Last Monday, the American Academy of Pediatrics released an updated policy statement on screen-time guidelines for children, including the recommendation to make a “family media use plan.” Although the AAP has been criticized (usually by parents or journalists) for its “draconian” recommendations to limit screen time to no more than 2 hours/day for school-age children and teens and to discourage it altogether for children less than two, there’s a growing body of research that support these guidelines. Few parents follow them, and in my experience have never heard them (from their pediatrician or anyone else).
Recently, a large study conducted by Iowa State University followed over a thousand children for 13 months and examined television and video game habits (separately and together). They found screen-time was associated with subsequent attention problems for both television and video games, and, importantly, that children who engaged in more than two hours of daily screen-time were indeed at higher risk for developing attention problems. Although there are many studies demonstrating screen-time’s health effects, this study actually provides support that the “2 hour” rule isn’t arbitrary.
Let’s go over the recommendations; I’ve added some comments in italics:
Recently I asked a family to remove the television and Xbox out of their son’s bedroom. He’d been drawing gruesome pictures at school and telling scary stories that disturbed the other children. We’d already removed all the horror movies and video games, but he continued the behavior and was about to become expelled. Finally, after discussing the subject on multiple occasions over many months, the parents agreed to remove the TV and Xbox out of his room.
Why is this intervention met with such resistance, even in the face of dire consequences? I suspect it’s become such the norm that the idea seems radical. Regardless, it’s important to appreciate that studies show light-at-night devices are linked to poor sleep, depression, and impaired cognition. And as you might guess, sleep disturbances in children and teens are at an all-time high.
All children and teens need to hand their phones over before bedtime, and preferably by sundown to limit light-at-night exposure. Do NOT trust that your child or teen won’t use their phone at night (they’ll try to convince you otherwise); they simply don’t have the capacity to self-regulate their use.
If you have tips about managing screens in your household, please share them by commenting. Also, forwarding this article to others (your child’s friends’ parents, teachers, coaches, etc) helps promote awareness at the grassroots level.
 Edward L Swing et al., “Television and Video Game Exposure and the Development of Attention Problems,” Pediatrics 126, no. 2 (August 2010): 214–221, doi:10.1542/peds.2009-1508.
 Council on Communications and Media, “Children, Adolescents, and the Media,” Pediatrics (October 28, 2013), doi:10.1542/peds.2013-2656.
 Takeshi Munezawa et al., “The Association Between Use of Mobile Phones after Lights Out and Sleep Disturbances Among Japanese Adolescents: a Nationwide Cross-sectional Survey,” Sleep 34, no. 8 (August 2011): 1013–1020, doi:10.5665/SLEEP.1152.
 Christina J. Calamaro, Thornton B. A. Mason, and Sarah J. Ratcliffe, “Adolescents Living the 24/7 Lifestyle: Effects of Caffeine and Technology on Sleep Duration and Daytime Functioning,” Pediatrics 123, no. 6 (June 1, 2009): e1005–e1010, doi:10.1542/peds.2008-3641.
 Council on Communications and Media, “Media Use by Children Younger Than 2 Years,” Pediatrics 128, no. 5 (November 1, 2011): 1040–1045, doi:10.1542/peds.2011-1753.