Exploring ten myths and facts regarding child mental illness origins and treatment Prior to the Covid-19 pandemic, research studies documented an alarming rise in child and youth mental illness. The long-term effects of imposed isolation of families and removal of family support networks are largely unknown, but early reports during the Covid-19 pandemic indicate an […]
Video games are a ubiquitous form of entertainment in today’s children and youth, and while fun and exciting, video games have a dark side that parents, teachers and clinicians can no longer afford to ignore. The recent rise in mass killings by gun, knife and moving vehicles, has wrongly focused on gangs and gun control as a primary intervention. Society would be wise to shift attention toward understanding the underlying components of a mass killer. While there are likely multiple factors contributing to the origins of mass killers, we do know that all shooters are gamers, and that gangs use video games to practice the art of shooting. Immersion in a virtual reality of violence has profound impact on developing brains, highlighting the urgency in looking at what type and how much violent media our children are exposed to, and at what age. Regarding brain and body development, what children do determines who they become. Children who excessively engage in mindless, fast paced, violent media content, will have a much different brain and body than a child who plays outside in nature. The new generation video games contain substantial amounts of increasingly realistic representations of physical and sexualized violence. The mature nature of such games is not suitable for children under the age of eighteen, yet many children I work with are playing violent, mature content as young as age 3. Managing video game use by children is not easy, but well worth considering with reference to the negative ramifications of gaming overuse on child health and wellness. Three parameters are important to consider in video game management: duration, content, and age of first exposure. Children who start gaming later in childhood, and who follow expert guidelines for game duration and content (see below), will demonstrate less negative effects. Whereas children who play fast paced, violent video games for long periods, and who start gaming as a young child, will exhibit a greater number of below noted negative effects. It is advised that children who experience 3 or more of the following escalating conditions should work with their parents, physician and/or therapist to reduce video game duration, change to non-violent content, and quit violent gaming altogether if < 12 years of age. This is a hard step for most parents to take, and an even harder step for parents with children exhibiting adverse effects of video games. Parents cannot continue to look away from these potential or real problems in their children. What we resists, persists; what we look at, disappears.
- Physical Harm
When children are gaming their bodies are sedentary and their hearts and brains overstimulated, causing significant physical harm. Developing bodies crave movement, yet video games entrance and hypnotize the brain into telling the body to sit still, often for very long periods. Psychiatrist Dr. Victoria Dunckley author of “Reset your child’s brain” reports that when children play video games, their sympathetic nervous system responds with a hyperarousal state of “flight or fight” characterized by adrenalin release from adrenal glands and dopamine production in the brain. We know that sustained high blood pressure and increased heart rate from prolonged gaming, increases risk for heart attack and stroke in later years. A child who plays video games who is also taking stimulant medication for adhd, or a gaming child who is physically unfit, increases their risk for eventual heart attack and stroke. In over 30 years as a pediatric occupational therapist, I have observed rapid escalation in prescription of stimulant medications to incredibly unfit children who refuse to participate in PE or outdoor activities. Causal factors for video game induced hyperarousal are fast paced and violent content, bright lights, rewards, multitasking, and interactivity. Long term high adrenalin stress states can result in chronic adrenal fatigue, implicated in a number of physical illnesses including cancer and autoimmune disorders.
Question: Is your child physically healthy?
To Do: More green time, less screen time. Only allow screens if homework finished and kids have played outside for at least one hour after school. Get out the bikes; do more family-based activities.
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- Brain Damage
To achieve functional efficiency during brain development, the brain prunes or cuts away neuronal tracks to areas of the brain that are not being used. The frontal lobes of the brain are known for executive functions such as attention, memory, and impulse control which are critical for academic success. Because brains develop in conjunction with stimuli in the surrounding environment, media content in high screen users is key regarding brain pruning. Exposure to mindful or educational content results in active or constructive learning, which maintains and strengthens neuronal tracks to frontal lobes. Whereas exposure to mindless or entertainment content such as fast paced and violent video games, constitutes passive or destructive learning which research shows rarely requires use of frontal lobes, resulting in frontal lobe pruning. Again, ‘what you do determines who you become’. Numerous research studies have documented frontal lobe atrophy in children who game over 4-5 hours per day. While brain development has a degree of plasticity or ability to repair damage, over half of the brain is hard wired at age 12, and the majority of the brain is hard wired at age 20 years. Children have the right to a childhood free from violence. Encouraging outdoor play in nature can heal the neurological damage created by overexposure of violent media content.
