Bright & Quirky Child Summit 2021: Tame The Overwhelm was a 5-day free online summit which aimed to help twice exceptional (2e) children - gifted children with ADHD, autism, learning differences like dyslexia, anxiety and/or depression. The conference featured 28 educators and psychologists who shared science-informed actionable strategies that promote social, emotional, and academic thriving even in tough times. The summit was hosted by Debbie Steinberg Kuntz, a licensed marriage and family therapist as well as the Founder of Bright & Quirky. Day 2 focused on motivating kids and balancing tech.
How to Help Kids Tame Screen Time and Find Motivation for School - Michael Delman, MEd & Clifford Sussman, MD
Michael Delman is an author, school founder, award-winning educator, and a pioneer and leader in the area of Executive Function coaching. He has served as CEO and founder of Beyond BookSmart, the nation’s largest Executive Function coaching company, since 2006. He has been featured in The Times of London, CBS Boston affiliate WBZ TV, and dozens of media outlets across the country. In 2018, he published his first book Your Kid’s Gonna Be Okay: Building the Executive Function Skills Your Child Needs in the Age of Attention.
Clifford Sussman, MD is internationally known as a pioneer in treating internet and video game addiction. He has been in private practice in psychiatry for children, adolescents, and young adults in Washington, DC since 2008 and is an expert consultant for the Digital Use Disorder Track at Caron Renaissance in Boca Raton, FL. He has been featured as an authority on screen use related issues throughout the media and peer-reviewed literature. He has presented on the topic to audiences of all types and sizes at conferences, hospitals, schools, and other venues locally and internationally. He continues to present frequently online during the pandemic.
Debbie observed that during the ongoing pandemic, many of the children’s physical outdoor activities like sports or scouts have been cancelled. Instead, there has been a lot of digital bingeing with children spending time on social media, video games, and web surfing. Dr. Sussman explained that there are various reasons why screen time is engaging.
Screen time is an escape from a tough world to be in right now, as one can have more control over things in a virtual world.
Screen time is a social aid, providing a way to seek social connections at a time when people are very isolated. For example, social media is made just for socialising, while multiplayer games also have social aspects.
Most importantly, screen time provides the brain with instant and continuous stimulation, just like other drugs or addictive activities. This is what the brain – especially the young growing brain – wants.
Dr. Sussman proceeded to explain that dopamine is the pleasure neurotransmitter of the brain. The release of dopamine is based not so much on the pleasurable stimuli itself, but on its time delay. The less time one has to wait for a reward, the more dopamine is released. In other words, dopamine is released in response to instant gratification. Because the instant gratification with screens is continuous, children tend to engage in digital bingeing, getting dopamine release continually for hours and days on end. As a result, they become desensitised to dopamine and its effects. The dopamine receptors in the brain decrease in number, and the children become less able to feel any kind of pleasure. They start finding things in life less stimulating and need to seek more instant gratification to get the same relief, analogous to how an alcoholic develops a tolerance to drinking and needs more drinks to get the same amount of buzz. This phenomenon of having high tolerance to pleasure and being easily bored is also known as the reward deficiency syndrome.
Michael agreed that screen time activities such as social media platforms provide instant gratification and back-and-forth engagement with friends, which are very compelling for children. He noted that average teachers just lecture and deliver information, without ensuring that students are engaged and understand the content. That is a very low bar for screen time activities to compete with. Good teachers may try to engage students by teaching high interest content that children can connect with, using effective gamified teaching strategies with teams competing for points, and checking in with students for accountability. Yet, the pandemic has also taken a toll on teachers’ energy levels, who now have to do far more preparation work for online classes than they have ever had to do. Thus, even good teachers now find it challenging to engage students in online classes when faced with the competition of screen time activities.
Dr. Sussman emphasised the importance of teaching children to develop self-awareness about the dopamine level of various activities. Activities can be sorted into low and high dopamine categories, though it is actually a continuum with some activities in between the two extremes. Regardless, the key is to have a balance between high and low dopamine activities.
High dopamine activities involve instant gratification and thus release a lot of dopamine. E.g. Using social media, playing video games, drinking alcohol, and smoking cigarettes.
Low dopamine activities involve delayed gratification and require patience. E.g. Doing homework, doing an arts and crafts project, learning to play an instrument, or playing a board game where there is a lot of setup and waiting one’s turn.
