Ment ental al He Heal alth th Se Series ries Todays topic : - - PowerPoint PPT Presentation
child & youth Ment ental al He Heal alth th Se Series ries Todays topic : Technology Overuse: Helping Patients and Families to Reconnect and Unplug Speaker: Michael Cheng, Psychiatrist, CHEO Thu, Apr 20, 2017 If you are connected
Thu, Apr 20, 2017
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CHEO MH Rounds Thu, Apr 20, 2017, 1200-1300 hrs
Children’s Hospital of Eastern Ontario (CHEO)
1200-1245 Talk (45-min.) 1245-1300 Questions (15-min.)
Atari, because my parents thought that it would rot my brain…
that…
to cut back on their kids’ technology…
nature
technology given by Dr’s Gandy and Cheng.
causes problems, this session will focus more directly on clinical interventions with the patients that we see.
parents…
reduce their kids recreational screen time…
inattention, irritability, and depression
Image: Boggett Photography
games!
Image: Boggett Photography
First Nations Mental Wellness Continuum Framework, 2014
Deep connections to people, in particular family Nature Other meaningful things such as community, culture, spirituality, etc...
Secure attachment to people oxytocin Nature exposure dopamine / adrenaline Other meaningful things such as community, culture, spirituality, etc...
NEED REFERENCES
Deep connections to people, in particular family Nature
Other meaningful things such as community, culture, spirituality, etc...
Deep connections to people, in particular family Nature
Other meaningful things such as community, culture, spirituality, etc... Technology Hedonism, materialism, consumerism… Peers
screens (Pew Internet Study, 2011)
video games
that today’s modern video games provide
a sub-cortical, polyvagal level
“Easy dopamine”, i.e. provides lots of dopamine, adrenaline with little effort When your brain gets used to “easy dopamine”, its harder to do things that provide less dopamine, that are ‘boring’ like:
provides optimal sensory experience, leading us to have optimal brain waves and feel calm, relaxed, refreshed
than even other things thought relaxing, e.g. classical music
Image: Boggett Photography
adrenaline / dopamine, it is actually not calming nor refreshing, and can trigger fight/flight responses
conditions, e.g. seizure disorders, sensory processing issues, issues that affect filtering such as psychosis, or anxiety
worse…
Image credit: Fair Use Policy
chronic alarm, i.e. stress
more primitive parts of the brain
creativity, social behaviour
sleep, disturbs concentration, causes weight gain
disorder
Dunckley, 2014
time, or other things which give purpose, belonging, hope and meaning
Repetitive use of Internet-based games, often with other players, that leads to significant issues with functioning. Five of the following criteria must be met within one year: 1) Preoccupation or obsession with Internet games. 2) Withdrawal symptoms when not playing Internet games. 3) A buildup of tolerance – more time needs to be spent playing the games. 4) The person has tried to stop or curb playing Internet games, but has failed to do so. 5) The person has had a loss of interest in other life activities, such as hobbies. 6) A person has had continued overuse of Internet games even with the knowledge of how much they impact a person’s life. 7) The person lied to others about his or her Internet game usage. 8) The person uses Internet games to relieve anxiety or guilt–it’s a way to escape. 9) The person has lost or put at risk and opportunity or relationship because of Internet games.
Repetitive use of screentime, often with other players, that leads to significant issues with
1) Preoccupation or obsession with screentime. 2) Withdrawal symptoms when not playing screentime. 3) A buildup of tolerance – more time needs to be spent on screentime. 4) The person has tried to stop or curb screentime, but has failed to do so. 5) The person has had a loss of interest in other life activities, such as hobbies. 6) A person has had continued overuse of screentime even with the knowledge of how much they impact a person’s life. 7) The person lied to others about his or her screentime. 8) The person uses screentime to relieve anxiety or guilt–it’s a way to escape. 9) The person has lost or put at risk and opportunity or relationship because of screentime
condition (such as ADHD, mood/anxiety problems), in which case, symptoms should resolve with screen detox.
sensory processing disorder, in which case, symptoms should improve with screen detox.
symptoms preceding screen time use
increasingly difficult to ascertain which is primary or secondary
than a medication trial for example!)
sensory seeking, which leads to the attraction of screens.
with people, and as a result, technology offers an easy distraction in the short run. The problem however, is that especially with ASD, their brains need exposure to face- to-face social interaction to help wire their brains, which is lacking with screens.
socially connecting with others, and hence turn to technology such as social media to try to connect. It can then become a vicious cycle as excessive social media use worsens mood.
sensory input such as sound, touch, or smell. As a result, individuals with SPD are even more sensitive to having sensory overload from using recreational screens.
particularly sensitive to technology overuse
school, and they may be in Section 23 programs
with screentime
rewarded with something which promotes more meltdown
Personal communication, Dr. M. Cheng
glasses
contributing
Personal communication, Dr. M. Cheng
each other.
wanting to continue playing or texting with others.
practice
using a device of some sort
week begin to have brain changes that resemble drug addiction. “[Children playing video games more than 20-hrs a week] showed increased glucose metabolism in the right obitofrontal gyrus, left caudata, and right insula after play. Decreased metabolism was seen ... while at rest. These patterns were similar to those seen in drug addicts ... suggest[ing] that online gaming may be addictive to the genetically vulnerable.” (Burke, 2010).
much, and if anything, probably the less the better.
