RISKS: THE IMPACT OF ONLINE LEARNING AND TECHNOLOGY

ON STUDENT PHYSICAL, MENTAL, EMOTIONAL, AND SOCIAL

HEALTH
Colleen Halupa
1
A.T. Still Health Sciences University, USA
1
East Texas Baptist University, USA

Abstract

Technology has proliferated society. Although it has many benefits, there are also risks, particularly
for youth. Excessive technology use can negatively impact the physical, mental, emotional and social
health of youth. This can result in pathological behaviors such as technology addiction. This paper
will provide a brief overview of technology use by youth primarily in the United States and global
incidence as available and applicable. The intent is to increase awareness of issues that may occur
with technology use in children and teens, particularly those from low income households, who report
more technology use overall.
Keywords: technology addiction, technology, youth health risk, technology and physical health,
technology and social health, technology and emotional health

1 INTRODUCTION
Technology has been integrated into every aspect of modern life. It is not possible in all but the most
remote cultures to not be exposed to some sort of technology on a daily basis. Technology allows
humans to connect without the limitations of geography, it makes processes more efficient and it
supplements the intellect and effectiveness of the human brain. Although it has a very significant
number of very positive attributes, the populace as a whole often does not consider it also has
negative attributes as well. Youth are particularly susceptible to these potentially negative effects.
What is technology and how can it be defined? In its most simplistic form, in prehistoric man
technology was a stone wheel. Today, technology has progressed to microchips and wearable
technology such as the Apple Watch. Peter Bleed 1, an anthropologist, noted even though different
types of technologies are studied, these studies occurred in isolation. He noted a behavioral definition
of technology remains “poorly understood and incompletely defined” (p. 1). Twenty years later, the
definition is somewhat clearer, albeit all encompassing, but the effects of technology on humans in the
long-term is still poorly understood.

2 TECHNOLOGY FACTS AND FIGURES

According to Lenhart2 of the Pew Research Center, in 2015 92% of American teens age 13-17
reported going online daily; 24% all teens reported they go online almost constantly. The breakdown
by ethnicity of teens that are online constantly was as: 34% percent of African American, 32% of
Hispanic and 19% of white teens. In this Internet Research Project study done by Pew, 56% of teens
reported going online several times a day, and only 8% reported going online less than weekly.
Almost 75% of teens reported they had smart phones; only 12% of teens did not have a cell phone at
all. African American teens reported the highest percentage of cell phone ownership at 85%; only 71%
of white and Hispanic teens reported having a cell phone. Older teens are more likely than younger
teens to have a smartphone Over 88% of teens have access to cell phones according to the Pew
Research Center3 and many teens sleep with their phones as noted by Pew 4 in 2012. Ninety percent of
teens report texting; the average number of texts a teen sends per day is 30. Girls are more likely than
boys to text, while boys are more likely to engage in gaming according to the Pew 3 in 2015.
Teens are major users of social media such as Facebook, Instagram, Snapchat, Twitter, Google+,
Vine, and Tumblr. Facebook is the most commonly used social media platform with 71% of teens
reporting they use it. In addition, Lenhart 2 reports 71% of teens use more than one social media site.
Males are more likely to visit social media sites often (45% compared to 36% of girls). In addition,
teens from household that have an annual income of greater than $50,000 USD per year are more
likely to use Snapchat, while teens from households with incomes less than $50,000 USD use
Facebook most often according to Lenhart2.
According to the National Consumers League 5, 56% of children ages 8-12 had a cell phone; all but 4%
were smartphones. In addition, 72% of children eight or under have used a mobile device for a media
activity such as viewing videos, playing a game, etc. Over 38% of children under the age of two years
had used a mobile device. The Council on Communication and Media 6 (CCM), in the American
Academy of Pediatricians Pediatrics journal, noted 90% of parents reported their children age two and
younger used electronic media. In addition, children in low income households spent more time with
media overall. CCM reported use of media under the age of two years does not promote language
skills as it might in older children. In fact, increased media use can decrease language skills because
there is less direct interaction with parents to actively learn the language. Children less than five who
engage in excess media use spend less time in creative play; this can negatively impact reading skills.
CCM also notes media use can be associated with “obesity, sleep issues, aggressive behaviour and
attention issues” in preschool and school aged children” (p. 1,042).
Overall, according to the American College of Pediatricians 7 American youth spend an average of 7.5
hours a day on entertainment technologies which include TV, playing games, using mobile devices
and using the internet. Common Sense Media 8 reported in November of 2015 this had increased to
nine hours a day for teens and six hours a day for “tweens.” This is a significant amount of time and
the amount of time spent has been increasing every year.

