Screen Time in Moderation: Advising a Healthy Media Diet


By Marjorie Hogan, MD, FAAP, pediatrician at HCMC and executive member of the AAP’s national Council on Communications and Media

For about 30 years, the AAP has recognized the importance of media in the lives of children and teens, but obviously the amount, complexity, and challenges of the various types of media continue to evolve. We all live in a world saturated with and surrounded by media, and even as I write this article, creative minds are at work on new products and programs! More than 75 percent of teens have cell phones; some send more than 100 text messages daily, and millions spend hours on Facebook.

The impact of media on children and adolescents is a major focus of the AAP into the future and the Board has committed time, money, and energy to the ongoing task of educating pediatricians, parents, teens, and children about media: How do we recognize and mitigate the potential harm? How do we embrace positive and pro-social media? In this spirit, the executive committee of the Council on Communications and Media (COCM) revised and published the policy statement now titled “Children, Adolescents, and Media” last fall. There are several other COCM policy statements and reports relevant to the impact of media on our patients and families, including the recent “Media Use by Children Younger than 2 Years” and “The Impact of Social Media on Children, Adolescents, and Families.”

Although media continue to evolve, so much remains the same. Many children and teens have few rules about media use, but still spend many hours daily with media — and television is still predominant. In 2013, children ages 8-11 years averaged 8 hours of daily screen time, while older children spent more than 11 hours daily with a variety of media. The amount of time spent with media concerns pediatricians and parents because during those hours children and teens are not socializing with family or friends, reading books, playing active games, enjoying creative pursuits, or just day-dreaming (still a valuable commodity!). Although TV captures the most hours, video games, social media, and other platforms are gaining in popularity.

Research confirms that media use for some youngsters is associated with negative outcomes, notably sleep disturbances, aggressive or antisocial behavior, obesity, and poor school performance. At the same time, positive and pro-social media has been shown to model empathy, tolerance, and a whole range of valuable interpersonal skills and can also teach valuable school readiness skills. Media can transport children and teens (and their parents!) to new places and open doors to learning and creativity. Social media allows teens to communicate and connect with friends and importantly, explore who they are. Media are not intrinsically good or bad — what matters is how we choose and use programs and activities.

The new “Children, Adolescents, and Media” policy statement provides some new ideas and tools for parents and pediatricians as we navigate the ever-changing media world.

We encourage implementation of a family media use plan in every home — ideally every member of the family can participate in creating this plan. This encourages families to think about a healthy media diet — analogous to the readily-understood healthy food diet. We should make, as a family, wise media choices — age-appropriate programs, games, and platforms — and not allow media to be random event in the home.

Parents should also keep televisions and Internet connections out of kids’ bedrooms and centralize media platforms, whenever possible. This allows parents to watch and monitor media use with children — another important tenet of the family media use plan. Co-viewing media is a golden opportunity for parents to teach about their own values and be certain children can comprehend and deconstruct images and messages in media. Our kids often are far more media savvy than we are — media education encourages parents to keep up to date on current innovations. Parents should also consider their own media habits — limiting children to less than 1-2 hours daily while we watch TV for hours or use cell phones at the table is confusing at best!

We advise limiting children and teen to less than 1-2 hours of entertainment media exposure daily — legitimate media use for homework not included! Another recommendation of the family media use plan is to implement and enforce a media curfew — a clear time when everyone’s devices are docked for the night (especially important considering the impact of late night media use on a good night’s sleep).

Importantly, for good evidence-based reasons, we encourage no screen exposure for little ones under the age of 2 years. There is no evidence that media exposure is beneficial for these very young children and there is growing reason for concern about the potential adverse effects on language and other development. Parents beware: now infant seats, potty chairs, and other products are coming equipped with an iPad holder to keep baby or toddler transfixed. Our littlest children need real-life interaction with loving adults, not more screen time!

Parents can be advocates, whether by encouraging schools and communities to teach media education courses or by pressuring the media industry to create positive and pro-social products and programs for children and adolescents.

Media are never going away and will only become more pervasive and important in our lives. This policy statement hopes to encourage media educated parents and children to make wise choices, mitigate the potential harm, and allow all of us to recognize and embrace the positives media can offer.

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