1. Screen Time Evaluation and Recommendations for Children
Mohammad Mertaban
Hinesburg Family Practice
January 2016
Mohammad Mertaban
Hinesburg Family Practice
January 2016
Screen Time Evaluation and Recommendations for Children

2. Why early experiences matter

4. AAP Guidelines Dilemma
2011 American Academy of Pediatrics Media Guidelines:
Children under the age of 2: no screen time.
Children above the age of 2: entertainment media for no more than hours per day.
2015 American Academy of Pediatrics Media Guidelines:
Optimal media education begins after 2 years of age
Loose interim guidelines

5. Problem
US Children/adolescents: more than 7 hours per day with media (more than in formal classroom instruction)
30% of US children play with a mobile device when they still are in diapers
75% of 13- to 17-year-olds have smartphones
24% admit using their phones almost constantly

6. Another Problem… Survey of 365 pediatricians:
50% recommend limiting media use to 1 to 2 hours per day
50% not interested in learning about media effects on their patients

7. ↑screen time = ↓ activity + ↑ distress

8. Scottish Health Survey of 1,500 children ages 4 – 12 year and their parents
Higher amounts of television/screen viewing time meant lower physical activity rates and increased psychological distress
Increased emotional symptoms
Increased conduct problems
Increased peer relationship problems

10. Precondition the mind to expect high level of stimulation
Prolonged exposure to rapid image change during critical period of brain development
Precondition the mind to expect high level of stimulation
Inattention in later life
Why are there no more explosions happening in front of my face? Why is everything so boring? Why do I have to walk from here to there?

11. AGE 3 AGE 7 MORE Television MORE likely to have attention problems
For each hour per day that a child watches TV, their chances of having attention problems by the time they reach 7 years old increased by 10%.
AGE 3
AGE 7
MORE
Television
MORE likely to have
attention problems

12. Cognitive Stimulation
Cognitive Stimulation was defined as someone who had a parent that read to them, how often they took them to the museum, how often they sang to them. Cognitive stimulation REDUCED the change of them having attention problems later in life. Each hour per day of cognitive stimulation reduced the changes of attention problems by 30%.
AGE 3
AGE 7
MORE
Cognitive Stimulation
LESS likely to have
attention problems

13. Should I eliminate screen time all together?
NO.

14. Power Puff Girls
Content. Content. Content.

16. The inventor of reality television…

17. …and its actually slower than reality

18. Content viewed at 0-3 and risk of attention problems at school age

19. Media & Public Health Costs
Violence: media violence may be associated with 10% of real-life violence
Sex: several studies have linked exposure to sex in the media to earlier onset of sexual intercourse
Drugs: witnessing smoking scenes in movies may be the leading factor associated with smoking initiation among youth.
Obesity: media currently implicated in obesity epidemic; unclear how
Children & Adolescents view about 7,500 food advertisements per year (most fast food or junk food)
Media replaces physical activity.
Eating disorders: In Fiji, a naturalistic study of teenaged girls found that the prevalence of eating disorders increased dramatically after the introduction of American TV programs.14

20. Early childhood for children is critical to their development
More real time play; less fast-paced media
Change the beginning and you change the whole story!

21. How to Talk to Patients and Children
Parenting has not changed – same parenting rules aply
Role modeling is critical – limit your own media use
We learn from each other – “talk time”
Content matters – content is more important than time spent
Co-engagement counts – family participation
Playtime is important – daily unplugged playtime (esp. for younger)
Set limits – reasonable
It’s OK for your teen to be online – social media
Create tech-free zones – family mealtime
Kids will be kids – mistakes and empathy

22. Resources
Zimmerman FJ, Christakis DA. Children’s Television Viewing and Cognitive Outcomes. JAMA Pediatrics. July 2005.