Reset Your Child's Brain

A Four-Week Plan to End Meltdowns, Raise Grades, and Boost Social Skills by Reversing the Effects of Electronic Screen-Time

New World Library

Contents

ELECTRONIC SCREEN SYNDROME

An unrecognized disorder

In diagnosis, think of the easy first.

— Martin H. Fischer

Consider the following questions:

• Does your child seem revved up a lot of the time?

• Does your child have meltdowns over minor frustrations?

• Does your child have full-blown rages?

• Has your child become increasingly oppositional, defiant, or disorganized?

• Does your child become irritable when told it's time to stop playing video games or to get off the computer?

• Do you ever notice your child's pupils are dilated after using electronics?

• Does your child have a hard time making eye contact after screen-time or in general?

• Would you describe your child as being attracted to screens "like a moth to a flame"?

• Do you ever feel your child is not as happy as he or she should be, or that your child is not enjoying activities like he or she used to?

• Does your child have trouble making or keeping friends because of immature behavior?

• Do you worry your child's interests have narrowed recently, or that these interests mostly revolve around screens? Do you feel his or her thirst for knowledge and natural curiosity has been dampened?

• Are your child's grades falling, or is he or she not performing academically up to his or her potential — and no one is certain why?

• Have teachers, pediatricians, or therapists suggested your child might have bipolar disorder, depression, ADHD, an anxiety disorder, or even psychosis, and there 's no family history of the disorder?

• Have multiple practitioners given your child differing or conflicting diagnoses? Have you been told your child needs medication, but this doesn't feel right to you?

• Does your child have a preexisting condition, like autism or ADHD, whose symptoms seem to be getting worse?

• Does your child seem "wired and tired," like they're exhausted but can't sleep, or they sleep but don't feel rested?

• Does your child seem lazy or unmotivated and have poor attention to detail?

• Would you describe your child as being stressed, despite few or no stressors you can clearly point to?

• Is your child receiving services in school that don't seem to be helping?

If these questions strike a familiar chord, like many other parents you may be confronted with difficulties all too common in today's electronically saturated world. These days, parenting a child who is struggling with behavior, mood, or cognitive issues is fraught with confusion and frustration: What's causing the problem? Where do we focus our resources? Does my child need formal testing? Should we get a second opinion, and from whom — a neurologist? A psychiatrist? A psychologist or educational specialist? And so on. Many parents feel lost; they are unsure of what's going on and often receive conflicting advice, leading them to feel pulled in different directions. They seek multiple opinions, scour the Internet for information, ask other parents what's worked for them, and agonize over whether to try medication. Parents often report that the process winds up feeling like they're simply going in circles. This paralysis of analysis is costly — in terms of time, money, resources, and a child's self-esteem.

You might notice that the quiz questions above cover a wide variety of dysfunction, but they all represent scenarios — related to symptoms, functioning, or treatment effectiveness — that can occur when a child starts operating from a more primitive part of the brain. During this state, two things tend to happen: 1) symptoms and functioning worsen, and 2) interventions don't work very well. Thus, the goal is to find out what's causing this state. Regardless of what your child's particular issues are, if they're not being managed adequately, it's safe to assume that something is being missed. Wouldn't it be nice if that some thing could be the same thing for each and all of these issues? If addressing one thing improved functioning across the board, whether your child carried multiple diagnoses or none at all?

To see how this might be possible, consider the following three cases:

Diagnosed with autism, six-year-old Michael was receiving in-home behavioral services. When he suddenly developed severe obsessive-compulsive symptoms, his treatment team called me for a consult. Upon learning he was earning video game time daily as a reward, I convinced the family and treatment team to try the Reset Program before initiating any medication. Four weeks later his obsessive-compulsive symptoms had diminished substantially, and as an added bonus he made better eye contact and displayed a brighter mood.

Calla was a high school junior who struggled with severe mood swings and insomnia. Calla's treatment providers suspected she was bipolar, and her defiant attitude and dramatic displays of emotion had recently landed her in a class reserved for kids with emotional problems, which only made things worse. Frustrated after a particular medication trial caused a rapid weight gain, Calla and her mother wound up in my office. After much discussion, they agreed to try the electronic fast as part of an overall treatment plan. Six weeks later, the sweet girl underneath all that turmoil resurfaced. Within six months, Calla was sleeping soundly, following the rules at home and school, and had lost ten pounds. By the end of the school year, she was back in mainstream classes.