Michael clarified that not all screen time activities are high dopamine activities, and not all school classes are low dopamine activities. For example, there can be a high dopamine classroom activity in which students have timed brainstorming sessions in groups and post sticky notes of their ideas on a board. This can also be done in online classes, such as by using the digital bulletin board app Padlet. On the other hand, there can be a low dopamine classroom activity, be it offline or online, in which students work on writing and organising essay outlines.
Debbie gave the analogy of food, where low dopamine activities can be seen as healthy food while high dopamine activities can be seen as junk food. Going on a weight loss diet that requires complete abstinence from junk food never lasts, as one is likely to eventually binge on the junk food. In contrast, going on a weight loss diet that allows a moderate amount of junk food as planned treats is more sustainable. As such, there is a need to create boundaries and balance.
Dr. Sussman agreed that there are parallels between binge gaming and binge eating. Food is prevalent, and even if we attempt not to eat at a birthday party, it is unrealistic to completely abstain from cake. Similarly, devices with screens are ubiquitous and cannot be avoided in today’s society. Even when one is doing low dopamine activities on a screen, there is easy access to other high dopamine activities. However, unlike food, it is less easy to judge and label whether screen time activities are good or bad. A lot of screen time activities, including high dopamine activities, do have some redeeming values. For instance, Dr. Sussman personally likes playing challenging video games which promote problem-solving and imagination. Michael also likes playing the word puzzle video game Wordscapes which builds vocabulary and lateral thinking. What children need to understand is that there can be too much of even a good thing. Video games might not be inherently bad, but it becomes an issue if children are addicted to only playing video games all the time to the point where their other aspects of life are getting neglected.
Dr. Sussman explained that rather than the frequency and duration of screen time, what really defines addiction is the negative impact it has on one’s life and functioning. Signs that screen time addiction has become an out-of-control problem include academic problems such as a crash in grades or dropping out of school, social problems, health problems, and psychological problems such as anxiety. In particular, he highlighted the following psychological problems to watch out for.
Depression, including low-grade discontent / dysthymia / reward deficiency syndrome in which everything seems boring.
Aggressive behaviour especially around screen limits, including seeking behaviour such as lying or stealing money to play video games. These children may be so addicted that they are not regulated and are just trying to get their next fix by any means necessary.
Suicidality, such as threatening, “If you take my screens away from me, I'm going to have no point to living and I'm going to kill myself”. Suicidal threats must be taken very seriously especially for teenagers who comprise a high-risk group, because the likelihood of suicide is higher among people with addiction and has also increased during the pandemic.
Dr. Sussman warned that if parents start seeing the above signs, the child might not be able to listen to reason, and it may be time to get professional help.
Higher level of intervention involves outpatient dopamine detox, as well as regular family and individual therapy assisting the child in balanced use of screen time and self-regulation.
Higher level of care involves inpatient programmes that provide the same types of steps.
Michael noted that before a child becomes addicted, the child simply likes screen time a lot and may sometimes have a problem but not all the time and not at an extreme level. The child might struggle with managing their amount of screen time, such that is sometimes affects their work and happiness. At this point in time, parents should have conversations with their child about the problem. However, the outcome of the conversation can be negative if the child is not in the mood to talk. Hence, both parties should agree to have a conversation ahead of time. This can be as simple as knocking the door before entering the room and saying, 'I want to chat for a few minutes. There’s something on my mind. Is this a good time?' If the child says no, parents can ask when would be a good time and perhaps give a forced choice, such as saying, 'Well, it could wait. Maybe after dinner? Or if not, why don't we set up a time to talk?' Dr. Sussman agreed on the importance of having such conversations at the right place and time. Parents can go through the following guiding questions step-by-step.
'Is everyone safe? Are we in the middle of a volatile situation?'
'Is everyone regulated? Is everyone in a place where we can actually listen, without having a tantrum or getting aggressive?'
Debbie did a role-play demonstration of how parents can talk to their 12-year-old child. 'Honey, I love seeing you having fun online, whether it's playing video games and whooping it up with your friends, or scrolling through social media catching up with your friends. I love that you can be social, especially during this time of social distancing. But what concerns me is that you’re in a bad mood when you get off, and you seem to be taking less pleasure in things. We’re having some power struggles about finding balance. I want to get along as a family. I would like to hear your thoughts on how these screens play a part in your life, and I would like us to run some experiments to find more balance.'
