September-October 2019 | Parenting

The Battle

Kids are hooked on their iPads and video games. When it's time to turn off the electronics, life at home can get ugly.

Psychiatrist Clifford Sussman, pictured at his D.C. office with his 6-year-old daughter, has a small technology-free room filled with games and toys. Photo by Michael Ventura

But sometimes that’s what works. Jessica Farnsworth’s son is motivated by rewards, not punishments, she says. Every morning, the first thing the 7-year-old asks for is time to play video games. Last school year, Farnsworth let him as she got ready for work, but only after he ate breakfast, got dressed, got his backpack ready, and put on his coat and shoes. When her husband came home from work in the afternoons, he allowed the boy to play the games again to keep him from bickering with his 5-year-old sister, who would then watch princess videos on YouTube Kids. “His video games are the only leverage we have because they are the most meaningful thing to him,” says
Farnsworth, who once reached out to a local Facebook moms’ group for advice about screen time. “That’s what we can dangle and offer him so that he does what we want him to do.”

In hindsight, Farnsworth wishes she’d handled things differently with her kids, starting early on, “but I feel I am past the point of saying: ‘Do this because I told you to,’ ” says the mother of three. “They’re not built that way now.” This school year, the Potomac family has an au pair. “We have another set of hands to keep them entertained or help monitor them,” Farnsworth says. “We don’t have to rely on the screens as much.”

Clifford Sussman, a child and adolescent psychiatrist who specializes in internet and gaming addiction, has seen patients as young as 9 at his D.C. office. For the younger set, he has a small technology-free room filled with games and toys, many of which require time and patience, such as puzzles and collaborative card games. “Kids with screen problems are always complaining about being bored, especially the younger kids, and they say the only thing that helps them with their boredom is being on a screen,” Sussman says. “But there’s value in delayed gratification and being bored. It’s the time when a lot of our creativity is generated.”

A self-proclaimed computer geek, Sussman has spent the better part of his 11 years in private practice studying the effects of video game addiction on the brain—long before “gaming disorder” was recognized as a medical condition by the World Health Organization in 2018. As he explains it, the brain consists of the “driver” (the inner portion that mediates pleasure by producing feel-good dopamine transmitters) and the “brakes” (the outer portion that controls impulses, decision-making and other factors that affect judgment). For all kinds of addicts, whether they’re hooked on drugs or video games, the relationship between the driver and the brakes is out of whack, making it tough for them to control their impulsivity. With excessive gaming, prolonged exposure to screens floods the brain with dopamine and desensitizes players to the pleasure-inducing effects of the game, so they hit the gas and play more to get the same high, even if it means neglecting schoolwork, jobs or relationships. They grow accustomed to getting what they want when they want it, and the less time they have to wait for something, Sussman says, the more dopamine their brain produces.

Sussman says his work informs his own parenting as he raises two young daughters, ages 3 and 6, both of whom are drawn to screens “like moths to a flame.” His older daughter, who has attention deficit hyperactivity disorder, probably could spend hours watching the YouTube videos of strangers cracking open hollow chocolate Kinder Eggs, each filled with a toy surprise. “When she was 4 years old, if you left her on a screen, she would find those videos and scream when you took them away,” says Sussman, adding that the response is predictable. Having the narrator open many eggs in rapid succession satisfies that craving for instant gratification, and having a different prize every time kept her glued to the screen. Knowing that she likes the eggs with Disney characters from Frozen, Sussman has offered to watch the movie with his daughter, but she declined. She doesn’t have the patience. “She just wants to see what comes out of the egg,” he says. “It demonstrates how simple the principles of addiction are.”

At his Bethesda home, Sussman tries to practice what he preaches. When he and his wife allow their daughter online, they no longer let her watch the egg videos, and they limit her to a consistent length of time. “We picked half an hour,” Sussman says. “I got her a digital watch, and she’s kind of fascinated with the concept of time. …She likes the numbers because they’re within her control. She can see when it’s zero, and she doesn’t fight with us because the numbers don’t lie.”

Giving her a warning before the 30-minute mark helps. Sussman says kids, and even adults, are prone to losing track of real-world time when they get on a screen, an effect known as time distortion. But having a clock within sight helps develop what he describes as the commuter instinct, the one that kicks in for subway riders who nod off on the way to work but wake up just in time for their stop because they’ve grown accustomed to a fixed pattern of behavior. Equally important, he says, is following up every block of time online with a stretch of off-screen time, which builds their capacity to entertain themselves and gives the brain time to recover from online stimulation.

Sussman doesn’t claim to have all the answers. He and his wife remain unsure of what to do about exposing their younger daughter, who is on the autism spectrum, to screens. They know from experience that screens soothe the little girl when she’s distraught. But they fear that allowing screen time when she’s agitated will reinforce the behavior they’re trying to avoid. So for now, they’ve decided to keep her off screens and away from toys that beep or play music. They say both are distractions that prevent her from connecting with people, focusing on faces and reading social cues.