2.1 Technology Disparities

Access to the internet increased from 42% in 2011 to 45% in 2013 according toCommon Sense
Media8. According to Rainie and Cohn 9 from the Pew Research Center, 73% of households in the
United States have broadband internet. However, in 2015 this decreased to 67% because more
households were utilizing mobile devices only; 13% of Americans are smart phone “only” according to
Horrigan and Duggan10.
Common Sense Media8 noted access to smart phones for low income families increased from 27% in
2011 to 51% in 2013. There are no ethnic disparities in smartphone or cell phone ownership in the
United States. In fact, the cell phone ownership for Hispanic and white teens is equal (71%), while the
number of African American teens who own cell phones is higher at 81% as reported by the Pew
Research Center3. In addition, African American youth are more likely to go online with a mobile
device than white or Hispanic youth. African American youth are also “substantially more likely” (p. x)
according to Lenhart2 to report playing video games. Common Sense Media 8 noted in 2015 lower
income tweens and teens spent more time with media that those from higher income homes with
African American youth spending the most time. Black American youth average 11 hours and10
minutes of media use a day, while whites and Hispanics average slightly over eight hours.
There is a disparity in computer ownership; 91% of white teens have a computer while only 82% of
Hispanic youth and 79% of African American youth have a computer at home. White teens are more
likely to have gaming consoles (85%); African American youth only vary slightly with 84% of them
owning gaming consoles while only 71% of Hispanic youth do reports Lenhard 2. In all cases, teens
who come from families with higher incomes are more likely to have a smartphone versus a basic
phone and a home computer. According to the Pew Research Center data reported by Lenhart 2, 7 in
10 teens had access to three or more devices (cell phone, tablet, home computer, game console,
etc.).

3 NEGATIVE TECHNOLOGY AND INTERNET INTERACTIONS

Strasberger, Hordan & Donnerstein11 noted adolescents often post improper pictures and personal
information. Technology has transcended the usually sexual boundaries for youth. According to the
U.S. Department of Justice in 201412, one in seven U.S. youth received unwanted sexual solicitations
online; 76% of these took place in a chat room. One in 25 youth received an unwanted sexual
solicitation where the youth was encouraged to meet in person; the majority of the youth met the
predator willingly and 93% ended up having sex with the person who solicited them online. Mitchell,
Jones, Finkelhor and Wolak13 reported in 2010, 1 in 11 youth Internet users received an unwanted
sexual solicitation. This did decrease from a high of 19% in 2000; however, it is still a significant risk
for youth who use technology. Mitchell et al. report this includes things such as requesting nude
pictures of youth or other inappropriate pictures, providing explicit sexual information, requesting
specific sexual information and other infractions. Mitchell et al. also noted these solicitations were
more concentrated among youth 16-17 years of age; reports of solicitation to 10-11 year olds declined
since 2000 as well. Men were more likely to sexually solicit youth online than females; the majority of
the solicitations were by a friend or acquaintances followed by strangers that were met online. Most of
the incldents happened only one time; however, some incidences continued long-term. The National
Campaign to Prevent Teen and Unplanned Pregnancy (2008) 14 reported 20% of teens had distributed
nude or partially nude photos of themselves via email or by posting them online; however, this sample
was not a random population and included both 18 and 19 year olds.
Mitchell, Finkelhor, Jones & Wolak15 reported data on youth sexting in 2012. They did a telephone
survey on a cross section of 1,560 youth Internet users; only youth in the 10-17 age group were
queried. In their study, 9.6% of youth reported posting nude or partially nude images of themselves;
61% were females and most were “selfies.” In addition, 7% reported someone else had posted a nude
or nearly nude image of them; 56% of these were females and most were ages 16-17. However, only
28% who had images posted by someone else contacted the authorities. In 2012, Wolak, Finkelhor
and Mitchell16 reported in a national survey of law enforcement agencies the number of arrests that
resulted from the posting of explicit sexual images online. When adults were involved, arrests occurred
62% of the time; youth arrests were significantly lower and depended on the nature of the offense.
However, this study did not address sexually explicit images that did not include nudity (complete or
partial). However, sexually-related technology interactions are not the only danger for youth;
cyberbullying has moved bullying into the virtual world in addition to the physical one.
Kowalski and Limber in 201320 defined cyberbully as bullying through electronic means. This includes
text messaging, email, online web sites and social media. Cowie 21 reported cyberbullying takes the
following forms:
 Flaming; angry messages
 Harassment: threats
 Cyberstalking: intimidation or threats
 Masquerading: pretending to be someone else
 Outing: sharing personal information told in confidence with others
 Exclusion; deliberately leaving someone out of a group (p. 1)

