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Technical report on youths’ digital media use answers 25 clinical questions :

October 21, 2016

It’s not just television and movies any more. It’s computers, smartphones, tablets, social media, blogs, vlogs, texting, sexting, video games and virtual reality.

A 2015 study showed that most 2-year-olds used mobile devices on a daily basis, and 92.2% of 1-year-olds had already used a mobile device. Furthermore, three-quarters of teenagers own a smartphone, 24% of adolescents describe themselves as “constantly connected” to the internet and 50% report feeling “addicted” to their phones, according to a 2016 survey.

Even parents young enough to be “digital natives” themselves are worried about how to guide their children in this new digital media world and ensure the risks of media use and overuse are avoided.

With digital media available at home, at school and at work, it’s helpful for pediatricians and parents to learn about the risks — and the benefits — of media for children, teens and families. The AAP Council on Communications and Media has authored the technical report Children and Adolescents and Digital Media that reviews the latest research studies about modern media and updates pediatricians and parents on how to navigate safely through this evolving media universe. The report is available at and will be published in the November issue of Pediatrics.

The report highlights 25 of the most common questions pediatricians ask about digital media. Among the topics addressed are changes in media use by children and teens, how advertisers reach children, whether apps and e-books are educational, behavioral risks of media use in early childhood, and how media use affects youths’ physical and mental health.

Along with two new related policies (see related content below), the report also recommends that pediatricians and parents use the new AAP Family Media Plan to develop guidelines that are specific to each child and each family for safe and healthy engagement with a breadth of media.

Media are not all bad but risks remain

New media can provide benefits. Because these platforms are interactive, children and teens can use them to learn, connect and communicate with family and friends, and engage in creative activities. The key is “moderation” and balance; media use should not replace or displace other activities that promote healthy development and wellness.

Research has shown that increased sedentary media use (over 1 to 1½ hours a day) is a risk factor for the development of obesity. Children and teens need at least one hour of dynamic physical activity each day. Furthermore, screen time in the hour before bedtime can interfere with healthy and sufficient sleep, and negatively impact school performance.

Excessive media use also has been associated with challenges such as isolation, victimization, depression and internet addiction. Unmonitored media use can leave children and teens vulnerable to online predators or allow them to make unwise decisions such as sharing inappropriate texts, videos or photos.

How to use media appropriately

The Family Media Plan allows pediatricians and parents to work together to design a plan for the whole family that addresses how much media are used and what behaviors are appropriate for each child and teen.

Children under age 2 learn best by interacting with the world around them and engaging in face-to-face communication. Aside from the occasional family video chat, there’s no need to begin media use early.

Three- to 5-year-olds benefit most by engaging with high-quality educational media with a parent or caregiver who reads, interacts and/or plays along.

Parents can be valuable “media mentors,” guiding older children and teens on practicing online citizenship and safety, treating others with respect, avoiding cyberbullying and sexting, being wary of online solicitation, and avoiding communications that can compromise personal privacy and safety. Parents also should be good role models by balancing their own media use with other activities.

Pediatricians can serve as a resource for families seeking advice on how to develop a Family Media Plan tailored to their needs and provide information about the benefits and risks of traditional and new media.

Dr. Chassiakos is a lead author of the technical report and a member of the AAP Council on Communications and Media Executive Committee.

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