Time off for good behaviour
Computers, smartphones and tablet devices have become an almost integral part of children's lives, be they for social or educational use. This has left many parents worrying about their children viewing inappropriate material on the internet or becoming the target of bullying or cyber predators. But health professionals have other concerns.
'Like adults who spend many hours in front of a computer, children also run a greater risk of developing physical and muscular problems,' says physiotherapist Jane Gorman, who is concerned that children are developing poor posture habits as a result of slouching. According to Gorman, who has worked with children and adults in Hong Kong and Australia, constant slouching can lead to a curved or hunched back and rounded shoulders, which can affect breathing and digestion.
As a mother of four children, she has seen first-hand the demands placed on young bodies. 'Even as teens and young adults, children who develop computer-related postural problems could suffer from back, neck and shoulder pain,' says Gorman, a musculoskeletal therapy specialist.
In a poll of more than 1,530 users of mobile devices aged 18 and above by the Hong Kong Multisports Association, 95 per cent of respondents had suffered neck or back pain in the previous 12 months. Half of the respondents in the poll, conducted in April and May, had suffered severe pain that had interfered with their work, sleep, mood or ability to concentrate.
Rather than constantly reminding children to sit up straight, Gorman says they should be made aware of the effects of bad posture.
'We need to place more focus on teaching children about taking care of their bodies and to listen to what their bodies are telling them,' says Gorman, a member of the Lift (life information for today) team that conducts school workshops in Hong Kong.
Using terms such as 'buzz' for tightness in the neck, caused by prolonged computer use and bad posture, Gorman says primary school children soon learn the difference between good and bad posture habits.
A recent Polytechnic University survey of more than 1,500 local Primary Four to Secondary Three students revealed more than half participated in sedentary activities for more than four hours a day, including computer use. 'We know from research involving adults that more than four hours per day of being seated in front of a computer raises the risk of musculoskeletal problems,' says Dr Grace Szeto, associate professor at PolyU's department of rehabilitation sciences.
'Some of the online games are so captivating that, mixed with television viewing and lifestyle trends, we are probably seeing a downward move from physical exercise to cyber games,' she says.
According to Szeto, only about 18 per cent of Hong Kong children in the Primary Four to Secondary Three age group have adequate physical activities essential to their physical and psychological development. 'Prolonged use of a single activity such as using a computer is likely to displace time allocation for other activities,' says Szeto.
A study by PhD project researcher Donald Lui, in the same department, revealed that children in that age group who spend time playing mobile device and computer games reported more neck and upper limb discomfort than children involved in physical activities.
With children spending more time in front of computers, Dr Do Chi-wai, assistant professor at PolyU's School of Optometry, recommends a well-lit working environment where there is no glare on the computer screen. When using a desktop computer, a large screen is preferable. Children should also take frequent breaks, particularly if they are using laptops and tablet devices.
He says parents should also be aware of problems caused by 'computer vision syndrome'. This can include eye pain, headaches, fatigue, blurred vision, dry-eye caused by reduced blinking and discomfort brought on by uncorrected eye problems.
As many home computers are set up for adults, Gorman says parents should pay attention to the positioning of the computer screen and seating to reduce the risk of bad posture habits for their children. For instance, when children are seated in front of a computer they should be able to place their feet flat on the floor. The screen should be at eye level and at a distance of about 50 to 60 centimetres from the child.
Gorman also recommends introducing children (and adults) to the 20-20-10 concept to guard against eye problems. This means that for every 20 minutes at the computer, users focus on an object more than 20 feet away for at least 10 seconds.
On the plus side, recent research suggests computer use among preschool children may actually improve their readiness for school and accelerate academic performance. As Hong Kong schools step up the amount of web-based assignments and online homework, advocates of computer technology also point to the benefits of web-based research and interactivity.
Professor Anisha Abraham, a visiting scholar at the Jockey Club School of Public Health and Primary Care at Chinese University, believes computers should complement, not replace, other educational activities.
'Used appropriately, technology and online programmes provide children with opportunities to learn in different ways. However, parents should ensure that time spent on computers does not replace other valuable learning tools such as socialising with other children, unstructured free play including outdoor exploration, art, books and music, says Abraham, who is an associate professor of paediatrics at Georgetown University Hospital in Washington.
Parents should make the effort to observe and participate in their children's computer activities, Abraham says. They should also keep tabs on the time children spend at the screen.
'Careful planning of computer use lets children reap benefits while keeping their different types of learning experience in balance,' she says. With older children, Abraham says, there are a variety of approaches to engaging with teens on the topic of online safety. She says parents can talk to their teens about safe and risky online practices, and about what behaviour is appropriate.
'Open communication is key,' Abraham says, adding that parents need to be aware of signs of isolation, depression and loneliness which can be associated with prolonged computer activities. Abraham advises that time spent watching television and playing with hand-held gaming devices is also taken into account when balancing electronic and physical activities.
Now that internet-connected devices have become an almost indispensable tool for adults, Abraham says it is important for parents to set examples by controlling their own use of computer and mobile devices. One suggestion is turning all mobile devices off during designated family time.
This may be easier said than done. According to a survey carried out by wireless location-based services company TeleNav, 22 per cent of respondents (43 per cent of iPhone users) said they would rather forgo brushing their teeth than being temporarily separated from their phones. As an increasing number of people sleep next to their smartphones, 20 per cent (43 per cent of iPhone users) would go shoeless for a week rather than temporarily hand over their phones.
Similar to many professionals, Grace Lung, a clinical associate at Polytechnic University's department of rehabilitation sciences, believes access to computers provides children with both positive and negative experiences.
'Research has shown us appropriate use and choosing the right programs can help children with spelling, reading and visual memory abilities, says Lung. Furthermore, web-based programs developed especially for children with learning and attention difficulties have also produced positive outcomes.
Meanwhile, Lung says research also indicates unrestricted computer use can lead to a disruption of sleep quality, a deterioration of academic performance, and social and psychological problems.
'Symptoms can include aggressive behaviour, attention problems, decreased attention to family and friends, and problems with physical and vision functions'.
Lung says children who spend long periods of time playing online games often feel an emotional high, commonly known as an adrenaline rush, which can lead to withdrawal symptoms when they are away from their computer.
'Research tells us the elated 'highs' children feel from playing computer games is caused by interference with neurotransmitters, which can affect performance during class work, revision and study time,' says Lung.
While there is no definitive evidence, Lung says research indicates more than two hours a day on top of classroom and homework computer usage is probably excessive. Studies suggest excessive time spent on social networks can affect self-confidence and interpersonnel skills, she says.
'Children and teenagers can lose their sense of responsibility in terms of what they write when they spend a lot of time communicating online. Excessive time spent using social media can also affect social behaviour in face-to-face and group situations.'