CoramBAAF Physical health impacts by Coram

Navigating online life with children and young people Physical health impacts corambaaf.org.uk CoramBAAF Adoption and Fostering Academy 41 Brunswick Square London WC1N 1AZ © CoramBAAF2024

Introduction Many aspects of a child’s life are dependent on technology, and there will inevitably be further evolution of social media, online content and uses. This brings new challenges, new opportunities and new threats. There are specific health benefits associated with the internet including access to health information, peer support groups for health conditions and emotional health support. Opportunities for maintaining relationships, communication, learning and creativity are all important for the health of children and young people in care.

Key points to remember For children and young people their online life is as real to them and as important to them, as their real life. If you are more vulnerable in real life you are more vulnerable online. It is behaviour online that is negative rather than the technology itself.

Written by Dr Victoria Walker and Jane Poore © CoramBAAF2024

Screen time is directly associated with increases in childhood obesity, reduced sleep hygiene and can have a negative impact on a child’s development and educational performance. However, evidence suggests that the quality and content as opposed to duration of screen time has a more significant impact.

NSPCC Data (2021)

83% 12-15 yr olds own a smart phone

70%

of 12-15 year olds have at least one social media account

49%

8-11 yr olds have their own tablet

45%

of 8-11 yr olds that have a smartphone take it to bed with them

37%

8-11 yr olds have a smartphone

Physical impacts Positives Emotional wellbeing

Support

Opportunities for creativity and socialising

Self harm and suicide

Challenges Sleep

Accurate public health guidance Improved compliance with health conditions

Activity and obesity

Development delay

Excercise

Body dysmorphia

Eating disorders

Symptoms linked to mental health, which can be negtively impacted

Our children and internet use – why it’s different Children in foster care, kinship care or adoptive families Children and young people exposed to inappropriate material at an early age are potentially desensitised. Children and young people who have experienced abuse and/or neglect may have different fight/flight/freeze responses to harmful requests or content . Children and young people using social media as form of rebellion or as a way to validate difficult feelings. Children and young people wanting to connect with others via social media – “looking for their tribe”.

Sleep Blue light is emitted by digital screens, the brain associates blue light with daytime. Melatonin is a hormone that occurs naturally in the body and helps to regulate the sleep cycle. Blue light is intrinsically linked to the natural circadian rhythm and the body’s production of melatonin. Anything that impacts a child or young person’s sleep routine and environment, can lead to disordered sleep. There may be negative developmental and educational outcomes because of daytime sleepiness. Therefore, protecting the hour before bed as ‘screen-free’ time is important to improve a child or young person’s sleep hygiene. It is important to consider that certain features of digital devices, such as music or audiobooks, may aid a child’s sleep routine; allowing music or audio books to stop playing after a set time, can support the natural sleep cycle. Children - The Sleep Charity

Obesity and activity The incidence of childhood obesity is increasing. This is multifactorial but includes a link between increased daily screen time, and the number of hours of television watched with the amount of highly calorific ‘advertised junk food’ consumed by children and young people. The NHS initiative, ‘Better Health, healthier families’ (which used to be ‘Change4life’)is a good resource to direct parents and children to and highlights simple changes that can be made to promote a healthy lifestyle including support and education around eating well, sugar-awareness, meal sizes, physical activity and screen time. There are often local services and support which may not require a referral from a professional. Fun activities and hobbies, and simple measures such as walking should always be encouraged.

Decreased physical activity due to increased screen time is a recognised concern, and as with most things a balance is needed. Availability, finance and logistics can all impact on the opportunity for children in care to undertake different activities. The internet and online games/programs that directly deliver physical exercise or fun physical activities can help. Excessive screen time can result in delayed motor development or poor coordination as children neglect outdoor and physical activities. Regular physical activity can support emotional health.

