“My precious,” coos Gollum from the Lord of the Rings, clutching his prized possession, the One Ring to Rule Them All. His obsession to possess the ring drives him slowly to madness. I often wonder, as a clinical psychologist who works with children and adolescents struggling with digital addiction, if the fantasy saga wasn’t in fact a cautionary tale about smartphones and the other ubiquitous, all-knowing gadgets that rule our lives, impinging on our children’s cognitive development, impacting our social relationships, and giving us all a literal pain in the neck.

“My 11-year old son has been throwing tantrums and talking back, he is always irritable and seems depressed,” said Kathleen, an accomplished professional and mom who seemed at her wit’s end. We had gone through all the usual background information about her son, such as medical history, psychosocial development, interpersonal relationships, etc., and nothing had stood out. I asked Kathleen if anything had changed in her son’s environment recently. “Not really,” she said after thinking for a while. “We haven’t changed schools or homes, he has the same teachers, his routine has been pretty regular.” Then she added, “I mean, he’s always on his phone. He sleeps with it, eats with it, but that’s not something I can do anything about.”

As adults, we have leveraged technology to accomplish amazing things in our lives: we do our work, manage our social lives, consume news and entertainment, even make new purchases for the holidays, all with the push of virtual buttons. Despite being cognitively mature, emotionally resilient and capable of delaying gratification, we struggle to set limits on our own usage. The negative effects on adult relationships, productivity and mental health are well known. Imagine how much more challenging such technology is on children, who have not yet developed to full emotional, cognitive and social maturity.

Parents also face unique challenges in restraining their kids’ usage and rehabilitating their habits and relationships with technology, due to the highly personal and addictive nature of smartphones, as well as the positive aspects of technology. The good news is, there are several strategies and coping skills that parents can learn and teach their kids. But in order for parents to buy into initiating an intervention, they must be aware of what those negative effects are.

It has been found that prolonged and unmonitored technology usage can impact children on the cognitive, psychosocial, and psychological levels.

COGNITIVE IMPACT: A child’s brain is still in the process of developing the ability for impulse control, attention, focus, organization, etc. This is a vulnerable time as the brain is beginning to adapt to internal and external demands. This is also a period of adjustment as the child develops refined cognitive functioning. Dr. Aric Sigman, of the British Psychological Society, talks of how too much screen time should not be introduced to children too early on. He discusses how exposing youngsters to screens at a young age can impede their developing brains and interfere with the very skills that parents think electronics will help their child develop (Computers in Human Behavior, 2014). For instance, children between the ages of 6 – 24 months have a 49% increased risk of developing speech delays (Pediatrics, Suppl 2, 2017), according to a large study conducted by 130 experts along with the nonprofit organization, Children and Screens. Dr. Dunkley’s article, Grey Matters: Too Much Screen Time Damages the Brain, points out several research studies that have implicated screen time with structural brain changes. She points out that while most of the research regarding brain damage is targeted towards internet addiction in teens, there is still a risk of mild damage occurring in a youngster with regular exposure. Dr. Liraz Margalit in her article, “What Screen Time Can Really Do to Kids’ Brains,” points out that when children are following a story on a smartphone, they do not have the benefit of processing a parent’s voice or using visualization and imaginative skills. Instead they are bombarded with images, sights, and sounds, that while initially help to provide a more vivid, immediate picture, may in fact weaken a child’s cognitive muscles. Kids with prolonged screen exposure are naturally looking for that same immediate gratification everywhere and when this does not occur, they have less mental capacity to handle the delays for mental stimulation.

There is also the issue of technology addiction which has been found to effect cognitive and emotional processing and connectivity (Hong et al.,2013), lowered impulse control, inefficient processing and an increased sensitivity to rewards and loss (Dong, Devito, Du, & Cui 2013). Research has shown that there are effects on gamers that are similar to those of drug addicts (Ko et al., 2009) (Kuhn et al., 2011).

Prolonged screen usage can impact a child’s executive functioning. This occurs in the developing prefrontal cortex, which is responsible for focus, attention, concentration, organization, etc. and the notion of Tech Attention Deficit Disorder (Mackenzie, 2010) (The Henry J. Kaiser Family Foundation 2010). I have heard from several parents that their kids are found doing homework with their phones close by and are often checking texts or social media, which detracts from getting their work done. The general excuse that they give to parents is that they need to look things up online. However, this greatly impacts the time it takes to complete homework, the quality of the work, and overall academic success.

PSYCHOSOCIAL In addition, to the physical impact of prolonged screen time use, parents are noticing that their kids are struggling with the psychosocial effects as well. In a study done at UCLA in 2014 and published in Computers in Human Behavior, it was found that children have a harder time grasping others’ emotions. The study found that preteens who had to interact with others face to face without screens for 5 days had improved nonverbal emotional cue recognition compared to controls who used screens regularly for both facial expressions and videotaped scenarios. This is an interesting result given that many children with Autism and other social issues often prefer online friendships and gaming over live interactions. Parents sometimes encourage these friendships especially if their child has difficulty forming attachments with friends in person. However, given the study’s results on the impact on socialization by emotional cue recognition, it appears that live and in-person interactions are ultimately more fulfilling and satisfying than virtual relationships. This is particularly true as we look at the roles that empathy and social reciprocity play as well in friendships. Additionally, online-only friendships run counter to the social skills training that therapists often provide for children in treatment for social deficits. A large portion of this skill training is on connecting emotions with facial expression and body language among other aspects of interpersonal communication. One mother talked to me about her shy son’s struggles with in-person friendships but had many friends, some as old as 33, via an online game. She stated that while she was happy that he was connecting with others, she was concerned that he was not making friends with whom he could engage in actual face to face conversation.

