Pediatricians Question the Use of Screens in Education

A debate about the impact of screen use in the education of children and adolescents is underway in the social, scientific, educational, and family spheres in Spain, as in other countries. At issue are the potential advantages of screens over traditional learning systems.

Over the past few months, many autonomous communities have adopted measures to regulate the use of screens in classrooms. The provisions vary depending on the location and the type of school (eg, public, private, or charter), leading to a lack of homogeneity.

Faced with this disparity, the Digital Health Working Group, which is part of the Health Promotion Committee of the Spanish Association of Pediatrics, recently presented its report titled “Impact of Digital Devices on the Education System.” Its intention is to present the latest evidence and shed light on the topic.

The document is part of the Family Digital Plan, a platform created by the Spanish Association of Pediatrics to assist families in the use of technologies in the family environment.

“Screens impact physical, mental, social, and sexual health; neurodevelopment; psychoaffective development; and healthy lifestyle habits,” María Salmerón told the Medscape Spanish edition. “However, this message is not reaching the population.” Salmerón is the coordinator of this group.

“For example, the recommended screen time for children under 2 years old is zero, as it interferes with their neurodevelopment. But the results of a study published in 2021 in the Journal of Public Health reflect that the average screen time for this age group reaches 72 minutes.”

Too Many Expectations?

“Based on these and similar data,” Salmerón continued, “the Health Promotion Committee decided that something had to be done, as the population has the right to know the scientific evidence regarding screen use and to apply it in their daily lives.

“Although the effects are the same, screen time, the type of applications, and the programming of the design of certain social networks differ from country to country. This variation in screen exposure means that the final impact on the health of children and youth may differ from one country to another.”

The most recent evidence on the impact of digital media for educational purposes in the school environment clearly points to the need to rethink the current trend toward digitizing education, said Salmerón. “Although it is a complex issue because the term digitization encompasses various concepts and objectives, the use of screens in education has not demonstrated better learning outcomes compared with reading on paper or handwriting.”

Specifically, the use of tablets is not associated with improvements in learning math, English, or science compared with the traditional method (paper and handwriting), according to the report. In addition, multiple studies have linked spending more time in front of a screen with lower academic performance.

When asked what level of screen exposure is most concerning, in terms of neurodevelopmental and psychoaffective outcomes, in this population, Salmerón stated, “It’s difficult to rank in terms of relevance when it comes to the health and development of children and adolescents. From my perspective, everything is concerning: The effects on physical, mental, social, sexual health, neurodevelopment, and psychoaffective development.”

Minimizing Exposure

“Therefore, with the data currently available and beyond recommendations focused on reducing harm, I believe the message that needs to be conveyed on this issue is that the lower the exposure, the lower the risk. And this implies delaying screen use as much as possible and ensuring that children and adolescents spend the minimum necessary time on these devices,” said Salmerón.

The report also highlights the limitations of the research on this issue. For example, scientific evidence on specific apps does not necessarily reflect risks under real conditions. “Studies on the impact of learning certain skills through apps do not assess situations such as a student getting distracted by having other apps open on the same device or how using a game associated with the app for gamification goals affects learning,” said Salmerón.

Furthermore, the sample size of these studies is often small, sometimes there is no control group, and occasionally only one study is conducted.

Adopting digitization in schools also underscores the need to train all stakeholders involved (such as teachers, students, and parents) in competencies related to the use of this technology. “This training should include information on the impact of screens on health, neurodevelopment, psychoaffective development, and learning, data protection, and cybersecurity. This approach is essential to optimize the possibilities of digitization and reduce its risks. Additionally, it should be remembered that screen use is not necessary to develop academic content.”

Salmerón emphasized the importance of distinguishing between the use of smartphones, which are owned by students or a family member, in classrooms and the digitization of education, “that is, the use of digital media for educational purposes.”

The use of personal devices during school hours is directly related to decreased attention, as demonstrated by large-scale studies. The latest PISA report (2022) indicates that, on average, one in three students in Organization for Economic Cooperation and Development countries states that they get distracted in math class by using their mobile device. For one in four students, distraction comes from classmates using devices. These distractions result in a 15-point difference in the math test scores of these students.

Regarding the use of mobile phones during breaks and leisure school periods, Salmerón noted that it is linked to less interest in face-to-face socialization and a reduction in the time dedicated to physical exercise. “It has also been observed that it increases the risk of cyberbullying and promotes distraction. Therefore, in my opinion, smartphones should be limited within the school at all educational stages.”

Reversing Course?

The inconclusive evidence on the benefits of digitizing education raises the question of “reversing course,” that is, restructuring the current screen-centric learning methods and returning to the traditional system.

But the scientific method is being applied incorrectly to the study of screen use in education, said Salmerón. “Before implementing the widespread use of screens in the educational system, we could have formulated hypotheses or questions. Is the screen or paper better for learning? Is the child’s age a determining factor? Do screens have a negative effect on well-being?

“The fact is that without prior research in this line, the information we have comes from studies on the impact of screens on health. In practice, this means we have already answered the last question without knowing if screen use improves the child’s learning.”

Salmerón compared this process to that of approving a new drug. “From a scientific standpoint, it is illogical to demand scientific evidence that demonstrates negative effects without requiring evidence, as is the case with drugs, that screens enhance learning to carry out the change in the traditional educational model.”

Regarding a hypothetical return to a traditional educational system, Salmerón stated that the evidence to date suggests that the paper option has more advantages, but more studies are needed. “Research with comparative groups has shown that learning is better on paper than with digital media. Therefore, with the data available to us and following the principle of prudence, it is advisable to use paper, but further research is necessary to delve into the differences between knowledge obtained with traditional learning versus that done through a screen.”

Pediatric Consultation

The use of screens in education poses challenges for pediatricians, who must raise families’ awareness about the problems associated with the misuse of this technology. “While the current debate is necessary and enriching, it is confusing for families because it is difficult to communicate when the messages coming from pediatrics are different from those of the education system,” said Salmerón.

To address this situation, the Digital Health Working Group of the Spanish Association of Pediatrics recommends reviewing the commitment to digital media and the use of smartphones in schools. It also advises the prioritization of reading and writing on paper, the removal of games from educational applications, the ownership of devices by the school, and the conduct of new research on this issue.

“In conclusion, we suggest reevaluating the need to use digital devices as a support for teaching and urge that applications claiming to have an educational purpose follow the same criteria as, for example, new drugs, which is something that is not being done,” concluded Salmerón.

Salmerón reported having no relevant financial relationships.

This story was translated from the Medscape Spanish edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.