Ergonomics & Dentistry

1. Tablet Use in Schools:
Ergonomics, Posture and
Screentime Recommendations
iPad Use in Schools ­ Recommendations Pg 1

2. Tablet Use in CEO Schools ­ Recommendations
“we have an
unprecedented
interactive
experience with
our increasingly
complex and
detailed online
world.”
Introduction:
Touchscreen tablets have been around for a while but the most prolific
and innovative tablet, the iPad was introduced just over three years ago
and became an overnight phenomenon. International market projections
now predict that there could be more than 300 million tablets sold
worldwide in 2015. This is primarily because of the interactive nature and
visceral response we have had to them but also because of the absolute
ease of use and portability of the devices. The touch and swipe
environment also means we have an unprecedented interactive
experience with our complex and detailed online world ­ web browsing,
online shopping, social media profiles and even education. Why
wouldn’t they be a success when we can personalise our whole internet
experience.
A recent report from the Kaiser Family Foundation has also confirmed
what most parents already know; kids are the most voracious consumers
of this new media and new technology. The average pre­teen owns a
television, laptop, smartphone, gaming system and a hand­held game or
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3.
“These devices
all utilize a
touch and swipe
environment.
Click, swipe,
pinch and
expand”
learning device. They also know how to operate and extract the most
use out of these devices.
For many people and students especially, the primary computing device
is no longer a desktop, or even a laptop, but instead a mobile device like
a smartphone or a tablet. We navigate online via a touchscreen. Click,
swipe, pinch and expand. Our fingers dance feverishly across the screen
as our shoulders continue to hunch, matched only by our continually
curving spines and crooked necks. The same necks that are either
staring at our own tiny screens or swiveling to catch the next fleeting
image on the massive HD screens we see installed in each and every
vantage point. We compete with our toddlers and grandparents for
screentime on our device. There are apps for everyone and everything.
We ‘need’ to find the information we want in a flash. We wait in
anticipation for the next new product release and then want to use it right
then and there.
We perpetuate this continually connected existence with little thought for
the social, cultural and physiological consequences. Our complex social
and physical systems struggle under the weight of this new tension. And
with each new method of interaction come new social or health
problems. What actually happens to our passive bodies when we are
constantly connected to our devices?
Things were much simpler 20 years ago, when students worked mainly
in computer labs where desk heights and screen positions could be
adjusted for differing physiques. Now our students have added
smartphones and tablets to their digital pencil cases, and they expect to
be able to use them anywhere at anytime. On­the­go access to devices
is not entirely a benign development especially when in the process we
treat our postures so poorly.
The tablet itself was designed to provide a portable work tool and flexible
media device where we could access or make movies, pictures, books
or music – for short periods of time. It was never intended to be used for
eight hours a day. Now that tablets are becoming commonplace in
everyday society, researchers have finally started examining some of the
iPad Use in Schools ­ Recommendations Pg 3