Developmental delay The quality of a child’s screen time is the most important predictor of developmental and educational outcomes. Passive and unsupervised consumption of poor-quality content such as television or games with minimal cognitive stimulation is detrimental to a child’s learning and development. Quality television programmes and online activities can enhance the learning experience, better engaging a child’s attention and creating moments of active reflection and learning (this still needs to be age appropriate with adult supervision). High quality television programmes can promote better understanding of social concepts such as feelings, friendships and how to interact with peers. Persuasive design e.g. automatic next play which tends to have more of an impact on younger children, has been theorised to have a negative influence on attention span. For young people, short attention span, inability to wait and expectation influences their experience of education and family. The 2D nature of screens can delay fine motor development, with increased screen time resulting in poor in-hand manipulation and coordination skills. Parent and child interaction is essential for development and factors such as background television, unsupervised screen time and single player games can result in negative long-term socio-emotional outcomes. © CoramBAAF2024

Misinformation and disinformation The availability and promotion of misinformation online is increasingly common. This can have a serious impact on health perceptions and compliance with treatment and advice including vaccines. There may be a direct negative impact with young people making their own health decisions or indirect with parents/carers not following recommended health advice or treatment. This may be the absence of doing something like taking a medication or undertaking a treatment or taking a substance perceived to be helpful that causes physical harm.

Definitions Misinformation is false or inaccurate information getting the facts wrong.

Disinformation is false information which is deliberately intended to mislead - intentionally misstating facts.

Eating disorders and body image The cause of disordered eating is multifactorial; however, the constant pressures of social media and focus on appearance contribute significantly to the development of these problems. Exposure to the ‘thin ideal’ on social media is linked to internalisation of this image, body dissatisfaction and subsequent disordered eating. In men, social media pressures tend to be related to a muscular physique.

What to do if you’re experiencing eating problems (Young Minds).

There has been a rise in disordered eating and changes to how this is influenced online, with positive and negative attention encouraging behaviour and websites targeting young people with challenges to achieve extremely low weight and body shape. © CoramBAAF2024

Body dysmorphia The focus on appearance can also be linked to body dysmorphia. This can be focused on body shape or can be about skin e.g. acne, freckles, texture, colour. With diagnosed body dysmorphia there is an unrealistic body expectation and young people obsess over perceived flaws. Online, they can edit, set angles for photographs, choose a beauty filter. With increased use, algorithms can make the situation worse with constant feeds about appearance and body.

Body dysmorphic disorder (BDD), or body dysmorphia, is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. These flaws are often unnoticeable to others (NHS).

There have been positive movements and media campaigns for ‘real’ images to try and combat this. Useful contacts - body dysmorphic disorder (BDD) – Mind

Self harm Exposure to harmful content and behaviours online including trolling and cyberbullying, is thought to have a triggering effect associated with increased rates of self-harm and suicide amongst adolescents. Self-harm is mentioned widely on social media in supportive and abusive ways. Self-harm imagery and peer to peer encouragement is increasing. However, there are many supportive websites, apps and resources to help young people manage anxiety and emotional health including self-harm and suicidal thoughts.

Consequence of emotional health difficulties Social media use and online content and behaviour can lead to emotional health difficulties, which in turn have physical symptoms, for example: Disordered sleep Changes to appetite Lethargy Poor concentration Risk taking behaviour Self-medicating with drugs or alcohol © CoramBAAF2024

Positive impacts Connectivity

Communication Creativity

Maintain relationships

Learning

Support for sleep, hobbies, exercise

Emotional support, counselling

Health information

Health condition support groups

Resources - Digital 5 a day Easy to follow, practical steps for children and parents to achieve a healthy balanced ‘digital diet’. 1. Connect 2. Be active 3. Get creative 4. Give to others 5. Be mindful

Resources Topic: Digital Wellbeing | SWGfL Children's digital wellbeing: 2024 report | Internet Matters Online safety for children with SEND | NSPCC Digital 5 a day | Children's Commissioner for England (childrenscommissioner.gov.uk) Online research – Ofcom

CoramBAAF Physical health impacts​

CoramBAAF Physical health impacts