Monday, October 28th, 2013
The American Academy of Pediatrics (AAP) has issued new guidelines on kids’ screen time – some of which will become incorporated in the well-child visit with a pediatrician. Here’s a breakdown of the key things to know:
Why Issue New Guidelines Now? It’s been over a decade since the AAP issued formal guidelines – so the current “2-hour” limit on screen time is quite dated. As noted in the AAP report, media use is a “dominant” force in kids lives. School-age kids may be spending 8 or more hours looking at a screen – teens might spend close to 11 hours a day. Some of this is productive time, some of it should be avoided. Thus, new guidelines are offered to help parents regulate screen time and give their kids a platform for making good choices to use screen time wisely.
What Are The Two Key Issues For Parents? Pediatricians will be counseled to ask parents two questions during well visits:
- How much recreational screen time does your child or teenager consume daily?
- Is there a television set or Internet-connected device in the child’s bedroom?
Let’s start with “recreational screen time.” It’s acknowledged that kids now use screen time for a variety of purposes – including educational ones. So rather than have an arbitrary number of total “screen time” hours as a guideline, the purpose here is to regulate and limit recreational time. Here the less than 2 hour rule will apply, which is more than reasonable. Kids need to spend time doing other things – like moving their bodies. Trying to cap recreational screen time is realistic and sensible.
The issue of screen time in a kid’s bedroom follows the same principle. Clearly some kids are doing homework in their room and will be using a computer. The point here is to develop some consistent and good practices – especially establishing a rule for turning off the electronics well before bedtime. Using technology is not a good way for kids to unwind and prepare for sleep – and we know that many kids do not get enough sleep. So while having screens in bedrooms – especially with mobile devices – may be common (though not necessarily endorsed), using them right up to bedtime should not be a common practice.
What About Babies? The AAP still does not love the idea of babies staring at screens. Nearly any professional who studies babies will tell you that they need to look at faces, hear voices, and interact with people a lot. This is not going to happen if parents are preoccupied with their mobile device while baby plays with a tablet. So the bottom line is to discourage (not ban) screen time for babies – specifically kids under 2 years of age. It may be added as a corollary that interactive time with baby is more than highly encouraged.
How Do You Make All This Happen? Pediatricians will suggest making a family home use plan for all media, keeping these recommendations in mind. This is a very solid idea, given how much time many of us spend with technology, especially mobile devices that become omnipresent. It will be important to come up with a realistic and enforceable plan for your family and your kids that considers the when and where and how of screen time – including a plan for becoming familiar with and monitoring the content of what your kids are watching. Having some type of plan – and these sensible suggestions to follow – can help parents proactively manage screen time at a time when it is, indeed, “dominant” in our society.
What career will your kiddo have? Take our quiz and find out! Plus, check out our 10 favorite apps for preschoolers.
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Tuesday, April 9th, 2013
A new study published in Pediatrics suggests that it may be, at least when it comes to risk for obesity.
WHAT DID THE STUDY DO?
91 teens (45 girls) around 14 years of age responded multiple times a day – via an electronic diary – to questions about what they were doing, over a 1-week period. Included were questions about a variety of screen time activities (for example, TV, video games, computer) and how much attention they were paying to each activity. Electronic diaries are an excellent method for getting kids to report on what they are doing in “real time” – it’s quick and easy for them to do and studies have shown that they provide reliable data using this method. The kids also had their height and weight measured by the research team in order to calculate their body mass index (BMI) – which is one metric used to measure risk for obesity.
WHAT DID THE STUDY FIND?
The overall findings were intriguing. First, the raw amount of screen time reported by the kids was not associated with their BMI. The statistical association of interest involved TV, but again it wasn’t about how much TV the kids were watching. Rather, it was how engaged the kids were when watching TV that was associated with BMI – the more a kid reported that they were paying the MOST attention to TV (versus all other activities), the higher their BMI.
WHAT DOES THE STUDY MEAN?
There are limitations to the study design that need to be addressed. The most prominent is that each teen was only observed during the 1-week period (this was a “cross-sectional” study). Finding statistical associations in a cross-sectional design limits what we conclude because we can’t tease apart what leads to what. It could be that kids with the highest BMI levels were the most likely to become engaged in TV viewing. It could be that TV viewing was one of the causative factors for their increased BMI levels. The point is that with these kinds of data we can’t distinguish between those interpretations. And of course we don’t have data on younger kids from this study, so technically there are no inferences to be made on non-teens.
WHAT SPECULATIONS CAME OUT OF THE STUDY?
Noting the limitation discussed above, researchers use cross-sectional data to generate and support hypotheses to be tested in future studies. The interesting idea that comes out of this paper is the speculation on the specific health risks associated with TV viewing versus other forms of screen time. One deserves particular mention. They note the potential impact of commercials promoting unhealthy foods – which may be particularly influential for kids who are highly engaged watchers. What’s interesting here is the idea that it’s not just about screen time, and it’s not just about TV – it’s about the specific risk of being a highly engaged TV viewer that seems to be linked with BMI. But future work will need to measure all these things and evaluate them longitudinally.
WHAT’S THE TAKE-HOME MESSAGE HERE?
Clearly this paper is the beginning, and not the end, of the story. The story, however, may be quite informative for parents if future studies replicate and expand the finding – and particularly if longitudinal studies provide clearer evidence of the directionality of the findings and support for the hypothesized mechanisms. Starting with younger samples of kids and tracking them across time will help determine if engaged TV viewing is especially linked with increases in BMI. But right now the interesting idea for parents to think about – at all ages – the potential downside of when kids get too attached to passive activities. This study suggests that TV may be the worst culprit for multiple reasons. But the bigger picture is that we are probably moving away from talking about screen time per se – many kids are increasing rather than decreasing screen time – and shifting toward a focus on unhealthy habits and unhealthy content that may be linked with specific types of screen time.
So … right now keep on eye on when your kid seems most likely to pair eating with screen time, and see if you can discourage that link. And see for yourself at home if it seems to happen more when they are especially glued to the tube.
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Thursday, February 28th, 2013
February 2013 was a busy month in the world of parenting – lots of things going on. Here’s a snapshot:
The news that an adult male slapped a stranger’s toddler on a plane led to a conversation about how our culture may be breeding, at a minimum, a lack of respect for our youngsters – and at worst, provide a context in which child-hating is tolerated.
Speaking of conversations, we had many about if we should use what we are learning about genetics to support genetic engineering, including targeting childhood psychiatric disorders. Then came news that new research suggests some genes might predispose to a number of forms of mental illness – but it’s not at all clear that this will move us closer to genetic solutions.
We always include applications of current research to help guide us decide on good parenting strategies. One study suggest how important it is to let your toddler – and not you – be the “boss” when you are playing. And compelling research showed how the simple act of turning off violent shows and replacing them with educational content – without limiting the amount of TV watched – is beneficial for kids.
BARRIERS TO SERVICES
We took on some key barriers to getting kids mental health services and broke them down in understandable turns. Now we all wait to see if sequestration is going to provide the biggest barrier of all.
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