We see it firsthand in the waiting room and treatment room. Mobile devices are often the tool parents have on hand to occupy or soothe their restless child waiting for an appointment. They’re also a common distraction and welcome reprieve for overwhelmed parents. Children engage in digital media more than nearly any other activity and we know that excessive media use is associated with lack of sleep, school problems, obesity and aggression (Rideout, 2015). A child’s Digital media use is influenced by how caregivers use media around their children, how family rules are implemented and how they consume and discuss media with their children (Coyne, 2017). Conversely, a child’s temperament can impact parental allowance of screen time. Babies who have poorer self-regulation are more likely to later exceed AAP media guidelines. (Thompson, 2013).
Setting rules regarding media time and content as well as co-viewing and engaging in parent-child conversations about the media that a child consumes are beneficial to social and cognitive development. These strategies can also decrease the negative impacts of media consumption. (Collier, 2016)
Primary care practitioners are in an important position to offer guidance to families on healthy media use starting in early childhood through adolescence. For young children, remind parents that children learn best through communicating with their caregivers with back and forth interactions. Passive consumption of media can take away from play time and talking. For older children and adolescents, advise caregivers that the same parenting practices apply in their child’s virtual world experiences as they would in their real-world experiences. For example, setting clear and consistent limits, knowing what apps and content the child is exposed to and who they are interacting with. It is also important to emphasize that children will mimic a parent’s media use and parents can set a powerful example by limiting their own use and showing their child how to be responsible on-line. Family media plans (link: https://www.healthychildren.org/English/media/Pages/default.aspx) are a great way for caregivers to conscientiously set goals and limits around media use in a way that works for each unique family situation.
Below are some useful resources for primary care clinicians and families to guide healthy media use:
The American Academy of Pediatrics (AAP) Media and Children Communication Toolkit: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/Media-and-Children.aspx
Why to Limit Your Child’s Media Use (AAP): https://www.healthychildren.org/English/family-life/Media/Pages/The-Benefits-of-Limiting-TV.aspx
Kids & Tech: Tips for Parents in the Digital Age (AAP): https://www.healthychildren.org/English/family-life/Media/Pages/Tips-for-Parents-Digital-Age.aspx
When Should You Get Your Kid a Phone? (Child Mind Institute): https://childmind.org/article/when-should-you-get-your-kid-a-phone/
Common Sense Media: reviews for what your kids want to watch (before they watch it): https://www.commonsensemedia.org/
Collier KM, Coyne SM, Rasmussen EE, et al. Does parental mediation of media influence child outcomes? A meta-analysis on media time, aggression, substance use, and sexual behavior. Dev Psychol. 2016;52(5):798–812pmid:26914217
Coyne, Sarah M., Radesky, Jenny, Collier, Kevin M., Gentile, Douglas A., Ruh Linder, Jennifer, Nathanson, Amy I., Rasmussen, Eric E., Reich, Stephanie M., Rogers, Jean. Parenting and digital media. Pediatrics. 2017: 140 (Supplement 2). Available at https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S112.full.pdf
Rideout V. The Common Sense census: media use by tweens and teens. 2015. Available at: www.commonsensemedia.org/research/the-common-sense-census-media-use-by-tweens-and-teens. Accessed January 15, 2015
Thompson AL, Adair LS, Bentley ME. Maternal characteristics and perception of temperament associated with infant TV exposure. Pediatrics. 2013;131(2). Available at: www.pediatrics.org/cgi/content/full/131/2/e390