Posted tagged ‘screen time’

How much media use is too much? The AAP weighs in

October 21, 2016

The Pediatric Insider

© 2016 Roy Benaroch, MD

Today, the American Academy of Pediatrics released two new policy statements outlining their official recommendations for media use in children and adolescents. Media, here, means television, video games, tablets, apps – pretty much anything with a screen. We know this kind of entertainment has become a huge part of our lives. How much is too much, and how do we ensure that media is being used wisely and safely? The policy and accompanying technical report rely on hundreds of solid references, providing the best answers based on the best science we know about how children learn and interact with the world of media.

Younger children, less than 2, need exploration and social interactions to learn best. They cannot learn from traditional “media”, at least not on their own. Some learning via electronics can begin by age 15 months, but only via caretakers participating with their children and reteaching the content in an interactive way. By 2 years, we know children can learn word skills by live video-chatting with a responsive adult, or by using apps that reward the child for choosing the right answers.

Preschoolers, aged 3 to 5, can boost their literacy and cognitive skills by watching well-designed TV programs (like Sesame Street.) However, higher-order thinking skills like task persistence, impulse control, and flexible thinking are still best learned during truly social, interactive play – and that’s just not something media can provide.

There are some specific medical concerns raised by media use in young children. Heavy media use increases the risk of obesity, by filling time with sedentary activity and exposing children to unhealthful food advertising. And increased media use directly corresponds to less sleep for children (this is especially true for evening exposures, before bedtime, which interfere with sleep onset, sleep quality, and sleep duration.)

Excessive media use in early childhood is also associated with cognitive, language, and social delays. Some of these associations depend on exactly what’s being watched — switching from violent to pro-social content has been shown to improve preschool behavior, especially in boys. There’s also concern that excessive media use by parents can interfere with other family activities, and may model and reinforce media excess in their children.

With all of this in mind, the AAP has made these specific recommendations for young children and media use:

  • Under 18 months, discourage all media use (other than video chatting with family. Facetime and Skype are OK.)
  • From 2-5 years, limit all media, combined, to a total of less than 1 hour per day of high quality shows. These should be shared together between parents and children.
  • No screens at all during meals and for 1 hour before bedtime.
  • Parents should keep bedrooms, mealtimes, and parent-child playtime screen free.

The AAP had a second policy statement about media use in school aged children and adolescents. There’s good evidence for some benefits of media use at this age, including exposures to new ideas and information, and opportunities for community engagement and collaboration. Social media can help children access support networks, which may be especially valuable for kids with ongoing illnesses or disabilities. Media can provide good opportunities to learn about healthy behaviors, like smoking cessation and balanced nutrition.

But: there’s a down side, too. There are risks for obesity and sleep problems with excessive or untimely media use. Children who overuse online media are at risk problematic, addiction-like media usage, sometimes characterized by a decreased interest in real-life relationships, unsuccessful attempts to cut back, and withdrawal symptoms.

Many teens use media at the same time they’re engaged in other tasks, like homework. They may think they’re learning, but good objective data shows that no one can truly multitask like that. And, of course, though media can deliver positive, healthful information, parents need to be wary of some of the misinformation that’s out there. Information about nutrition, vaccines, and exercise is often misleading or flat-out wrong. Kids can easily find material actually promoting risky health behaviors like eating disorders, sexual promiscuity, and self-mutilation.

There are also significant risks from cyberbullying, sexting, and online solicitation – issues that are especially problematic because the perpetrators may be anonymous. The internet has created some horrifying opportunities for the exploitation of children.

Bottom line, here’s what the AAP recommends for these school aged children and adolescents:

  • Families are encouraged to create their own Media Use Plan. This addresses how media is accessed, both how much and what kind. Consistent limits and a clear and explicit understanding of expectations is crucial. Families should work on these plans together.
  • Children should not sleep with their devices in their bedrooms (parents shouldn’t either.)
  • Media shouldn’t be used during schoolwork, family meals, or other family-designated “media free times.”
  • Parents should engage in selecting and co-viewing media with their kids.
  • There needs to be ongoing discussions of online citizenship and safety.

The AAP’s new policy doesn’t include a specific amount or number of hours of media time is recommended for children and teens. But media use should be limited, so there’s time for exercise, adequate sleep, and other activities. How much media is too much? For teens, when it prevents them from participating in other activities they ought to be doing. Media has become a huge part of all of our lives, but there needs to be time for other things, too.

My hero

Fisher-Price’s new iPad bouncy seat fail

December 16, 2013

The Pediatric Insider

© 2013 Roy Benaroch, MD

The Hatfields versus the McCoys. Potter versus Malfoy. That guy with the hat versus that guy who walked around naked (don’t ask me, I’ve never watched Survivor.) These are among the best-known feuds of our time.

Now it’s my turn for a feud. It’s me versus Fisher-Price. Don’t pretend you aren’t reading this, Fisher. Or Price. Or both of you. If you are two people, which I’m not so sure about.