4. possible ergonomic impacts of these devices. This means that they have
only just begun to quantify the ways in which a person’s posture may be
being compromised.
“by the time
the average
child born
today reaches
80, they would
have spent
one quarter of
their life
watching
non­related
screen
technology”
Current Situation
Although the use of mobile devices has increased significantly,
especially in the education sector, few institutions have actually
considered the posture or the well being of the students who use these
tablets and other mobile devices. British psychologist Dr Aric Sigman
made international headlines when he suggested that, by the time the
average child born today reached 80, they would have spent a quarter of
their life watching non­related screen technology.
Posture guidelines and best use practices are well established for
traditional computing devices; desktop and laptop computers.
Musculoskeletal issues are addressed and the risks to users health
minimised by government legislation and regulatory guidelines. Thanks
to efforts by government agencies, unions, and professional
organisations, people who use desktop computers are now familiar with
strategies to reduce risk by choosing equipment wisely and using it
properly.
Devices with new touch technology, however, are inadequately covered
by established guidelines and legislation and so can potentially present
health risks and challenges for users. Awareness about the risks hasn't
trickled down to the world of touchscreen devices and in order to
maintain the health and well being of all students and to reduce the
potential of any risk, school professionals must address the ergonomic
risk factors faced by students with mobile devices.
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5.
“Students
rapidly shift
between
individual
tasks, group
focused tasks
and creative
collaboration”
After decades of research on human biomechanics, medical experts
have pinpointed three categories of computer­related concerns, both in
traditional PC use and with the new touchscreen devices. These include;
● Neck and Back strain caused by unnatural postures and forces.
● Eye Strain due to poor screen positioning and extended use
● Repeated motion injuries from recurrent large or small
movements
Neck and Back Strain:
The series of postures generally adopted by tablet and smartphone
users puts them at long term risk of chronic neck, shoulder and back
pain. The tendency is to stand or sit over the device while over extending
the neck and back to view the screen. Extended hours in the same body
position can also lead to various musculoskeletal injuries.
There has been a cumulative effect of poor postures with both old and
new technologies, leading to a surge in two specific ailments. The first is
connected with the overuse of texting and touch­based devices: a
tendon­related disorder with the thumb, called de Quervain’s
tenosynovitis, which involves the inflammation of the tendon sheath in
the thumb. This disorder is called ‘text thumb’. The second can be
attributed to screens being used in the lap or way below a comfortable
eye­level ­ chiropractors are seeing an increase in spinal disc–related
disorders called ‘tech­neck’.
We now recognise that people need to move and change positions
regularly, especially as they engage with new technologies. The very
nature of school work has changed, how the student’s body interacts
with new technologies and how it transitions as people shift from one
device to another has influenced the environment in which students
learn. Students rapidly shift between individual tasks, group focused
tasks and creative collaboration and this impacts on the use of physical
space. This allows the students to move within their learning
environments helping to ensure a regular and healthy change of
postures.
Eye Strain:
In broad terms, the risk of eyestrain and similar problems from tablets
and smartphones is directly related to three inherent attributes of the
display;
● resolution (the sharpness of the image),
● contrast (how characters are compared to the background),
● brightness (how much light the display emits)
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6.
“biomechanics
of tablet
technology is
closer to that
experienced
when working
with pen and
paper”
The superior resolution of current tablet devices can in fact be a problem
in itself. The increased capacity of the resolution allows for far smaller
print to be used on these tablet devices. Like the fine print on paper
documents, these tiny characters can be difficult to read and cause eye
strain. Devices with touchscreens that support multi­touch zooming
usually allow students to selectively magnify text that is too small.
Students should ensure characters are easy to read at least 50 cm away
from the screen and are large enough to see without squinting.
Setting the Contrast levels means your screen will be less prone to glare
and reflection. Setting the screen to display dark characters on a light
background works for most people in most situations. You should adjust
the brightness and contrast of the screen to suit the lighting conditions in
the room or environment in which you are working. The characters on
the display screen should be stable and sharply focused. They should be
of an adequate size for legibility.
Brightness levels are one of the characteristics that users can have
absolute control over. Since the days of dim, low­resolution screens in
early tablet devices, technology has made substantial strides in all three
areas, and sharp, bright displays are now commonplace nowadays.
Repeated Motion Injuries:
Repeated Motion Injuries or RSI is one of the main parental concerns
with mobile devices. The fact is, as many as 5­10% of the world’s
population do actually suffer from RSI (repetitive strain injuries) and that
number is far higher for computer users (with various studies showing up
to 30%).
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7.
With touchscreen and tablet computers the keyboard is part of the on
screen display. Therefore the unit must be positioned for both viewing
and frequent touch interaction by the student. This appears to be part of
the problem but in itself may not be as big an issue as original thought.
This is because the close association of the screen and onscreen
keyboard is very close to what kids are used to. The biomechanics of
tablet technology is closer to that experienced when working with pen
and paper.
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8.
“head and
neck posture
could be
improved by
placing tablets
higher to avoid
low gaze
angles”
Necks and Backs
A study on the ergonomic impact of tablet use, carried out by
researchers at the Harvard School of Public Health in Boston, explored
how users configured their tablets and the tilt produced by tablet cases
affected head and neck flex angles. The findings showed that head and
neck posture could be improved by creating low gaze options by placing
tablets higher than usual. Tablet cases and stands can also be
employed to provide optimal and neutral viewing angles.
Optimal positioning
depends largely on the task
at hand. Supporting the
tablet in an elevated
position can help improve
neck posture while reading,
but “this is less likely to be
of benefit if there is lots of
hand interaction with the
iPad,” he suggests. In that
case, using a separate
keyboard may be a user’s
best bet.
Tablet use is associated with a ‘high degree of flexion’ in the head and
neck; 15­25° beyond a neutral, relaxed posture. This increase will
quickly lead to fatigue and discomfort, and over time, injury. By elevating
the device and avoiding lap­level locations students can minimise any
associated risks.
Students should resist the temptation to over­extend their necks and
especially avoid turning their heads or tilting them to one side for
prolonged periods. They should take frequent breaks.
If you do set the tablet down on a table or your lap, it’s much easier on
your hands and arms, but you’ll need a significant forward head posture
to view the screen. Your head, rather than being aligned with your
spine, now hangs out in front of your body, becoming like a bowling ball
that your neck muscle must statically fight to hold up.
It’s impossible to simultaneously keep both the head/neck and upper
extremities in a good posture. Get used to looking down by bending the
upper cervical area just like nodding your head “yes”. From there, your
eyes should be able to take over without excessive neck strain.
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9.
“Many people
blink less than
half the
normal rate of
15 blinks per
minute when
they are
concentrating
on a digital
screen”
Eye Strain:
Using any digital device for extended periods can cause visual
discomfort, headaches and blurred vision. It is unlikely that students will
suffer damage to their eyes because the structure of the school day
doesn’t really allow for extended periods on a particular activity.
Students may experience minor symptoms whenever they use a digital
device intensively for periods of more than 2 hours or longer. The
symptoms will diminish soon after they stop working on the device.
Parents will need to ensure this does not occur at home.
Eye strain refers to optic fatigue. Common causes include:
● glare on the computer screen
● poor visual correction (out of date eyeglass prescription)
● reading small text sizes on the screen
● poor contrast between text and background colour
● noticeable screen flicker
● dry eyes
Blurred vision can be caused by normal physiological changes in the eye
(i.e. aging or disease). It can also be caused by constant focusing on
objects within 30 cm of the eyes. The eyes will be put under strain in just
the same way as reading a book in dim light for hours can lead to
headaches, eye pain, and other conditions.
Dry and irritated eyes occur when there is insufficient fluid in the eyes to
keep them moist. Eyes are kept moist and refreshed by a normal blink
reflex which is present from birth. Blink rates vary with different activities
and can become slower when concentrating. Many people blink less
than half the normal rate of 15 blinks per minute when they are
concentrating on a digital screen. Eyes can become red and itchy.
Common causes include:
● reduced blinking when using a digital screen
● air movement that is noticeable in the face area
If you feel your eyes become dry or tired with digital activities, remember
to take frequent vision breaks. Look away from your screen every 20
minutes, look 20 feet away for 20 seconds. This is the 20­20­20 rule of
ergonomics for your eyes, they need to move too and take a mini break!
The focusing on an object some distance away allows your eyes to shift
their focus. This allows the muscles in and around the eye to be
exercised in a variety of different positions.
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10.
“tablet users
seem to shift
position and
move around
more than
students
locked into
traditional
desks”
Repetitive Strain Injury:
Ergonomics needs to be considered with the increased time and use of
tablets in the classroom. Ergonomist Dan Robinson, president of
Robinson Ergonomics Inc. in Coquitlam, British Columbia, agrees people
commonly overlook ergonomics when using seemingly innocuous
lightweight and portable devices such as tablets. “We need to consider
ergonomic principles to avoid neck and shoulder pain or other physical
challenges associated with poor posture” he states. Tablets and
smartphones almost guarantee awkward use because they can be
accessed almost anywhere and in any position ­ most of which involve
poor posture. The aim is to ensure that the individual student is primarily
assuming a neutral working posture when they are using tablet devices.
Although those who sit at desktop computers also adopt improper
postures, the line of sight and hand position for data input on the tablets
— on the touchscreen or its virtual keyboard — are very close together.
“That typically means we take care of putting the tablet into a position
that is easy to reach, but requires awkward neck positions to look at the
screen,” Robinson says.
Although he has yet to see specific research linking tablet use and
circulatory problems, any posture involving contact pressure on parts of
the body or sustained joint angles that generate muscle fatigue are likely
to restrict blood flow. The problem is that some of the postures students
are in when using a tablet can be awkward and lead to discomfort with
prolonged use. Maintaining a static posture for certain periods of time
can contribute to creating muscle strain “because you’re not really
getting the blood into the muscles, you’re getting a build­up of lactic
acid”. Any activity where you hold your head/neck forward in a flexed or
bent position for a prolonged period will cause neck injuries (Herald Sun,
2011).
The good news is that tablet users seem to shift position and move
around more than students locked into traditional desks. Changing
position is crucial since there is no ideal posture to cover off all human
elements. Students with mobile devices should be conscious of taking
breaks throughout the day if no natural breaks occur.
There are a number of aspects to consider in order to reduce RSI;
● holding a tablet and typing on a tablet
● positioning an tablet for use
● screen orientation and size
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11.
“the remaining
fingers of the
dominant
hand must be
held up and
out of the way
so that they do
not
accidentally
touch the
screen”
Holding a Tablet:
Technology, no matter how innovative is rarely designed with human
beings and more specifically the human hand in mind. Tablets and
mobile devices invariably requires one hand to hold the device, while the
other is used to complete the small precise finger movements to
manoeuvre on the screen. These precise movements involve the wrists,
hands, and fingers, particularly the thumb. The hands consists of small
muscle groups that fatigue easily and are highly susceptible to Repetitive
Strain Injury (RSI). Additionally, the remaining fingers of the dominant
hand must be held up and out of the way so that they do not accidentally
touch the screen.
While most tablets are generally very light, holding one, even a low
weight model in a fixed position for long periods of time without support
can cause discomfort. This pinch grip hold requires a static grip in the
holding hand that also can contribute to muscle fatigue.
One viable solution is to obtain a tablet case that incorporates an
alternative grip mechanism. These allow the student to hold the device
more naturally and without the associated discomfort of the traditional
pinch grip hold. There are various alternatives on the market if
necessary.
In the same way if the student is using a stylus make sure a model with
a larger grip is recommended so it reduces the need for tight, pinched
grips. This will allow the student to use the stylus both more effectively
and for longer periods of time.
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12.
“Studies
suggest that
texting alone
accounts for
almost 2 hours
per day of
some student”
Typing and texting are the two activities that fatigue the hands most
quickly. It should be stressed to students that any activity that requires
extensive typing should be completed with the aid of an external
keyboard. Studies suggest that texting alone accounts for almost 2 hours
per day of some students screen time. The average number of texts per
day is more than 100. That is a lot of characters and a lot of action for
the hand’s small muscle groups and will certainly contribute to muscle
fatigue.
There are numerous suggestions to alleviate hand fatigue.
● if possible place the tablet on a surface rather than holding it
● hold it with two hands as much as possible to share the load
between your hands
● use gravity, rest device in your palms rather than pinching it with
your thumb and fingers.
● consider a case with hand straps to reduce grip fatigue
● make a conscious effort to alternate hands
● alternate hands for touching and swiping as well
● take short breaks every 30 minutes
● use stretching techniques to alleviate muscle soreness in hands
● for extended word processing use an external keyboard.
Typing on an Tablet:
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13.
“For any
extended
typing on
tablets
consider using
a keyboard
rather than an
on­screen
keyboard”
In theory, on­screen tablet keyboards pose the same risks of RSIs and
related injuries as physical keyboards. Typing on touchscreens with the
tablet resting on a flat surface forces the neck into a more extreme
position depending on the users posture and a traditional QWERTY
keyboard forces your wrists and forearms to ‘pronate’. Essentially, you
twist your bones, muscles, and nerves in a very unnatural way, which
can, over time, contribute to problems like RSI or carpal tunnel.
The ideal angle for touchscreens, according to studies, is about 30
degrees. Make sure students can comfortably keep their wrists straight
across their keyboard, not arched over it. For any extended typing on
tablets an external keyboard rather than the on­screen keyboard is
recommended. This is probably a good idea anyway to help maintain
good ergonomics when doing extended writing on a tablet.
Other suggestions include;
● Raise the device so that your head remains in a neutral position
● Sit in a comfortable upright position with hips approximately at 90°
and feet on the floor
● When using keyboard keep arms at side and elbows about 90°
● Support your elbows on an armrest or tuck them into your sides
● Don’t reach forward to the keyboard
● Reduce the number of required keystrokes with text shortcuts
● Tilt the screen so that it is perpendicular to your line of sight
● If you are leaning forwards to view the tablet, enlarge the text
● If you do need to use a tablet to type and do not have access to a
keyboard, hold the tablet in one hand and type with the other.
The biggest distinction between traditional input and touch­screen
devices is virtual keyboards have little, if any, feedback for users. Unlike
mechanical keys, which move and offer resistance, virtual keys don't
react when they're pressed. According to Alan Hedge, director of the
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14.
“..users have
a tendency to
employ
greater force,
up to eight
times the
force, when
typing on
keyboards
without tactile
feedback”
Human Factors and Ergonomics Laboratory at Cornell University, users
have a tendency to employ greater force, up to eight times greater, when
typing on keyboards without tactile feedback. All that force puts strain on
your fingers, wrists, and forearms. This is because the keyboard lacks
the tactile qualities that tells us the keys have been activated and that it
has been depressed.
Tapping too hard isn’t the only concern, as the study warns that simply
holding fingers rigidly over the surface in anticipation of accidental
touches causes “isometric tension,” which presents even more problems
for your muscles and tendons. As such, the individual often ends up
employing either an index finger or a two­finger typing method that
requires watching the keys while the fingers not being used are folded
into the palm in a flexed position or held out of the way in an extended
pose — neither of which is ideal. For that reason alone a tablet should
not be used heavily for typing.
The virtual keyboard allows manufacturers to experiment with alternative
key layout and button arrangement, which could help alleviate some of
the stress associated with prolonged use. As yet this has failed to
happen. As for avoiding long­term injuries, the study makes some fairly
obvious recommendations, if possible connect it to a physical keyboard.
Split Keyboard
Thumbs are more vulnerable than fingers because they have two bones
instead of three, Professor Hedge said. They have been pressed into a
level of service they were never meant to provide. Texting has led to an
increase in a condition known as De Quervain’s tenosynovitis, where the
tendons become so inflamed that it becomes painful to move your
thumb, affecting your ability to hold things, Professor Hedge said.
Positioning a Tablet for Use:
The Harvard School of Public Health in Boston research study observed
15 experienced media tablet users and the findings showed that the
placement of tablets in a higher position avoided the low gaze angles
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15.
“ To
recommend a
best position
for the device
for each user,
it is necessary
to take into
consideration
which tasks
are being
undertaken.”
and therefore ensured better head and neck posture. The study also
added that the correct selection of cases and stands can assist to
provide optimal and neutral viewing angles.
To recommend a best position for the device for each user it is
necessary to take into consideration which tasks are being undertaken –
primarily viewing, inputting or a mixture of both. If the device is used
primarily to consume media such as viewing and reading web pages,
then the position should be optimized for viewing. This means:
● Place the device higher than the lap
● Tilt the screen toward the eyes
● Ensure the device is at an appropriate viewing distance to avoid
forward bending.
● If the device must be hand­held, consider an armrest to prevent
fatigue.
If the device is primarily being used to create or input content, the
positioning must be balanced to accommodate the two interactions;
viewing and the touch and swipe motion for inputting.
● Placing the device flat is not recommended.
● Positioning the device at 30 degrees is optimal
● It is recommended that a separate keyboard be used for typing
For best work practice to reduce the risk of fatigue, discomfort and injury
the following pointers will help a student maintain a neutral and
comfortable working posture.
● Reduce the duration and frequency of use.
● Use speech­recognition applications.
● Avoid excessive looking down when using a tablet.
● The best location for use is just below the field of vision.
● Avoid twisted and asymmetric postures – place the tablet directly in
front of the body.
Unfortunately the Harvard study did not consider the myriad of other
body parts (like the hands, arms, and the back) in the research, nor were
a number of other postures and ways people use tablets, such as
standing, walking, perched on a stool, lying down or hunkered down in a
beanbag.
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16.
For students a novel position has been suggested for optimal postural
care. This includes sitting with their backs against a couch, chair or wall
and bringing their knees up at a angle. The elbows are then rested on
the knees as they hold the tablet. This ensures the most neutral
positioning of the head and neck and supports the arms and shoulders
as they hold the tablet. As with all body positions it should be alternated
with other positions regularly. This is not a position that would be
recommended for typing.
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17.
“recommend­
ations for
people who
use
touchscreens
are scarce
and
sometimes
contradictory”
Screen Orientation and Size:
Screen recommendations for people who use touchscreens are scarce
and sometimes contradictory because they depend on the task being
completed. Horizontal use is typically a less stressful position, especially
when the tablet is in a comfortable position for your arms and hands
(similar to how you should use a keyboard on a laptop or desktop PC).
Touchscreens that are positioned upright are considered ergonomically
inferior. They force you to use the large muscles in your shoulder and
arms in ways that promote fatigue. Many people consider that touch
surfaces don't work well in the vertical position. The more perpendicular
the screen, the more you have to bend your wrist to type, a posture that
anatomists call "dorsiflexion."
If using the tablet for reading, it’s best to place the device so that you
can see the entire screen clearly. Generally, that means a steep angle
close to perpendicular to your line of sight ­ in other words, like that of a
standard desktop monitor. The ability to telescope the tablet up and
down would allow the device to be adjusted to the proper height for
reading comfortably, ensuring neutral neck postures and subsequently,
comfortable viewing. One solution is to use a tablet stand that props up
the device so the user can view the screen at eye level.
Tablet Stands
Electro Stand
Arkon Tab Stand
Note for Parents:
The mini Tablets may be a better ergonomic fit for your child. Consider
the weight of the device and size of your child’s hands and buy an
appropriately sized device. Larger screen real estate is not always the
best decision. Don’t buy a larger screen than necessary. Smaller, lighter
models may be all your child needs while still providing the computer
power requested by the school.
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18.
“You didn’t
end up with
square eyes
and neither
will they. As
with
everything in
life, it is about
balance”
Parents
Statistically speaking Australian parents believe that the use of media
technology to access educational programs benefit their children’s
knowledge and academic abilities. Parents should, however, continue to
proactively manage all their children’s use of technology, regardless of
the device being used. The inherent risk of long­term use of computing
or gaming tools on body postures while using ANY technology is real.
The monitoring should include posture, screentime, type of media being
accessed and information being shared.
Advice to parents
Do not panic. Using tablet devices is the same as reading a comic book
or watching TV. You didn’t end up with square eyes and neither will they.
As with everything in life, it is about balance. We can all become a little
obsessive with a new toy or device but there are benefits to technology.
Researchers have in fact identified “positive and constructive
screentime” as opposed to “passive” screentime and in much the same
way they have identified some beneficial and educational apps on
mobile devices. So what can you do?
Become an Expert
Educate yourself on the ergonomic realities that are involved with the
use of tablets and hand­held devices. Have a conversation with your
children about why correct posture is important. Positively reinforce and
model correct posture.
Manage Usage
You are the parent. Take control of your child’s use of technology.
Monitor and manage your child’s use of all electronic and computing
devices. This includes being aware of the total amount of screentime
your child experiences ­ TV, DVD, gaming consoles, tablets and
smartphones.
Apply the 30 minute Rule
Limit usage of any one device to 30 minutes. Take a look at the body
postures your child uses when computing, gaming, texting and talking.
Provide guidance on body postures and their importance. It is your
house, you need to set the rules for all digital devices.
Lead by Example
What tools and devices do you use for work and leisure? Provide a great
example for your child and talk about it. Why do we use particular
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19.
“....they can
spend so
much time
online that it
can impact on
their health
and
wellbeing."
devices and what tasks may be better performed on a more appropriate
device? Have a device free period for the whole family in your week at
home.
Get involved at School
Get involved in your school’s Parent and Friends Association. Introduce
the topic of Ergonomics to the agenda and make it part of any move to
BYOD. Start an open and constructive discussion about how, when,
where and why your kids are using digital devices.
Research ­ Impact of digital media:
Steve Houghton director of the University of Western Australia Centre for
Child and Adolescent­Related Disorders said it was important parents
took an active role in monitoring the balance of screen time in their
child's life. Given the pervasiveness of these technologies,
understanding the links between use and the mental health of young
people and developing evidence­based guidelines are crucial, Professor
Houghton said. A study of children from across WA, led by a research
team at UWA, will provide a world­first insight into the mental impact it
has on young people.
The research will examine the frequency, intensity and types of
screen­based activity, and how this varies for different ages and
genders. "We're not saying all screen use is bad because there are
many good things about modern technology. But for some young
people, it becomes their reality and they can spend so much time online
that it can impact on their health and wellbeing."
The areas of most concern for parents and educators include;
● childhood development
● online violence
● eating disorders
● harmful substances
● suicide
● mental health issues
● sexualisation of children
● inappropriate sexual images
● impact of marketing
● obesity and other health related issues
● cyberbullying
● sexual solicitation
ScreenTime:
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20.
“...most of the
screen time
research and
position
papers seem
to predate the
release of the
most
significant
tablet ­ the
iPad.”
This discussion needs to start with the premise that the healthy
cognitive, social, emotional and physical development of the whole child
is just as important in the digital age. Parents often want to know ‘how
much’ screen time is appropriate for children. They want an amount of
time prescribed and quantified. Whilst there are Australian
recommendations regarding screen time, these recommendations are
based on passive screen time that includes watching TV and DVDs.
They do not consider the many types of interactive technologies that are
now available to children, such as using a tablet or playing a video
game.
Current Australian guidelines for screen time recommend the following:
● Children younger than two should spend no time viewing TV or
other electronic media
● 2­5 year olds accumulate no more than 1 hour of screen time
● 5­18 year olds accumulate no more than 2 hours of screen time
for entertainment purposes
Quantifying how much screen­time children should be exposed to each
day is not the most crucial question when it comes to children and
technology. Instead, parents need to focus more on what they are doing
with this screen time. We need to place some parameters on how
children use technology and guide them so that they can eventually do
this type of monitoring themselves.
Tablets and touchscreens are relatively new on the market having only
been commercially available for just over four years. They are so new in
fact that most of the screen time research and position papers seem to
predate the release of the most significant tablet ­ the iPad, American
Academy of Pediatrics 2010; Common Sense Media 2011. It is easy to
forget just how new a device like the iPad really is. As such, little if any
conclusive research on the impact of tablets and touchscreens has been
conducted. There are, however, a number of longitudinal studies like the
Kaiser Family Foundation 2010 and the Always Connected: The new
digital media habits of young children studies on the impact of
technology and mobile devices on children’s well­being but little
specifically on tablets themselves. As such, many advisory agencies and
health organisations have simply included all screentime experienced by
children on the tablet within the same realm as all other screentime.
Initially that may have seemed appropriate but as we explore the touch
interface and the sheer volume of both educational and content creation
apps that are available this decision is now under review by policy
makers, researchers and educators.
iPad Use in Schools ­ Recommendations Pg 20

