My ten year old son spends at least three hours per day using his computer. I am worried that the amount of computer exposure both at home and school may impact his health and weaken his vision. How concerned should I be?
Your child is doing what most children in North America do these days: spending close to three hours per day on the computer doing homework, talking on-line with friends, and playing games. Close to 90% of school-aged children have computer access at home or in school. Some parents even encourage children as young as two or three years old to use the computer.
An increasing number of children present at clinics with symptoms of visual strain, headaches, and musculoskeletal concerns related to computer use. During a recent literature search done on this very topic, I was unable to get enough articles in peer-reviewed journals that addressed this important topic in sufficient detail.
According to the Cornell University Ergonomics website, extended computer use by children may be associated with poor posture, back-ache, neck pain, shoulder pain, wrist discomfort, eye strain, and headaches (See www.ergo.human.cornell.edu/cuweguideline.htm).
The International Ergonomics Association website (www.cehd.umn.edu/kls/ecee/default.html) confirms that an ever-increasing number of children report musculoskeletal symptoms and eye strain secondary to prolonged computer exposure. Many of these symptoms are resolved once the children are in an ergonomically healthy environment.
Ergonomics is the scientific study of how humans interact with their work areas, and more recently has included school environments. The word ergonomics has its roots in two Greek words: “ergon” (work) and “nomoi” (natural).
There are unique ergonomic considerations for children. Very young children may not be as aware of the position of their extremities. They may also become so absorbed in their computer activities, they forget to take breaks - unless their parents remind them or monitor the duration of uninterrupted computer exposure. Children also have smaller hands than adults, thus conventional keyboards may be too large for them. Some schools have started to use keyboards which are more age-appropriate.
The level of the computer is critical, especially when it is at a fixed height. Experts suggest the monitor be placed in the center, not to the side where it may lead to neck strain. It should be viewed comfortably without the child having to tilt the neck backwards or forwards. When families share the computer workstation, it becomes important to set it up in such a way that the level of the computer can be adjusted to suit the age of the user. An adjustable chair may be useful to position the child in the “Neutral Work Posture” (For visual images of these postures, please see www.cehd.umn.edu/kls/ecee/guidelines.html).
The various positions of the Neutral Work Posture include:
- Sitting back in chair with proper back support and back greater than 90 degrees.
- Chair seat should not put pressure on the area behind the knees.
- Both feet should rest firmly on a surface for support.
- Head should not be tilted.
- Upper arms should be close to the body and relaxed.
- Elbows must be at an angle greater than 90 degrees.
- Wrists must be neutral to the forearm (less than 15 degrees).
- Both shoulders should be relaxed.
It is not only important to make sure the computer monitor is at the correct level, it must also have no glare. The area where the child works should also be correctly lit. Experts recommend the use of additional light, even though the computer screen is self-illuminating. Ideal lighting is indirect, which illuminates the walls and ceilings, in combination with a task lighting, which is positioned as far away as possible from the screen.
According to the Mayo Clinic, eye strain is characterized by these symptoms:
- sore, tired, and burning eyes
- watery eyes
- blurred or double vision
- headache and sore neck
- increased sensitivity to light
- difficulty shifting focus between the monitor and paper documents in work area
Eye strain associated with computer use is not thought to have serious or long-term consequences (See www.mayoclinic.com/health/eyestrain/WL00060). However, some optometrists are concerned as there is some data suggesting an association between excessive computer use and the risk for early myopia (nearsightedness).
The Alberta Association of Optometrists offers further information on how to avoid eye strain (See www.optometrists.ab.ca/guide/vdt.htm). Some of the highlights are:
- Take eye breaks at least once every 30 minutes (deliberately shift the focus between different distances or keep the eyes closed for a minute or two).
- Blink often (children may get so mesmerized by computer games that they blink less).
- Consider using artificial tear drops.
- Keep the monitor at 20-28 inches from eyes.
- Ensure the screen is dust free (dust can cut down on contrast and contribute to glare).
Since tracking the duration of computer exposure is critically important - some parents may need additional help to do this - there are software programs which alert the child, via the computer screen, that it is time to take a break. During breaks, encourage your child to focus on stretching the neck, shoulders, back, wrists, and fingers. Deep breathing and progressive relaxation may also help to reduce stress and fatigue.
According to the Cornell University Ergonomics site, more and more teachers, parents and librarians feel that teaching younger children ergonomically appropriate exercises may be as important as teaching the use of seatbelts or bicycle helmets. The thinking is that the earlier one can teach children good habits, the easier it becomes for them to make these habits second nature. The Cornell group also offers advice to families who prefer to use laptop computers. These mobile devices have also been associated with symptoms of eye strain, perhaps more so than desk top computers.Access www.healthykids.ca for a terrific new resource in helping families raise healthy children - HealthyKids with Dr. Nieman will optimize your child's complete health.
An informed parent is ... an empowered parent.