In the United States 25% of U.S. teenagers reported they have experienced bullying via their cell
phone of internet; 95% of teens who have witnessed bullying on social media ignore it. Approximately
10-20% of teens experience cyberbullying regularly according to the No Bullying 17 website. In the UK
in 2013, 8% of children 12-15 years experienced cyber bullying; 4% ages 8-11 had experienced online
bullying within the last year reports OFCOM 18. Cyber bullying rates are highest in India (32%), Brazil
(20%), Canada (18%) and Saudi Arabia (18%); rates are lowest in Italy according to Reuters 19.
According to the information posted on the stopbullying.gov website 22, bullying, including
cyberbullying, can have a negative impact on physical and mental health. This includes depression,
loneliness, anxiety and other changes in behavior such as a lack of interest in activities the youth used
to enjoy. This can progress to lack of sleep, changes in eating patterns and other physical health
complaints. There is often a major negative impact on academic performance. Cowie 21 reported the
same health risk findings. In addition, she reported emotional and physical damage including
decreased self-esteem, increased incidence of alcohol and drug abuse, increased headaches,
phobias, and paranoia.
Cowie21 notes the way to deter cyberbullying is through prevention which includes school safety
policies that specifically address technology and internet interactions. Education of youth on how to
deal with negative interactions in the virtual environment is critical to decrease the incidence of
negative interactions such as cyberbullying, sexting and dealing with unwanted sexual solicitations.
4 POSITIVE TECHNOLOGY AND INTERNET INTERACTIONS
The news about youth, technology and the internet is not all bad. The internet has many positive
attributes as well. The first one is online learning which has opened up numerous opportunities for
youth. This includes the ability to take classes on the Internet for fun and for high school and college
credit. Although online learning has proliferated higher education with over 7 million students taking
online course as reported by the Babson Survey Research Group 23, it has proliferated much slower in
secondary education. According to the International Association of K-12 Learning (iNACOL) 24 in 2013
there were 31 states that had state-wide full time online schools. Over 1.8 million K-12 students were
enrolled in online courses from 2008-2009; over 2 million were taking online courses from 2011-2012.
Students as young as first graders were taking online courses. Online leaning provides students in
rural and other underserved areas the ability to engage in more diverse educational experiences. In
addition, with the advent of the internet information is widely available for today’s youth with just a few
keystrokes. Learning online can contribute to goal-setting behaviors and self-discipline since this is
what is required to succeed in this environment.
Strasberger et al (2013)11 noted several positive effects of technology and the internet. This includes
increased academic achievement and an increased feeling of social connectedness that enhances
well-being if technology is used to engage with friends and family (but not strangers). Increased
happiness was also reported by Chou and Hsiao 25 and Morahan-Martin & Shumaker26. Educational
media at a young age can have positive effects if it is truly educational and requires direct participation
according to Bavelier, Green & Dye27 and Strasberger et al.11.

5 IMPACT ON MENTAL, SOCIAL HEALTH AND EMOTIONAL HEALTH

Perhaps the most significant impact of technology use is the impact on their mental, social and
emotional health. Numerous studies have found negative impacts in these areas of health. Some of
these effects are outlined below.