Paediatrics (AAP) suggest not so much a fixed number, but rather
impairment of some sort
based mental health services, medications) have not been successful
cases of treatment-resistant depression
various problems.
mood (REFERENCE REQUIRED)
without screens improved their non-verbal skills (e.g. reading facial expressions) (Uhls, 2014).
anxiety, autism spectrum disorder (ASD)
impulse control may make it harder for a child to detach from technology and thus, treating ADHD may help
similarly make it hard for such a child to connect with people
more likely to be overconnected with a device; hence, appropriate interventions with ASD may be able to help connect a child to healthier attachments
with parents
nurturing and caring
development rather than technology, to protect yourself against negative influences from television, media, video games
rather than technology
with mood, attention, and low frustration tolerance
hours of recreational screentime that your child is getting
they at?
concerns about your technology use?”
concerns about your child’s technology use?”
Precontemplation Contemplation Action Maintenance
Stage of Change Parent Response Pre-contemplative “We don’t have any problem with tech overuse” Contemplative “Yes, we have a problem, but we’re not ready/able to change right now…
a tantrum.”
technology these days. Action “Yes, we have a problem, and we are open to whatever you suggest!”
Stage of Change What the clinician might say Validation “I appreciate, that at this point, you don’t feel a need to make changes.” “How else can I support you?”, e.g. you can work on other goals together with the family, such as improving family communication, etc. ”In the meanwhile, can I just ask you a few other questions…” Cost-benefit analysis “What would be the advantages of cutting back?” E.g. improved mood/concentration; less need for medications or therapists “What would be the challenges with cutting back?” E.g. how to occupy their time? ; how else to connect with peers? Identifying other support (or lack of support) “Any people that could helpful to help you in cutting back on screen use?” “Any people that might be an obstacle for cutting back on screen use?”
mood and feeling tired all the time.
energy and concentration?
emphasize cutting back on electronics
happens
problem, as this may lead the youth to feel threatened, and resist
to-face time, 3) etc.
you believe will be healthy for the whole family
you believe will be healthy for the whole family
dinner walks together. And we used to have board game night. Let’s start that up again!”
reduce the recreational screens to ZERO hours/day, followed by a “detox” period of a few weeks
and it just so happens that there is no internet
recommended.
allowable screen time
have suddenly cut off video games from youth, with catastrophic results
before direction
cutting off the technology
weeks
activity with mom, e.g. board games
with mom, etc…
1) Dr. Dunckley’s “Reset Your Child’s Brain”, which has a four-week ‘electronic detox’ protocol for parents 2) Going to http://www.drdunckley.com and signing up for the “Save Your Child’s Brain” mini course – 4 newsletters that summarize the electronic detox protocol
technology use
that should be met by a human being
instead, pick up the child and co-regulate yourself
experience creativity
Image: Boggett Photography
devices into a basket when they come in through the door, and only retrieve them at a pre-designated time, e.g. after dinner
as reading, sports, crafts, nature, etc.
writing a story, making a movie, etc.)
‘consuming’, e.g. playing a violent video game, binge watching TV…
Image: Boggett Photography
balanced by non-screen time
restorative nature time is needed (Louv, 2005)
minutes doing non-tech (Rosen, 2014)
Image: Boggett Photography
development
Canadian Paediatric Society (CPS) Technology Guidelines
Image: Boggett Photography
Canadian Paediatric Society Guidelines Image: Boggett Photography
child development
eye-hand coordination but not in development overall
games such as multiplayer games
many European countries (e.g. Waldorf movement from Germany; nature schools from Scandinavia, especially Finland)
school boards in adopting more nature- based education in order to optimize brain development
Catholic Board, on Main Street, Ottawa
Gatineau and West of Ottawa
http://www.nytimes.com/2011/10/23/techno logy/at-waldorf-school-in-silicon-valley- technology-can-wait.html?pagewanted=all
ask him what makes it hard to connect with his mother
lectures him, gets upset…
Image: Boggett Photography
all parents get upset from time to time…
empathy that of course, it would feel difficult talking to mother if she gets angry and upset…
mother, focusing on
reconnect with her
technology, focusing on ‘stages of change’
Image: Boggett Photography
the importance of connection to things that give belonging (i.e. attachments), purpose, hope and meaning
technology and materialism, and not attached to parents and others
the internet
him first
acceptance, by teaching her the skills of (radical) empathy, validation and acceptance
Image: Boggett Photography
in the waiting room with them, as they reconnect with each other
Image: Boggett Photography
Available from
Aussi disponible en français
Quitters website, as featured on TED talk
Image: Adobe
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