21.
“.....it seems
obvious that
each unique
screentime
experience
may need it’s
own criteria for
acceptable
use.”
When screentime recommendations were initially developed, children’s
media options were primarily delivery systems like TV, Video and DVD
with little if any input or interactivity. This was purely a one way transfer
of information and data. The tablets were initially also seen almost
exclusively as consumption devices primarily for accessing movies,
music, photos, email and browsing the internet. This assumption has
now been discarded as we have seen the explosion of user generated
content creation that is occurring both informally and formally in
education settings.
There is preliminary research at the Queensland University of
Technology ­ Active versus Passive Screentime for Young Children and
findings contained within the Kaiser Family Foundation Generation M
publication that suggests that different digital devices have “unique and
parallel, not identical functions”. As digital technology has expanded to
include a range of interactive media options, it seems obvious that each
unique screentime experience may need it’s own criteria for acceptable
use. Using a tablet may be deemed different to using a Nintendo Wii.
The research findings suggest that the context of the tablet use is
paramount. Many uses of tablet devices do in fact encourage self
contained, solitary or individual use but that other activities both foster
and promote collaboration, communication and connection with others
both in the classroom and around the world.
photo ­ kids play wii at school
These reports also found the students increased tablet use did not come
at the expense of physical or outdoor activities. In fact the statistics for
daily time spent on physical activities actually increased between the
2011 and the 2013 studies. The messages about screentime occurring
at the expense of more valued physical activities is simply untrue. Not
only is it not true but with the careful selection of specific apps physical
activities can be promoted ­ app controlled flying devices, QR Code
Hunts or even Geotagging orienteering can help to support and not
replace outdoor activities. The intentionally selective use of tablet
iPad Use in Schools ­ Recommendations Pg 21