Michael noted that the demonstration was good as the parents avoided judging the child, understood the value of the child’s interests, and empathised with the child’s stress. Parents should try to meet children where they are, talking to them in a way that they will actually listen. Dr. Sussman concurred that if parents approach their child in a way that completely rejects what they like to do, parents will probably just push him away and lose his attention. It is important for parents to learn how to acknowledge their child's interests and their frustration with having to stop. There is a distinction between validating behaviours and validating feelings. Even if parents do not approve of the child’s behaviour, parents can still at least validate their feelings and concerns. Doing so can help to de-escalate situations in families.
Michael proposed that parents can use collaborative problem-solving methods to brainstorm strategies with their child. It is important for the child to go first and share his perspective. Parents should then validate what the child said and ensure the child knows he has been heard, before offering their own perspective stating observable behaviours they have seen in the child without any value judgment. The child should then reflect back what the parents have said by listening and restating the parents’ points. Instead of arguing over differences in opinion, parents and the child can learn to see each other’s point of view and look for overlaps in opinions.
Dr. Sussman agreed with Michael’s approach of reflective listening during conversations, which is used by therapists in the motivational interviewing technique developed for treating addiction. Parents typically focus on giving insight to their child, such as by telling the child all the problems in their life. In the process, parents become an authority figure demanding their child to do as they say, with the child’s motivation to change being imposed by outside forces. This results in an unproductive power struggle. In contrast, the motivational interviewing technique focuses on helping the child explore their own insight and discover their own motivation to change from within. Motivational interviewing involves asking open-ended questions to get the child talking and exploring their ambivalence about things.
'How do you think you do with setting limits with yourself on video games? How much of a balance do you think you have?' Instead of, 'Do you think you have a problem with video games?'
'What sorts of benefits do you get out of playing video games? What makes you keep coming back to it?'
'What makes it a problem for you? What sorts of problems have you seen in your life because of the playing video games?'
Next, Michael suggested that parents can conduct small experiments with their child to yield data, tracking the situation together to see what is going on, before agreeing on reasonable limits. For example, parents and the child can check the child's mood after different durations of screen time. Parents can also use apps to monitor the child’s screen time. He recommended the app Forest, in which users set up timed sessions and plant virtual trees, which either grow if users stay focused on their work, or die if users get distracted by other apps. Examining the number of alive and dead trees in the child’s virtual forest can be a good conversation starter.
Dr. Sussman conceded that his favourite apps involve monitoring and giving users feedback on the number of hours spent on various screen time activities, so that users can see the consequences of their behaviours. However, he is not a fan of apps that actually set limits on screen time, and he likens this approach to fighting fire with fire using technology. In his experience, such apps rarely work, with users giving up on using the apps after a short while. This is because users rely on the apps to limit screen time, instead of relying on inner strength. Moreover, a child who is addicted to screen time may simply find ways to hack parental control softwares and cover their tracks.
Nevertheless, Dr. Sussman gave the caveat that whether such apps are helpful also depends on the users themselves. Users may find success with limit setting apps if they genuinely want to use the apps and commit to using the apps. Michael shared an anecdote of how a student’s mother tried various apps with different locking mechanisms to limit the child’s screen time, and even physically locked the child’s devices in the care. However, the child broke into the mother’s car. On the other hand, there was a student who chose to use the app SelfControl, which allowed her to blacklist and whitelist specific websites. The app helped her to avoid distractions while writing essays, but it worked for her only because there was a sense of ownership.
Instead of limit setting apps, Dr. Sussman recommended parents to adopt a more hands-on approach in setting limits, checking on their child in-person from time to time, especially when the child is supposed to be doing low dopamine activities. Parents can ask the child do their homework and screen time activities in an area within parents’ sight instead of alone in the room. Furthermore, parents should set clear rules, as well as have reasonable, logical, and natural consequences stated ahead of time. For example, if the child uses his phone while he is supposed to be playing a board game with the family, he may lose his next block of high dopamine activity. It is alright if the child fails to follow every rule, because that is how the child can learn. The important thing is for parents to be consistent with rules and consequences, following through on what they say will happen.
