New recommendations for children's electronic media use

The AAP recommends that parents and caregivers develop a family media plan that takes into account the health, education and entertainment needs of each child as well as the whole family.

"Families should proactively think about their children's media use and talk with children about it, because too much media use can mean that children don't have enough time during the day to play, study, talk, or sleep," said Jenny Radesky, MD, FAAP, lead author of the policy statement, "Media and Young Minds," which focuses on infants, toddlers and pre-school children. "What's most important is that parents be their child's 'media mentor.' That means teaching them how to use it as a tool to create, connect and learn."

A second policy statement, "Media Use in School-Aged Children and Adolescents," offers recommendations for children ages 5 to 18, and a technical report, "Children, Adolescents and Digital Media," provides a review of the scientific literature to support both policies. All three documents will be published in the November 2016 Pediatrics (online October 21).

The AAP recommends parents prioritize creative, unplugged playtime for infants and toddlers. Some media can have educational value for children starting at around 18 months of age, but it's critically important that this be high-quality programming, such as the content offered by Sesame Workshop and PBS, and that parents watch media with their child, to help children understand what they are seeing

For school-aged children and adolescents, the idea is to balance media use with other healthy behaviors.

"Parents play an important role in helping children and teens navigate media, which can have both positive and negative effects," said Megan Moreno, MD, MSEd, MPH, FAAP, lead author of the policy statement on media use in school-aged children and teens. "Parents can set expectations and boundaries to make sure their children's media experience is a positive one. The key is mindful use of media within a family."

Problems begin when media use displaces physical activity, hands-on exploration and face-to-face social interaction in the real world, which is critical to learning. Too much screen time can also harm the amount and quality of sleep. Organizations like Common Sense Media can help parents evaluate media content and make decisions about what is appropriate for their family.

Among the AAP recommendations:

• For children younger than 18 months, avoid use of screen media other than video-chatting. Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they're seeing.
• For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
• For children ages 6 and older, place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.
• Designate media-free times together, such as dinner or driving, as well as media-free locations at home, such as bedrooms.
• Have ongoing communication about online citizenship and safety, including treating others with respect online and offline.

Today's generation of children and adolescents is growing up immersed in media. This includes platforms that allow users to both consume and create content, including broadcast and streamed television and movies, sedentary and active video games, social and interactive media that can be creative and engaging, and even highly immersive virtual reality. "Even though the media landscape is constantly changing, some of the same parenting rules apply," said Yolanda (Linda) Reid Chassiakos, MD, FAAP, lead author of the technical report. "Parents play an important role in helping children and teens navigate the media environment, just as they help them learn how to behave off-line. The AAP wants to provide parents the evidence-based tools and recommendations to help them make their children's media experience a positive one."