Anyway: last year I wrote about the Fisher-Price Rock-n-Play Sleeper, which despite being called a “sleeper”, is not a suitable place for babies to sleep. It fails to meet many of the AAP’s guidelines on safe sleep for babies. You can Rock in it, or Play in it, but I wouldn’t let any baby sleep in it. Judging by the comments on that article, many people agreed with me. Other people think I’m an idiot with some kind of odd Fisher-Price preoccupation. Those people will not be pleased with the rest of this post.

Because Fisher-Price, you’ve done it again.

Introducing the Fisher-Price Newborn to Toddler Apptivity Device for iPad Device. It’s a bouncy seat, suitable for babies from about 1-4 months, with a handy swing-arm that holds an iPad right in their cute little baby faces. With a protective screen so they don’t goober it up, this is guaranteed to make 100% certain that your baby stares at a glowing  screen. Don’t let the name—“Newborn to Toddler”—fool you. This is a little infant bouncer, and no toddler is going to use this, and they’re not trying to sell it to toddlers. No, this is for basically our youngest babies. The ones who are supposed to be watching your face and smiling back at you. Instead, let’s plop ‘em in front of a screen. I’m sure that will work out well.

What, you say your infant prefers to lie down? Fisher-Price has got you covered. Here’s their Apptivity Gym for iPhone and iPod Touch Devices. That would also be appropriate if your baby doesn’t yet own an iPad. He could just use his phone.

Both of these “Apptivity” things come with, you guessed it, apps. They’re designed by “child care experts” to turn your baby into a screen-obsessed zombie. Well, admittedly, the Fisher-Price site doesn’t exactly say that, but sometimes you have to read between the lines.

Now, I’m not saying that Fisher-Price wants to kill your babies, or rob them of the precious and irreplaceable joy of normal childhood development. No sir. I didn’t say that at all. So no Cease-and-Desist Letter is necessary. What I am saying is that our babies need better than this. They don’t need a screen mounted in front of their faces, blocking their view of the world they’re supposed to enjoy, master, and inherit. They need love, and touch, and human interaction, and someone to smile back at them when they blow a raspberry. They need parents, not iPads, and not this kind of crap from Fisher-Price.

An evil in your home

April 5, 2011

The Pediatric Insider

© 2011 Roy Benaroch, MD

What if there were one sinister thing in the bedrooms of your home—an evil, odious thing that not only contributes to childhood obesity, but also to school failure, depression, and social isolation? Its wickedness not only damages your children, but affects you as well: it interferes with marital intimacy, promotes divorce, and by interfering with sleep can make it difficult to drive safely and perform well at work.

Ready to get out the torches and pitchforks? Ready to get rid of this hideous monstrosity, this malevolent, hateful force that sickens children and their parents, ruining health, marriage, and careers?

The sad irony: there’s nothing good on, anyway.

Get those things out of your bedrooms, and your children’s bedrooms. You’ll be glad you did.

Television, ADHD, and other bad things

September 28, 2009

The Pediatric Insider

© 2009 Roy Benaroch, MD

Steve wanted to know: “I have a 16 month old and I was wondering how much television watching is too much? Also I heard too much TV viewing can lead to ADHD. Is this possible?”

I’ve written about television a few times before—about its association with depression in teens, and why having TVs in bedrooms is a bad idea. Studies such as this one also seem to tie excessive TV watching to symptoms of Attention Deficit Hyperactivity Disorder (though other authors dispute those findings.) The association of TV with ADD seems especially strong if televisions are kept in children’s bedrooms. However, it’s not really clear that excessive television actually causes ADHD—it could be the other way around. A hyperactive, difficult-to-control child may be offered more “screen time” by exhausted parents. Or maybe the association is even less direct. We know that ADD and ADHD run in families, and we know that parents who watch a lot of TV tend to have children who watch a lot of TV, so maybe the excessive TV watching reported in children with ADD just reflects a family habit rather than anything that’s really causing anything else.

There are plenty of reasons to limit television time for children. Besides issues including teen depression and ADD, excessive television watching is also associated with a poor diet choices in preschoolers, more fast food consumption, and difficulty with sleep. Reducing TV time can also both prevent and treat obesity in children.

Need more reasons to turn off the set? How about delayed speech development (also here) in children who watch excessive TV, or an increased risk of psychological disease? Or a greater likelihood of unplanned teenage pregnancy and high blood pressure? I also found studies linking television with an increased risk for asthma and poor bone mineral content. I’m sure there are even more negative associations, but I’ve read enough to convince me many times over: television and especially young children are not a good mix.

Current guidelines from the American Academy of Pediatrics suggest no television at all for children less than 2 years of age, and not more than 1-2 hours per day of quality, non-commercial television entertainment for older kids. The current average screen time (adding television, video games, computer time, etc) for an American child is over six hours a day—more time, on average, than they spend in school. You can quibble over the exact amount that is “OK”, but clearly there is far too much TV now, and less of it would be a very good thing.

Besides, there isn’t anything good on, anyway.