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As pediatricians, we monitor children’s height, weight, diet, healthy and risky behaviors, including smoking, drugs, alcohol and sex to get a sense of their general health. As primary care providers, we should also be monitoring a child’s media use because children and adolescents are now using media for more time each day than they spend in school or any other activity.
Excess screen time increases a child’s risk of obesity, social isolation and attention problems, and exposure to certain content may lead to risky behaviors, ranging from smoking to early sex, eating disorders, substance abuse and violence. These effects are real, measurable and reproducible. Yet media can also help build academic skills, reinforce learning, encourage social behavior and connect children with each other and the larger world.
Since 1985, the AAP has encouraged pediatricians to address media as a health influence, but only about a quarter of pediatricians assess or offer recommendations to families—a shortfall that becomes more pressing as media use starts earlier and engages more of children’s lives. Many of us are unaware of media’s powerful health effects as a leading cause of morbidity and mortality in our young patients. At Children’s Hospital Boston’s Center on Media and Child Health (CMCH), we have collected and posted the scientific evidence linking media use and children’s health at cmch.tv.
Some pediatricians don’t address their patients’ media use because they worry that families will resist advice or feel that there just isn’t enough time. Unexpectedly, many families are relieved that their trusted pediatrician is bringing up a subject about which they are worried, but have no idea how to address. Done correctly, a media assessment takes only a minute or two. It’s important to be non-judgmental and accept media’s positive potential while educating and empowering children and parents about risks. I talk to parents about managing their child’s media use like they manage meals or education. Parental expectations that the child will do what’s best for himself are very effective.
We help parents recognize that children learn from and are changed by the media they use. Recommend that the child limit his media use, focusing it on what he wants to learn. Media should not be used all the time or as a default, but a special experience that should be enjoyed as part of the child’s rich and varied activities if the essentials—homework, a family meal, physical activity and adequate sleep—are taken care of. With many children’s school schedules, there’s little or no time for media on weekdays, and weekend media use should be limited to one or two hours so the child can pursue other activities. Whether they are surfing the Web or watching TV, children’s media use should be in public, rather than behind closed doors in their bedrooms, where parents can monitor and interact with them, helping them learn, and protecting them from harm.
In support of your efforts to help children stay healthy in the constantly evolving media environment, CMCH has information and strategies, a free e-newsletter and an online advice column at AsktheMediatrician.org for physicians, parents and caretakers. We answer questions about cell phones, video games, TV or the Internet with evidence-based, accessible ideas on how to use media in healthful ways. There’s no longer any reason to avoid what may now be the most powerful and pervasive health influence on the children and adolescents for whom we care.
—Michael Rich, MD, MPH, director of CMCH
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