Although video games have been a part of American culture for over 40 years, their influence in the lives of youth has grown exponentially in recent years, particularly for those on the Autism Spectrum. The Kaiser Family Survey found that, between 2000 and 2010, the average amount of time that 8-18 year olds spend playing video games quadrupled to an average of one hour per day for girls and two hours per day for boys. Those whose parents did not set rules on how much they are allowed to play video games spend twice as much time doing so. Evidence confirms that children on the Autism Spectrum spend twice as much time playing video games as their typically developing peers. Video games have come to dominate the free time of many autistic children and teens, leading parents and health professionals to wonder about their long-term effects. There are undoubtedly some advantages to youth engaging in this hobby. When kids are busy playing video games, they are typically content, physically safe, and don’t appear to require much parental attention. Video games can enhance eye-hand coordination and visual attentions skills, and educational video games can be effective teaching tools. However, a growing body of scientific research confirms what parents and mental health professionals have long suspected; that too much gaming can be a serious detriment to our children’s health.
For example, numerous studies indicate a negative correlation between time spent playing video games and academic success. In other words, the more kids play on their Xbox or the Nintendo, the less likely they are to earn good grades. The reasons for this are complex, but the primary effect appears to be that excessive video game habits displace activities with academic value and those that teach patience and delayed gratification, such as reading for enjoyment or devoting adequate time to homework. In my psychiatric practice, I often care for youth who are able to perform well on their schoolwork at school, where video games are not a distraction. However when these youth are at home they are so motivated to play video games that they consistently fail to complete homework. This is particularly evident in the case of children who performed well academically until they were given a computer or video game console, after which their grades quickly deteriorated. Some research evidence indicates that playing video games excessively over months may weaken a child’s academic skills, particularly the ability to concentrate.
Video gaming can also interfere with a child’s sleep habits, particularly if played in a child’s bedroom or before bed. Access to video games in the bedroom in strongly associated with inadequate sleep, which can in turn lead to problems with learning, memory, depression, and hyperactivity. Children on the Autism Spectrum are particularly vulnerable to this effect, and are more likely to have behavioral problems if they have a video game console in their bedroom, especially those who have no consistent rules on how much they are allowed to play. Playing video games before bed also significantly increases the amount of time it takes a child to fall asleep, partly because youth often resist turning the game off when instructed, but also because the activity is mentally stimulating and promotes wakefulness. I frequently evaluate children who habitually play handheld video games (on a phone, tablet or Nintendo DS) in bed at night, leading to severe sleep problems which can only be reversed after parents confiscate these devices at bedtime.
In the wake of an increasing number of school shootings such as the tragedy at Sandy Hook, there is a significant concern about the effects violent video games play on vulnerable youth. Research reassures us that most youth who play violent video games do not go on to act out violently. However, younger, impressionable, or unsympathetic children who play violent video games excessively are at risk to develop more aggressive thoughts and behavior problems over time. Aggressive youth tend to prefer violent video games and play more, which can lead to more aggressive thoughts in a harmful cycle.
Can video games be addictive? Although most children and teens play video games in moderation, some habitually spend excessive time playing, causing significant problems in their lives. Video game addiction is not yet an official psychiatric diagnosis in the United States as it is in other countries such as China and South Korea; it has only recently been listed as a provisional diagnosis in the DSM-V entitled “Internet Gaming Disorder.” However, a great deal of research evidence confirms that 8-12% of young people develop an impairing behavioral addiction to video games. These youth become psychologically dependent on video games to give them an immediate sense of competence, independence, and relatedness (through interaction with video game characters) and to relive negative moods. However, over time addicted youth feel diminishing competence, independence and relatedness in the real world often leading to decline in mood and depression. Excessive video game play negatively impacts the lives of children in a number of ways, including deteriorating sleep and academics habits as noted above. Overuse of video games often results in decreased face-to-face social contact with peers, which can degrade existing social relationships and skills and ultimately lead to social anxiety. Caring parents often respond by attempting to control the child’s video game habit, which is very threatening to a child who has become depend on the video game habit to meet their psychological needs, resulting in severe conflict which can impair the parent-child relationship as well.
How can we parents protect our children from the insidious effects of excessive video game play? Although it is important for us to teach our children that too much time playing video games is unhealthy, most children need parents to set firm limits to guide their screen habits. The American Academy of Pediatrics recommends a total screen time (including television, computer, and video game play) of no more than one or two hours per day. This is a healthy but ambitious goal, as it is significantly less than the average amount of screen time the average American youth engages in. Whatever limit parents decide upon, it is vital that they maintain the rules in their household, using rewards or punishments to ensure the child’s compliance as needed. In order for parents to adequately supervise their children’s media habits, all screens should be left in public areas of the home, not allowed into a child’s bedroom. Parental controls can be set on video game consoles (such as the Xbox or PlayStation) which will limit what types of video games will play and can set time limits for game play by the day or week. Details on how to set these controls (which can be locked with a password) can be found with a YouTube search or by calling the console manufacturer. If parents significantly restrict the amount of time their child spends on video games, it may create a void in their child’s free time. It will be important to help the child to fill that void by encouraging healthier activities, such as reading for enjoyment, social contact with peers, sports or family activities. In order to protect our children from inappropriate content, parents should understand how to use video game ratings system (such as the ESRB) and encourage video games with positive and educational content. Playing video games with our children can be an enjoyable way to understand the game’s content and what it means to our children. Finally, it’s important for parents to act as a positive role model by monitoring and limiting their own electronic media habits as appropriate.
Although youth who are addicted to video games are in particular need of such limits, those whose access to video games has been abruptly restricted will sometimes threaten their parents or themselves in a desperate attempt to coerce their parents to relent or simply out of despair. In such situations, a parent must act immediately to ensure the safety of their child and themselves. If a parent feels that they cannot effectively enforce limits on their child’s excessive video game habits, or if they feel that attempting to do so may cause their child to act out in an unsafe manner, consultation with a qualified mental health professional is indicated.
For most American youth, video games are an enjoyed in healthy moderation. However, a number of youth, particularly those on the Autism Spectrum, suffer from the effects of excessive play. It is the duty of all parents to protect our children from the dangers of excessive video game play and guide them towards healthy media habits which will last a lifetime.
Paul Weigle, MD, is a Child and Adolescent Psychiatrist and the president of the medical staff at Natchaug Hospital. Dr. Weigle has served on the American Academy of Child and Adolescent Psychiatry’s Media Committee since 2002. Since that time, he has studied the mental health effects of electronic media habits, and has taught on the topic at numerous national psychiatric meetings, as well as on radio and television. Correspondence for this article can be sent to firstname.lastname@example.org.
Kaiser Family Foundation (2010). Generation M2: Media in the lives of 8- to 18-year-olds. Menlo Park, California: Author. Retrieved from www.kff.org/entmedia/mh012010pkg.cfm