Pediatricians Should Encourage a Family Media Use Plan to Manage Kids’ Screen Time

ORLANDO — Just as parents ought not let their children play unsupervised in vehicular traffic on the street, neither should they let them do the digital equivalent on the information superhighway. That's the message of a revised American Academy of Pediatricians policy statement released Oct. 28, at the AAP National Conference and Exhibition.

Many younger children and adolescents have few rules and little supervision of their media use, and the statement, "Children, Adolescents and the Media," provides pediatric health care providers with practical recommendations and advice to offer pediatric patients and their parents about safe, savvy, and sensible use of screens and the content on them.

"It's time for renewed commitment to change the way we address the media, and to keep up-to-date in this evolving media world, to not only try to mitigate the negatives that media can offer, but also to foster and promote all the positives," Marjorie Hogan, MD, FAAP, co-author of the AAP policy, said in a media briefing.

While media by itself is not the leading cause of any health problem in the United States, it can contribute to numerous health risks. Excessive media use has been associated with obesity, lack of sleep, school problems, aggression and other behavior issues. Nevertheless, media use can offer children and adolescents a wealth of positive information in addition to facts — it also can help teach empathy, racial and ethnic tolerance, and interpersonal skills. Thus, promoting a healthy "media diet" — helping children make good choices in their media consumption — is key, Hogan said.

The policy statement was published in Pediatrics online ahead of print on Oct. 28, and it will be included in the November 2013 issue of the journal. The policy statement replaces one issued in 2001.

The report also calls on pediatricians to work with the AAP and other groups to advocate for better research and more of it about how media exposure affects children. According to information supplied by the AAP, the average 8- to 10-year-old spends nearly 8 hours a day with different media, while older children and teens spend more than 11 hours per day. About 7% of 12- to 17-year-olds have their own cell phones, and nearly all teenagers use text messaging.

The statement includes these recommendations for parents:

• Parents can model effective "media diets" to help their children learn to be selective and healthy in what they consume. Take an active role in children's media education by co-viewing programs with them and discussing values.

• Make a media use plan, including mealtime and bedtime curfews for media devices. Screens should be kept out of kids' bedrooms.

• Limit entertainment screen time to less than one or two hours per day; in children fewer than two, discourage screen media exposure.

Also included arte these recommendations for pediatricians:

• Ask 2 questions at the well-child visit: How much time is the child spending with media? Is there a television and/or Internet-connected device in the child's bedroom? Take a more detailed media history with children or teens at risk for obesity, aggression, tobacco or substance use, or school problems.

 • Work with schools to encourage media education; encourage innovative use of technology to help students learn; and to have rules about what content may be accessed on devices in the classroom.

• Challenge the entertainment industry to create positive content for children and teens, and advocate for strong rules about how products are marketed to youth.

 • As the media landscape continues to evolve at a rapid pace, the AAP calls for a federal report on what is known about the media's effects on youth and what research needs to be conducted. The AAP calls for an ongoing mechanism to fund research about media's effects. 

—Michael Gerchufsky

For more information on children and the media from Consultant for Pediatricians:

• When Grandma Can't Monitor Online Behaviors, by blogger Linda S. Nield, MD

• Screen Time and the Sandman: Does Increased Screen Time Before Bed Delay Sleep Onset? By Chalanda Jones, MD

• Promoting Safe Use of Electronic Media, by David S. Reitman, MD

• Parent Coach: When Johnny Can't Sleep, by Heather Clawges, MD and Linda S. Nield, MD