The American Academy of Pediatrics released new guidelines for how children interact with digital media, doing away with its 2011 ban on any screen time whatsoever before age 2.
Hearing that news, 39-year-old Minneapolis mom Stacey Gunderson heaved a sigh of relief. Gunderson summed up the AAP’s former ban in one word: Impossible.
“Try. Just try,” Gunderson said. “No matter how good your intentions are, you cannot keep kids away from all screens all the time. It’s just not realistic.”
Dr. Ari Brown, a pediatrician and lead author of the original 2011 recommendation, feels the same way. That’s why for the past year, the AAP has been rigorously reviewing all available research into the possible risks and impacts associated with screen time for children of different ages. She hopes what the academy has come up with will give parents like Gunderson a better guide for how little ones should and should not interact with digital devices.
“It was too simplistic,” Brown said of the original recommendation. “The reality is, we want parents to look at a child’s day and carve out all things that need to happen and then say, here’s the rest of the time you have — if you’re using screens during that time, what are you doing with them?”
The new guidelines recommend avoiding screens for children younger than 18 months, except for video chatting via services like Skype or FaceTime, which researchers argued could help babies to facilitate social skills. For 18-24 months of age, digital media use is OK as long as a parent or guardian uses the media with them. For children ages 2-5, the academy recommends no more than one hour of media use per day.
But perhaps the most interesting thing about the new recommendation is that it recognizes that not all screen time is equal, and the idea of a child using a tablet or a smartphone means different things to different families, especially for families that are struggling economically.
The report seems to understand it has arrived at a uniquely troublesome moment when technology is becoming increasingly important to human life, even as doctors don’t yet know how deeply it may affect life. The Kaiser Family Foundation estimates that children between the ages of 8 and 18 spend about eight hours a day in front of a screen — a fact that has been associated with obesity, sleep disruption and a variety of developmental delays in children.
Yet, as the AAP said in a 2015 article it released just before it announced it would revisit its screen time policy, “Screen time is becoming simply time.”
Given that, Brown said, the new guide tries to do what every parent in America has to do every day: Figure out what’s best for individual children being raised in an environment that’s more media-driven than ever.
“Media is just one more environment your child is in, so where’s safe?” Brown said. “It’s important for parents to understand that’s a moving target.”
In the AAP’s new recommendations, healthy child development in the digital age depends heavily on the quality of content the child is exposed to.
Determining the quality of digital content can be extremely difficult for parents, said psychologist and author Jim Taylor.
“If the content is demonstrated to have value, like 'Sesame Street,' have that if you’re going to consume media,” Taylor said. “But let’s be realistic. Apps are developed to make money and they want to create dependence, if you will.”
Massachusetts General Hospital child psychiatrist Steven Schlozman agreed.
“There’s a vast differentiation in content quality, maybe even more for apps than for TV, because there’s so many of them,” Schlozman said. “At the end of the day, the purveyors of app content have a different agenda than consumers.”
Brown said that the main problem is apps can claim to be “educational” without offering any actual evidence it teaches kids anything.
“The latest studies tell us that there are more than 80,000 apps on the market that are educational — but are they?” Brown said. “There are no requirements to adhere to. No one is regulating whether or not anyone actually benefits from the app.”
This is why the AAP’s new recommendations put such an emphasis on parental involvement with childhood media use.
“I think that’s what I like most about the new recommendations,” Schlozman said. “If you emphasize parental involvement, what comes with that is they’ll approve the content for their kids using services dedicated to that. (Digital content review website) Common Sense Media is terrific at that.”
Schlozman also said that while he liked the AAP’s new guidelines, more research needs to be done to see how different technologies could potentially aid in child development.
“In our rush to demonize technology, we forget that it has amazing potential,” Schlozman said. “We just have to study it.”
Brown said the main takeaway for now is that young children (under age 2) are never to be left alone with a device. Parents are needed to ensure the content is good and to explain what they see on the screen.
“If you’re giving your child an alphabet app on your phone, are they going to get what the an ‘A’ is? That it makes an ‘A’ sound, as in apple?” Brown said as an example. “They may not be able to apply what they’ve seen in the app until a parent reinforces it with something like a magnet on the fridge and says ‘A.’”
If parental involvement is so important to safeguard children’s media diet, Taylor questions the use of digital media when a book would suffice without posing health risks.
“The AAP tried to cut parents some slack by emphasizing co-viewing like it’s OK for kids to be in front of a screen if a parent shares it with them,” Taylor said. “The reality is, parents use screens to free themselves up. If you’re engaging your kid, what do you need a screen for?”
Parenting with screens
While lots of parents use mobile devices to occupy their children, experts say that in many American households, screen use points to bigger problems.
Brown said AAP researchers also had eye-opening conversations about how digital media may keep children safe in many American households.
“For a child who has a single parent and doesn’t live in a safe environment, where there is no safe playground, the safest thing to do might be to play video games inside,” Brown said. “What do you say to that? That’s a hard place to be.”
For families struggling with poverty, letting the kids entertain themselves with a mobile device is sometimes a necessity.
“A lot of the families who use TV and digital devices to occupy their kids are doing it because they’re both working or they’re socio-economically challenged,” Schlozman said, adding that low-income households are also more likely to experience problems like obesity and developmental delays, which often correlate with excessive screen use. “Policies don’t always take into consideration the real challenges families have.”
One 2016 study the AAP study cited in its recommendations found that inappropriate content paired with minimal parental involvement had negative impacts on low-income preschoolers’ development.
This can become a vicious cycle, the AAP cited: Excessive media use is linked to behavioral issues and socio-emotional development delays, and children who exhibit temperament issues are more likely to be given a mobile device to calm themselves down, one study found.
For overworked families struggling to make ends meet or dealing with other problems, these situations can be a double-edged sword.
“Let’s say you’re someone who gets frustrated with a difficult toddler and the toddler calms down when they watch a video,” Brown said. “Is it better for that kid to get hit than to look at YouTube?”
It’s important for parents to know they’re not alone when trying to find alternatives to screen time in today’s world, Brown said. That’s why the new recommendations also include a helpful link for parents to go online and create a family media plan, tailored to each member of the family depending on their age.
Taylor said it’s a terrific tool that will give parents rules they can enforce, which he hopes will cut down on the time kids spend on screens overall.
“Digital media is quantitatively and qualitatively different from other media forms like TV — it’s addictive,” Taylor said. “These recommendations are all reasonable, but we also need more emphasis on alternative activities like free play and engaging with our kids without screens.”
Until the policy is reviewed again in another five years, Schlozman said there’s still a lot doctors need to know about how media use impacts kids, like how the developing brain changes as different technology is introduced, or what physically happens to a brain that binge watches TV shows regularly.
“We’re basically conducting a big experiment right now to answer these questions,” Schlozman said. “And we’ll have our answer in about 10-15 years.”