22.
“Active or
‘lean forward’
screentime
involves a
cognitive or
physical
engagement
in the activity.”
devices does not discourage or inhibit social interaction, real­life
experimentation or imaginative play.
Differentiating Screen Time:
The emerging evidence from this research suggests that content
creation on a computer and video game play should not be classed as
the same type of screen time as TV viewing. All of this suggests that
digital devices should be categorised into two distinct areas. The two
categories should include ‘Passive’ screentime like TV or DVDs and
‘Active’ screen time like that of interactive tablets and motion sensor
gaming devices like Nintendo Wii, Kinect, X­Box or Playstation. The
interactive nature of the touchscreen devices is what actually warrants
this separate classification.
Passive Screen Time:
Passive or “lean back” screentime is where the student is a passive
participant in the interaction. There is little if any cognitive investment in
the outcome of the interaction and there is little if any physiological
changes to the large muscles of the body. This would suggest that the
educational value of such screen time is extremely limited and unjustified
from a cognitive aspect. There is still conflicting scientific evidence but
the possible side effects identified of “Passive Screen time” include;
● irregular sleep patterns and behavioral issues
● focus and attention problems
● decreased academic performance
● negative impact on socialization
● negative impact on language development
Passive screen time is an inappropriate replacement for play, interaction
with other students and interactions with significant adults. Teachers
would be expected to select age appropriate experiences by selecting
screen time that suit the ages and developmental levels of the children in
their classes. Digitally literate educators know when and how to integrate
technology into the program effectively.
Active Screen Time:
Active or “lean forward” screentime involves a cognitive or physical
engagement in the activity. The interactive nature of the devices allows
the user an ability to provide input, thus enabling a sense of user control
and engagement. This occurs when appropriately selected and
educational valid screentime activities are intentionally planned for
students. Moreover the Power of Play Panel Report also suggests that a
range of positive outcomes are related to ‘Active’ Screen time including:
● reduced classroom absenteeism,
iPad Use in Schools ­ Recommendations Pg 22

