Ages 0 to 3: no screens; ages 3 to 6: as little as possible; primary and secondary students: non-study use no more than 1 hour a day

The national health commission says ages 0 to 3 get no screens, and ages 3 to 6 should avoid them as much as possible. For primary and secondary students, non-study use is no more than 15 minutes at a time and no more than 1 hour a day. The reason is that long near work makes myopia come early. Evidence that screens cause myopia is weaker; what has been shown to work is 2 hours outdoors a day.

Cost

No money. The hard parts are taking the screen out of the child’s hands, and parents themselves looking less in front of the child.

Benefit

Article 4 of Ten Core Knowledge Points for Preventing and Controlling Myopia in Children and Adolescents (防控儿童青少年近视核心知识十条) says in the original wording: “Infants and toddlers aged 0–3 shall not use phones, tablets, computers, or other screen electronic products; children aged 3–6 shall avoid contact with and use of phones, tablets, computers, and other screen electronic products as much as possible; for primary and secondary students, non-study screen use should not exceed 15 minutes per session, and cumulative daily use should not exceed 1 hour.” The same article states that “prolonged near use of electronic screen products readily depletes children’s hyperopia reserve and is an important cause of early and high rates of myopia in children and adolescents.” The 2018 implementation plan from the Ministry of Education and seven other departments gives parents the same requirements and adds “the younger the age, the shorter continuous use of electronic products should be.” Research evidence is much weaker: a systematic review took in 33 studies, 11 entered the pooled calculation, ages from 3 months to 33 years. Counting only phones and tablets, the odds ratio for myopia was 1.26 (95% CI 1.00 to 1.60, I²=77%). Combined with computers it was 1.77 (1.28 to 2.45, I²=87%). The authors conclude only “may be related,” and state that none of the 33 studies had a reliable measure of screen time

Notes

Grade B because officials give tiered rules, not numbers from a trial. The lower bound of the research odds ratio sits at 1.00, and the authors only dare say “may be related.” Treat it as a household rule that is easy to run, not as “no screens means no myopia.” What has a lot-assigned trial behind it is item 4 (2 hours outdoors). Preschool eyes should also be checked. The same document says ages 1–3, 4–6, and after 7 should all have regular refractive screening to see how much hyperopia reserve remains. How to check is in item 12 (cycloplegic refraction). Screens and children’s language ability were also pooled in a meta-analysis of 42 studies with 18905 people. Longer screen time went with weaker language (r=−0.14, 95% CI −0.18 to −0.10). But co-viewing and educational content went the other way (r=0.16 and 0.13). That is association, not cause — it only shows that swapping screens for talking with the child is a poor trade.

Sources · 4

1. 国家卫生健康委办公厅 (2023). 防控儿童青少年近视核心知识十条（国卫办妇幼函〔2023〕278 号）. gov.cn/zhengce/zhengceku/202307/content_68942…
2. 教育部等八部门 (2018). 综合防控儿童青少年近视实施方案（教体艺〔2018〕3 号）. moe.gov.cn/srcsite/A17/moe_943/s3285/201808/t…
3. Foreman J, Salim AT, Praveen A, et al. (2021). Association between digital smart device use and myopia: a systematic review and meta-analysis. The Lancet Digital Health, 3(12), e806-e818. doi.org/10.1016/S2589-7500(21)00135-7
4. Madigan S, McArthur BA, Anhorn C, Eirich R, Christakis DA (2020). Associations between screen use and child language skills: a systematic review and meta-analysis. JAMA Pediatrics, 174(7), 665-675. doi.org/10.1001/jamapediatrics.2020.0327