Scotland must act now on screen time for under-fives, says expert

Scotland must act now to address children under five exceeding the screen time guidelines, according to a public health expert.  

It comes as many children aged five and below are exceeding the World Health Organization (WHO) guidelines for screen time.  

The WHO guidelines, published in 2019, recommend that children between three and four years old should have a maximum of one hour of screen time per day. It suggested that children aged one to two should have even less time in front of screens, and those under one should have no screen time at all. 

However, guidelines for screen time for under-fives is absent from Scottish population health and obesity policy. 

The evidence cited by the WHO highlighted that lower screen time is linked to healthier weight and body composition, better motor and cognitive development, improved sleep, and stronger social and emotional development.  

Excessive screen use in early childhood has been found to impair development and learning, contribute to long-term inequalities in health and education, reduce vital family interaction, and establish unhealthy habits that persist into later life. 

John J Reilly, professor of physical activity and public health science at the University of Strathclyde, who chaired a UK Chief Medical Officers (CMOs) working group tasked with developing evidence-based guidelines for physical activity, screen time and sleep in the under-fives between 2017 and 2019, said “scientific evidence was both strong and clear” in pointing towards less screen time resulting in better health outcomes.  

However, he criticised the lack of action in Scotland, while the UK Government published advice in March stating that children under two should avoid screens altogether except for interactive uses such as video calls, and those aged two to five should be limited to no more than one hour a day, with less being better. 

Reilly said: “Many years on, policy inertia persists in Scotland. Screen time in the under-fives remains absent from Scottish population health and obesity policy. How should we proceed?  

“Scottish guidelines on screen time for the under-fives, long overdue, would be a start. New English screen time guidance for the under-fives, not evidence-based, was published at the end of March. Scotland should adopt the WHO 2019 Screen Time Guidelines with appropriate adaptations, then turn the new guidelines into action using all the other key stages of policymaking – education and awareness raising among the public and professionals in health and education; health policy development and policy implementation, evaluation and monitoring.”  

He added: “The science and evidence have been settled for some time – high levels of screen time in early life are both very common and very harmful. Great damage has been done by the reluctance to tackle early life screen time in Scotland, and we can no longer afford to delay action.”