Ready player one? How to help kids develop healthy gaming habits

• Know what kinds of video games your kids are playing
• Game time should be scheduled after schoolwork, family time and physical or other activities
• Develop a family media plan for everyone—including the parents

Whether it’s your young child learning his letters on your iPad or your teen who could play Fortnite for hours, video games are a commonplace part of childhood today. But many parents grapple with questions and concerns — what games are appropriate, how much screen time is detrimental, how should limits be set on gaming?

“Technology is becoming such an increasing force in all of our lives,” says Elizabeth Meade, MD, Chief of Pediatrics for Swedish Medical Center and Director of Medical Communications for Swedish Health Services in Seattle, WA. “In my decade or so of practicing pediatrics, we have gone from not talking about it very much at all to now talking about it lots of times with every family we see. Parents have a lot of questions about how to make technology work for their kids and enhance their lives, rather than taking away.”

When it comes to video games, the content of the game matters — a lot. There are differences between solving math puzzles and shooting an army of invaders in a postapocalyptic society. “Video games have ratings like other media and that’s for a reason,” Dr. Meade says. “Some content can be graphic and violent and can be disturbing to kids if they’re not at an age or a mindset to be ready for that. There have been some studies that show that heavy viewing of violent media can actually be associated with violent behavior in real life. I think that’s something parents worry a lot about. Young kids in particular tend to have difficulty distinguishing between reality and fantasy, so we worry a bit that kids can become desensitized to violence if they view a lot of violent acts. Even though those acts are on a screen, a younger kid can’t always separate that from reality.”

But parents should keep in mind that not all video games are bad. “They can help kids develop communication, team building and problem solving skills,” Dr. Meade says. “There are also lots of age- appropriate games with online communities, which can be a pro-social way to spend time for some children. For younger kids, there are games that families can play together and I always advocate for that.”

In fact, being well-versed in a game’s content is a good rule of thumb for any parent. “It’s most beneficial if you can familiarize yourself with the content before the child starts playing the game,” Dr. Meade says, adding that parents should know what video game ratings mean. “We talk a lot about different ratings systems. Every video game is reviewed by the Entertainment Software Rating Board. Common Sense Media is another great resource that I often refer parents to; it has tons of information about age and maturity ratings for video games, as well as movies and TV shows. It’s very practical so it’s a great place for parents to start.” Common Sense also has a list of recommended games, but games that kids can play with the family are always going to be a good choice, Dr. Meade says.

The bottom line, Dr. Meade says, is that parents have to make the final decision on what’s best for their own kids. “It’s important for every family to have their own ratings system.  If a video game is not in line with your family values, then that’s a really great place to start a discussion with your kids about why that is and why certain games are not allowed in your house even if your kid’s friends are allowed to play them.”

It helps if you set up clear guidelines, or what Dr. Meade calls a family media use plan. She adds that healthychildren.org, the website of the American Academy of Pediatrics, offers advice on how to get started devising a plan. And you should keep in mind that a family media use plan covers everyone in the family — even you. “As technology is more and more ever present and all of us are connected all the time, as parents we can be just as guilty of over-technologizing ourselves.”

Dr. Meade says a plan isn’t just putting time limits on gaming or other media. “We used to talk about no more than one hour of screen time a day, and we were really time based. As technology is more present in our daily lives and our minute-to-minute interactions, pediatricians have recognized that it’s more important to think about how media is playing into the context of a child’s life, rather than a strict time limit. So, what we say now is that if your kids have enough time to get homework done, participate in family activities that aren’t technologically oriented, and have some physical, active play time and healthy meals with the family — if all of that is happening, then the time spent with media will naturally self-regulate. So it’s about prioritizing what’s important and if they still have time for media on top of that, it will be for an appropriate amount of time.”

Of course, it’s not good for kids to sit and play video games for hours on end. Long stretches of gaming can cause problems with posture, or sore hands and fingers. Also, Dr. Meade recommends that kids stay off screens for one to two hours before bedtime. “That blue light and mental stimulation can affect not only the quality but the duration of sleep for children,” she says. “The screens should be off, it’s time to wind down and get ready for bed. It helps kids’ minds and bodies know it’s time to fall asleep.”

You should also find a spot for your video game console in a central location, so your child isn’t tucked away alone without any supervision. “Part of the concern for some parents is that some of these games have online communities where players can talk to each other, and there is definitely a concern for younger children about predators that may be out there,” Dr. Meade says. “It’s unusual, but it does happen, so parents should be aware of it.”

If your children are playing online games, it’s wise to talk with them about being a good online citizen. “Not using a real name or a full name is a great idea, as well as making sure kids know that if anyone asks them for personal information — whether that’s a birthday, an address, an email or phone number — or if they’re asked for photos in any online capacity they should never do that without talking to a parent first,” Dr. Meade says.

“In general, once kids reach middle or late adolescence and they’ve exhibited good online behavior I think it’s OK for them to have some online independence. But for younger children I always recommend that parents monitor their online activity and that they are very honest about it. Say, ‘You’re allowed to play this video game but I’m going to be looking at it from time to time.’ As parents, we don’t want to feel like we’re spying on our kids and we want that trust to be there, but younger kids should know that this is something parents have the authority and duty to monitor for them.”

And speaking of younger kids, the age when children start playing seems to be getting younger and younger, thanks to a plethora of games and online platforms. “I’d say there’s no hard age limit, like when your child turns 7 it’s OK to play video games, but parents know their own kid very well. If you feel your child is mature enough to play a certain game, review the content and make sure it’s generally age appropriate,” Dr. Meade says.

However, keep an eye on your child’s behavior. “If your kid starts playing a certain video game and you notice behavior changes such as more violence or aggression, or your child is getting more snappish or withdrawing from other things he liked to do, then you may need to back off and come up with hard time limits and really reevaluate the content. If there are any negative changes that are occurring, that can be a time to say maybe it wasn’t the best choice right now.”

For teens, there is the occasional risk of developing a technology addiction if they spend too much time on games, or other electronic media. “If you notice your kid is feeling a compulsion to be online all the time, they’re neglecting real-life friends and family members or their schoolwork in order to have more tech time, or if they are pulling out of activities that they love, that’s the time to talk with your pediatrician about how you can intervene.”

Once the guidelines are set, it helps to write them down so everyone can connect with it, Dr. Meade says. “As parents, it’s important to model the same behavior we expect from our kid. So if you decide on a media plan as a family that includes no screens at the dinner table, then you shouldn’t be pulling out your phone. We have to say that if we are setting rules for our kids, we are also willing to comply by them.”

Do you have questions about how to raise healthy kids? If so, you can find a Swedish health care provider near you, or download Circle by Swedish, the free pregnancy and parenting app with provider-approved articles, tools and resources.

Entertainment Software Rating Board ratings have three components

• The first is a letter designation
  • E: Everyone
  • E 10+: Everyone older than 10
  • T: Teen
  • M: Mature, for ages 17+
  • A: Adults only, for ages 18+
• The second part of the rating is a brief description of the content relative to the rating, such as song lyrics or violent acts
• The final element of the rating is a description of any online features, such as multiplayer capability or the ability to purchase items in the game.