How do we reduce harms to children from smartphones?

One of the central arguments against children having smartphones is that smartphones and the platforms on them are addictive. Is this true? And what other impacts could they be having as young brains are still developing? Richard Cytowic is a neuropsychologist and professor of neurology at George Washington University. His new book is called ‘Your Stone Age Brain in the Screen Age.’

Richard - People are familiar with physical addictions like alcohol, drugs and cigarettes, but there are also behavioural addictions like gambling, shopping and compulsive sex for example. The endless scroll that you do on your phone is an example of behavioural addiction, because when do you stop? You don't because there's no end in sight. So it's like a slot machine that you keep playing, hoping for a hit, something interesting, funny or important is going to come up and you just keep going at it. That's called positive intermittent reinforcement, because you get a hit every now and then and that's enough to keep you hooked.

James - Is it really inducing the brain chemistry changes associated with addiction in the same way a harmful drug does, for example?

Richard - Yes, there have been some studies with fMRI and tractography that show that we're getting the same kind of physical changes with these behavioural addictions as we do with physical addictions.

James - So that's addiction, a serious harm in its own right. You also talk about the risks, though, of the cognitive load imposed by screen devices and whether this is impacting on our brain functions?

Richard - Well, it is. The whole reason I talk about the stone age brain, I think this will surprise most of your listeners, is that we operate under a fixed bandwidth of available energy and no amount of diet exercise, sudoku puzzles or supplements is going to be able to change that. We've now reached the point where we're asking it to do so much that it's like over exercising a muscle. It fatigues and collapses.

James - What are the cognitive costs of that?

Richard - Well, take a look at school grades for attention spans. Everybody agrees that our attention spans have all gone to hell. It affects memory, it affects sleep. And of course your lack of sleep affects your ability to learn or not to learn, or retain what you've learned in school. If you've been paying attention in the classroom instead of looking at your screens, which is what so many kids do, they don't pay attention to the teacher. They're looking at TikTok.

James - Once your attention span deteriorates. or your memory gets worse, how easy is it to claw those capabilities back? Are younger people at a bit of an advantage perhaps in this area, in that there's time to turn it round up to the development of their brain, as you say?

Richard - Yeah, well they still have a lot of plasticity left, but all of us have some degree of plasticity even into our nineties. So the answer is yes, it's easy. Also, no it's really difficult. It's easy because the solution is simple. It's difficult because people don't want to do it. That is, turn the phone off, put it face down, put it in another room, go for a walk, talk to someone on the phone rather than texting them and interact in person. I mean, this is what the pandemic taught us. Kids were doing Zoom schooling and they weren't getting the socialisation that they needed in the first, second, third, fourth, fifth grades. That really affected their ability to interact with other people, to make small talk, for example. They're terrified of anything in person.

James - What's the role of face-to-face interaction for the developing brain?

Richard - We're a social animal, and so socialisation is where it's at. Infants and toddlers learn by imitation learning. They mimic their adults. Playing patty cake and imaginative games like restaurant or shoe store, these are imaginative exercises in socialisation. So is being able to talk to other kids or their parents, their relatives. The whole notion of social media is such a misnomer. It's not social at all. It's isolating! That's why we see so much anxiety in young people, particularly as they head off to college for the first time. They have no idea how to navigate life. It's really sad. This is what I mean by virtual autism, is that this heavy screen exposure induces autistic-like symptoms in heavy users. Poor eye contact, verbalisation and regression of social skills. Now if you take the phones away, these symptoms go away in a short period of time, something that never happens in real developmental autism. So the solution is easy, but the participants don't want to implement the solution.

James - Is that the only way to row back on the screens or is there a way of harnessing the potential for access to so much knowledge, to really positive opportunities to interact with the world, without all the negative aspects as you've outlined them?

Richard - Of course, my iPhone is a wonderful device and a tool. It's far better than anything on Star Trek, but you have to use it wisely, realising that, yes, it's a great boon, but it's also an narcotising agent. It calls on your emotional intelligence which is, first of all, self-awareness, the ability to regulate your own behaviour, the ability to have good social skills, adaptability, and most of all resilience. People who are addicted to their phones don't show any of this, because they're so sucked into the screen.

James - So this is a big call to action really. This is something up to this point we've got badly wrong? The situation has crept up on us where children have access to these platforms and we are leaving many vulnerable to harm?

Richard - Yes. In the beginning, all the tech boosters approached this as if it were an unalloyed good. Anybody who said, "I don't know, maybe there's some downsides here" was dismissed as a technophobe or a Luddite. They were explained away. I think now the cows have come home, we're seeing the results of this. The critics would say there's not enough evidence, we should wait until we have evidence. Well, that's misunderstanding the precautionary principle which is, if something might be doing harm, then don't do it, or be careful of how you're using it. Doing research like this is so complicated, multifactorial and messy. By the time we get the data that the critics want, the damage will be done. We'll be waiting forever for that evidence to come out. So in the meantime, I say, there's a strong likelihood that these devices are doing harm when used in excess. So how about not using them in excess?