For reference in this article:
“Screens” or “electronic media” = visualization/interaction with any glowing rectangle, ie- TV, tablet, computer, phone, video game.
The harmful effects of excessive and inappropriate electronic media use cannot be overstated. Increased risk of obesity has been related to passive TV viewing, as is having a TV in the bedroom. Sleep disruption is also a consequence of having electronic devices in the bedroom and of using screens before bedtime.
Behavior and mental health risks are present with certain exposures – viewing sexual behaviors, substance use including alcohol and tobacco use, self-injurious behaviors or disordered eating can make these behaviors seem normative or even desirable and may be associated with earlier initiation of risk-taking behaviors. The Netflix show “13 Reasons Why” was associated with a 28.9% increase in suicide rates in youth 10-17 years old in the U.S. during the month following the show’s release in 2017.
The internet can magnify real-world struggles and leaves a permanent reminder or “digital footprint”. Social media provides another avenue for bullying and exploitation. Children used to be “safe” at home, but cyberbullying can occur at any time and perpetrators can be anonymous. With the ability to post images or thoughts, privacy is reduced, and removal of shared content may be difficult or impossible. Sexting, the electronic transmission of nude/ seminude images or sexually explicit texts, is not uncommon among adolescents.
Displacement of normal activities can occur as electronics can be so stimulating and exciting that it may limit what children will want to do in the real world- going outside to play, interacting with family members, joining clubs or sports, doing homework. Fortnite (i.e. Forntnite: Battle Royale) is an example of a compelling video game that some youth seem to play obsessively. It is a first-person shooter game that has been described as Minecraft + Hunger Games and is actually rated “Teen” but played by many children who are much younger. One of the biggest draws of Fortnite is its social component as kids can play with a friend or in a squad of friends. This frequently competes with parental expectations – kids don’t want to miss out on social interactions with friends that are occurring online and don’t want to abandon their squad when told to stop playing.
Of course, there are also many benefits to electronic media use and other factors are involved in answering the question of how to set limits around electronic use. Social media platforms can provide exposure to new ideas and information. Students can research topics of interest and collaborate online with others on assignments and projects. The use of social media helps families and friends communicate and enhances access to valuable support networks, which may be particularly helpful for people who have physical or mental health issues. Social media can also be used to enhance wellness and promote healthy behaviors, such as smoking cessation and balanced nutrition.
Here are the recommendations by age regarding media exposure and use:
< 18-24 months old: For 20 years now, the American Academy of Pediatrics (AAP) has stated and continually reaffirmed that electronic media has no known positive effects and potentially has negative effects for children younger than 2 years. Infant and toddler programming is marketed to make your child as smart as “Einstein”, but babies and young toddlers do not learn from electronic media. It takes around 18 months for a baby’s brain to develop to the point where the symbols on a screen come to represent their real-word equivalents. Babies and toddlers learn from unstructured playtime and 1:1 interaction with family members or other nurturing adults. They need to touch things, manipulate them, see the faces and hear the voices of those they love. (The only exception for media use would be for video chatting with distant loved ones). In addition to not being beneficial, screen time before age 18 months may have negative effects on the development of language, reading and short-term memory. Even having the TV on in the background is distracting for the child being able to play and think creatively and independently. It also gets in the way of the adult’s attention and communication with their child. When a toddler is around, a parent typically speaks about 940 words/ hour but when the television is on, that number falls to less than 200. Since children’s language development is affected by the amount of language they hear from parents, just having the TV on in the room where the parent and child are spending time can be harmful to development.
18 months-2 years old: For parents who want to introduce digital media to their children, choose high-quality programming and watch it with your children to help them understand what they are seeing and re-teach in the real world around them. Keep in mind that excess screen time displaces critical talk and play time. Toddlers are also learning to pay attention for prolonged periods, and those who watch more TV are more likely to have problems paying attention at age 7. Electronic screens are constantly changing, constantly interesting, and almost never force a child to deal with the need to wait or sustain attention.
2-5 years old: Limit screen use to 1 hour of high-quality programming, preferable co-viewing. During the preschool years, children can learn some skills from educational media. Well-designed shows can teach kids literacy, math, science, and prosocial behavior. Children get more out of interactive programs (ex-Sesame Street) when they answer the characters’ questions.
5-18 years old: Two important aspects to media use in school aged children and adolescence is to have balance with other activities and parental involvement in what media is being used. There is no specific number of hours that are “too much” as many factors contribute to what would make electronic media use a problem.
Research has suggested an increased risk of depression with extremes of internet use (very low use and very high use) showing a U-shaped relationship between Internet use and depression. It has also been shown that older adolescents who used social media passively (viewing others’ photos) reported declines in life satisfaction, whereas those who interacted with others and posted content did not experience this.
As with younger children, parent media use can also be a problem. Parental engagement is critical for their children’s emotional and social development, and electronic media distractions may interfere with this. Parents also need to remember that they are role-models for their children 24/7, media use included.
In summary, parents need to be involved in their children’s media use and set limits. The following guidelines from the AAP are recommended including the development of a Family Media Plan (www.HealthyChildren.org/MediaUsePlan) ensuring adequate sleep, physical activity (at least 1 hour per day) and time away from media. The “media time calculator” is helpful for prioritizing these activities.
1. Parents should place consistent limits on amount of media use and what types of media are allowed.
2. It is not recommended for anyone to have a TV in their bedroom or sleep with an electronic device (TV, computer, smartphone) in their bedroom. Avoid exposure to electronic screens for 1 hour before bedtime.
3. Discourage entertainment media while doing homework
4. Designate media-free times together (family dinner) and media-free locations (bedrooms) in homes.
5. Help select and co-view media with your child and have ongoing communication with children about rules of the internet- expect the same behaviors (appropriate language use, no bullying, don’t talk to strangers) that you would offline.
6. Parents and/or other family members should “follow” or “friend” their children on social media.
Here is a graphic to help remember the defined media guidelines.
With respect to content, Common Sense Media (www.commonsensemedia.org) is an invaluable resource where parents can look up ratings and reviews for books, TV shows, movies, video games and apps.
“Media Use in School-Aged Children and Adolescents” – Pediatrics November 2016
“Media Use by Children Younger Than 2 Years” – Pediatrics November 2011
Article by: Dr. Sharon Richter, Annapolis Pediatrics
About Annapolis Pediatrics:
For 70 years, Annapolis Pediatrics has provided superior healthcare to infants, children, adolescents, and young adults in Annapolis and the surrounding communities. In some cases, we have cared for three generations of families. We strive to provide high quality medical care, from excellent clinical care to a positive customer experience for our patients and their parents.
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