Video Games

Consoles, PC, Handhelds and Mobile

Online gaming is very popular; Australian research shows that an estimated 81% of Australian young people (aged 8-17 years) have played an online game, although the average age of an Australian gamer is 34 years old and 46% of video game players are women showing that this activity is popular across the community.

Distinguishing Between Healthy & Problematic Gameplay

An important issue for parents is identifying whether video game play is healthy – representing enthusiasm and enjoyment – or becoming problematic.

When children are not happy about stopping game play, this does not mean that they are suffering a disorder. It is normal for kids to be a bit grumpy after gaming, they are just transitioning back to normal life, which is much less stimulating than gaming. It is a good idea to be mindful of when is the right time in the day and week for children to be playing games and perhaps restrict this activity to weekends and avoid playing games before sleep or when children need to concentrate such as before school.

Children test limits regularly, and this does not mean that they actually want more gaming time, or more importantly, that parents should give in. Young people who want to play games more than they are allowed are not necessarily ‘addicted’. It is essential that parents model good behaviour in terms of balancing screen time with physical activity and social relationships: be strong and stick to limits, with consistency, kindness and support.

Whether internet gaming should be classified as an addiction or mental health disorder is the subject of much debate and ongoing research. The World Health Organisation (WHO) included this in their most recent diagnostic manual published in 2018, however the DSM-5, most commonly used in Australia, does not include gaming disorder as an official diagnosis. According to some research, gaming addiction may co-occur with other mood disorders such as anxiety disorders, depression and stress. Young people with attention problems and those who are socially isolated and dissatisfied with life may be vulnerable to developing gaming problems.  It is important when considering any problems to be mindful of other underlying issues which may be masked by the apparent problems related to gaming.

Some key indication of problematic gameplay:

Do any of these apply to your child(ren) or significant other?

  • They have a pre-occupation with gaming
  • They are hiding or lying about game use
  • They are spending large amounts of time and money gaming
  • They show signs of social withdrawal and isolation – neglecting relationships with friends and family
  • They show signs of degrading ability to play with peers and have fun
  • They display defensiveness, anger, sadness and anxiety related to not being allowed to play games
  • They have been getting little physical exercise – children aged 5-17 years should have at least 60 minutes of moderate to vigorous intensity physical activity daily
  • They have been neglecting school (or paid) work
  • They display disengagement from school life and other social and recreational activities
  • They are neglecting personal health and hygiene (eating healthy meals regularly, failing to brush teeth, hair, get dressed, shower)
  • They are not getting sufficient sleep – children and teenagers should sleep 8-10 hours per day

Tips for Parents

It is important that parents don’t just focus on the child who appears to be playing games at problematic levels. This is an important issue for parents and the whole family.

Participate in Gameplay: The best way to prevent and resolve gaming problems is for parents to be present in the gaming world of their children. An Australian study found that 44% of parents had played online games with their children, 75% of parents had rules about children’s video game play, and 84% of parents had talked with their children about playing safely online.

Playing video games with children is a great way to see what children are playing and how they engage in game worlds. There are many positive benefits of game play, which are enhanced when playing together and taking advantage of teachable moments.

Source: Digital Australia 2018, Interactive Games and Entertainment Association

Parents can ensure game play is healthy by playing with children, helping them set healthy limits, and actively finding a variety of alternate activities for both, online and offline entertainment. A large review of studies on problematic gaming found that paternal bond was a protective factor against problem gaming and there is a strong need for families to be involved in both prevention and efforts to assist adolescents exhibiting symptoms of problem gaming.

Some ideas for talking with young people about games.

  • What is fun about the game?
  • Can you show me how to play?
  • What do you wish I understand about the game and why you like it?
  • Who do you play with online?
  • What can you do in games that you can’t do in real life?
  • Have you seen any negative behaviours online?
  • What do you think is an appropriate amount of time to play each day?
  • How do you think that the game companies make money?

It is important that parents help children learn how to play games at healthy levels, given that they are likely to do this well into adulthood. Online game play has many positive benefits and provide(s) opportunities for creativity, imagination, developing social and collaborative skills and strategic thinking. There are no clear guidelines on how much game play is appropriate, although an University of Oxford study suggested that video-game playing for less than one hour a day is linked with better-adjusted children and teenagers than those who did not play at all and those who played for three hours or more.

Present a United Front: Parents need to present a united front – it is important that all parents and caregivers take the issue seriously and have an agreed and consistent strategy for children and back each other up.

Establish Clear Limits: Parents need to establish clear limits on how long and how often children can play games online. This may include a written contract or rules for age-appropriate children. The best way to determine limits is to involve the children and sit down together to work out what is a reasonable amount of time to play the game. By involving teenagers in the decision-making process, they are more likely to adhere to the boundaries set. Many gaming devices provide parental controls such as limits on how much time devices can be played per day.

Establish a Space for Gameplay: Where games are played is another important consideration. Ideally, games should only be played where parents can easily supervise game play, such as common areas in the house rather than children’s bedroom or playrooms.

