Growing up in a digital world: Guiding children and youths towards safe and healthy screen use

07 Sep 2026 | Special Delivery

Key points:

Screen use is an inevitable part of childhood today. Well-designed digital media can support children’s learning, social development and well-being.
Health risks arise when digital use displaces healthy behaviours. Prolonged and unguided use is associated with health risks including distress, sleep disruption, cyberbullying, eye strain, joint and muscle aches and discomfort.
Age-appropriate guidance, open family communication and early professional support are key to help children and adolescents grow up safely in the digital ecosystem.

Children today are “digital natives”, growing up in a world where the digital ecosystem – television, the internet, social media, video games and interactive assistants – forms a fundamental part of their lives. Digital media can be beneficial in supporting parents as the child learns and develops, but excessive, unmonitored use can pose physical and mental health risks.

The health implications of screen use in children and adolescents are of sustained clinical and research interest, with a growing body of evidence informing how we counsel families. The question is not whether children will engage with digital media, but how they can so in ways that benefit rather than undermine their health and development.

Benefits of digital media for learning, exploration and discovery

A digital ecosystem designed with children’s developmental needs in mind can meaningfully support learning and well-being. For younger children, age-appropriate educational content can support early literacy, numeracy and cognitive development when used in moderation with caregiver involvement.

For older children and adolescents, social media is a space to connect with friends, explore interests and discover communities with shared passions. The anonymity of online spaces allows them room to explore aspects of their emerging identities. For those with health conditions or disabilities, digital platforms can offer essential social connection and improved mental well-being.

Complex and concerning impact of digital use in children

The health risks of digital media use differ across age groups. In younger children, primary concerns are displacement of physical activity, face-to-face social interaction and unstructured play, which are all foundational to healthy early development. Excessive screen time in this age group is also associated with delayed language development, reduced attention span and disrupted sleep patterns.

The design features of social media platforms – infinite scrolling, notification-driven engagement and algorithmically curated content – are all engineered to maximise time spent on screen. Neurological immaturity causes youths to be especially vulnerable to these tactics, which can lead to excessive screen use. During adolescence, the brain undergoes significant development, particularly in the prefrontal cortex, and youths are still gaining mastery over their impulse control, decision-making and emotional regulation. As such, they may find it hard to self-regulate their own screen time and activities.

Negative impact of screen use on adolescents include:

Physical discomfort and visual symptoms	Poor sleep
Increased risk of joint and muscle aches and discomfort from prolonged static postures as a result of excessive or poor patterns of screen usage. A local study¹ of 1,884 adolescents aged 10 to 18 years found that more hours of daily smartphone use was associated with increased risk of neck/shoulder, upper back, arms and wrist/hand discomfort, and visual symptoms. Eye strain, dry eyes and persistent headaches from sustained close-range focusing and reduced blink rates.	Late-night device usage is a primary contributor to poor sleep quality. Blue light exposure and digital hyper-arousal can impair growth and immune function during critical adolescent developmental years^2,3.
Risky behaviours, bullying and sexual dangers	Psychological distress
Adolescents are highly sensitive to social pressures and peer comparisons, making them particularly susceptible to harmful online trends, unrealistic beauty standards and content promoting body dysmorphism, gambling, pornography, self-harm or substance use. Risk-taking behaviour peaks during adolescence, and the online environment provides ample opportunity for this to manifest in harmful ways. A 2018 report by the DQ Institute⁴ found that 54% of Singaporean children aged eight to 12 years were exposed to at least one cyber-risk, with 43% having experienced cyberbullying. By 2023, nearly 70% of those aged eight to 18 years worldwide had experienced at least one cyber-risk in the past year⁵. The anonymity of social media also raises serious concerns around online grooming and exploitation.	Youths who had experienced cyberbullying are found to have 1.4 times higher odds of severe symptoms of depression and anxiety⁶. Those spending more than three hours daily on social media were more likely to report symptoms of depression, anxiety or stress⁶. Local youths aged 15 to 34 years were also most likely to experience problematic smartphone use associated with psychological distress⁷.

When does digital use become problematic?

Screen use warrants professional attention when children compulsively use it to the extent where it negatively impacts upon their physical function or mental health.

Physical red flags include persistent joint and muscle pain, the characteristic “tech-hunch” posture of rounded shoulders and a forward-leaning head, digital eye strain and unexplained headaches. Those with persistent or worsening joint and muscle discomfort or pain, postural concerns or significant visual symptoms should be referred for physiotherapy and ophthalmological assessment as appropriate.

Parents should be alert to disturbed sleep, loss of appetite, low mood, anxiety, social withdrawal or being unable to effectively perform their daily activities. Being overweight or obese may also be an indirect effect of too much sedentary screentime.

Parents and caregivers should refer to the following age-appropriate guidance on screen use:

For children aged zero to 12

Children younger than two years are not recommended to have screen time apart from video-chatting with adults caring for them.
Children aged two to five years are recommended to have screen time limited to an hour a day.
For primary school-age children, recreational screen time should not exceed two hours per day.
Parents should stay involved from the moment children begin accessing devices.
Use parental controls, ensure content is age-appropriate, and encourage device use in shared spaces.
Have open conversations with children about both the benefits and potential harms of digital media, including privacy, personal information and digital footprints.