23.
“The levels of
thinking and
engagement
with these
interactive
media tasks
are in stark
contrast to
passive media
use.”
● reduced tardiness
● reduced negative classroom behaviours
The Queensland University of Technology ­ Active versus Passive
Screen time for Young Children study also suggest that there are
tangible benefits “in terms of developing cognitive skills and
development.” They would purport that ‘Active’ screentime promotes
social interaction as well as providing an environment that not only
allows students to use language extensively but an opportunity to
improve both vocabulary and language fluency.
There are big differences between what occurs in a student’s brain when
they are passively 'watching' media to when they are 'interacting' with
media. The levels of thinking and engagement with these interactive
media tasks are in stark contrast to passive media use. In fact we now
have an overwhelming body of research that tells us that
developmentally appropriate and intentional use of technology can
actually enhance a child’s learning and development. Some emerging
research from Australia and America suggests that the use of ‘active’
media may be beneficial to a child’s learning, even young children from
approximately 18 months of age.
Unfortunately the recommendations suggested by the Australian
Government tend to mirror those found in overseas guidelines. These
recommendations have not been based on any current Australian
funded research or research carried out within the Australian context. It
would be fair to say that these recommendations do not take into
consideration the two different definitions of Screen time that are now
being suggested. Research reviewed by the Queensland University of
Technology ­ Active versus Passive Screentime for Young Children
paper suggests that “not all screentime should be treated as equivalent.”
Further the research would suggest that “it is not appropriate to assume
that all screen­related activities are negative or harmful.”
Social Issues and Screen Time:
Some children’s medical researchers have found no evidence to support
the belief that screen time is inherently harmful. Statistical TV screen
time have not changed significantly in 40 years. In one English Study
“Screentime Does not Breed Bad Behaviour in Young Children” headed
by Dr Alison Parkes and Jane Gentle, they studied more than 11,000
primary school students to determine if there was a link between ‘screen
time’ and bad behaviour.
"We found no effect with screentime for most of the behavioural and
social problems that we looked at and only a very small effect indeed for
iPad Use in Schools ­ Recommendations Pg 23

