I met my first best friend in kindergarten. She lived about 5 blocks away from me in my neighborhood. Afternoons were spent walking back and forth between our houses, just the two of us, through the streets, without sidewalks. The woods were our playground, and the streetlights were our clocks. Our mothers did not text us to see where we were. They knew we would be home for dinner when the sun began to set.

Gaming

It is rare today to see kids outside playing after school. So, what has changed over the last 50 years? I feel that the advances in technology have had a great impact on childhood experiences. Central air conditioning, which was introduced in new homes in the 1960s, was a major player.1 It allowed people to stay in their homes to escape the heat, rather than play outside on the cooler porch. Arcades became the place to go in the 1970s with the introduction of the popular video game, Pong.2 Kids could spend the whole afternoon putting quarters into the machines. Soon after, the first home video gaming system became available. Children could now be entertained without ever leaving their couch, just them and the controller. Sometimes, groups of kids would play together, but other times, they played alone in their own living rooms. The music video for the song “Video Killed the Radio Star” was the first played on Music Television (MTV), which made its debut in 1981.3 Kids rushed to the TV set in their homes to watch the latest music videos. With entertainment easily found in their own houses, children had less of a reason to run around outside, partaking instead in more sedentary activities.

Computers

Perhaps the biggest explosions in technology occurred in the 1990s, with the introduction of the World Wide Web and text messaging.4,5 Facebook premiered in 2004, and Apple revolutionized the world in 2007 with the introduction of the first iPhone.5,6 Computers, now in the palms of kids' hands, have drastically changed children's behaviors. Kids can now spend hours a day on computers, which are used in all aspects of life: to gain knowledge and to communicate with one another, as well as for entertainment. Rarely does anyone leave the house without their cell phone. Survey data suggest that 42% of 10-year-olds, and almost all highschoolers, have their own cell phones.7 Texting has become the main form of communication. It is rare to see kids just sitting in the playground speaking with one another. No longer does someone simply place a phone call without first texting to see if the person is available. This can lead to social isolation and a deterioration in the ability of kids to recognize social cues and facial expressions.

Social media has forever changed the meaning of the word “friend.” Posts are thoughtfully crafted to get the most “likes” or “thumbs up.” Kids can paint whatever image of themselves that they want to portray to others online, regardless of if it is true or not. Others can comment on posts in positive or degrading ways, sometimes hiding behind a fake profile. Emojis have replaced actual physical reactions. Communication with each other is via a keyboard or screen, without any personal contact.

COVID-19

COVID-19 forced us into an even greater reliance on technology. With the mandates to quarantine, remote schooling evolved. Video conferencing, which was learned overnight, replaced classrooms. Kids could no longer look forward to seeing their friends in person on a daily basis. Social isolation deepened, and kids were expected to remain engaged in learning while lying in their bedrooms.

Conclusion

Children play and explore: That has not changed over time. What has changed is the location and the type of activity. Fifty years ago, groups of kids could be found running around in the backyard; today, kids often interact with each other through a screen. Group interactions have been replaced with more solitary and sedentary activities. The net effect of these changes in technology seems to be one of increasing social isolation for children. It is not a stretch to believe that this can lead to anxiety and depression like never before. Indeed, there has been a rise in anxiety and depression as well as obesity in childhood over the last 50 years.8,9 In this special issue of The Nurse Practitioner on pediatric healthcare, various articles focus on the challenges that kids face today, including mental health concerns and obesity. Perhaps these trends are a direct result of less time spent playing with others on the playground after school and more time alone in front of a screen.

REFERENCES 1. Biddle J. Explaining the spread of residential air conditioning, 1955-1980. Explor Econ Hist. 2008;45(4):402–423. 2. Malliet S, De Meyer G. The history of the video game. In: Handbook of Computer Game Studies. 2005:23–45. 3. Smith DJ. Can video save the radio star? Using music-plus-video in the classroom. Music Educ J. 2003;90(1):37–41. 4. Baldwin K. History of the Internet | Overview & Timeline - Video & Lesson Transcript | Study.com. 2023. Accessed January 11, 2024. 5. Thales DIS. How has the mobile phone evolved in 50 years? - Thales blog (thalesgroup.com). 2023. Accessed January 11, 2024. 6. McFadden C. A brief history of Facebook and its major milestones. Interestingengineering.com. 2023. Accessed January 11, 2024. 7. Burgert N. What is the best age for a child's first smartphone? Forbes Health. The best age for a child's first Smartphone – Forbes Health. 2023. Accessed January 11, 2024. 8. Centers for Disease Control and Prevention (CDC). Data and statistics on children's mental health. 2023. Assessed January 11, 2024. 9. World Health Organization (WHO). Obesity and overweight. 2021. www.who.int. www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed January 11, 2024.