ABCs of Child Psychiatry

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New Limits for Child Screen Time: Two Hours or Too Naïve?

Your pediatrician may have some tough recommendations for you.
Polly Palumbo, Ph.D.
This post is a response to Screen Time Gets a Time Out, Again by Polly Palumbo, Ph.D.

According to a new position paper by the American Academy of Pediatrics (AAP), children and teens spend a truly astonishing amount of time watching TV, playing video games, and using social media. The report cites previous studies showing that the total time per day using media for entertainment purposes rises from about 8 hours per day in 8-10 year olds to a stunning 11 hours or more in teens (it is hard to figure out the math for that one while still leaving time for school).   Over 70% of youth reportedly have a television in their room with even more having access to an internet connected phone or tablet.  As many parents of teens already know, texting 50 to 100 times per day is now commonplace to the point that it seems like the last thing teens use a phone for is to talk.  Adolescents also report that they typically have no clear rules about media use from their parents (although parents tend to give a slightly different account).  The authors of the study state that these concerns are balanced by evidence that the some forms of media can be positive and may enhance learning and social interactions.

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In response to these numbers, the AAP issued new guidelines about child media use. The guidelines recommend that pediatricians, when seeing families in their practice, ask two specific questions about media usage to the parents, namely  1) How much recreational screen time does your child or teenager consume daily? and 2) Is there a TV set or an internet connected electronic device in the child’s bedroom? 

The report also issues specific recommendations doctors should convey about media use for children and teens:

  • Total media use should be less than 2 hours per day
  • Children under age 2 should be discouraged from any media use
  • TVs and internet connected devices should not be in youth’s bedroom
  • Media use should be monitored and discussed, and
  • Family rules about media use, such as no usage during meals, should be made and modeled by parents

Getting less press attention but also contained in the article are also recommendations that primary care clinicians become more actively involved in educational and political groups to advocate for specific policies and laws, such as banning alcohol advertisement on television (which the kids wouldn’t be watching so much anyway if adhering to these guidelines).

Following the release of these guidelines, many parents responded online with some skepticism that such limits can be realistically followed.  For some, it is a matter of whether or not such guidelines make sense as technology becomes more and more an essential part of life.  For others, it is a matter of simple enforceability.   As one person commented, "Good luck with that!"

Indeed, a potential danger is that parents will dismiss the guidelines altogether rather than try to enforce attainable limits even if they fall somewhat short of the specified numbers.  The authors have commented themselves that the recommendations are not meant to be rigidly followed each day but are rather benchmarks that can be more flexibly applied.  A previous post from  Dr. Polly Palumbo asks a very good question.  Why two hours?  What not one or three?  I posed this question to lead author Dr. Victor Shasburger, who responded by saying that the limit comes from a number of studies that indicate that many of the negative behaviors linked to excessive media use tend to show up around that cutpoint.  “We didn’t just make it up,” he added.

Public health messages tend to be made as simple as possible to avoid confusion. Thus, while it is easy to criticize the “one size fits all” approach to the guidelines that don’t differentiate between, for example, a 3- and a 17-year-old, there is an understanding that some degree of customization will be necessary.  If these quite remarkable statistics are true, however, any concerted effort to bring media use into greater balance is a welcome enterprise, with primary care clinicians needed to support children and families to make healthier choices.

@copyright by David Rettew, MD

Image courtesy of imagerymajestic and freedigitalphotos.net

David Rettew is author of Child Temperament: New Thinking About the Boundary Between Traits and Illness and a child psychiatrist in the psychiatry and pediatrics departments at the University of Vermont College of Medicine.

Follow him at @PediPsych and like PediPsych on Facebook.

David Rettew, M.D., is a child psychiatrist at the University of Vermont and author of Child Temperament: New Thinking about the Boundary between Traits and Illness.

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