The World Health Organization, (WHO) just classified “gaming disorder” as a mental health condition. This WHO announcement comes on the heels of the American Academy of Pediatrics considering Internet Gaming Disorder as a new DSM-5 mental health disorder.  Many psychologists, parents, medical professionals, and ex-Silicon Valley folks have warned of the same thing: Screens are addictive and have serious health and privacy risks, especially for children. However, what the WHO and American Academy of Pediatrics fail to do is outline safety guidelines on age appropriate education or academic related screen use, at a time when schools are promoting (even requiring) screen use at an alarming rate

 

As CNN reports about the WHO announcement,

“Watching as a video game ensnares their child, many a parent has grumbled about “digital heroin,” likening the flashing images to one of the world’s most addictive substances.

Now, they may have backup: The World Health Organization announced “gaming disorder” as a new mental health condition included in the 11th edition of its International Classification of Diseases, released Monday. “I’m not creating a precedent,” said Dr. Vladimir Poznyak, a member of WHO’s Department of Mental Health and Substance Abuse, which proposed the new diagnosis to WHO’s decision-making body, the World Health Assembly. Instead, he said, WHO has followed “the trends, the developments, which have taken place in populations and in the professional field.

…[T]here are three major diagnostic features or characteristics of gaming disorder.
“One is that the gaming behavior takes precedence over other activities to the extent that other activities are taken to the periphery,” he said.
The second feature is “impaired control of these behaviors,” Poznyak said. “Even when the negative consequences occur, this behavior continues or escalates.” A diagnosis of gaming disorder, then, means that a “persistent or recurrent” behavior pattern of “sufficient severity” has emerged, according to the ICD.
A third feature is that the condition leads to significant distress and impairment in personal, family, social, educational or occupational functioning, Poznyak said. The impact is real, he said, and may include “disturbed sleep patterns, like diet problems, like a deficiency in the physical activity.”
Overall, the main characteristics are “very similar” to the diagnostic features of substance use disorders and gambling disorder, he said. Gambling disorder “is another category of clinical conditions which are not associated with a psychoactive substance use but at the same time being considered as addictive as addictions.”
For a diagnosis to be made, the negative pattern of behavior must last at least 12 months: “It cannot be just an episode of few hours or few days,” Poznyak said. However, exceptions can be made when the other criteria are met and symptoms are severe enough.”  -CNN

 

The American Academy of Pediatrics:

Watch the teen boy in the video above, as he describes his video game addiction escalating over the course of 5th grade, then 6th grade, 7th grade, etc. The American Academy of Pediatrics, AAP,  in this 2016 report,  highlights the risks associated with media (screens) and children, including screen time associated with academic tasks.

AAP on Risks of Media

“A first area of health concern is media use and obesity, and most studies have focused on TV. One study found that the odds of being overweight were almost 5 times greater for adolescents who watch more than 5 hours of TV per day compared with those who watch 0 to 2 hours.9 This study’s findings contributed to recommendations by the American Academy of Pediatrics that children have 2 hours or less of sedentary screen time daily. More recent studies have provided new evidence that watching TV for more than 1.5 hours daily was a risk factor for obesity, but only for children 4 through 9 years of age.10 Increased caloric intake via snacking while watching TV has been shown to be a risk factor for obesity, as is exposure to advertising for high-calorie foods and snacks.11,12 Having a TV in the bedroom continues to be associated with the risk of obesity.13

Evidence suggests that media use can negatively affect sleep.14 Studies show that those with higher social media use15 or who sleep with mobile devices in their rooms16 were at greater risk of sleep disturbances. Exposure to light (particularly blue light) and activity from screens before bed affects melatonin levels and can delay or disrupt sleep.17 Media use around or after bedtime can disrupt sleep and negatively affect school performance.13