24.
“.....there was
no association
between TV or
screentime
and other
issues such as
hyperactivity
or problems
interacting
with friends.”
conduct problems, such as fighting or bullying," said research author Dr.
Alison Parkes.
The data showed that even though two thirds (65%) of the 11,000
children watched TV for between 1 and 3 hours a day these children
show little if any signs of increased behaviour concerns.
Time spent playing computer games seemed to be different from TV
viewing time in that it did not cause these same kinds of behavior at age
7, according to researchers. Researchers also noted that there was no
association between TV or any screentime and other issues such as
hyperactivity or problems interacting with friends.
"We found no effect with screen time for most of the behavioural and
social problems that we looked at and only a very small effect indeed for
conduct problems" she said. "Our work suggests that limiting the amount
of time children spend in front of the TV is, in itself, unlikely to improve
psychosocial adjustment."
While social commentators and critics have issued many warnings
against television and computers and their negative effects on children’s
learning, the most logical conclusion to be drawn from the existing
research review is that it is the educational content that really matters.
Prof Annette Karmiloff­Smith, of Birkbeck, University of London, has
suggested that the focus on TV and video games as causes for
problems in children would be better shifted to what positive impact
active screentime could have on children.
Professor Hugh Perry, the chair of the Neurosciences and Mental Health
at the Medical Research Council, thinks that entertainment is part of a
complex puzzle that needs to be examined more closely.
"We are living in a world that is increasingly dominated by electronic
entertainment, and parents are understandably concerned about the
impact this might be having on their children's wellbeing and mental
health," he said. "This important study suggests the relationship between
TV and video games and health is complex and influenced by many
other social and environmental factors."
Learning Screen Time:
That is not to say that the amount of screen time for children is not
important but The NAEYC Position Paper suggest that what students
are doing in that time is just as important. The impact of the screentime
is mitigated by the “same developmentally appropriate principles and
iPad Use in Schools ­ Recommendations Pg 24

25.
“..effective use
of touch
technology
allows active,
hands­on,
engaging, and
empowering
learning.”
practices that guide the use of print materials and all other learning tools
and content”. Obviously technology should be used to support learning
but it is not an isolated activity and screen time in classes is often
completed in small groups, in pairs or actually led by the teacher. These
activities are often combined with question time, discussions and small
group explanations. The notion of screen time needs to be put within the
classroom context. No activity within a classroom occurs without
instruction, clarification and constant and constructive feedback. This in
effect means that students screen time is conducted for long periods of
time of ‘close up’ work.
The reality is that students who are using touchscreen technology can
harness these tablets to communicate their ideas and feelings,
investigate the environment around them, and locate relevant
information. As tablet devices become ubiquitous younger children are
becoming increasingly capable of using them to complete specific tasks
like drawing a picture, recording a story or taking a photo. The really
proficient ones then use all of these artifacts to make them into online or
digital artifacts in order to document their own learning.
This effective use of touch technology allows active, hands­on,
engaging, and empowering learning. It actually gives the child some
control over the process of their own learning. This is the context in
which “Screen time” needs to be considered. With a focus on interactive
touchscreen tablets as a tool and not as ends in and of themselves we
can avoid the “passive” and potentially harmful use of non­interactive
linear screentime that is inappropriate in educational settings and
iPad Use in Schools ­ Recommendations Pg 25

26.
“...light from
computer
screens,
tablets and
television
might
suppress the
production of
melatonin, the
hormone that
we need to get
to sleep.”
hopefully encourage productive, creative and engaging learning
experiences.
Screentime and Sleeping:
New research from the American Academy of Pediatrics looks
specifically at the correlation between what children do in the 90 minutes
before bedtime and how long it takes them to get to sleep. children who
watch television or play video games before bedtime, can have their
sleeping patterns disrupted. Participants who say it took them the
longest to go to sleep were the ones who cited more screen time in the
last hour­and­a­half before they turned in.
The research team from universities in New Zealand and Australia points
out that electronic media usage prior to sleep can affect a child’s rest in
three ways:
● When a digital screen is in the child’s room, they stay up later,
instead of going right to sleep.
● Diminished melatonin, caused by light emitted by electronic screens,
can throw off circadian rhythms, resulting in delayed sleep onset.
● And watching action­packed shows or video games makes a child
too stimulated to go to sleep.
Since reduced total sleep time is presumed to be caused by later
bedtime rather than earlier waking, it’s an obvious assumption that
pre­sleep activity can disrupt or displace sleep.
Inadequate sleep has been linked to a host of behavioral and health
issues in young children. Among these: poor concentration and
academic performance, inability to remember new information, lack of
coordination, and even increased aggression, hyperactivity, and obesity.
There could be a few reasons why screen time affects children’s sleep ­
there’s research suggesting that light from computer screens, tablets
and television might suppress the production of melatonin, the hormone
that we need to get to sleep. This suppression occurring right at the time
we need it most could be the root of many sleep complaints.
Screentime Recommendations:
● Primary students use tablets for 20 minutes at a time of close up
work
● Primary students to use the tablets for no more than 2 hours a day
● A recognition that not all tablet work is close up work
iPad Use in Schools ­ Recommendations Pg 26

27. ● Secondary students use tablets for 45 minutes at a time for close up
work
● Appropriate Screen time will depend on the activity being performed
● Match the device selection to the task to be performed
● Limiting screen time before bedtime can improve bedtime
resistance, ease the difficulty falling asleep, and help children sleep
longer.
iPad Use in Schools ­ Recommendations Pg 27

