From Still to Strong

Rethinking Screen Time and Raising Kids Who Move

People who know me now: a fitness-loving pediatrician, and mom always on the move, might be surprised to hear I spent my own childhood glued to the couch. I was overweight and by the medical definition, an obese, kid.

I had a familiar after school routine:
🎒 Backpack dropped at the door
🍿 Snack in hand
🎮 Video game glowing
🛋️ Hours of stillness until my parents came home

This same combo of mindless snacks, passive screens, and very little movement, still shapes far too many childhoods today. The difference now? Screens are everywhere: in strollers, at dinner tables, even in kid’s bedrooms. Nearly 40% of U.S. two-year-olds own a tablet. By age eight, one in four has a smartphone (Common Sense Census 2025 )

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How Much Is Too Much?

Screen time itself isn’t “bad”, but still time, especially time spent alone and sitting, adds up. In pediatrics, we see it daily:

📈 Rising BMIs📱 Thumb tendinitis (yes, really) 🧠 Shorter attention spans 🥴 Poor posture and core weakness 🥱 Sleep issues 😫 Parents desperate for answers

The common thread? Too much sitting. Not enough active play.

That’s part of why the American Academy of Pediatrics recommends:

• 0–18 months: No screens (except video chat)

• 2–5 years: No more than 1 hour/day of high-quality content

• 6+ years: Family media plans that protect sleep, physical activity, and face-to-face interaction

But these guidelines were created for passive screen use - just like the kind in my own childhood after school routine where I sat, watched, and zoned out. So what happens when a screen encourages kids to move?

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When Screens Get Kids Moving: Active Play

A new category of screen time has emerged—one that flips the script.

Call it what you will: active play, active video games = AVGs in the research world (more on this later!) or exergaming. These experiences don’t involve handheld controllers or passive observation. They engage kids’ full bodies encouraging running, squatting, balancing, reacting, and often laughing with others.

At our house, this is the only screen that doesn’t come with a timer. It self-limits: when the kids are tired, they stop. There’s no passive scrolling, no isolated zoning out. Just active play, in every sense of the words.

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The Missing Rulebook

We know a lot about passive screen time. We know it can disrupt sleep, increase sedentary behavior, affect mood, and shape brain development. But we know far less about active screen time, particularly the kind that uses natural movement, encourages shared play, and doesn’t rely on controllers or scripted sequences.

This form of active play is newer, it didn’t exist when I was a child, and because of that, it doesn’t fit neatly into existing guidelines. Trying to apply traditional screen limits to these experiences might be like using dietary advice for 🍭 to judge 🥦. It’s not that unlimited use is automatically okay, but the framework for understanding it needs to evolve.

We’re just starting to explore what this type of screen-fueled movement can offer:

• Improved coordination and strength

• Increases in physical activity and energy expenditure

• Enhanced mood, engagement, and social connection

• Potential benefits for kids with attention or sensory challenges

As pediatricians and child wellness experts, we are learning through observations and through very early data. But even now, it’s clear: not all screen time is created equal. And we shouldn’t treat it like it is.

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My Own Off-the-Couch Moment

Nobody handed me a high-tech active play solution when I was little, but in middle school, I got lucky: horses.

Afternoons turned into endless motion mucking stalls, carrying water buckets, grooming ponies, and earning every minute in the saddle. It was hard physical work, yes, but disguised as passion. Without realizing it, I rewired my brain: movement > stillness. That shift stuck with me through med school, early parenthood, and now my work helping my own kids and others make that same shift.

I still struggle with the scroll (I’m human), but my kids now have an option I never did: a way to play with screens that sparks sweat, not stillness.

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What’s Next? We are in the middle of a shift!

Parents are hungry for screen experiences that don’t pause movement, but inspire it. We need research, yes, but we also need to start updating our assumptions.

When parents ask me for screen time recommendations I often suggest a different approach:

My pediatrician-parenting litmus test is simple:
✅ Are they moving their body?
✅ Are they connecting (with real humans)?
✅ Are they actively thinking?

❌If the answer is no, I take a second look.
👍If it’s yes, that’s screen time worth defending.

Active play screen time is “screen” time. But it’s a kind we’re only beginning to understand, and likely one that deserves its own set of rules.

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Invitation: I’d love to hear how you approach screen time in your family.

Have you created different rules for different types of screen use?…like shows vs. video calls vs. tablets vs. active play?

What’s working for your kids? What’s still a challenge?

Drop your thoughts in the comments, share your family’s screen-time strategy, or tell me what’s surprised you most. We’re all figuring this out in real time, and your approach might help someone else navigate their own version of the scroll vs. sweat dilemma.

✨ Keep moving,
Dr. Emily Greenwald
Nex Playground Chief Pediatric Advisor

P.S. If this resonates, hit subscribe so we can keep turning stillness into play—one post (and one burpee) at a time.

Drawings used in this publication were generated using OpenAI’s ChatGPT image capabilities (DALL·E, July 2025) to illustrate conceptual models.