Introduce Technology Breaks: Ensure that children have a technology break, there should be hours in the day and certain times when everyone should avoid devices – including parents. Family mealtimes can be a useful start and parents need to act as role models and emphasise the importance of social connections, without devices interfering. Engaging together in healthy, social, and physical activities – ideally outside – is an important part of family life. Activities should fulfil some of the needs that games do, such as a sense of achievement, competition, and being in control. It is important for young people to engage in a wide variety of activities and find ways other than gaming to manage their mood, including coping with stress, emotions, and interpersonal issues.

Sleep is hugely important for children and adolescents and research has shown that devices interfere with sleep. Internet connected devices should not be used in bedrooms or available when children are trying to sleep. If needed, buy a standalone alarm clock, disconnect Wi-Fi, and use parental locks on devices.

What types of games are appropriate?

The Classification Board in Australia classifies games that are sold or hired. Classifications describe the minimum maturity level of content and factor in themes including violence, sex, language, drug use and nudity. Gambling content does not impact a game’s classification and games with gambling content are often rated PG (8+) or G (for a general audience).

There are many games available online and offline. Some have an educational base, others can be very violent, graphic, and depict themes that are inappropriate for children. Many games have social features, which enable players to communicate with each other, but also enable predators to contact children. For example, one Australian study found that 17% of multiplayer games had experienced in-game bullying. Most games have in-game monetisation features which allow players to purchase items of known or unknown value (e.g., a loot box is a mystery item which players pay for without know what is inside). Parents should consider all these features and discuss with children what is appropriate or not.

Some games have common structural and aesthetic features with gambling, creating a convergence which has risks in terms of normalising gambling, creating positive attitudes towards gambling, and even acting as a gateway to online gambling. For some games this may be through the content with games mimicking gambling (e.g., poker, slot machines, casino games, bingo) as the core game, or an in-game feature or component. Other games contain mechanics which require players to purchase a mystery item (e.g., loot box) which may contain an item of low or high value. Some countries (e.g., Belgium) have classified these as a form of gambling in games which provide a marketplace for players to trade or sell and purchase items. As with all online game content, it is important for parents to be mindful of what lessons children are learning and whether these are accurate depictions of the real world. If young people do choose to (and are permitted) to play gambling-themed games, parents can use these as an opportunity to discuss gambling issues such as the how the odds of winning in real gambling are lower than in games, how it feels to win and lose, what a ‘near miss is’ and how it makes you feel, and how some people develop gambling problems. For youth curious about gambling, games may be a safe way to explore this content, provided that this is done with supervision and guidance. Running out of virtual currency may be a useful lesson that ‘the house always wins’.

 

Many video games can be violent, bigoted, racist, sexist, and highly inappropriate for young people. Such games often portray violence as insignificant with no consequences to the victim or perpetrator, which as we know in real life is not the case. This can send a message to players that violence is harmless, funny, or even an acceptable way to get what you want. Research has demonstrated that violent video games do not create violent behaviour in players. Nonetheless, many games contain content that may be harmful for children who are still developing their perception of the adult world. For example, females are often displayed as victims or displayed in hypersexual ways which can be damaging to perception of gender-related attitudes.

A note about advertising

Free games such as those on mobile devices make revenue through in-app purchases and advertising. Even though parents may download games and feel comfortable that children have limited opportunities – many games include advertisements that directly link to additional content, which may be age-inappropriate. The only way to know what content your child is viewing while online is to actually supervise your child whilst playing.

Treatment

Gaming disorder and problematic gaming is a new classification, so there are no established treatments. In Australia, gaming disorder may not be considered a mental health disorder, making it potentially difficult to qualify for Medicare rebates. Nonetheless, there are resources to seek help for individuals experiencing problems and concerned significant others.

  • General Practitioners: Talk to your doctor if you are having concerns about your or a family members gaming. Be sure to mention any issues relating to sleep, mood, lethargy, and loss of interest in other activities. Your GP can provide a referral to specialised care, including speaking with a mental health professional.
  • Family therapy: If gaming is negatively affecting the whole family, seeking help as a family unit may assist in resolving any underlying issues that are exacerbating or contributing to excessive gaming.
  • Child and adolescent therapy: Mental health professionals are available to provide therapy sessions specifically for children and adolescents. There are often bulk-billed (free) options available through community mental health centres and university clinics. Contact your local government to receive information about local services that provide support and counselling to young people.
  • Cognitive Behavioural Therapy (CBT): Although there are no proven treatments for problematic gaming, CBT has the most support. This form of treatment involves identifying the underlying thinking processes behind a gaming behaviour and developing more helpful beliefs. CBT is also helpful in identifying and treating related mental health issues, which often coincide with problematic gaming.

Wolrd Heath Organisation (WHO) criteria for Gaming Disorder:

  1. Impaired control over gaming?
  2. Increased priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities.
  3. Continuation or escalation of gaming despite the occurance of negative consequences.

The behavioural pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and have been evident for at least 12 months.

Nonetheless, parents do need to keep a close eye on children who starts to show some of the risk factors for problematic video game play.

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