Dr. Sussman also recommended some actions that parents can take to help with managing screen time. Doing these actions is relatively easy and painless, compared to directly telling their child to reduce screen time. It is especially helpful with younger children who may not be ready for mature discussions, as well as with early teenagers who may be tricky to reason with as they are at a defiant and rebellious stage.
Firstly, as the human brain is triggered by cues, parents should be aware of the environmental cues in the home, and make adjustments in the environment. He gave the analogy of how the sights, smells, and sounds of a bar can trigger dopamine release for an alcoholic even before he has his first drink. Similarly, parents are setting their child up for failure if the child takes distance learning online classes on a gaming computer with distractions such as his phone and tablet next to him on the desk. Parents can set up a screen-free zone in the house for low dopamine activities, and a completely separate area for high dopamine activities. Parents can even provide the child with different devices, one associated with taking classes and doing work, and another for gaming and social media.
Secondly, although parents may be wary about overprogramming their child, it can be beneficial to add some structured activities to their child’s schedule. Most children have long stretches of unstructured time during the weekends, and the amount of unstructured time has increased with the implementation of distance learning during the pandemic. When children sit at home all day with no structured activities to do, they need to rely on willpower in order to not take out their screen devices. In contrast, when children are occupied with structured activities, they are unlikely to pull out and use their screen devices midway through. In particular, parents can introduce structured activities that address their child’s social needs, so that the child has options besides screen devices to seek social interaction.
Michael commented that although it is necessary for children to develop self-control, it may not always be immediately possible. Children with ADHD can have a developmental lag of up to 3 years. Therefore, parents need to set realistic expectations and allow a peaceful transfer of power. When the child is 8 to 10 years old, parents can set some limits on screen time, structuring what the child can access and how long the child can access it for. When the child is 11 to 14 years old, parents can start to have a more hands-off approach, gradually releasing control and sharing more power with the child, who has developed some metacognitive self-awareness. Parents should avoid a laissez Faire parenting style in which they trust the child to do whatever he wants, especially when he is too young. This would be akin to pushing the child out of the nest before he is ready. At the same time, parents should also avoid a command and control parenting style in which they tell the child exactly what to do, especially when he is mature enough. This would make the child overly-reliant on parents even as they get older. Instead, parents should have a parenting style somewhere in between, teaching the child the skill of self-sufficiency.
Michael added that screen time activities are designed to be addictive and challenging to stop, such as the function in which the next video plays automatically. Hence, it is up to the child to learn to set limits and stick to them, as there are reinforcing mechanisms. The more the child gives up on his self-imposed limits, the more he doubts his own word and the more he will not bother to try in the future. Conversely, the more the child sees that he actually does have some self-control, the more he realises that he means what he says and the more he is able to exercise self-control in the future. It is preferable for the child to set realistic goals that he can achieve, even if it is slightly more screen time than the parents’ ideal, than to set unrealistic goals that he cannot hold to. With reference to the movie Screenagers, Debbie noted that screen time moderation is a skill that children need to learn on their own.
Dr. Sussman wrapped up by reminding parents to practise self-compassion, as the pandemic has created emotional burden and social isolation, not to mention the challenges associated with distance learning. Although it is a struggle, parents should try their best and not give up. It is better to make some attempts at screen time management, than to simply throw in the towel and enable everything. Michael agreed that it is important for parents to strike a balance between being gentle with themselves and their child, and pushing themselves to do as well as they can in any given moment.
All blogposts on Bright & Quirky Child Summit 2021:
Day 1 Talk 4 A Quick, Shareable Overview of Twice Exceptional (2e) Kids - Dan Peters, PhD
Day 2 Talk 8 Understanding High IQ Kids With ADHD and Co-Occurring Diagnoses - Thomas E. Brown, PhD
Day 3 Talk 13 How to Know When It's Time to Change Schools or Homeschool - Colleen Kessler, MEd
Day 4 Talk 17 How to Help Bright Kids Avoid Autistic Burnout - Kieran Rose
Day 4 Talk 19 How Different Kinds of Minds Can Become Inventors and Engineers - Temple Grandin, PhD
Watch this space for more blogposts from the Bright & Quirky Child Summit 2021!