Children who overuse online media are at risk of problematic Internet use,18 and heavy users of video games are at risk of Internet gaming disorder.19 The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition,20 lists both as conditions in need of further research. Symptoms can include a preoccupation with the activity, decreased interest in offline or “real life” relationships, unsuccessful attempts to decrease use, and withdrawal symptoms. The prevalence of problematic Internet use among children and adolescents is between 4% and 8%,21,22 and up to 8.5% of US youth 8 to 18 years of age meet criteria for Internet gaming disorder.23

At home, many children and teenagers use entertainment media at the same time that they are engaged in other tasks, such as homework.24 A growing body of evidence suggests that the use of media while engaged in academic tasks has negative consequences on learning.25,26  http://pediatrics.aappublications.org/content/138/5/e20162592

The American Academy of Pediatrics, AAP also reported on the cancer risk associated with wireless (Wi-Fi) connected devices.

AAP on Cancer Risk

“The Academy continues to reinforce its recommendation that parents should limit use of cell phones by children and teens. “They’re not toys. They have radiation that is emitted from them and the more we can keep it off the body and use (the phone) in other ways, it will be safer,” said Jennifer A. Lowry, M.D., FAACT, FAAP, chair of the AAP Council on Environmental Health Executive Committee.”

Responding to the AAP announcement, the Environmental Health Trust shared this,

“The findings of brain tumors (gliomas) and malignant schwann cell tumors of the heart in the NTP study, as well as DNA damage in brain cells, present a major public health concern because these occurred in the same types of cells that have been reported to develop into tumors in epidemiological studies of adult cell phone users,” stated Ronald L. Melnick, PhD, the National Institutes of Health toxicologist who lead the NTP study design and senior advisor to the Environmental Health Trust. “For children the cancer risks may be greater than that for adults because of greater penetration and absorption of cell phone radiation in the brains of children and because the developing nervous system of children is more susceptible to tissue-damaging agents. Based on this new information, regulatory agencies need to make strong recommendations for consumers to take precautionary measures and avoid close contact with their cell phones, and especially limit or avoid use of cell phones by children.”

 

Children and Social Media Risks

Research studies point to screens being harmful and addictive. An important recent study found that screen time and social media use in teens is associated with increased depression and suicide related outcomesThis 2018 publication states,  

“In two nationally representative surveys of U.S. adolescents in grades 8 through 12 (N = 506,820) and national statistics on suicide deaths for those ages 13 to 18, adolescents’ depressive symptoms, suicide-related outcomes, and suicide rates increased between 2010 and 2015, especially among females. Adolescents who spent more time on new media (including social media and electronic devices such as smartphones) were more likely to report mental health issues, and adolescents who spent more time on nonscreen activities (in-person social interaction, sports/exercise, homework, print media, and attending religious services) were less likely.”

Facebook’s first President Sean Parker, is quoted here in ZeroHedge voicing his regret regarding helping create social media in the form we know it today, saying:

“I don’t know if I really understood the consequences of what I was saying, because of the unintended consequences of a network when it grows to a billion or 2 billion people and it literally changes your relationship with society, with each other,”…

”God only knows what it’s doing to our children’s brains.”

Parker says the social networking site exploits human psychological vulnerabilities through a validation feedback loop that gets people to constantly post to get even more likes and comments.

“It’s exactly the kind of thing that a hacker like myself would come up with, because you’re exploiting a vulnerability in human psychology,” he said.

“The inventors, creators — it’s me, it’s Mark [Zuckerberg], it’s Kevin Systrom on Instagram, it’s all of these people — understood this consciously. And we did it anyway.”