For children aged 13 and above

For adolescents, less than three hours of daily use is recommended. Research indicates that those who exceed this duration are at an increased risk of experiencing poor mental health outcomes^8,9.
Parents should shift towards a more collaborative approach, recognising that teenagers are more receptive to guidance when they feel respected and heard.
Given adolescents’ heightened vulnerability to compulsive use and harmful content, open and ongoing conversations about online safety and responsible digital behaviour are especially important.
The American Academy of Paediatrics (AAP) recommends that families create a family media plan, setting agreed boundaries such as limiting social media on school nights, enforcing screen-free mealtimes and planning regular screen-free activities.
Adolescents should also be encouraged to take regular breaks, avoid sustained postures during screen use and avoid screens in the hour before bedtime.

Resources for parents and caregivers

General

MDDI Screen Smart from the Start Movement: https://www.bescreensmart.gov.sg
MDDI Digital For Life Portal: https://www.digitalforlife.gov.sg/online-safety
MDDI Digital For Life “Positive Use Guide”: https://www.digitalforlife.gov.sg/-/media/digital-for-life/resources/documents/2025/09/positive-use-of-guide-on-technology-and-social/positive-use-guide.pdf
AAP Family Media Plan Tool: https://www.healthychildren.org/English/fmp/Pages/MediaPlan.aspx
TOUCH Cyber Wellness: https://www.touch.org.sg/get-assistance/cyber-wellness.html

Younger children

HPB Parenting for Wellness Portal – Tips of cyber wellness for children: https://parentingforwellness.hpb.gov.sg/Module-11
MOE’s commentary on social media use in pre-teens: https://www.schoolbag.edu.sg/story/13-and-ready-for-social-media-or-not

Teenagers

MindSG resource on teenage cyber wellness: https://www.healthhub.sg/programmes/mindsg/caring-for-others/my-child-teen-practising-cyber-wellness
MindSG resource on dangers of cyberspace for teenagers: https://www.healthhub.sg/programmes/mindsg/caring-for-ourselves/learning-about-cyber-wellness-teens#dangers-of-cyberspace
MindSG’s resource “Social Media: Positive and Negative Impact on Youths’ Well-Being”: https://go.gov.sg/pfw-social-media-impact

References

Toh, S. H., Coenen, P., Howie, E. K., Mukherjee, S., Mackey, D. A., & Straker, L. M. (2019). Mobile touch screen device use and associations with musculoskeletal symptoms and visual health in a nationally representative sample of Singaporean adolescents. Ergonomics, 62(6), 778–793. https://doi.org/10.1080/00140139.2018.1562107
Haug, S. (2024). Late-night smartphone use and sleep quality in adolescents. Journal of Adolescent Health.
van den Eijnden, R. J. J. M., Geurts, S. M., Ter Bogt, T. F. M., & Vollebergh, W. A. M. (2021). Social media use and adolescents’ sleep quality. Sleep Medicine.
DQ Institute. (2018). National DQ Impact Report: Singapore. DQ Institute.
DQ Institute. (2023). DQ Global Standards Report 2023: Child online safety index. DQ Institute.
Institute of Mental Health. (2023). National Youth Mental Health Study. Institute of Mental Health, Singapore.
Subramaniam, M., Abdin, E., Vaingankar, J. A., Shafie, S., Sambasivam, R., Zhang, Y. J., Shahwan, S., Chang, S., Chua, B. Y., & Chong, S. A. (2024). Problematic smartphone use and psychological distress among youths in Singapore. Asian Journal of Psychiatry.
Institute of Mental Health. (2024, September 19). Excessive social media use, body image concerns and being cyberbullied are significantly linked to mental health symptoms among youths. https://www.imh.com.sg/Newsroom/News-Releases/Documents/NYMHS_Press%20Release_FINAL19Sep2024.pdf
Riehm, K. E., Feder, K. A., Tormohlen, K. N., Crum, R. M., Young, A. S., Green, K. M., Pacek, L. R., La Flair, L. N., & Mojtabai, R. (2019). Associations between time spent using social media and internalizing and externalizing problems among US youth. JAMA Psychiatry, 76(12), 1266. https://doi.org/10.1001/jamapsychiatry.2019.2325

Dr Nur Adila Binte Ahmad Hatib, Senior Consultant, General Paediatrics Service, KKH

Dr Nur Adila is a clinical assistant professor with the SingHealth Duke-NUS Paediatric Academic Clinical Programme, director of the KKH Community Paediatrics Service and clinical lead for general paediatrics at Sengkang General Hospital. She has a keen interest in advancing child and population health through continued engagement with the community and primary healthcare sector.

Her medical qualifications include MBBS (National University of Singapore), Master of Medicine (Paediatric Medicine) and Membership of the Royal College of Paediatrics and Child Health (United Kingdom).

Dr Juliet Tan Sher Kit, Consultant, Adolescent Medicine Service, KKH

In her clinical practice, Dr Juliet Tan attends to general paediatric patients in the inpatient setting as well as adolescent patients with eating disorders, obesity, high risk behaviours, mental health concerns and somatisation disorders.

Her medical qualifications include MD (Doctor of Medicine), Master of Medicine (Paediatric Medicine) and Membership of the Royal College of Paediatrics and Child Health (United Kingdom).

Dr Toh Siao Hui, Principal Physiotherapist, Physiotherapy Department, KKH

Dr Toh Siao Hui’s clinical and research interests include digital health, physical activity and sedentary behaviours, childhood obesity, and paediatric musculoskeletal and sports conditions. She has led the development of telehealth services and is actively involved in research and innovation, education and the advancement of evidence-based allied health practice.

Dr Toh also holds a joint appointment as Assistant Professor at the Singapore Institute of Technology. She holds a Bachelor of Physiotherapy (Hons) from the University of Melbourne and a PhD from Curtin University, where she received the Vice Chancellor’s Commendation.