28.
“match the
technology to
the task you
want to
perform,”
Conclusion:
The reality is that you need to “match the technology to the task you
want to perform,” Professor Hedge says. “If what you’re doing is a lot of
typing, you need a keyboard”
There needs to be a recognition that there may be a more appropriate
tool available for any particular task. Tablets in schools actually only get
used about for a percentage of the time in a classroom. The nature of
the learning environment as well as the structure of the day means that
students are often learning in different ways and in different situations.
The use of tablets is one of many tools that students use during any
particular school day.
Although it is unlikely that we will see the same problems we did in the
past, anecdotal evidence suggests that in the extreme cases we are
already seeing children with musculoskeletal weaknesses caused by
excessive use of tablet and touch screen technology. Common sense
prevails here ­ if a students is using a tablet device inappropriately or
excessively then the appropriate adults in the situation needs to provide
guidance and even restrictions on its continued use.
This means that the most important preventive tool is simple awareness.
Computers and tablets are not going away, so we have to try to adapt
how we use them and become ergonomically sound. Although student’s
bodies are flexible, teaching healthy habits of positioning and
appropriate use early may have lasting benefits for their long term
health.
Photo kids sharing an iPad
There are researchers who are attempting to identify best practice and
standards for interactions for touch screen devices. They are attempt to
construct recommendations that would alleviate concerns whilst at the
iPad Use in Schools ­ Recommendations Pg 28

29. same time allowing students to gain maximum educational benefits from
the multi­touch technology.
Research would also need to quantify what constitutes good quality
educational and interactive media. The identification of engaging,
effective and appropriate digital media is paramount. These conclusions
are needed in order to inform educational policy making and ensure best
practice in the integration of technology into the classroom.
sitting student
An interesting finding from the Harvard study was that the only posture
where subjects had no stressed placed on the neck and head was when
the tablet was not held at all but rather placed on a table at a high angle.
Put another way the least stressful way to interact with a tablet was not
to interact with it at all. Look but do not touch. Obviously we need to find
an appropriate compromise. Peter Opsvik, a Norwegian furniture
designer who pioneered the idea of active furniture used to say that “the
best posture was the next posture”.
The best advice is to sit with your back against a couch, chair or wall,
bring your knees up and rest your elbows on them as you hold the tablet.
iPad Use in Schools ­ Recommendations Pg 29

30.
Recommendations:
Neck and Back
● If using tablets for several hours a day, use a case with a stand
● Sit in a comfortable upright position with hips approximately at 90° and feet on the floor.
● Keep your neck straight, your shoulders relaxed, and arms positioned near your sides.
● Position tablet upright to maintain head/neck in a neutral position.
● Keep head and neck in a relaxed posture and avoid excessive neck flexing
● Keep elbows close to the body whilst operating the tablet
● Adjust height of the tablet so it’s just below field of vision when head is in a neutral position
Posture
● Tablets are inherently portable devices so move position frequently
● Find new positions to use the tablet in ­ laying down, sitting up, leaning back or standing
● Take a quick mini break to shift your posture.
Typing
● Use a separate keyboard rather than on on­screen keyboard
● Raise the device so that your head remains in a neutral position
● If you are leaning forwards to view the tablet, enlarge the text
● Sit in a comfortable upright position with hips approximately at 90° and feet on the floor
● Sit back, support your feet and ensure arms are relaxed as you type
● Don’t reach forward to the keyboard, bring the keyboard toward your hands and arms.
● When using a keyboard keep your arms to the side and elbow flexed/bent about 90°
● Support your elbows on an armrest or tuck them into your sides
● Reduce the number of required keystrokes with text shortcuts
● If you do need to use a tablet to type and do not have access to a keyboard, hold the
tablet in one hand and type with the other.
Eyes
● Tilt screen of the device so that it is perpendicular to line of sight
● Tone down the brightness of the screen
● Ensure appropriate lighting in the space you are working
● Avoid reflections and sun glare that cause a visual disturbance in work areas
● When reading, use a stand/tilt the tablet to reduce bending your head forward to read.
● Avoid eye strain by making the font larger when possible
● Adjust contrast and brightness for better viewing
● Maintain a comfortable viewing distance from screen ­ 450­700mm;
● Look away from your screen every 20 minutes, look 20 feet away for 20 seconds.
● Working on tablets can contribute to dry eyes due to lack of blinking.
ScreenTime
The screentime issue is a perplexing one because of the nature of the work that students do with
tablets in the classroom. The collaborative nature of many activities mean that students are often
working with one tablet between a number of students or are documenting their learning by
iPad Use in Schools ­ Recommendations Pg 30

31. typing, photographing and videoing different aspects of the tasks mean that many of the concerns
are unwarranted. The fact that a series of these activities are often completed within a period
between morning tea and lunch or lunch and end of school time also mitigate concerns about
excessive use or excessive screen time. As a general rule these suggestions are appropriate.
● Primary students to use tablets for 20 minutes at a time of close up work
● Secondary students to use tablets for 45 minutes at a time for close up work
● Keep sound levels from earphones to a minimum to prevent excessive noise exposure
Repetitive Strain
● Alternate hands and fingers when using a tablet
● Whenever possible try to place the tablet on a surface rather than holding it.
● Consider a case with hand straps for reducing the grip mechanism
● Use stretching techniques to alleviate muscle soreness
● A standard ergonomic recommendation is to move every 20­30 minutes
● Where Tablet usage exceeds 30 minutes of continual work, take short rest breaks of 5
minutes for every 30 minutes of work to stretch your hands, shoulders and neck
● If you are using a tablet for several hours a day, consider a case with a stand
● Use suitable accessories such as a dock, an external keyboard or documents holder
● Position tablet upright to maintain your head/neck position in a neutral position.
● Support elbows Rest your elbows on an armrest or tuck them into your sides to support
your arms and shoulders when using a handheld device.
iPad Use in Schools ­ Recommendations Pg 31