To quote noted digital addiction experts, Tracy Markle, MA, LPC & Brett Kennedy, PsyD,

“In the United States, 8.5% of children ages 8-18 meet the criteria for Internet Gaming Disorder (Gentile, 2009). Numerous statistics identify the first exposure to pornography occurs between the ages of 11-13. According to data from Child Guard: 65% of children between the ages of 8 and 14 have been involved in a cyber-bullying incident that occurred on social media. Without restrictions to content and access, it is a certain guarantee that digital media issues will escalate due to what we know about cognitive development. In general, the development of the prefrontal cortex, where our all-important executive function cognitions reside, are not developed and impulse control is impaired for children/adolescents. Digital media impacts this command center of the brain and makes resisting online gaming, porn, social media, and entertainment difficult, if not impossible, for many young people. Consequently, these students will struggle a great deal with attention, comprehension, memorizing, and staying on task. According to a 2013 American Academy of Pediatrics study, those with ADHD and Autism are particularly at risk.”

The Risks of VR “Experts say the Future of Education will be Gaming on a screen and Virtual

As the above video suggests, that Oculus Rift (owned by Facebook) and other Virtual Reality platforms like Google Cardboard are proposed to be the future of education.  This VR invasion is planned despite warnings that immersion in VR can have psychological effects that last after leaving the virtual environment, and despite there being NO independent research on the exposure of children and Virtual Reality (VR).  Many in the global edtech industry still promote gaming and VR as the future of education…and even give this warning about Virtual Reality,

“The spread of new technologies in child and family education has its downside, too. Media stories discuss the problem of ‘tablet children’, the new ‘Mowglis’ raised by computers — the threat that modern children overusing tablets and smartphones (instead of playing with toys, their mothers or their peers) from a very early age would lose some important cognitive skills & abilities that they could not develop with limited tablet inter-faces. However, this is likely a temporary problem: the next generation of technologies will unify all educational, developmental and entertaining solutions surrounding a child (her own room, playing area in the kindergarten, or entertainment center in the mall) into inte-
grated learning environments where long-term gaming scenarios will combine physical, virtual and augmented realities in a natural way and will provide ‘seamless’ experiences of educational scenarios. However, in the long term we can expect other serious, yet under-estimated, problems, that will jeopardize the formation of complex mental structures in children and younger adults — in particular:

  • ‘new dyslexia’: many complex cognitive activities (e.g. proper use of language such as
    the correct spelling and punctuation; skills of complex information retrieval through
    remembering and analyzing; proper use of technical environments through device
    programming or configuring, etc.) will be done by automated services and advisory
    services — and ‘intuitive interfaces’ will ‘dumb down’ the majority of population that
    will lose relevant skills & abilities;
  • ‘flexible’ morality and worldview: when virtual worlds with arbitrarily constructed physical and ethical laws become the main developmental & educational environment for the majority of children and adults (which, as we believe, is a highly realistic scenario for education beyond 2020), and the basic motivations are driven by gaming achievements, a generation is soon formed with highly volatile and distorted value system, that may likely be incompatible with needs & goals of their real families, future employers, and society overall.

These threats (and many others that could be listed alongside) indicate a fundamental challenge that the new education faces even today. New technology solutions rarely take into consideration specific goals and functions related to the development of individuals and communities.

So far, they have not produced any major disastrous effects on human cognitive abilities (or at least these effects have not been too dramatic to risk the functioning of our society) — but it should be seen as a responsibility of hardware, software and virtual world designers to avert these effects in the future.” –Page 14, Future Agendas For Global Education [Emphasis added]

 

Privacy and predictive profiling

The cost of public education should not be paid for with a child’s data. The former CEO of an education platform called Knewton famously said, “Education is the most datamineable industry by far and it’s not even close”.  It’s not just your child’s grades being collected and tracked, it is everything– from mouse clicks to page visits, to reading speed, algorithms to track children’s eye movements on the screen or how your child feels.  The edtech industry wants student data to be interoperable (share-able) and they don’t need or want your permission to take it, analyze it or share it. An astonishing amount of data is collected on students and edtech can collect millions of data points per day.  The analyzing part?  That’s where you should be concerned. In education, it’s touted as Personalized Learning, it can predict and make decisions without the student or parent being aware. These analytics are often hidden, as in computer programs and algorithms.  Software programs can scrape together sources of education or family related data and can combine that data with other available data to make all kinds of predictions.  For example, one popular online assessment measures how quickly children answer the test items. This company then did a study combining that data with personal behavioral surveys students took. The online assessment company used that research data to predict students’  “deep rooted problems”.

