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How to help families determine if social media may be problematic for their child

October 12, 2021

The Wall Street Journal published a series of articles in September about leaked Facebook documents that caused quite a stir. Slides from internal presentations showed that researchers had asked teens about their experiences on Facebook's image-sharing app Instagram. Nearly one-third of teen girls said Instagram contributed to their negative body image, and 6% of U.S. girls reported they had thoughts of self-harm based on their Instagram experiences.

According to The Wall Street Journal articles, it appears Facebook leaders were made aware of these concerns but did not act. Furthermore, Facebook internally talked about tweens as a “valuable but untapped audience” that could help grow profits.

This may be upsetting to pediatric providers, who see children with eating disorders and self-harm far too frequently and who feel an ethical obligation to protect the interests of children as a vulnerable population.

So, what can you say to families to help them make decisions, even when the tech industry isn’t playing fair?

Since each child has a different experience on social media, there is no one-size-fits-all approach. Many teens mainly have neutral or positive experiences, finding social support or civic engagement, while others struggle more. Here are a few points you can make during office discussions to help families determine when a social media platform may be a problem for their child:

  • One important take-away from the Instagram research was that image-based social media can have a powerful effect on vulnerable teens. Instagram’s focus on appearance, with face filters and image editing, attracts influencers, diet and exercise content, and unrealistic body ideals. Teens with body image concerns and eating disorders may want to avoid Instagram and other appearance-focused social media or at least check in frequently about how it is making them feel.
  • On any social media platform, more extreme or attention-grabbing content is likely to trend and wind up in children’s algorithmic feeds. Therefore, users must stay alert for stereotypes, misinformation and inappropriate content.
  • Teens who voluntarily take a break from social media say that it gives them a clearer perspective about why they use it and how it makes them feel.
  • Social platforms have done a poor job of protecting teens, and governments are starting to intervene. For example, Instagram used to allow strangers to contact teens through direct messaging with inappropriate sexual content (, and Facebook allowed targeting of teens by interests such as extreme dieting ( Laws in the United Kingdom are eliminating these practices. While the U.S. has been slow to regulate tech companies, The Wall Street Journal articles led to Senate hearings on how Instagram can harm teens.

Social media can be a tricky topic for families to discuss candidly, but children and adolescents shouldn’t be navigating the waters without a parent’s help and oversight. Pediatric providers can spur parent-child discussions by asking these types of questions during office visits:

  • What are your strengths and challenges that might make social media more or less of a problem for you (or for your parent)?
  • Do you ever feel like social media feeds you a distorted sense of what’s normal? Of beauty? Of what’s important in life? Are you good at identifying when that happens?
  • Have you tried to take a break from social media when it’s feeling too toxic? What happened?
  • Who can you talk to in your family when you see disturbing things on social media or stuff you’re not sure about?

These conversations need to happen over time, so follow-up is essential.

If patients are considering starting a social media account, here are some options to suggest:

  • If the goal is social connection with friends: Try using video chat (FaceTime, Skype) and text messaging first. These approaches may not be drama-free, so these tools still need monitoring.
  • If the goal is sharing creativity and getting inspiration: Apps like PopJam (for 7- to 12-year-olds) and LEGO Life (for children under 13) allow sharing of creativity without showing the child’s face or private information.

The social media landscape is changing constantly, so encourage parents to be informed and keep the conversation going.

Dr. Radesky is a chair-elect of the AAP Council on Communications and Media Executive Committee.


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