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home : columns : ask the doctors August 22, 2017

4/10/2014 9:53:00 AM
Limit the time your kids spend playing video games

DEAR DOCTOR K: My son plays a lot of video games. What do I need to know about them? And how can I make sure they don't become a problem?

DEAR READER: I've yet to meet a child who doesn't like video games. But as you imply, this kind of entertainment has its downsides. I've talked with several colleagues who are pediatricians here at Harvard Medical School, and they've helped me answer your question.

Video gaming is a sedentary activity. This isn't a big deal if your son spends less than a total of two hours a day watching TV or playing video games. But you don't want media time to crowd out time spent being physically active.

Too much fast-paced video gaming can cause behavioral problems. Children who spend a lot of time playing fast-paced video games can have trouble with executive functioning. Such games throw a new stimulus at a kid every few seconds, and the child has a limited number of potential responses. Granted, most children are not executives -- but many are future executives, and the skill-set required begins to be developed in childhood.

"Executive functions" are the mental processes involved in planning, trouble-shooting and delaying gratification. They are crucial for good behavior -- and good social interactions.

An executive needs to be deliberative. He or she needs to consider an issue from all sides. This requires calling on past business experiences to help predict the best decision. And it involves identifying the people in the organization who need to be involved in considering the best course.

Many video games contain a lot of violence. Exposure to media violence has been linked to behavioral problems and aggression in children. Experts also worry about the effects on children of being the one carrying out the violence, as opposed to just watching it.

Friends and patients who work with children often tell me that some kids seem to think that the consequences of violence are not "real." Or that, because "winning" in a video games involves successful acts of video game violence, being violent in real life will make them "winners."

Some children may get addicted to them. It's easy to get caught up in making it to the next level and lose all track of time.

This doesn't mean that children should never play video games. But as with everything in life, common sense and moderation are key. Here are some ways you can help ensure that video games don't cause problems for your son:

-- Limit the time spent playing them. The American Academy of Pediatrics recommends that children limit screen time to no more than two hours a day. Have rules -- and enforce them.

-- Choose games wisely. Pay attention to the age ratings. Encourage games that are educational, or that require activity such as dance competition games or games that involve playing a sport virtually.

-- Supervise -- and join in. Watch your son while he plays to see what the games are really like. Even better, play with him. You'll get a real sense of the game and how your child reacts to it.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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