Question: Is your child impulsive or has difficulty paying attention?
To Do: Talk with your child’s teacher to see how they are doing academically, and ensure your child is not allowed to game at school.
- Sleep Deprivation
The National Sleep Foundation reports that over 60% of children and youth are chronically sleep deprived. While we know that sleep is essential for brain repair and body health, what the general public doesn’t know is that sleep deprivations increases incidence of obesity, diabetes, poor academic performance, risk taking, heart problems (stroke and heart attack) and even cancer. During my classroom-based Tech Talks, 75% of students report they are allowed screens in their bedrooms and 50% report they use screens when they should be sleeping.
Question: Is your child using screens late or in the middle of the night?
To Do: Prohibit all screen usage one hour prior to bed; book, bath, bed. Do not allow screens in bedrooms, or any other area where you can’t monitor content e.g. back seat of car, bathroom, when you’re not home.
With rise in video gaming, prolific research is documenting concomitant rise in violence and aggression. In 2009 the American Academy of Pediatrics profiled extensive studies showing media violence is causally linked to child aggression, desensitization to violence, nightmares, and fear of being harmed. Early exposure to violent media content has been shown to increase risk of violent behavior. The American Academy of Pediatrics published a policy statement Virtual Violence in July 2016 advising pediatricians, parents, industry and policy makers regarding current video game research and recommendations. Regarding research findings, Virtual Violence policy states: “Summarizing the results of > 400 studies including violent media of all types, researchers found there was a significant association between exposure to media violence and aggressive behavior, aggressive thoughts, angry feelings, and physiologic arousal. Another study performed a similar analysis focusing only on video games. The results, based on 140 such studies, found slightly larger negative effect sizes. Some contend, rightly, that these correlations are in the small to moderate range, but they are stronger than the associations between passive smoking and lung cancer, and many municipalities have banned smoking because of that risk”. APA goes on to recommend that children under the age of 6 years have no exposure to media violence, and first-person shooter games should be restricted from children under the age of 12 years.
Question: Has your child threatened to harm you or themselves if video games are restricted?
To Do: Get your family physician on board to talk with your child about video games and if needed, get a referral for a family counsellor or therapist immediately. This is an urgent situation and requires assistance from trained professionals. Check out Common Sense Media’s list of non-violent video games!
- Game Transfer Phenomena
Media imagery affects behavior, a fact capitalized on by the advertising industry. Video game imagery is increasingly realistic and highly immersive, even more so with the onset of large screens and virtual reality headsets. Research is now documenting Game Transfer Phenomena, where gamers retain visual imagery and violent behaviors endemic in the game and transfer these to real life. A study of adult gamers showed 71% visualized video game imagery with eyes closed after gaming; 31% visualized imagery with eyes open. This raises the question of what children experience following video game immersion. The problem with younger children is that they are more impressionable, and what they see on TV or video games, they act out in real life. Gamer brain is becoming increasingly problematic in schools where children act out scenes from violent mature video games resulting in acts of sexualized and physical violence toward other students. One 9-year-old boy I assessed who spoke incessantly about playing Halo Zombies, threw a rock at a passing truck breaking the window stating “I thought I saw zombies in it”. Matthew de Grood, a noted ‘chronic video gamer’, killed five college students stating “I thought they were zombies”. Dr. Andrew Haag testifying psychiatrist in the trial proceedings, stated that de Grood “was having delusional symptoms which had a profound impact on how he perceived reality”. The recent mass shooting in a Saskatchewan school killing 4 students was by a noted ‘loner and video gamer’. Serial killer Dillan Millard reported he played Halo 4 hours per day using Zombie bullets which explode upon entry. ISIS recently created the ARMA III video game to train ISIS recruits. The recent mass shooting in Florida killing 49 people was by an ISIS militant.
