It’s not unusual for Dr. Vernon Rubick to see a patient who has a child in tow. He is, after all, a family practice physician. It’s also not unusual for a parent to hand a child a cell phone to keep them occupied while the adult consults with the doctor.

“It’s amazing,” he said, “but even toddlers can manipulate the device.”

That concerns Dr. Rubick, DO, and lead physician at North Springs Family Medicine, part of UCHealth Primary Care in Colorado Springs.

The American Academy of Pediatrics warns that children between the ages of 8 and 18 average 7½ hours of entertainment media per day, according to a 2010 study by the Henry J. Kaiser Family Foundation. And Rubick added that children younger than 2 should not be using them at all.

They “are not supposed to have any of that stimulation because their brains are still neurologically developing and it can have a detrimental effect on that.”

The total time most school-age kids spend on electronic devices, from cellphones to computer screens, often includes time in the classroom or doing homework. The use of technology in a learning environment has its benefits.

“Remember when we were in school and had to use the Dewey Decimal System to look up things at the library to find stuff?  Reports that took us all semester now can be done in a night,” Dr. Rubick said.

In moderation, hand-held devices and video games also can be good for hand-eye coordination, he said.

“But they become such a time dump – they don’t even know how long they’re playing and before you know it, it can be multiple hours. It’s really important for parents to monitor the time. Use an egg timer if you have to.”

Over-use of electronic devices can have a definite down-side, too, he said.

“It can affect a child’s ability to sleep because the constant visual stimulation doesn’t allow the brain to ‘relax’ – to get into a state where it’s ready to sleep.”

That, in turn, can affect attention span and learning ability in school the next day.

Overuse of electronic devices also has been shown to be a factor in childhood obesity.

“Instead of going outside and playing, they’ll sit and do a low-calorie-burning activity, like playing video games and watching TV. And there are a lot of ads (on TV) for unhealthy food that kids will be stimulated to eat. Both adults and kids eat more when we watch TV.”

There also may be a link to behavior problems, he said.

“There’s definitely links to social things which can lead to depression and anxiety,” he said. “Studies show they get into a pleasure state (from dopamine) which provides a source of immediate gratification. In the real world, that doesn’t happen. It takes time to make friends or to succeed at something.”

Kids can develop the inability to make social interactions, he added.

“It feeds upon itself.  They can become depressed, irritable, angry or withdrawn. A lot of behavior problems can be related to too much screen-time. And though we can’t blame all problems on Johnny watching too much TV, there is some evidence to show that increased screen-time does increase behavior problems.”

The problem often becomes worse as children age.

“I do see, especially in teen-agers, that their phone has become like a secondary organ,” Rubick said. “When they get up on the table for an exam, they bring the phone with them.  They seem to feel like if a friend texts them they have to text them back right now.

“There is definitely a conditioned response for kids to be interacting through their devices all the time.”

Kids don’t call a friend and talk on the phone any more, he has noticed. They text.

“It’s a replacement for reality,” he said, “and kids today are not experiencing life as we have known it to this point.”

Because there is not as much real-life interaction, he said, today’s youth have “a hard time recognizing body language. They’re not developing those subconscious but essential human skills they will need in real life.”

In his practice, he urges parents to arrange these real-life interactions with their children through play, sports or clubs.

“And in the process, they also learn other skills, such as sportsmanship,” he said. In these real-life interactions, children learn to deal with losing a game or not being the best at something. They come out of isolation and get a better idea of what the real world is about, he added.

Parenting has changed over the years, he said, “but kids still need structured boundaries. We know that kids do better with well-structured boundaries.”

So by limiting their time on electronic devices, “we’re doing them a favor,” he said. “They don’t understand it now, but they’ll appreciate it in the future.”

Though he doesn’t label their dependence upon their devices an addiction, he does think that withdrawal from them should be done in stages.

Start with how much time a child is spending on devices, then cut it back gradually, he suggested.

“Believe me, it’ll be easier on both the kids and the parents. So gradual withdrawal is the best way to do it.”