The problem is that data can make decisions about a child, and there is often no way for the individual child or parent to know this has happened or if it is correct. This is a violation of Fair Information Practices,  FIPs and many would say the use of online personalized learning, is too personal.

Unlike Europe, the United States does not have a law to penalize companies who misuse our data.  In Europe, under  GDPR, companies now face steep fines (4% company’s net) for sharing or using personal data without consent. In the US, when it comes to children’s data– our federal children’s privacy laws have many loopholes, no private right of action, and no real enforceable penalties. The FTC regulates COPPA, a privacy law for children under the age of 13. The US Department of Education polices FERPA, a law weakened in 2011, to allow data collection without parent consent.   PPRA is also policed by the USDoE.

Recently, there have been several privacy complaints filed and two important USDoE guidance letters issued.

  • Electronic Frontier Foundation files FTC complaint against Google for tracking students  See complaint here
  • Thousands of educational apps found improperly tracking children.  Click here to see apps
  • 20+ watchdog groups file complaint against Google YouTube for COPPA violations.  Click here for complaint
  • Common Sense Media files complaint against Facebook data sharing policy for teens  See story here ; complaint here
  • U.S. Ed. Dept. Warns Districts to Step Up Student Privacy Protections for SAT, ACT   See here and here
  • U.S. Ed. Dept. Agora Guidance: “A parent or eligible student cannot be required to waive the rights and protections accorded under FERPA as a condition of acceptance into an educational institution or receipt of educational training or services.”  See Agora letter here 
  • Multi-year study Transparency and the Marketplace for Student Data finds:

Student lists are commercially available for purchase on the basis of ethnicity, affluence, religion, lifestyle, awkwardness, and even a perceived or predicted need for family planning services. This study seeks to provide an understanding of the commercial marketplace for student data and the interaction with privacy law. Over several years, Fordham CLIP reviewed publicly-available sources, made public records requests to educational institutions, and collected marketing materials received by high school students. The study uncovered and documents an overall lack of transparency in the student information commercial marketplace and an absence of law to protect student information. https://ir.lawnet.fordham.edu/clip/4/

The majority of parents are concerned about their child’s screen time. 

The makers of the documentary, Screenagers: Growing Up in the Digital Age have developed the “Away For The Day” (AFTD) initiative to help transform middle schools into cell phone-free spaces.  According to Screenagers, 

“The Screenagers team decided to conduct a national survey on cell phone policies in schools and parental preferences. They learned that 55% of middle schools let students carry phones all day yet 82% of parents do not want their kids using phones at school.

We have looked deeply into the scientific literature and have found several concerning studies about academic performance and emotional well-being regarding cell phones in middle schools.We believe that having phones put away in lockers, so the phone is physically off of the students, is the best practice.”

Edtech and Silicon Valley proponents like to say cell phones are part of the “real world” and put the onus on children to regulate themselves as good Digital Citizens.  These same groups like to say that content matters and if it is an “educational” video game or YouTube, then “educational”  screen time isn’t as detrimental as screen time for entertainment purposes.  However, the edtech industry is working hard to gamify education, making engaging (addictive?) video game-like curriculum. They call it gamification.

Instead, of gamifying education, we believe parents should have the equitable choice of textbook, human teacher and paper pencil for their child’s education.   Also, regardless of content, a child’s retina, a child’s developing brain should have age appropriate limited screen time —of any kindThese so called “educational” apps and video games pose the same risk as any other digital media to our children’s health.

 

How much “educational” screen time is your child exposed to–including homework.   Ask.

