Some screen time better than none during children’s concussion recovery

Too much screen time can slow children’s recovery from concussions, but new research from the University of Calgary and the University of British Columbia suggests that banning screen time is not the answer.

The researchers — including Dr. Keith Yeates, department head of UCalgary’s Department of Psychology and Ward Chair in Paediatric Brain Injury — looked for links between the self-reported screen time of more than 700 children aged eight to 16 in the first seven to 10 days following an injury, and symptoms reported by them and their caregivers over the following six months.

The children whose concussion symptoms cleared up the fastest had engaged in a moderate amount of screen time. “We’ve been calling this the ‘Goldilocks’ group, because it appears that spending too little or too much time on screens isn’t ideal for concussion recovery,” says Dr. Molly Cairncross, an assistant professor at Simon Fraser University who conducted the research while a postdoctoral fellow working with associate professor Dr. Noah Silverberg in UBC’s psychology department.

“Our findings show that the common recommendation to avoid smartphones, computers, and televisions as much as possible may not be what’s best for kids.”

The study was part of a larger concussion project called Advancing Concussion Assessment in Paediatrics (A-CAP) led by Yeates and funded by the Canadian Institutes of Health Research.

The data came from participants aged eight to 16 who had suffered either a concussion or an orthopaedic injury, such as a sprained ankle or broken arm, and sought care at one of five emergency departments in Canada.

The purpose of including children who had orthopaedic injuries was to compare their recoveries with the group who had concussions.

Patients in the concussion group generally had relatively worse symptoms than their counterparts with orthopaedic injuries, but within the concussion group it was not simply a matter of symptoms worsening with more screen time. Children with minimal screen time recovered more slowly too, says Yeates.

“Kids use smartphones and computers to stay connected with peers, so complete removal of those screens could lead to feelings of disconnection, loneliness and not having social support,” Cairncross adds. “Those things are likely to have a negative effect on kids’ mental health and that can make recovery take longer.”

The UCalgary/UBC study differed from another study conducted last year in the U.S. in that it tracked screen time and recovery over a longer period. The earlier study found that screen time slowed recovery, but it measured screen use only in the first 48 hours and symptoms for only 10 days.

The longer timeline led to another interesting finding, described by Silverberg:

The amount of time spent in front of screens during the early recovery period made little difference to long-term health outcomes. After 30 days, children who suffered a concussion or another type of injury reported similar symptoms, regardless of their early screen use.

The researchers also observed that screen time seemed to have less bearing on symptoms than other factors such as the patient’s sex, age, sleep habits, physical activity, or pre-existing symptoms.

“Screen time didn’t make a lot of difference relative to several other factors that we know can affect concussion recovery,” says Yeates. “Encouraging concussion patients to sleep well and gradually engage in light physical activity will likely do a lot more for their recovery than keeping them off their smartphones.”

Ultimately, says Yeates, the findings suggest that blanket restrictions on screen time might not be helpful for children and adolescents with concussion. Instead, the researchers suggest using the same approach as with other activities, which is moderation. If symptoms flare up, screen time can always be limited.

The study was published Oct. 17 in Pediatrics.