Children are growing up in a world surrounded by media that are portable and instantly accessible. Parents and pediatricians may find it hard to keep up with the vast amount of content and new features constantly being introduced, and this can be anxiety-provoking. But one thing that will never change is that parents and trusted caregivers help children make sense of the world, particularly when things are in flux.

This is especially crucial in early childhood, according to the new policy statement Media and Young Minds from the AAP Council on Communications and Media. The policy addresses the influence of media on children 0 to 5 years of age and offers guidance to pediatricians and families in managing their media use. It is available at http://dx.doi.org/10.1542/peds.2016-2591 and will be published in the November issue of Pediatrics.

According to the policy, media use should be discouraged for children under 18 months old, except for video chatting (e.g., Skype or FaceTime). Parents of children 18-24 months who want to introduce digital media should choose high-quality programming and watch it together. For children 2-5 years, media use should be limited to one hour a day to ensure they have enough time to engage in other activities.

Parents as media mentors

The statement focuses on guidelines for how parents can be media mentors by choosing good content; co-viewing and co-using with children to help them apply what they learn on screens to the world around them; and teaching children how to use media to enrich their relationships and connect with others. Time limits still matter, and age limitations still are in place, but just as important is the how of media use.

Media mentoring involves making decisions about:

  • how children will use media (e.g., to learn a new skill from an Elmo video);
  • how parents will serve as role models on media use (e.g., putting phones away during playtime);
  • where families will and will not use media (e.g., dinner table, bedroom); and
  • when families will and will not use media (e.g., bedtime).

Smart choices

The goal is for parents and caregivers to prepare children to grow up in a media-saturated world, from infancy (when video chatting is fine) to toddlerhood (when apps should be chosen wisely and used together with kids) to preschool (when effective programs such as Sesame Street can help them learn prosocial behaviors or new ideas to engage their minds).

When advising parents on media content, it is important to communicate that most of the content labeled as “educational” in app stores has not been evaluated. Furthermore, some features of “interactivity” may actually distract from parent-child teaching interactions and child comprehension. Research shows that the most important “interactive” element is how an adult supports and plays with the child while using media, not the bells and whistles of the app or game itself — despite marketing claims.

Because parents want practical guidance from pediatric providers about how to manage the media in their households, the policy suggests good digital practices and products, such as the need to make co-viewing the norm; why parents should not feel pressure to introduce media early; and the need for children to take part in other healthy activities.

What pediatricians can do

  • Ask parents about family media use and help them develop a Family Media Plan (www.HealthyChildren.org/MediaUsePlan).
  • Educate parents about brain development and the importance of hands-on, unstructured and social play to build language, cognitive and social-emotional skills.

Recommendations for families

  • For children younger than 18 months, discourage use of screen media other than video chatting.
  • For parents of children 18-24 months who want to introduce digital media, select high-quality programming/apps (see resources) and use media together with children.
  • For children 2-5 years, limit screen use to one hour a day of high-quality programming, and co-view with children.
  • Avoid using media as the only way to calm a child.
  • Keep bedrooms, mealtimes and parent-child playtimes screen-free for all. Stop using screens an hour before bedtime and remove devices from bedrooms before bedtime.
  • Avoid fast-paced programs, apps with lots of distracting content and violent content.

Dr. Radesky is a lead author of the policy statement and a member of the AAP Council on Communications and Media Executive Committee.