Children and Adolescents and Digital Media – Summary of AAP Recommendations

This blog is a thorny subject for many families – use of tech and amount of screen time. It first appeared in Quora.

Research into the impact of limiting screen time in children and adolescents is in it’s infancy. Excuse the pun.

However, an excellent Technical Report by the American Academy of Pediatrics (AAP) was just published and is probably the best guide to parents on the matter.

The AAP recommends a Family Media Plan. Do you use one?

Children and Adolescents and Digital Media, Yolanda (Linda) Reid Chassiakos, Jenny Radesky, Dimitri Christakis, et al

We have summarized the main contents of the report – where context allowed, we used direct or slightly adapted quotes from the article. A PDF of the article is available at the link above and I recommend viewing it if you have a particular interest. Uncontrolled use of social media appears harmful, and it is worth considering the other good and bad outcomes linked with digital media in general.

Preschool Children

The Good

AAP discourages media exposure for children younger than 2 years based on research on TV and videos, which showed that in-person interactions with parents are much more effective than video for learning of new verbal or nonverbal problem-solving skills.

Video chat (eg, Skype or Facetime) for short duration with parental support is OK for infants and toddlers.

High-quality TV programs (eg, Public Broadcasting Service [PBS] programs, such as Sesame Street and Mister Rogers’ Neighborhood) can demonstrably improve cognitive, linguistic, and social outcomes for children 3 to 5 years of age. For families who find it difficult to modify the overall amount of media use in their homes, changing to high-quality content may be a more actionable alternative.

As content from PBS high-quality programs is translated into apps and game formats (eg, Martha Speaks, Big Bird’s Words, and Cookie Monster’s Challenge apps), educational benefits have been shown in preschoolers. Unfortunately, very few of the commercially available apps found in the educational section of app stores have evidence-based design input with demonstrated learning effectiveness. Apps designed for joint adult-child use and that have automatic ‘stops’ hold promise but are not commonly used.

The Bad

An earlier age of media use onset, greater cumulative hours of media use, and content that is not of high quality all are significant independent predictors of poor executive functioning (impulse control, self-regulation, mental flexibility).

Strong associations between violent media content and child aggressive behavior have been clearly documented.

A recent study of 2-year-olds found that body mass index (BMI) increased for every hour per week of media consumed.

School-Aged Children and Teens

The Good

Digital media can increase collaboration and tolerance in older children. The media can also enhance access to support networks for children with ongoing conditions as well as those with differing gender identities.

Reducing media consumption in older kids has been shown to reduce BMI.

Parent media use is a strong predictor of child media habits and parents have an important role in creating ‘unplugged’ zones and times in their households.

The Bad

Children are more likely to be overweight if they have 2 or more hours media use per day, a TV or equivalent in their bedroom. Adolescents who have higher uses of social media or who sleep with their mobile phones in their bedroom are at greater risk of sleep problems. Studies have found associations between media use in bed before sleep, sleep difficulties, and symptoms of depression in teenagers. The problems appear to worsen with later media turn-off times and number of devices in the bedroom. A ‘dose-response’ relationship has been discovered between daytime and bedtime use of electronic devices and sleep duration.

Adolescents frequently access depictions of risky behaviors on their media devices and a growing body of evidence suggests that peer viewers of this content are influenced to see these behaviors as acceptable and desirable. There are also numerous web sites that promote unhealthy behaviors or even offer life-threatening advice to vulnerable adolescents.

Research has suggested a U-shaped relationship between Internet use and depression, with increased risks for depression at both the high and low ends of Internet use. Passive use of social media has also been linked to a decline in wellbeing, whereas those who actively use it to post content did not experience this decline.

Cyberbullying is the focus of increased research and is known to lead to short- and long-term negative social, academic, and health consequences, including an increase in suicidal thoughts and attempts.

Teenagers who engage in ‘sexting’ are at increased risk of a greater number of sexual partners, depression and substance misuse.

Child pornography and abuse has increased with the help of anonymous cyberspace sites (‘the dark net’). Children who have had online sexual images of themselves posted online experience an increased risk of anxiety and depression. Sexual grooming tends to involve adolescents rather than very young children.

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