Ask a pediatrician: How much gaming is too much for children?

By Dr. Claire McCarthy

American Academy of Pediatrics

Q: My son is playing a lot of video games during the pandemic. Should I be worried?

A: As we watch our children and teens play video games during the COVID-19 pandemic, many parents wonder: How much is too much?

People are spending a lot more time staring at digital screens. But after your kids log off from school and homework for the day, is it OK if they spend a few hours gaming with their friends? When video game lives replace real-life time with family and friends, is it a sign of addiction?

Playing video games is a fun and normal part of teenage life. But there’s a small number of kids who have a hard time controlling the time they spend gaming.

Researchers are studying this and learning more about who is at risk and why. During a six-year study, they noticed that about 10% of adolescents had symptoms of unhealthy gaming that got worse over time. These kids seem to have a few things in common:

■ They are more likely to be boys.

■ They play video games at the expense of homework, sleep, exercise, or relationships with family and friends.

■ They may have depression, anxiety, shyness, aggression and problems with too much cellphone use. Children with Attention Deficit/Hyperactivity Disorder (ADHD) may be particularly vulnerable.

This is because video gaming, like gambling, may activate the reward system in the brain, research suggests. Companies often hire psychologists to help design games that make players want to keep playing.

There is not an official diagnosis for gaming disorder in the U.S., but there may be one soon. Symptoms of internet gaming problems are listed in a reference book used by mental health doctors. Here are things that might indicate a child has unhealthy gaming habits:

■ Is obsessed with gaming, and is sad, irritable, or anxious when gaming is taken away.

■ Wants more gaming time and is not able to cut down or quit.

■ No longer is interested in other activities he or she used to enjoy.

■ Lies about how much time he or she spends gaming.

■ Uses gaming to relieve a bad mood.

There are a few things that parents can do to prevent unhealthy video game habits from happening. Staying on top of how much your children use all forms of media can help. Here’s how:

Have a family media plan. Use the American Academy of Pediatrics media plan tool to help you map out your child’s media diet. Be sure that media, including gaming, isn’t crowding out other important activities like homework, exercise or sleep.

Be aware. How does your child use electronic devices and video games and what games and apps is your child downloading? Make sure he or she understands that internet games usually have hidden messages and ads. They also might collect your child’s personal information.

Keep gaming in common areas. Teens go off to their rooms with their smartphones and do schoolwork on their laptops, so it’s nearly impossible to keep track of everything they do. But try to keep the activity where everyone can see.

Play games along with your child and set a good example. Not only does this help you see what your child is doing, it also can help put some time limits on gaming.

Focus on real-world games for younger children. Young children learn a lot when they connect with other people. Encourage them to play with toys, books and crayons.

Most children and teens who play video games do not become addicted or have other problems. But when gaming starts to get in the way of other parts of life, it’s time to step in. If your child or teen resists your efforts to cut back on gaming, call your pediatrician for advice. Your pediatrician can recognize when a teen is struggling and can help get the support your child needs.

Dr. Claire McCarthy is a primary care pediatrician at Boston Children’s Hospital, an assistant professor of pediatrics at Harvard Medical School and a member of the American Academy of Pediatrics. For more information, go to www.healthychildren.org, the website for parents from the AAP.