How to Manage Your Toddler’s Screen time with Andrew Doan, MD, PhD

Andrew Doan, MD, PhD, Co-founder of Real Battle Ministries

How to hack screen time? Parent’s Dilemma: How to manage your toddler’s screen time. Andrew Doan, MD, PhD, Neuroscientist and co-founder, Real Battle Ministries, will tell us when to allow children a smartphone, what the risks are in doing so and how we can manage their screen time.

Full Interview Transcript

Dr Doan WIDE-Small

Smart phones: harmless modern pacifier or mind altering device that hinders your child’s brain development? Joining us today is Dr. Andrew Doan, an eye physician and surgeon, neuroscientist and author. He will tell us more about the epidemic and how it’s impacting our children’s ability to learn and what we can do to help.

Speaker 1:           Dr. Doan, thank you so much for being here.

Speaker 2:           Thank you so much for having me, it’s a pleasure.

Speaker               We’ve all seen that everywhere we go people are buried on their cell phones including babies and toddlers. So I’m wondering, I see a lot of parents going out to eat, or maybe they’re on a long plane ride, and they give their toddler or baby a cell phone. How harmful is that?

Speaker 1:           It’s how you use it. In clinical medicine, it’s kind of like if I give you an anesthetic for surgery to numb your eyeballs so I can do surgery on your eyeball. I’m an ophthalmic surgeon by the MD training route. So that will be a healthy use of an anesthetic to numb the eyeball. However, if I give you an anesthetic drop and you have dry eye syndrome and you use it all the time for dry eyes because you couldn’t handle the dryness and the greenness and the pain, the numbing drop that I prescribed to you if you used chronically will melt your cornea. Literally, will melt you’ll have a ruptured eyeball and infection that could actually result in loss of eye or death.

So, my analogy to medicine with digital media actually applies. Because clinically we have doctors who are using digital media like on a tablet or a VR glasses, we’re using it to reduce anxiety and reduce pain in clinical procedures. For example, I talked to anesthesiologist who actually has done work on this and they share with me that a tablet video game before surgery is equivalent to ten milligrams of valium. So valium is used for anxiety disorders and that’s a prescription controlled drug. If you use VR gaming there’s a company in LA called Applied VR who’s working with seether cyanide. So one thing that VR headsets can do is actually reduce pain to the point where pediatric children who have burns can actually undergo scrubbing of their burns during treatment while they have the VR headset.

So, the answer to you took a long time to get there is that yes, if you used a tablet to let’s say occupy your child on a plane ride and use it in a structured orderly fashion and knowing that what you’re doing is to tame the child and also using that tablet to get through to the next plane stop or the airport arrival then that’s okay. But if you’re using it all the time then it’s like giving a drug to your child, to sedate that child which will inhibit brain development. This is critical because the brain develops and at certain ages if there’s not enough behavioral feedback to the brain there could be permanent atrophy or damage to those areas]

Speaker 1:           So how much is too much? When you’re at risk for some of the damage of brain because I know your brain develops so quickly the first three or four years.

Speaker 2:           Yes. We don’t have enough research. The only way to know this is to take identical twin studies. Because right now research is so hard because you’re studying different populations, different people that are susceptible. That’s why we have people who can drink alcohol and don’t have an effect or some people watch a movie and they don’t cry or get scared. You know, people have different responses so the answer to you is that it varies from individual to individual. But what we do know is that if you give it to your children all the time there is a certain point in time when it’s going to be damaging. The only way to know is identical twin studies.

What we do know from China though, they have over 200 addiction centers, specialized in addiction on digital media on internet and gaming. What we do know is that they said the sweet spot for addicts, meaning that addicts are people who are dysfunctional in multiple areas of their lives — financial, emotional, sleep problems, emotional problems, suicide ideations, you know there’s criteria to become the label addiction. But that’s a lot. You’re talking about four or five significant areas in people’s lives that are affected in order to become an addict.

The research at China has said about six hours or more is indicative or non-indicative but associated with internet or gaming or digital media addiction. So that really doesn’t answer you because definitely you don’t want to expose your kid for six hours a day. But the sad part is the Kaiser foundation in 2010 estimates that in ages 8 to 18 in their research the Kaiser foundation found that the average American child uses digital media for entertainment, not for learning, not for training, not for benefit. On average about seven hours 38 minutes a day.

So based on that right there on the China studies and the China’s research on the internet addicts over there the US on average are already one hour 38 too much based on that.

Speaker 1:           But what about the real small children? I know they don’t have a lot of research on that. What is your opinion on giving them something that age?

Speaker 2:           Very dangerous, very, very dangerous because in children they have limited time to develop their brains. So the brain develops from back to front; vision, touch, somatocentric cortex develop first and then the frontal cortex which is the front part of the brain, that’s frontal cortex here, that’s higher executive reasoning such as empathy, relationship with others, reasoning, advanced reasoning, all these things that are important to be successful. So I have an analogy for you is that in a young child that starts with a blank slate, so what you expose child to, let’s say empathetic situations they develop empathy.