Question: Does your child “see or hear” video games when not playing, or act out behaviors endemic in the video game?
To Do: In addressing the recent rise in mass killings, a prevention protocol should include restriction of violent media content for developing brains. Banning video games for children < 12 years is an excellent start toward protecting civilians from those intent on mass killings.
- Mental Illness
The Canadian Mental Health Association reports 1 in 7 children and youth have a diagnosed mental illness. Douglas Gentile’s 2009 study indicated 1 out of 10 children aged 8-18 years are addicted to technology, with Common Sense Media reporting 50% of youth self-report screen addiction. Never in the history of humankind have there been child addictions. Difficult and expensive to treat, very soon this will become the job of every health and education professional…treating child and youth screen addictions. Schools wouldn’t give children cocaine or crack, yet they readily hand out equally as damaging and addictive devices to students on a daily basis, unmonitored. I routinely walk behind students in the hallways, playground, and classrooms and observe social networking, video games, and even pornography. A 14-year old youth I was assessing for aggression toward other children told me he played violent video games “almost all the time”. When asked why he hurts other children stated “I get a rush when I hurt others”. While this boy reported he understood there could be a link between violent video game use and aggression, he did not believe that playing video games had any impact on his liking to hurt other children. When asked if he could do the “Unplug Challenge” and not use any screens for 24 hours, he immediately responded with “No way”. With increasing research showing harmful effects of screens on child and youth mental health, prohibiting violent media content in children under the age of 12 years is urgently needed. Prohibiting personal device usage in school settings makes a strong statement to children and their parents of the need to limit screen usage.
Question: Do you think your child is happy?
To Do: Children want to play with their parents and friends. Put the phone down, pick up your kids, and go do something fun outside…now.
- Poor Social Relationships
Children learn social skills from watching and interacting with their parents. If parents rarely communicate with each other or their children, these children fail to learn social skills, and go onto a life strife with communication and behavioral issues. There is a critical period at 6-18 mo. of age for attaining social ability. Infants who spend too much time in front of screens, and too little time interacting with their parents, have increased risk of developing autism and oppositional defiance disorder. Parents model functional (or dysfunctional) relationships, which dictate to a large degree how their child will relate to others. Parents who have good relationships with each other, generally understand how to relate to and meet the needs of their children, who in turn pass these social skills onto their siblings and friends. Children who live in a virtual world for long periods, have great difficulty dealing with problems and demands in the real world. Children who’s parents overuse screens feel neglected, and consequently find solace in screens. Hilarie Cash, director of reSTART internet addiction recovery center, states in this video that youth and young adults in her program tell her that there are a number of steps parents can take to prevent gaming addiction including:
- Help your child develop alternate interests to video games;
- Repair your own relationship;
- Do not expect perfection in your child;
- Be attune to your child’s needs;
- Set rules and guidelines for internet usage;
- Model those rules yourselves.
As social skills are key in establishing primary relationship with partners, as well as securing jobs upon graduation, children and youth who have social anxiety or are socially phobic will have much greater difficulty experiencing meaningful relationships and finding work.
Question: Does your child have real (not screen-based) friends?
To Do: Prepare and eat dinner together screen-free every night and invite conversation and dialogue with your children, spend at least half a day once per week in screen free outdoor activity, spend your family holiday screen free. One hour per day, one day per week, one week per year screen free.
