ADHD and Technology: Helping Our Children Reclaim Their Focus and Attention

Immediate gratification is most certainly one of the reasons for a child or a teenager not being able to pay attention in school and it is a powerful one. How can school, even when technology is added as part of the curriculum, ever compare to the lure of an action video game?
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A recent New York Times piece by Richard A. Friedman entitled "A Natural Fix for A.D.H.D."caught my eye this past week as I am right in the middle of writing a book chapter about how technology impacts people who have a range of psychiatric disorders. In particular, my co-author, Dr. Adam Gazzaley, and I are exploring how and why we react the way we do to interfering stimuli to create a "Distracted Mind." The article pointed out that as of 2011, according to the CDC, a staggering 11 percent of young people in America -- between the ages of 4 and 17 -- suffered from Attention Deficit Hyperactivity Disorder making it the most common psychiatric illness in that age group and representing a 41 percent increase from only eight years prior in 2003. One specific passage seems very relevant and echoed some of my thoughts on the subject:

"I think another social factor that, in part, may be driving the "epidemic" of A.D.H.D. has gone unnoticed: the increasingly stark contrast between the regimented and demanding school environment and the highly stimulating digital world, where young people spend their time outside school. Digital life, with its vivid gaming and exciting social media, is a world of immediate gratification where practically any desire or fantasy can be realized in the blink of an eye. By comparison, school would seem even duller to a novelty-seeking kid living in the early 21st century than in previous decades, and the comparatively boring school environment might accentuate students' inattentive behavior, making their teachers more likely to see it and driving up the number of diagnoses."

I agree with Mr. Friedman that "digital life" is omnipresent in the home, the car, and, in fact, anywhere the child or teenager happens to be able to use a smartphone. Immediate gratification is most certainly one of the reasons for a child or a teenager not being able to pay attention in school and it is a powerful one. How can school, even when technology is added as part of the curriculum, ever compare to the lure of an action video game or constant connection afforded by a seemingly infinite electronic communication opportunities through texting, email, Skype, and, of course, social media sites?

However, I feel that there are other reasons that school students might fail to pay attention other than simply wanting a more engaging electronic environment and ultimately I feel that it comes down to how we parent our children. Due to my earlier books on the impact of technology on children, teens and young adults in the Net Generation and the iGeneration, I have been able to speak at dozens of schools around the world where parents all ask the same question: "What is the right amount of technology for my child?"

The answer is fairly straightforward and it is composed of four main parts:

  1. Technology time should not be all consuming. My guidelines are not as stringent as those of the American Academy of Pediatrics, which recommends no screen time prior to the age of 2. Recognizing that parents need downtime and that technology can have educational benefits, I recommend that parents of young children set a rule of no more than 30 minutes of technology (and that includes television) at any one sitting which is to be followed by between three and five times that time doing non-technological activities that must include conversation -- necessary to learn the pragmatics of communication -- and free play time -- to allow the brain's Default Mode Network to take over and aid the child in developing creative thoughts and actions. So, if a child watches a half hour of Dora the Explorer then she should spend about 90 minutes or more playing with adults or other children and engaging in free play with a variety of toys and objects to allow for a future young adult who is able to communicate with others and possesses a creative mind.

  • As children get older and technology has more to offer, the ratio of tech time to nontech time changes. Preteens should be allowed to spend an hour or so at a single stretch with any form of technology, which is to be followed by an equal time spent communicating with others or simply playing without technology. By the time your preteen becomes a teenager technology will be all consuming. Regardless, it is important to limit tech time to no more than 90-120 minutes at a stretch followed by at least a 10- to 30-minute break doing something else. This break allows the brain to reset itself from the constant bombardment of technology's multisensory environment, which then makes it easier to learn new material.
  • If your child is like many, and is constantly torn from whatever he or she is doing to another activity then it is time to help relearn how to focus. Although this lack of focus is not entirely due to technology, there is ample research indicating that technology, with its constant alerts, notifications and multisensory stimulation, provides a strong external pull on a child's attention. [NOTE TO PARENTS: just know that you are not exempt from this pull and these suggestions might be helpful for you, too!] When your child is using a smartphone or websites to communicate with friends -- which includes online gaming and even email -- have them check in with each one of them for a total of one minute (OK, if your child complains make it two minutes) and then turn them all off including shutting down websites and email and silence the phone, tablet and any other device that might bring an alert or notification. Then set a timer on the phone for 15 minutes and place it upside down in plain sight. Upside down means that flashing alerts will be out of view and keeping the phone in plain sight is an important stimulus to the brain saying, "Don't worry! You will get to check in within 15 minutes or less." [In one recent study we took away smartphones from college students for an hour and their anxiety soared making learning impossible.] When the alarm sounds let your child spend another minute checking everything and then repeat the process until it feels comfortable. The first few times do this "technology break" in a public place where you can watch because the 15 minutes will seem like an ETERNITY to a constantly task-switching child or teenager (or adult). Then increase the 15 minutes to 20 and eventually hope to get to 30-60 minutes of focus time separated by short "check-in" breaks.
  • Technology must be removed prior to bedtime. Research by the National Sleep Foundation and other researchers has shown that using technology right up to bedtime interferes with getting a good night's sleep. Children and teens are supposed to get at least eight hours a night and many organizations recommend nine hours a night as optimal for a healthy learning brain. One culprit in a bad night's sleep is technology (see references below for recent studies on the impact of nighttime technology on sleep among children and teens). During the day sunlight increases our exposure to light in the short blue wavelength portion of the light spectrum, which increases our alertness by releasing neurotransmitters that energize our body. As the sun starts to go down, the predominant light is now in the red wavelength part of the spectrum which suppresses those energizing neurotransmitters in the brain and releases melatonin which helps us get tired and fall asleep over a period of hours. The problem is that all of our devices emit light in the blue portion of the spectrum so using a smartphone or laptop or any device close to your face retards the melatonin and makes it more difficult to fall asleep. The solution? No technology during the last hour before bedtime. There are exceptions. Television is fine as long as it is far enough from the eyes that the blue light is dissipating rapidly. Music is also fine as long as it is being played from a device that is not close enough to be checked allowing the blue light to retard the melatonin. [NOTE: For more detailed explanations about these guidelines on sleep check out my Huffington Post blog entitled, "Keeping Your Family 'Brain Healthy' in an Always Connected World" from earlier this year.
  • I hope that these suggestions will help you keep your children healthy while allowing them to get the most out of their software and hardware while keeping their "humanware" intact.

    The following published articles summarize the research on the role of technology in sleep disturbance among children and teenagers:

    Lemola, S., Perkinson-Gloor, N., Brand, S., Dewald-Kaufmann, J. F., & Grob, A. (2014). Adolescents' Electronic Media Use at Night, Sleep Disturbance, and Depressive Symptoms in the Smartphone Age. Journal of Youth and Adolescence, 1-14.

    Hale, L., & Guan, S. (2014). Screen time and sleep among school-aged children and adolescents: A systematic literature review. Sleep Medicine Reviews.

    Adams, S. K., & Kisler, T. S. (2013). Sleep quality as a mediator between technology-related sleep quality, depression, and anxiety. CyberPsychology, Behavior, and Social Networking, 16(1), 25-30.

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