AAP calls for system-level changes to improve children’s digital media environments

The American Academy of Pediatrics (AAP) has released an updated policy statement that reframes how clinicians, families, and society should approach children’s and adolescents’ digital media use, moving beyond screen time limits to address the broader digital ecosystem shaping youth health and development.¹

Rather than focusing solely on individual behaviors, the policy emphasizes that children’s digital experiences are influenced by interconnected factors, including caregiver relationships, platform design, commercial incentives, and broader social systems. The AAP notes that while digital media can support learning and connection when thoughtfully designed, engagement-driven environments may encourage prolonged use and displace health-promoting behaviors such as sleep, physical activity, and in-person interaction.

The policy defines the digital ecosystem as encompassing television, the internet, social media, video games, apps, artificial intelligence, and interactive devices. According to the authors, digital environments designed with children’s developmental needs in mind can promote well-being, whereas those that prioritize engagement and commercialization may contribute to negative outcomes.² As a result, the statement asserts that children’s media use “cannot be viewed solely through the lens of individual child behaviors or screen limits alone.”

Developmental considerations across childhood and adolescence

The updated guidance draws on observational, longitudinal, and meta-analytic evidence examining associations between digital media use and child development. While causal conclusions remain limited, the policy highlights consistent links between greater digital media exposure and less optimal outcomes across multiple domains.

In early childhood, infants younger than 18 months have difficulty transferring information from screens to the real world because of immature cognitive processing. Among preschool-aged children, high-quality educational content—particularly when used with caregiver involvement—has been associated with improved language and prosocial skills. In contrast, heavier use of noneducational and solo media has been linked to delays in language, cognition, social-emotional development, and sleep disruption.

For school-aged children, well-designed digital media with clear learning goals, used in moderation, may support academic skills such as reading and mathematics. However, excessive media use has been associated with lower academic achievement, weaker attention control, increased sedentary behavior, and sleep disruption, particularly when devices are used in bedrooms or late in the evening.

Among adolescents, associations between digital media use and well-being are described as small and variable. Early adolescence may represent a period of increased susceptibility to negative effects. At the same time, the policy acknowledges that digital media may support learning, identity exploration, and social connection, especially when teens have supportive caregiver involvement and access to high-quality content. The statement also highlights concerns about algorithmic amplification, social comparison, and exposure to harmful content, which may increase risks for anxiety, depression, eating disorders, and self-harm among vulnerable youth.

Role of caregivers and relational health

Caregivers are positioned as central to children’s digital experiences. The AAP emphasizes that caregivers act as gatekeepers, teachers, and co-users of media, and that strong caregiver-child relationships are protective in digital contexts. Joint media engagement, such as co-viewing and discussing content, is associated with improved learning and relational health.

Conversely, frequent digital interruptions of caregiver-child interactions have been associated with behavioral challenges in children. The policy also highlights caregiver stress as an important contextual factor, noting that high stress levels are associated with increased caregiver device use. Clinicians are encouraged to approach media discussions with empathy and to recognize structural stressors—such as limited childcare, long work hours, and lack of community resources—that shape family media habits.

Digital design and system-level recommendations

A central focus of the policy is the distinction between child-centered and engagement-based digital design. Engagement-based features, including endless scroll, autoplay, algorithmic recommender systems, and behavioral reinforcers, may prolong use and undermine child agency. In contrast, child-centered design prioritizes privacy, safety, developmental appropriateness, and meaningful engagement.

The AAP extends recommendations beyond families and clinicians to industry and policymakers. The statement calls for safety and privacy to be default settings on platforms used by minors, limits on data collection and targeted advertising, increased transparency around algorithms, and accountability for designs that amplify harmful content. The policy also recommends greater investment in community resources, including libraries, recreational spaces, and nonprofit child-centered media, to support healthy development and reduce reliance on digital media.

Implications for pediatric practice

For pediatricians, the policy provides practical guidance for integrating digital media discussions into routine care. Clinicians are encouraged to weave media conversations into discussions of sleep, school performance, and development, and to use strengths-based frameworks that explore content quality, emotional regulation, and activities displaced by media use. Screening for underlying conditions such as attention-deficit/hyperactivity disorder, anxiety, or depression is advised when problematic media use is identified.

Overall, the AAP positions children’s digital media use as a shared responsibility among families, clinicians, industry, and society. The policy concludes that child-centered digital ecosystems are achievable and represent an important opportunity to promote healthier development and well-being in an increasingly digital world.

References

1. Munzer T, Parga-Belinkie J, Milkovich LM, et al. Digital Ecosystems, Children, and Adolescents: Policy Statement. PEDIATRICS. Published online January 20, 2026. doi:https://doi.org/10.1542/peds.2025-075320
2. McCabe MA, Prinstein MJ, Alvord MK, et al. Health advisory on social media use in adolescence. American Psychological Association. May 2023. Accessed January 28, 2026.. https://www.apa.org/topics/social-media-internet/health-advisory-adolescent-social-media-use.pdf