Parents in Maryland state have made history in this realm–other states should follow suit.  Thanks to the hard work and research of screensandkids, as this NY Times piece reports, Maryland passed a bill this year to create best practices and age appropriate guidelines for digital media use in schools.

“Maryland could become the first state to address parental concerns about computer screen time for children in the classroom.

Legislation passed this month would require state education officials to develop optimum health and safety practices for the use of digital devices in schools. …The bill throws Maryland into an already heated national debate over the potential for digital devices and apps to addict children — and whether it is up to the tech industry or parents to make sure children don’t get hooked.”

 

What can parents, educators, others do?

Prevention: reduce exposure.
Research first.
Ensure safety first.
Parent and student rights to direct education.

As stewards of children: school officials, legislators, medical professionals, software developers have an ethical (and often legal) obligation to protect children from addictive and harmful technology.  As such, companies should conduct independent (not bought and paid for by tech industry) science-based research on  safety and efficacy of devices and software; schools should verify safety BEFORE exposing these platforms to children.  Children should never be used in a research experiment without informed parental consent.

Every state needs to create age appropriate, independently researched safety guidelines and screen time limits in schools.  Ask your school to create a policy to put the cell phones away for the school day.   Parents absolutely have the right to direct their child’s education.  Until federal and state laws protect children’s health and privacy, many parents are opting out of tech in schools. (Surprise, you won’t be alone in your low tech quest —Bill Gates and Steve Jobs raised their kids tech-free.)  This Truth in American Education piece by Jane Robbins offers advice for how parents can push back. 

Silicon Valley knows there are billions (trillions) to be made in edtech–technology in education–but those dollars shouldn’t come at the risk of harming children.  

 

 

References 

CNN, WHO classifies ‘gaming disorder’ as mental health condition  https://edition.cnn.com/2018/06/18/health/video-game-disorder-who/index.html?no-st=1529351950

WHO, ICD 11 Report  2018 http://www.who.int/classifications/icd/en/

The American Psychiatric Association,  DSM-5 Diagnosis of  Internet Gaming Disorder http://pediatrics.aappublications.org/content/140/Supplement_2/S81

Maryland Bill HB1110 Public Schools – Health and Safety Best Practices – Digital Devices https://legiscan.com/MD/bill/HB1110/2018 

Screens and Kids research http://www.screensandkids.us/

Campaign for a Commercial-Free Childhood (CCFC),  Children’s Screen Time Action Network  https://screentimenetwork.org

Dr. Victoria Dunckley,  Autism and Screen Time: Special Brains, Special Risks https://www.psychologytoday.com/us/blog/mental-wealth/201612/autism-and-screen-time-special-brains-special-risks

Dr. Victoria Dunckley Gray Mattters: Too much screen time damages the brain https://www.psychologytoday.com/us/blog/mental-wealth/201402/gray-matters-too-much-screen-time-damages-the-brain

Tracy Markle, MA, LPC  & Brett Kennedy, PsyD –Digital Media Treatment and Education; Clinicians handbook: Internet Addiction in Children and Adolescents: Risk Factors, Treatment, and Prevention. digitalmediatreatment.com/tracy-markle/

Dr. Nicholas Kardaras, It’s digital heroin–how screens turn kids into junkies https://nypost.com/2016/08/27/its-digital-heroin-how-screens-turn-kids-into-psychotic-junkies/

Dr. Richard Freed, Wired Child– Reclaiming Childhood in a Digital Age richardfreed.com/wired-child/
Disrupted Childhood The Cost of a Persuasive Design https://5rightsframework.com/static/5Rights-Disrupted-Childhood.pdf
As more countries ban iPads and mobile phones from the classroom, could wifi be giving our children cancer?  http://www.dailymail.co.uk/news/article-5872001/Could-wifi-giving-children-cancer.html
.
EdScoop updates on Screen Time and Tech Safety Research https://t.co/5yR123OOJA?amp=1