Eight-year-old Sam was a typical kid with no formal diagnosis who had always enjoyed learning. But in third grade, Sam's math and reading achievement scores dropped inexplicably, and he began to dread going to school. He was nearly constantly in trouble for being disruptive, and both his teacher and the school psychologist suggested to his mother that Sam might have ADHD. Yet within two months of completing the Reset Program, Sam was turning in more assignments, getting glowing reports from his teacher about his "attitude change," and making steady progress in math and reading.

Though their individual presentations varied, each child was essentially in a state of dysregulation — that is, they lacked the ability to modulate mood, attention, and/or level of arousal in a manner appropriate to the given environment or stimulus. Something was irritating these kids' nervous systems, making it difficult to handle everyday life. All three kids felt miserable and out of control, their families felt taken hostage by whatever had taken hold of their child, and their support teams struggled to identify what was being missed. Yet all three children responded to the same simple intervention. The fact that each child's nervous system renormalized with an electronic fast suggests that screen-time played a role in the development of each child's decline.

The Dawn of a New Disorder

Like many other aspects of our fast-paced but often sedentary lifestyle, screen-time is introducing new variables into the health equation. Screen-time affects our brains and bodies at multiple levels, manifesting in various mental health symptoms related to mood, anxiety, cognition, and behavior. Because the effects of screen-time are complicated and diverse, I've found it helpful to conceptualize the constellation of common phenomena as a syndrome — what I call Electronic Screen Syndrome (ESS). Importantly, ESS can occur in the absence of a psychiatric disorder and yet mimic one, or it can occur in the face of an underlying disorder and exacerbate it.

ESS is essentially a disorder of dysregulation. Because it's so stimulating, interactive screen-time shifts the nervous system into fight-or-flight mode, which leads to dysregulation and disorganization of various biological systems.

Sometimes this stress response is immediate and obvious, such as while playing a video game. At other times the stress response is more subtle, taking place gradually from repetitive screen interaction, such as frequent texting or social media use. Or it may be delayed, brewing under the surface but managed well enough, then erupting once years of screen-time have accumulated. Regardless, over time, repeated fight-or-flight and overstimulation of the nervous system from electronics will often eventually culminate in a dysregulated child. The sidebar "Characteristics of Electronic Screen Syndrome in Children" (page 17) provides a good idea of what ESS looks like.

One way to think about the syndrome is to view electronics as a stimulant (in essence, not unlike caffeine, amphetamines, or cocaine): electronic screen device use puts the body into a state of high arousal and hyperfocus, followed by a "crash." This overstimulation of the nervous system is capable of causing a variety of chemical, hormonal, and sleep disturbances in the same way other stimulants can. And just as drug use can affect a user long after all traces of the drug are out of the body, electronic media use can affect the central nervous system long after the offending device is actually used. Furthermore, also like drug use, functioning may not be impaired immediately, and in some cases it may even improve initially, but then become worse. In fact, abuse and addiction of stimulant drugs such as cocaine and methamphetamine have a very similar presentation to that of ESS, including mood swings, concentration problems, and restricted interests outside of the substance or activity of choice.

It's the Medium, Not the Message

Now that ESS has been broadly defined, let me clarify some terms and address some questions readers may have at this point.

For instance, if mental health issues arise because of screen-time, the first question is often: Is it because of the sheer amount of screen-time, because of the type of activity, or because of the nature of what's seen? The truth is, research suggests that all screen activities provide unnatural simulation to the nervous system and can cause adverse effects. But contrary to popular belief, content isn't as important as amount, and interactive screen-time causes more dysfunction than passive.

Strictly speaking, the term screen-time refers to any and all time spent in front of any device with an electronic screen, such as computers, televisions, video games, smartphones, iPads, tablets, laptops, digital cameras, e-readers, and so on. It includes any screen-related activity, whether for work, school, or pleasure. This includes time spent texting, video chatting, surfing the Internet, gaming, emailing, engaging in social media, using apps, shopping online, writing and word processing, reading from a device, and even scrolling through pictures on a phone. It includes activities like playing electronic Scrabble or solitaire, "educational" electronic games or apps, and reading from a Kindle.