32.
Tablet Research Studies:
1. D is for Digital ­ The Joan Ganz Cooney Center at Sesame Workshop
2. Family Matters ­ The Joan Ganz Cooney Center at Sesame Workshop
3. ICT Learning Online World ­ Contemporary Learning ­ MCEETYA
4. Curricular Opportunities in the Digital Age: Universal Design for Learning Edition
5. Aruba White paper ­ Conquering Today’s Bring your Own Device Challenge ­ A Framework for
Successful BYOD Initiatives
6. iLearn: A Content Analysis of the iTunes Education Content ­ The Joan Ganz Cooney Center at
Sesame Workshop
7. iPad as a Pedagogical Device ­ Norwegian University of Science and Technology, Henrik
Valstad, December 13, 2010
8. iPad Pilot Report 2011 ­ Trinity College, The University of Melbourne, Report on the Step Forward
iPad Project, Jan 2012
9. iPods in Early Childhood ­ Mobile Technologies and Storytelling ­ ascilite 2008 Melbourne,
University of Wollongong, Olney, Herrington and Verenkina
10. Learning: Is there an app for that ? ­ The Joan Ganz Cooney Center at Sesame Workshop
11. PBS Kids iPod App Study Executive Summary ­ 2010 Rockman et al
12. Technology and Interactive Media as Tools in early Childhood
13. Young Children Apps and iPads
Media Use / Ergonomic Research Studies:
1. Technology and Interactive Media as Tools in Early Childhood Programs Serving Children from
Birth through Age 8.
2. The Kaiser Family Foundation Generation M 2 ­ Media in the lives of 8 to 18 year olds
3. Zero to Eight ­ Children’s Use in America Common Sense Media Research Study
4. Children, Adolescents and the Media ­ AAP
iPad Use in Schools ­ Recommendations Pg 32

33. 5. Always Connected: The new digital media habits of young children ­ The Joan Ganz Cooney
Center at Sesame Workshop
6. Learning: Is there an app for that ? ­ The Joan Ganz Cooney Center at Sesame Workshop
7. The impact of media technologies on child development and wellbeing ­ Susan Pitman OzChild
8. Risks and safety for Australian children on the Internet: AU Kids Online Surevy of 9 ­ 16 years
olds and their parents ­ ARC, Centre for Excellence for Creative Industries and Innovation
9. “Active versus passive screentime for young children”, Queensland University of Technology,
Sweetser, Johnson, , Ozdowska, and Wyth. 2012
10. “An Ergonomic Solutions ­ White Paper”, Melanie Swann, 2013
Tablet Media Articles:
1. Reading with iPads
2. Setting up a Multi Preschool
Ergonomics and Screentime Media Reports:
1.” Ergonomics and the Mobile Environment”, ASSE.Org, Tina Minter, 2013
2. “A Screen is a Screen is a Screen” is a Meme The Huffing Post, David Kleeman, President,
American Center for Children and Media, 12/08/10
3. “Not All Screen Time Is Created Equal – Young Children and iPads” Multiple Pathsway Blog
written by Mike Muir, 23/11/13
4. “Stop trying to figure out if screentime is good for students” Lisa Neilsen, The Innovator Educator,
30/10/13
5. “Why ScreenTime Limits are NOT Essential”, Sunny Coast Kids, Kristy Goodwin 13/02/13
6. “Look, Learn in Digital Age”, The Sunshine Coast Daily, Helen Hawkes, 26/04/13
7. “How to use your iPad Ergonomically” Elemental Ergonomics Blog, Tania Lillak, 21/06/11
8. “iPain in the Neck” OHS Canada, Ann Ruppenstein, 18/04/12
9. "Reducing risk of head and neck pain from tablet computer use" , Harvard School of Public Health
News, 26/01/12
iPad Use in Schools ­ Recommendations Pg 33

34. 10. “The hidden danger of touchscreens” Infoworld, Franklin Tessler, 01/11/12
11. “Study Reveals the Health Risks of Touch Screens”, PCMag, Eugene Kim, 17/01/2012
12. “Can touchscreens save you from carpal tunnel? They might actually be worse”, Meghan
McDonough, 17/08/2013
13. “You're Holding It Wrong: Here's How to Hold Your Touch Screen Gadgets Correctly”,
Lifehacker, Whitson Gordon & Adam Dachis,17/01/12
14. “Are tablet ergonomics a pain in the neck?”, Digital Trends, Geoff Duncan, 26/01/12
15. “Everything you Need to Know About iPad Ergonomics”, GottambeMobile, Josh Smith,
26/01/2012
15. “Ergonomics and iPad Use #1”, OT with Apps, Carol Leynse Harpold, 21/05/13
16. “How can I use laptops and tablets without suffering from physical pains?” The Guardian, Jack
Schofield, 21/06/13
17. “Using your tablet (Apple iPad, Samsung Galaxy Tab, and Amazon Kindle Fire) comfortably and
safely” Deakin University HR Depart, OHS,
18. “Surprise: Mobile devices don't help office ergonomics”, ComputerWorld, Lamont Wood
08/08/13
19. “Ergonomics in the Digital Age”, Metropolis Magazine, Avinash Rajagopal, 01/11/13
20. “Steelcase Global Study Uncovers New Postures Driven By Mobile Technology”, Yahoo
Finance, 12/03/13
21. “Ergonomic Guidance for Mobile Devices” Stanford University
22. “So Many Gadgets, So Many Aches”, New York Times, Phyllis Korkki, 09/09/11
23. “Tablet Advice Sheet” ­ pdf, Posturite UK, 2011
24. “Ergonomic update: Are you taking the tablets?”, Insight, Sara Bean, 03/04/13
25. “What you need to know about babies, toddlers and screentime” , All Tech Considered, Elise
Hu, 28/10/13
iPad Use in Schools ­ Recommendations Pg 34

35.
26. “New research suggests extended screen time does not breed bad behaviour in young
children”, BBC News/Health, Michelle Roberts, 26.03.13
27. “Study finds computer, television screen time directly linked to childhood obesity” Herald Sun,
Miles Kemp, 03/09/13
28. “Screentime”, SchoolAtoZ Technology,
29. “Pediatricians call for limits on kid’s screen time” Reuter, Health, Genevra Pittman, 28/10/13
30. “Why parent shouldn’t feel guilty about screen time”, WorklifeBliss, Kristy Goodwin, 13/05/13
31. “Screen time for tiny tots ­ How much is too much ?”, Paula Goodyer, Sydney Morning Herald,
18/11/13
32. “Screen time link to insomnia in young children”, Kate Hagan, Sydney Morning Herald, 19/10/13
33. “Effects of Screen time before bed”, Lisa Guthrie, Baby Gooroo, 25/01/13
34. “Is the iPad bad for Children” Peter Weber, The Week, 01/04/13
35. "Study to reveal impact of screen technology", Robyn Preston, WA Today, 24/06/13
36. “Active, engaged, meaningful and interactive: putting the education back in educational apps”,
Roberta Michnick Golinkoff and Kathy Hirsch­Pasek, The Huffington Post, 01/10/14
37. “Screen time and children”, Raising Children Network Australia, 07/02/12
38. “Forget TV! iPhones and iPads dazzle babies”, Kelly Wallace, CNN News, 30/10/13
39. “Tots get thumbs up for touch screens” New Zealand Herald 18/01/2014
iPad Use in Schools ­ Recommendations Pg 35