ScreenQ  fMRI shows screens “too hot” for young brains  http://www.aappublications.org/news/aapnewsmag/2018/05/05/passcreens050518.full.pdf

The depressing chart mark Zuckerberg does not want you to see https://www.zerohedge.com/news/2018-05-21/depressing-chart-mark-zuckerberg-does-not-want-you-se

The American Academy of Pediatrics 2016,  Media Use in School-Aged Children and Adolescents  http://pediatrics.aappublications.org/content/pediatrics/138/5/e20162592.full.pdf

Carcinogenesis Studies on Cell Phone Radio Frequency, National Toxicology Program, part of the National Institute of Environmental Health Sciences https://www.biorxiv.org/content/biorxiv/early/2016/05/26/055699.full.pdf

Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among U.S. Adolescents After 2010 and Links to Increased New Media Screen Time   http://journals.sagepub.com/doi/10.1177/2167702617723376

CREDO, the Center for Research on Education Outcomes at Stanford, Study of Online Charter Performance University https://credo.stanford.edu/pdfs/OnlineCharterStudyFinal2015.pdf

NEPC, National Education Policy Center,  Asleep at the Switch: Schoolhouse Commercialism, Student Privacy, and the Failure of Policymaking  http://nepc.colorado.edu/publication/schoolhouse-commercialism-2017

NEPC, National Education Policy Center, Virtual and Blended Learning Schools Continue to Struggle and to Grow http://nepc.colorado.edu/newsletter/2016/04/virtual-schools-annual-2016

Kids Still Prefer Books to Screens  https://qz.com/930173/kids-still-prefer-paper-books-to-screens-according-to-a-new-study/

Forbes, ‘Personalized Learning’ wants to get very personal https://www.forbes.com/forbes/welcome/?toURL=https://www.forbes.com/sites/petergreene/2018/06/21/personalized-learning-wants-to-get-very-personal

Studies show pen and paper beats laptop for retaining info in class www.foxcarolina.com/story/38238142/studies-show-pen-and-paper-beats-laptop-for-retaining-info-in-class

Real Virtuality: A Code of Ethical Conduct. Recommendations for Good Scientific Practice and the Consumers of VR-Technology https://www.frontiersin.org/articles/10.3389/frobt.2016.00003/full

Five Ethical Considerations For Using Virtual Reality with Children and Adolescents  https://www.kqed.org/mindshift/46103/five-ethical-considerations-for-using-virtual-reality-with-children-and-adolescents

Mobile Phone Bans Lead to Rise in Student Test Scores https://news.utexas.edu/2015/05/18/mobile-phone-bans-lead-to-rise-in-student-test-scores

Have Smart Phones Destroyed a Generation? https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/

20+ groups file FTC complaint against Google YouTube for improperly collecting children’s data  http://www.commercialfreechildhood.org/sites/default/files/devel-generate/tiw/youtubecoppa.pdf
U.S. Ed. Dept. Warns Districts to Step Up Student Privacy Protections for SAT, ACT   https://mobile.edweek.org/c.jsp?cid=25920011&item=http%3A%2F%2Fapi.edweek.org%2Fv1%2Fblog%2F179%2Findex.html%3Fuuid%3D76444
U.S. Ed. Dept. Agora Guidance: “A parent or eligible student cannot be required to waive the rights and protections accorded under FERPA as a condition of acceptance into an educational institution or receipt of educational training or services.” https://studentprivacy.ed.gov/sites/default/files/resource_document/file/Agora%20Findings%20letter%20FINAL%2011.2.17.pdf
Parent Coalition for Student  Privacy https://www.studentprivacymatters.org/
Fordham CLIP Multi-year study:  Transparency and the Marketplace for Student Data https://ir.lawnet.fordham.edu/clip/4/
Belmont: In human subject research, individuals always must give informed consent and participation must be voluntary. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html

 

 

 

 

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Cheri Kiesecker