Interactive vs. Passive Screen-Time

In terms of impact, perhaps the most important distinction is between interactive and passive screen-time. Interactive screen-time refers to screen activities in which the user regularly interfaces with a device, be it a touch screen, keyboard, console, motion sensor, and so on. Passive screen-time refers to watching movies or television programs on a TV set from across the room. Nowadays parents often let their children watch TV shows or movies on an iPad, laptop, or handheld device, but because viewing media this way is more stimulating and dysregulating (for reasons I'll get into later), I consider this to be interactive screen-time.

Generally speaking, both interactive and passive screen-time are associated with health issues. Research indicates both types are involved in obesity, attention problems, slower reading development, depression, sleep problems, diminished creativity, and irritability, to name a few. What is somewhat counterintuitive with ESS, however, is that interactive screen-time is much worse than passive. Many families I work with already limit passive screen-time (such as television) but not interactive. This is because we associate passive viewing with inactivity, apathy, and laziness. In fact, parents are often encouraged to provide interactive screen-time (particularly in favor of passive screen-time), with the rationale that surely this type of activity engages the child's brain. Children are forced to think and puzzle rather than just watch, so it must be better, right? But interaction is in and of itself one of the major factors that contributes to hyperarousal, so sooner or later, any potential benefit of interactivity is overridden by stress-related reactions. Furthermore, interactivity is what keeps the user engaged by providing a sense of control, choices, and immediate gratification, but unfortunately these attributes are the same ones that activate reward circuits and lead to prolonged, compulsive, and even addictive use.

Burgeoning research comparing the two supports this theory that interactive screen-time is more dysregulating to the nervous system than passive. A 2012 study surveying the habits of over two thousand kindergarten, elementary, and junior high school children found that the minimum amount of screen-time associated with sleep disturbance was just thirty minutes for interactive (computer or video game use) compared to two hours for passive (television use). A 2007 study demonstrated that sleep and memory were significantly impaired following a single session of excessive computer game playing, while a single session of excessive television viewing produced only mild sleep impairment and had no effect on memory. And a large 2011 survey of American adolescents and adults demonstrated that interactive device use before bedtime was strongly associated with trouble falling asleep and staying asleep while passive media use was not. Notably, this study also revealed that adolescents and young adults under thirty were the age group most likely to use interactive devices before bedtime, and they also reported the most sleep disturbance. Moreover, of those experiencing sleep problems, 94 percent also reported an impact on at least one area of functioning: mood (85 percent), school/work (83 percent), home/family life (72 percent), and social life/relationships (68 percent). Not coincidentally, these are the very areas of functioning the Reset Program addresses! And finally, we know that actual brain damage occurs from excessive Internet and video game use that looks remarkably similar to that from drug and alcohol abuse, so something about the interactive nature either directly (through hyperarousal) or indirectly (through addiction processes) makes interactive screen-time more potent as well as distinct.

When implementing the electronic fast in the Reset Program, I typically allow small amounts of television or movies under certain conditions (as discussed in chapter 5). If these conditions are met, the fast is still highly effective. On the other hand, allowing even small amounts of gaming or computer play often renders the Reset useless. Thus, for the Reset Program, we are primarily concerned with eliminating interactive screen-time. Additionally, most parents become overwhelmed at the thought of taking away all electronics, so allowing a small amount of passive viewing of appropriate, calm content provides parents with a bit of a respite. That said, I do not take television's effects lightly, especially on the very young, and I applaud anyone who removes all passive screen-time in addition to the other requirements of the fast. Regarding computer use for school purposes, I typically allow it during the Reset, but certain exceptions and rules apply (as discussed in chapters 5 and 10).

Common Misconceptions about Problematic Screen-Time

Misconceptions abound when it comes to screen-time, even among mental health professionals. For starters, it's not just violent video games that can cause dysregulation, but any video game — including educational or seemingly benign games, like puzzles or building games. Another myth is that it's only children who are "addicted" to gaming, Internet use, or social media who experience issues, or that screen-time only becomes a problem when parents don't restrict it. In fact, many children display symptoms from screen-time without being addicted per se, and some children become over-stimulated and dysregulated with only minimal amounts of screen exposure. I see many families in which the parents limit usage to levels at or below what the American Academy of Pediatrics recommends (no more than one to two hours total screen-time daily), but if some or most of that time is interactive, it can easily create a problem.

The truth is, every child is affected differently. Comparing your child's screen-time to his or her peers isn't helpful either, as it doesn't necessarily provide protection if it's less than others'. The average child is exposed to several fold–higher levels of electronic screen media compared to just one generation ago — not to mention the constant bombardment of wireless communication that often accompanies it.