- Poor Academic Performance
Regarding early exposure to violent media content, Dimitri Christakis study on fast paced, violent cartoons in 2011 exposed 4-year-old children to 9 min. of SpongeBobs, and found significant decreases in memory, concentration and attention…after only 9 minutes! Research by Jay Hull in 2015 found that moderate gamers who use less than 4 hours per day of video games show increased risky behaviors (sex, reckless driving, drugs/alcohol, smoking), increased defiance, and decreased executive function (attention, concentration, memory). Heavy gamers who use > 4 hours per day of video games, have 4-5 times increased incidence of previously noted effects. While high school drop out rates have steadily declined over the past decade, gamers are at much higher risk than non-gamers for dropping out of high school and university. Increasing incidence of absenteeism and tardiness of children and youth in schools always has me asking students what they were doing at home, and not surprising to hear they were gaming late into the night. Students who are good at gaming often tell me that school is “boring” or “too hard”, and that they don’t get rewarded for trying to do their work. Many students I work with outright refuse to do school work, and many teachers are turning to using video games as a reward for produced work at school. We are all aware that high school dropouts have much greater difficulty finding and sustaining jobs, as do video game addicts who again are looking for rewards and achievement in their work that they find favorable in video games. One alarming Canadian statistic is that 42% of 20-29-year-old men are living at home, neither working nor attending school; up from 27% in 1981 and 32% in 1991. What is this potential work force doing at home, and why are parents allowing it to happen?
Question: Is your child struggling at school?
To Do: Talk with your child’s teacher to see how they are doing academically, and ensure your child is not allowed to game as a reward at school.
- Sexual Perversions
42% of children have viewed pornography by age ten. Early exposure to porn is linked to hypersexualized behaviors including early entry into sex, sexting (sending sexualized messages and photo’s), high risk sex, and sexual violence. What studies fail to include in their data is that all video games rated Mature contain graphic sexual content and sexualized violence. One of the major “enhancements” in Grand Theft Auto 5 is that the player can not only rape and kill women, but they’ve now added torture scenes. It is imperative that parents investigate and continuously monitor what their child is watching/playing on their device. Children are curious about sex, and while it’s natural to ask questions and want to know more about sex, there is nothing natural about what children are readily viewing on the internet. The dark web is now easily accessible and contains slasher videos and extremely violent porn. In 2017 the UK reported a rise of 71% of sexual assaults by children on children over the past 4 years which they attributed to internet porn. Utah was the first state to declare pornography is a public health crisis. Again, what children watch is who they become.
Question: Have you asked your child if they are using porn?
To Do: Watch what video games your child is using or ask them and look up rating on Common Sense Media; remove access to all sexualized content.
- Mass Killings
Some (but not many) parents I talk to who have children with problematic gaming issues, tell me their child has threatened the parent or themselves with harm should they proceed with video game restrictions. When a child threatens harm to self or others, they are clearly in trouble and not in control of themselves or their actions. If a parent feels threatened when trying to implement video game restrictions, then it is imperative they seek assistance from a medical professional e.g. physician, psychiatrist or psychologist. While most shooters are gamers (14 mass murders are linked to violent video games), this does not mean most gamers will become shooters. What parents, teachers, clinicians, and government can do to prevent mass killers is stop letting children under the age of 12 be exposed to violent media content. Student education regarding impact of violent media content by trained teachers in schools is paramount, as is parent education by counsellors and clinicians (RN’s, Dr.’s, therapists, psychologists). Government should legislate video game industry to include clear warnings on all video games referencing harmful effects of video games on children. Parents spending more time with their children and less time on screens will improve child mental health and lessen problematic behaviors and acts of violence.
Question: Are you scared of your child?
To Do: Have your child urgently assessed by a medical professional e.g. physician, psychiatrist, or psychologist. Engage in more healthy activities as a family. Listen to your child’s concerns and stories, don’t talk and lecture.
This article was written by Cris Rowan, pediatric occupational therapist, biologist, international speaker, and advocate for children. Cris can be reached at email@example.com.
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Zone’in Research Fact Sheet 300 research references on detrimental impact of technology on children.
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Ten reasons to ban handheld devices for children under 12 years of age Huffington Post 2.6 million likes.
Suffer the Children – 4 min. slideshow profiles problems associated with tech overuse by children.
Balanced Technology Management – 7 min. slideshow profiles solutions in six sectors: parents, educators, health professionals, government, researchers, and technology corporations.
Tech Tool Kit manual of tools and strategies for families to balance technology with healthy activity.
Unplug’in Game board game to build skills and confidence in activities alternate to technology.
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