So let’s say this brain area in the frontal lobe represents empathy. Let’s say the other finger here represents an area for communication skills and eye contact. This one represents let’s say relationship with others, relationship with Mom and Dad and siblings. Then this one, let’s say patience, how to sit still and behave. Then, this one, let’s say the digital media stuff such as the hand eye coordination and the whole host of other benefits that people use as an indication of using it earlier or exposing children earlier to digital media.

But here’s the problem. If  you’re primarily exposing  your child to digital media to occupy that child, what happens is to the other areas of the brain that you desire the child to develop; the communication skills, empathy, relationship with others, how to sit patiently through a doctor’s visit office or on the plane or car ride, will actually not develop. So what happens is the other areas of the brain relate to digital media develops and gets bigger. So literally they become all thumbs thinking.

Here’s the danger, in a little child if we don’t know that exact time point but in vision in the world of ophthalmology and optometry, children of visual deprivation of one eye is called amblyopic. The brain shuts down at around eight to nine to ten, maybe 11 where that eye literally in the brain becomes disconnected. That area in the brain that controls that eye or receive inputs in that eye shuts down in its atrophy.

I think the same thing can happen in young children if they do not develop their developmental milestones that are essential to be a well-rounded individuals, that by the time they are older, in teenage years, there could be a permanent, or if not a permanent but a significant reduction in those areas of the brain. Once those areas of the brain pass those developmental milestones there’s some neuroplasticity however is very difficult to train the brain and record new pathways once it passes the developmental milestone because we know that from vision. If we don’t correct the vision and correct amblyopia or the lazy eye problem, by let’s say age 14 or 15, that’s really late, people are literally useless, have useless vision in that eye. The brain cannot be rehabilitated to that point for vision.

Speaker 1:           We have talked a lot about the negative impact of technology. There are so many educational apps and learning tools associated with technology. Is there any benefit at all to using technology in a learning capacity?

Speaker 2:           Absolutely. So what they way I’d describe this is kind of like a syringe in a clinical medicine. The syringe is a plastic container that I can put any kind of medication in there. I can put let’s say a diabetic who needs insulin to inject insulin to help them with their type B or type one diabetes. I can also put heroine in the syringe. So really technology is that. So what I broken down to people is that they tend to use the overriding term like video games to cover all video games. So that’s why the research is still difficult. What happens is video games is actually broken on its spectrum of what I call digital potency.

Now, things that are potent, meaning that they arouse the body, they arouse mind, helps get the body excited, goes from educational which I called digital veggies to the other spectrum called digital sugar.

So then to describe what I’m talking about is that educational games that you refer to Kelly would be somewhere like pass the point of Excel spreadsheets and checking emails. So what happens is so there’s the email, word processing goes over here, really boring digital veggies, you know that. We don’t like it. Then we jump over here and it’s a Math learning game. You see, what I’m saying? When you jump over here and it could be a game or you build Lego blocks and build online worlds. Over here, you have online play for first person shooters where you can get to kill other people and show how good they are. Then, over here you can have like maybe digital fantasies where you role play, social media, and meet really exciting people. Then, finally over here you have the digital crack of pornography and sexual images. You see what I’m saying?

So therefore, so my answer to you is that we have to define that first because the research does show that educational games can actually be very effective for learning tools. We know from research for example that surgeons, those surgeons who play video games actually are better surgeons than surgeons who don’t play video games. So it helps with hand and eye coordination. We also know this also from the research from the University of California Riverside where they actually studied video game played in baseball players where they played this very boring video game. I mean, when you look at it it’s like black and gray, circles, and objects on a white, black background and they’re moving, they are working on the eyes to move, you wouldn’t even think that’s a video game. It’s so boring. But they play that video game 3 minutes a day and the entire baseball team on the average improved their vision from 20/20 vision to 20/15 and their hand-eye coordination improved to the point where the team’s batting average all improved.

You see? We also know that the arousal aspect is that when you arouse the hypothalamus pituitary adrenal access through digital media for example, you raise the level of cortisol. Well, cortisol from the adrenal gland is actually a conicoid and it’s a transcription factor.  It actually goes into the brain and helps record memory better.

So, yes when you have games and you have an engaging let’s say a TV show or engaging games or engaging digital media input it turns you on. As it turns you on, the brain record things better.

Speaker 1:           How interesting.

Speaker 2:           That is why if you’re in a lecture that’s boring it doesn’t work so much to help people learn. So when games are used in that aspect of digital veggies they are very effective in helping kids learn and develop educational skills.

Speaker 1:           What age are we talking about the really young kids too or just when they’re a little bit older?

Speaker 2:           So the American in Academy of Pediatrics basically recommended no screen exposure 18 months or less. That means if your baby from 0 to 18 months, no screen time whatsoever. Now, I don’t know what research they used to determine that 18 months is better than 24 months. So they should for six months. I don’t know where that research is. I’ve tried to look for the reason why they cut six months.