PSYCHOLOGICAL Nervousness, anger, oppositional defiance, and lowered frustration tolerance all indicate the psychological effects that can occur from prolonged screen use. In my own practice, I have witnessed kids having panic attacks and appearing extremely stressed out when parents attempt to take away their tablets or phones. Younger ones roll angrily on the floor or scream hysterically, while teens either sulk, grow tearful, argue, swear at parents, and appear as if their very life has come to a standstill. The consequence of losing a device can be devastating and somewhat traumatic. One Highschool senior Nina, grew tearful every time she recalled how she had lost phone privileges during the end of her sophomore year, which resulted in a loss of connection with her friends for an entire summer.

In an article on children and electronics, Dr. Victoria Dunckley, discusses how these problems can develop. She explores overstimulation and hyperarousal in the brain, and how this can result in the negative impact of several areas of psychological functioning, such as mood, cognition, behavior, interpersonal skills, attachment, and addiction, which appear to contribute to a syndrome, she coins Electronic Screen Syndrome (Dunckley, 2017).

It is important to be aware of the misdiagnosis of symptoms as many of these appear to mimic anxiety, depression, or ADHD. For instance, teens are often found texting late at night under the covers and appear exhausted for school the next day. This plays a detrimental role on sleep hygiene, which contributes to not only lowered physical energy, but cognitive and emotional energy as well for handling day-to-day tasks. Over time, less sleep can contribute to ADHD-like symptoms such as spaciness, forgetfulness, and lowered attention. If a child is staring at screens before bed, he or she is likely to be affected by insomnia or restless sleep. The blue light that emanates from screens suppresses melatonin production, a hormone that keeps our circadian rhythm in balance (https://www.sleep.org/articles/ways-technology-affects-sleep/). Such sleep interruptions and disruptions caused by night time screen use can contribute to or exacerbate depressive or anxious mood symptoms.

Cyber bullying and sexting are also serious challenges facing teens. I have heard heartbreaking cases of teens having their reputations ruined by Instagram posts or snapchats blasted out to large groups. Additionally, female youth often feel pressured into sending inappropriate pictures of themselves to boys who are demanding this via text. A client confided that she had done this only due to fear that a boy would lose interest in her. Such problems, if not dealt with appropriately can result in lasting psychological scars on the psyche of a teen.

Lastly, there is the more obvious risk of your child stepping into some minefields online if they aren’t monitored, such as chatrooms and porn sites. Kids also find pseudo-porn cartoon sites where they learn to role play sexual stories with strangers by using cartoon characters. This can become trauma-inducing or addictive to the youth involved. I have heard accounts from teens about how they happened upon such sites innocuously but then this eventually devolved into an unhealthy obsession.

So why do parents struggle to set limits for their kids? For one thing, it is not easy. It can be painful and exhausting. Parents tell me they are afraid. They are literally terrified of the “monster” (some even comparing their child to the girl in The Exorcist) that their child will morph into. One daughter would hit her mother and grow physically abusive when the phone was taken from her. They are apprehensive to initiate new structure such as earned privileges and permission for tech usage, especially if their child has been entitled to use these devices at will, no strings attached. A single Latino mother had similar issues with her 15- year old son, who was on the Autism spectrum, and was quite helpless to handle this. Crisis workers would often be called to handle the situation. I believe this mother experienced what we as psychologists call “learned helplessness” around this issue. She simply gave up trying to initiate rules because they were met with severe tantrums which left her feeling incompetent as a parent. Therefore, she and many o ther parents are in a constant state of passivity and frustration about what to do.

Unfortunately, to make matters more challenging, we have children seeing their peers with smartphones in school, starting as young as third grade (or even below). It can be difficult to counter the argument that “everyone else has one.” Parents often feel guilty that they are depriving their child of fitting in with the rest of their peers. Parents may feel guilty that their child is being left out due to not having a device.

It is important and in parents’ best interest to decide on the right approach, before giving a child access to devices. Even if limits have to be set after a child has been using it without restrictions, this can be done. It will take some perseverance but the benefits will be well-worth the effort. The decision to set screen use limits will aid a child’s physical and mental health and possibly evade significant mood and behavioral problems. And parents will be teaching their children the invaluable life skills of delayed gratification and how to creatively deal with boredom. Here are a few things parents can try that will hopefully make life easier, reduce stress around this issue, and create a more healthy and positive outlook for parents and children around . Some of these strategies work better with younger children than teens or vice versa:

The decision to limit and manage a child’s tech usage is an important and worthwhile endeavor. As this may be new for the child or teen, they will most definitely resist initially. I urge parents to not give in. They will come to terms with the new system of normalcy. Kids are resilient and will be able to cope with the changes and structure parents provide, as long as they are consistent. I have received positive feedback from parents who have set appropriate limits for their children, who initially could not handle such changes. They talk of their children as sleeping better, eating better, feeling less moody, and overall being more open to the family.