5.1 Impact on Cognition.

Much of the research on widely used consumer technologies in youth is on television viewing and
children since the television has been readily available since the 1950’s. Negative effects have been
observed with excess use. Lilliard and Peterson 28 found TV viewing has a negative effect on enterprise
skills in preschool age children. According to the University of Leicester 29 enterprise skills are key
skills children need in life such as motivation, initiative, creativity, individuality, the ability to get along
with others and strategic thinking. Lilliard and Peterson found just nine minutes of viewing caused
immediate negative effects on these enterprise skills in pre-schoolers. A control group and
experimental group of four year-olds was used in this study. The control group was asked to draw
pictures while the experimental group watched a fast-paced cartoon. Both groups then watched an
educational video. Both groups were then tasked to build a tower of pegs and disks and then perform
some simple physical tasks (like touching their toes). Next, they were shown a bag of marshmallows
and a bag of fish crackers. The experimental group participants were instructed if they waited for the
researcher to return, they could eat 10 pieces of their choice. A bell was also placed next to the treats
and the children were told if they rang the bell, the researcher would return and they could only have
two treats. Times were recorded. Last students engaged in a creativity task that was video recorded
and reviewed. Children who watched the fast-paced cartoon scored much worse the combined score
for all of the assessed tasks although there were no differences in the amount of television usually
watched between the two groups and no difference in attention problems. Delay of gratification was
significantly impacted. This study confirmed the findings of Hyson, Hirsch-Pasek and Rescoria 30 who
found that if stimilu are presented at the wrong time, or in the wrong manner, the neural connections
may accommodate in a way that is not preferred. Today’s video streaming technology is television and
games are in essence interactive television. Excessive media and technology use presented at the
wrong time (age) or wrong manner can have negative effects. Bavelier et al. 27 noted cognitive impact
depends on the type of technology used, but most all technologies cause transient mood changes and
long term changes in brain function and behaviour. They noted internet use and video gaming can
become pathological.
Strasberger et al11 reported seven different research studies have demonstrated language delays in
infants exposed to excessive technology. Today technology is often used to entertain young infants
and toddlers and the impacts have truly have not been determined.
Several researchers have noted that overuse of technology can result in mental overload and
disconnect people from nature, play and people. A child who spends too much time in virtual worlds is
less likely to have effective social skills to interact in the real world simply from lack of practice. Kim,
LaRose & Peng49 posited technology negatively impacted social skills. Park and Hyun31 reported
those engaging in excessive technology use have a decreased sense of time and concentration due to
multi-tasking. In addition, they are not future-thinking and are more impulsive. Park & Hyun also found
academic performance was affected more than any other factor.

5.2 Other Issues

Chirico (1997)32 reported Piaget’s premise that child development should not be artificially rushed. Yet
excessive media use at a young age can do exactly that. Young brains are malleable and so much is
yet to be determined on children who begin significant technology use in infancy.
According to the Council on Communications in Media (2011) 6 media use is associated with “sleep
issues, aggressive behaviour and attention issues in preschool and school age children” (p. 1,042).
Grusser, Thaleman & Griffiths33 noted excessive gaming causes aggressive attitudes and behaviors.
Bavelier et al.27 noted it changes arousal levels and mood. Numerous researchers including Amnchai-
Hamburger & Ben-Arzi34; Ergodan35; Hardie & Tee36; Morahan-Martin & Schumaker26 and Mitchell,
Lebow Uribe, Grathouse & Shoger37 reported excessive media and technology use leads to isolation.
Isolation can lead to depression which has been reported by Jang, Hwang & Choi, 2008 38 and Yen,
Ko, Yen, Wu & Yang 2012 39, as well as low self-esteem as reported by Barker 40 and Ehrenberg,
Juckes & White41. Grusser et al. 33 reported technology overuse can cause aggressive attitudes and
behaviors. It can also lead to disassociative symptoms according to Boxoglan, Demirer & Sahin 42 and
Canan, Ataoglu, Ozcetin & Icmeli43. Several researchers have reported mental overload (Berntsson44;
Haugland, Wold, Stevenson, Aaroe & Woynarowska 45 and Kaltiala-Heino, Lintonen, & Rimpelä 46.
Rowan47 reported excessive technology use can impact youth sense of identity as well since they can
no longer separate the real world from the make believe world. Misra and Stokols48 reported excessive
technology use can have negative behavioral and psychological impacts.