What I recommend doing is going to the old recommendation of two years or less, no screen time whatsoever. And then basically from let’s say three to ten you can go to half an hour to an hour max a day. It has to be directed, educational, digital media like TV shows that are educational. There’s research out there that certain cartoons that are sporadic and lots of stimulation actually lowers your child’s IQ. I mean, that was published literature. I don’t want to mention the show because I don’t want to get in trouble by the show. But you know literally you know what kind of cartoons I’m talking about. Parents can judge. But if you have the long, kind of like Mr. Roger’s type shows, the Captain Kangaroo type shows, the Magic School Bus type shows, those are healthy and they can actually teach your kids to learn.

The research is still out on video games in young kids. So what I tell parents is avoid video games in kids until they are 12 or 13. Let their brains develop. There are so much other things that you can do to fill up their brains. Introduce the games later and introduce it carefully. But for those families who have to play video games; let’s say Dad or Mom played that are gamer, that I recommend using the video games kind of a family event. So on a weekend, for a reward, play together. Play the sports game together. But it has to be age appropriate.

I’ve seen Dads who played Grand Theft Auto with their six year old. If you’ve ever played Grand Theft Auto, it’s inappropriate. So mature video games should be only for mature audiences. But if you play appropriate games, if you’ve got a common sense media, the age appropriateness of the content for kids, if you played like it for everyone games, play with the kids. Use that opportunity of that arousal, of the hormones being released from the games, the bond with your child together. In that way you build an experience. So after a half an hour play you stop.

What I also recommend doing is that if you spend half an hour of digital media, you spend half an hour of physical activity as well. So that kind of counteracts the sedentary lifestyle where kids are getting obese and having problems. Then, I recommend no Smart phones until the child is 18. The amazing thing is that if you call your cell phone carrier and asked them at what age would you recommend cell phones being used, and this is from Melanie Hempey from Families Managing Medium, she called multiple phone companies and the consensus is unanimous, 18 years old because that’s the age where they can actually sign a phone contract.

So that’s interesting. Now, that’s not based on research whether it’s good or bad. But what what’s interesting about this is that phone companies cannot sell a smart phone to a minor because of the contract issue. But parents are giving literally these handheld computers to their kids too early who don’t have the frontal low to stop from looking up digital media

Kelly:           This information you shared is so fascinating and such important for everybody because we live in a digital age and no one knows what the implications are. So is there anything else that you would want a parent of young children to know about technology that we haven’t covered?

Dr Doan:           You guys are heroes for your children. It’s not going to be Dr. Doan or Melanie Hempy or Chris Rowin, or Victoria Dunkley or all these people who are working in the field already that are going to be heroes for your kids. You’re going to take this information from us, apply wisdom, data without wisdom is garbage. You can look at all the research you want but without wisdom it’s useless. So use your parental of wisdom to be your child’s hero. You have the chance to make a huge impact in your child’s life.

Because everyone’s using digital media, if you can take what I even said today and apply it to your children, your children with be outliers, will be successful outliers in the digital age because everybody else is suffering while your child is now developing essential behavioral neuro pathways that will be superior to everyone else.

Kelly:           That is spot on, it’s amazing. I think I’m so glad to have you on here and talk about everything you know about this.

Dr. Doan:        Thank you, Kelly. Thank you for inviting me. I’m honored. This is fun for me as you can tell I love it. I love doing this.


About Andrew Doan, MD, PhD

Dr. Andrew Doan is a recognized expert in digital media addictions. With a doctoral degree in neuroscience, his background in molecular neuroscience adds in depth knowledge into the areas of Internet Addiction, Video Game Addiction, and Technology Addiction. He is a doctor, doctor, i.e. M.D. and Ph.D., meaning that he was one of the National Institutes of Health (NIH) medical scientist doctors. Every year the NIH provides funding for the training of medical scientists, M.D./Ph.D.'s. These medical scientists comprise of about 200 students every year out of 16,000 medical students. They get paid to go through this eight year program to teach and do research. The goal is to create medical scientists and educators to teach and do research in medical schools and public settings. These medical scientists pick a clinical discipline as well as a basic science discipline. Dr. Doan chose ophthalmology as a clinical discipline which compliments well with his interest in neuroscience. He received his M.D. and Ph.D. degrees in neuroscience from Johns Hopkins, the premier neuroscience training program in the world. He has had over 10 years of experience doing research on learning, memory, and brain development.

The neurosensory retina in the eyes connect with the brain through approximately 2.4 million nerve fibers, making the eyes an extension of the brain. With Dr. Doan's clinical knowledge in visual systems and his research training in neuroscience, his expertise is unique and rare. He is able to speak with medical and scientific authority on brain development, the visual system, and how digital media work through the visual system to reprogram the brain via neuronal plasticity. For more information, visit:

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