Why Kids Can't "Just Turn It Off": The Impact of Digital Design on Child Wellbeing
By Caroline J, Kistin, MD, MSc, Associate Professor of Health Services, Policy & Practice, Brown University
“ Kids often can't 'just turn it off'—because many digital platforms are intentionally designed to keep them engaged ”
In my pediatric clinic the other day, I met with a parent who was at her wit’s end. She described daily escalating fights with her 7-year-old over the family tablet – specifically the battle that ensued every time he was asked to turn it off or put it away. She had already tried setting timers, discussing firm limits, and creating a schedule, yet the constant conflict continued to strain their relationship. She worried that there was something very wrong with her child, as he seemed completely unable to stop using the tablet on his own.
This parent is far from alone; navigating technology use in the home is now a common source of stress for families. For-profit platforms, which typically make money through advertising revenue, are highly motivated to increase the frequency and duration of time online. What looks like a child behavioral or impulse control problem can be the direct result of the way that digital games and apps are designed.
Engagement-based design, also called persuasive or manipulative design, includes different features engineered to make a site as easy as possible to start and keep using but nearly impossible to stop. While these features impact all users to some degree, research shows that children who struggle with emotional regulation or have conditions such as attention deficit disorder may be particularly susceptible. Notable design elements include:
Notifications and Badges: Red dots, vibrations, noises, and other alerts prompt frequent device checks and pull users back to see what is new.
Endless Scroll: By removing natural stopping points, these features keep users engaged and can make them lose track of time.
Auto-play: When the next video clip starts automatically, the user does not consciously choose whether to keep watching or not
Algorithmic Recommender Systems: Trained algorithms predict what content will keep a user engaged and often show more emotional or more extreme content over time.
Rewards and Consequences: Features like "streaks" and badges reward frequent user engagement. Losing a streak can feel like punishment for taking time away. Content that disappears in 24 hours or games that are impossible to pause or save make users feel like they are missing out if they take a break.
The impact of digital design on child wellbeing has come under increased scrutiny. This year for the first time, juries have found tech companies liable for design elements that cause harm. In one case, a jury in Los Angeles found Meta and YouTube negligent in designing addictive platforms that resulted in severe anxiety and depression for a plaintiff who began using the sites as a young child. In a separate case, a jury found that Meta misled families about platform safety and failed to protect children, disregarding state consumer protection laws. These legal decisions set a precedent that digital design features should be treated as consumer products, subject to safety and quality standards.
While systemic change requires ongoing advocacy for child-centered design and platform regulation, there are steps that families can take in the meantime to regain control. With an understanding of how default design works, parents can turn off non-emergent notifications, disable auto-play features on video and social platforms, and set total device and app time limits.
If a child’s feed becomes saturated with negative or distressing content, families can proactively reset the algorithm, using platform tools to clear the search history and reset content preferences. Finally, implementing a formal family media plan, using the guide developed by the American Academy of Pediatrics, can help establish digital boundaries that apply to everyone, including designated screen-free zones during meals and before bedtime. Clinicians should continue to recognize parental stress and look for opportunities to empower families while advocating for digital spaces designed with the developmental needs and wellbeing of children at their core.
Interested in contributing to our blog? We welcome perspectives from researchers, clinicians, policymakers, advocates, and community members working to advance children's behavioral health. If you'd like to contribute to a future blog, please reach out to us at info@necbhn.org.
