In 2016, the American Academy of Pediatrics published recommendations for children’s media use that strongly recommended caregivers allow no more than one hour a day of media exposure for children between 2 and 5 years of age. How much do children actually watch? Normally we learn about screen behaviors of our patients by asking questions of the child and parent to get a sense of how much screen time is being spent and what types of things are being watched—but how accurate are parental assessments given the potential for recall bias when we do ask about media viewing for their young children? Radesky et al (10.1542/peds.2019-3518) used a technique called mobile device sampling using an app on Android phones or screen shots of the battery feature in iOS devices to compare usage behaviors with parent-reported duration of screen time use. The authors enrolled parents and guardians of children ages 3 to 5 years, with 126 young children using an Android, and 220 on iOS. Of note and concern is that 35% of these young children had their own tablet. The authors found that of the 121 children with their own device, the average daily use was nearly 2 hours, almost twice the AAP recommendation. The time of use ranged from less than a minute to 632 minutes. About two-thirds of the time, parents were inaccurate in their assessment of the time that their children used these devices, equally split between over- and under-estimation. Streaming services were the most commonly used apps, but some preschoolers were noted to use games with violent content.
To find out what the future might hold for the use of this approach to evaluate device use, we invited a commentary from Dr. Libby Milkovich (Children’s Mercy Hospital) and Sheri Nadigan (University of Calgary) (10.1542/peds.2020-1242). Take some time to read this study and commentary so you can decide whether you want mobile device sampling to be a tool you and your patients could use to reduce the quantity and improve the quality of programming that children watch when on a smart device.