that are educational, a child is better off at learning through hands-on activities.”

The Spragues increase TV time to one to two hours a day and iPad time to one hour a day on the weekends, depending on what else the family has scheduled. But they monitor what electronic devices are being used for.

“We make sure that weekday iPad time is for schoolwork only — educational websites approved through the school,” Rosie Sprague said. “We monitor their time in front of the TV by activities that take us out of the house.”

Simple education also benefits children when they are using iPads and other devices, Ulmer said. She added it’s important for kids to have privacy, but screen time should happen in a public place so parents can easily monitor the time spent on a computer and the content being viewed.

“Have conversations about safety and what they are watching and being exposed to,” she said. “Kids often can stumble upon things they don’t mean to.”

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