Pediatrician Maria Angustias Salmerón increasingly sees in her practice adolescents using ChatGPT as a search engine because Google "is tedious for them and requires them to verify information." Many times, the AI responds to their questions with false information, but the kids not only do not question it, but they give it more credibility than adults. She has observed this especially with issues related to the reasons for the consultation. "There is an increasing permeability to inappropriate content, with adolescent patients questioning their own illness or stopping treatment because the AI tells them it is incorrect. Since they cannot challenge it, they reinforce it and become more emotionally dependent on the AI, which tells them what they want to hear," she explains.
She once had a patient who frequently talked to ChatGPT:
- "What was your last conversation with the AI?"
- "Well, I asked if it was appropriate to have two partners at the same time."
- "No, no, that's happening to a friend..."
- "What did the AI tell you about that?"
- "It tells me that there are cultures where polygamy is fully accepted."
- "I had to look up what the word polygamy meant because I didn't understand it, but then I felt reassured."
- "The relationship is based on trust and respect. Have you talked to your two partners to inform them?"
Salmerón, president of the Spanish Society of Adolescence, says that "there is beginning to be an emotional dependence of minors on AI" that worries her and other experts who presented 70 scientific evidences on Wednesday "demonstrating that certain digital exposures contribute to specific adverse outcomes." All Spanish scientific societies specialized in minors have agreed on a document with a compilation of evidence supporting the need to address this issue as a "public health problem."
The document with the 70 proofs of screen damage has been presented to the Justice Commission of the Congress, which is currently addressing the bill for the Protection of Minors in Digital Environments, in the amendment transaction phase. The list of signatories is extensive: in addition to about twenty civil society groups, it is endorsed by the Spanish Association of Pediatrics, the Spanish Society of Neurology, the Spanish Association of Child and Adolescent Psychiatry, the Spanish Society of Adolescent Medicine, the General Council of Psychology... and up to 13 state-level medical societies. None have abstained.
The dossier with scientific evidence aims to avoid "indiscriminate alarmism attributing all adolescent dysfunction to digital use" but also to prevent "systematic minimization invoking the absence of perfect causality as an argument for inaction." Therefore, it justifies the existing European regulation, with age verification mechanisms, platform accountability requirements, and design limits, among other measures.
It also proposes usage times, although experts believe that hourly counting "is insufficient to characterize the risk," as they have also found that the type of content, children's and families' characteristics, parenting style, and other factors influence. Broadly speaking, scientific societies recommend zero screen exposure for children under six, a maximum of one hour per day for children between six and 12, and a limit of two hours per day for those 12 and older.
"We are not against screens or technology, but we must respect the fundamental rights of children, such as the right to health, the right to life, and the right to personal development. If we as adults already struggle to control it, it is impossible for children to self-regulate. We say this from ideological neutrality and scientific evidence. We are facing the biggest brain hack in human history: it is changing our children's behavior, their way of playing, and relating," warned Mar España, president of the Control Z Platform, which brings together these medical societies and third-sector organizations.
David Ezpeleta, vice president of the Spanish Society of Neurology, has provided longitudinal studies and neuroimages showing "poorly developed brain highways" in young people who have received the "monotonous stimulus" of screens, as indicated by a 2020 study by Hutton that found differences in white matter microstructure in frontotemporal pathways linked to language with increased screen time in preschoolers.
"Current scientific evidence can affirm that early screen exposure, especially when passive, prolonged, or substituting adult-child interaction, is associated with worse outcomes in language, cognition, self-regulation, and executive functions. Content inappropriate for age and screen use by the caregiver, a phenomenon already known as technoference, are also associated with worse psychosocial outcomes. Overall, screens in early childhood are particularly concerning when, whether due to the child's or the caregiver's use, they displace human interaction, at a stage where that interaction is not a complement but a biological requirement for proper brain development," summarized Cristina Cordero, co-coordinator of the working group of the Spanish Society of Neuropediatrics, to EL MUNDO.
Among the papers cited by the experts is the Adolescent Brain Cognitive Development (ABCD) study from the US, which finds associations between digital activity and variations in cortical regions of attention, cognitive control, and reward processing. Another large international cohort is the Japan Environment and Children's Study (JECS), which states that more screen time in early years leads to worse communication, social skills, and daily life outcomes in preschool age. The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) study indicates that greater exposure in the first year of life is associated with differences in electroencephalographic markers and in attentional and executive functions in school-age children. And so on, up to 70 studies published in recent years.
José Antonio Luengo, vice president of the General Council of Psychology of Spain, notes that they are seeing children very attached to the use of the "digital pacifier" with difficulties in creating secure attachment. He also states that this lack of attachment, which is "a system of affective regulation that plays a fundamental role in development," when affected by these circumstances, "may correlate with addiction in the future."