6 IMPACT ON PHYSICAL HEALTH

Kautianen, Koivusilta, Lintonen, Virtanen and Rimpela 50 noted the use of technologies, including video
games and computers, is one of the factors contributing to overweight and obesity. They researched
the effects of technology on a population of 6,515 adolescents and found a statistically significant
difference in the rate of obesity and overweight in those who spent more with technologies; however,
the time playing games was not statistically significant in the population as a whole. However, there
was a statistically significant difference in the time spent playing games and overweight in 18 year-old
girls. There was also a statistically significant relationship between increased time spent on the
computer and overweight. CCM6 linked media use with obesity in pre-school and school-aged
children. Obesity has doubled and technology is a contributing factor according to Cawley 51 and the
American Academy of Pediatrics7 (2014). In addition, sleep deprivation found with excessive
technology use can increase obesity as well. Strasberg et al. 11 in 2013 found technology in a child’s or
adolescent’s bedroom increased overweight by 31%. In addition, according to the Department of
Health and Human Services52, excessive technology use caused disordered and unhealthy eating. It is
well documented obesity and overweight can lead to Type II diabetes and early onset heart disease.
In addition to mental developmental delays, physical developmental delays can also occur. According
to Rowan47 in Sensomorotishe Intergratie, children’s sensory and motor systems are not adapted to
the physically sedentary and mentally chaotic nature of technology. Excessive technology use has
resulted in failure of children to reach developmental milestones and decreased motor development
and decreased sensory stimulation. This was supported by Lilliard and Peterson 28 in their study where
technology had a negative effect on children building a tower. In very young children, increased media
use can cause language delays reports CCM6.
According to the Technology and Teenager’s Blogpot 53, excessive media exposure on the Internet
leads to increased risk for smoking, drug and alcohol abuse and early sexual activity. Other more
immediate physical risks for older youth include being involved in auto accidents when texting while
driving a car.
7 TECHNOLOGY ADDICTION
Internet and technology addiction is multi-faceted and truly has no standard definition because of
diverse types of technologies available. However, in its most simplistic form, technology addiction is
overuse of technology to the point of where it interferes in daily activities, school and relationships with
family and friends. In 2009 Pies 54 and in 2012 Cash, Rae, Steel and Winkler 55 called for technology
addiction to be considered for inclusion in the American Psychiatric Association 56 (APA) Diagnostic
and Statistical Manual of Mental Disorders (DSM) update. In the 5 th edition, internet gaming disorder
was added as a condition warranting more experience before it is considered for inclusion in the main
book. China and Korea have identified technology addiction as a significant public health threat noted
as noted by Cash et al55; Cao and Su57; and Leung & Lee58.
Cash et al.55 reported a prevalence rate of internet addiction between 1.5 and 38% with Asian
countries experiencing the highest incidence; in response, these countries have opened health clinics
specifically to deal with this disorder. Prevalence in the U.S. ranges from 1.5 to 8.2% and in Europe
between 6% and 18.5%. They note internet activities activate the pleasure pathway of the brain which
causes a release of dopamine similar to opiate ingestion. Over time, more stimulation is needed to
provide this pleasure stimulation. Activities such as social media and internet gaming are specifically
designed to provide rewards which increases addictive behaviors. For these reasons, internet
addiction is most often compared to the phenomenon of gambling addiction. Dong, Lu, Zhou and
Zhao59 reported increased depression and anxiety which progresses to hostility and psychoticism in
some cases. Belanger, Akre, Berchtold & Michaud 60 found this type of behavior is more prevalent in
adolescent girls than in boys; however, Ha and Hwang 61 reported it was more prevalent in depressed
females. Decreased interpersonal sensitivity was also found in those with this addiction.
Misra and Stokols48 performed a study of 484 students in their late teens; 82% of the population was
Asian which has been found to have a predisposition to technology addictions. High self-reported
levels of cyber-based overload predicted a poorer health status as measured by injuries, frequently of
health problems and visits to the doctor. The most common physical symptoms were sleep problems,
depression, headaches, loss of appetite and stomach complaints. Misra and Stokils also noted those
with a high level of cyber activity decreased concentration and self-reflection. Lee 58 discussed the
effects of social networking fatigue which they defined as a “self-evaluated feeling of tiredness (p. 51)
caused by an obsession with social media and the need to respond immediately. They noted this
leads to both physical and psychological strain. Young 62 reported there is a paucity of literature on
Internet and technology addition in Europe and additional study is needed. Technology addiction is a
growing health risk in the child and adolescent population.

8 SUMMARY
Caution must be used in technology use in both children and adolescents. It is important to balance
technology use with other activities that promote relationships, creativity and development. Excessive
use can negatively impact the physical, mental, emotional and social development of youth. More
health education interventions are needed in the United States and other countries to increase
awareness of this potential issue.

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