Nina Shapiro M.D.

Medical Myths


Which Came First, ADHD or Screen Time?

A new study shows an association in teens.

Posted Jul 21, 2018

It may come as no surprise that teens are glued to screens. And while groups such as the American Academy of Pediatrics have recommended no screen time (including good old fashioned television) for children under age two years, it seems that hand-held devices are being given to younger and younger teens, tweens, and even tots. The phrase "wait until eighth" has been promoted among parents of middle schoolers, emphasizing that eighth graders could handle phones, but it's best to hold off in earlier grades.  Sadly, many have skewed this to "wait until eight." Yes, eight-year-olds have phones, social media accounts, and certainly access to desirable, addictive games such as Angry Birds, Pokemon Go, and now Fortnight.

While many studies in recent years have shown that screens have a negative impact on social behaviors, sleep quality, and mood, a recent study has linked ADHD (attention deficit-hyperactivity disorder)-type behaviors to teen use of devices. This study followed close to 3,000 teenagers in Los Angeles for two years, who demonstrated no ADHD-related behaviors at the beginning of the study. These behaviors were assessed by using the Diagnostic and Statistical Manual of Mental Disorders (DSM) questionnaire to determine ADHD manifestations. After two years of monitoring these teens by questionnaire every six months, the study authors found that those frequently using digital media platforms were twice as likely to demonstrate ADHD behaviors compared with those who used digital media less frequently. To many of us, these finding seem obvious. The visible distractability from using smartphones is seen all around us. Look at any morning bus stop filled with teens waiting for the school bus. No longer are they chatting, joking around, or even greeting each other. The tell-tale turtle-like neck posture of all hunched over their phones is the norm. Look at any busy crosswalk in any city across the world. Most are crossing while on their phones. Not talking on the phone—but texting, gaming, or watching a video. Unfortunately, this is also the case in cars. Texting while driving (TWD) is the new drunk driving, and the outcomes have been devastating. 

It is easy to place blame on teens for falling prey to online digital distractions. Because the use of technology is not illegal, such is the use of alcohol, cigarettes, or even vaping, parents are hard pressed to set limits on technology use, especially in late middle and high schoolers. Many shrug off their teen's use of technology, as it has become the norm for communicating with peers, and has become a means for self-expression. Most middle and high schools now require use of laptops and even hand held devices to communicate with teachers, hand in assignments, and perform research for projects. Some schools use online educational sites, even to the exclusion of face-to-face instruction. Thus teens, and even those in younger grades, are often faced with the quandary of an inordinate amount of internet use required for school, with additional use for socializing and recreation.

Instead of throwing one's hands up at teen's hand-held device use, perhaps we should step back, look up, and look at our own hands. I challenge each of you to keep a log for just one week about your handheld device use and laptop or desk top use that is not directly related to your work. How many times do you click on your social media sites, check your private emails, click on a video link, browse an online shopping site, or text a friend instead of calling? Now be honest with yourself. Nobody will be monitoring but you (except, of course, for the sites that know what you're searching for and follow your trends on a continuous basis). I wouldn't be surprised if adults have as many (or more) ADHD-type behaviors with digital media as do teens. We may just be hiding them better.