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The intrusion of digital media into the lives of children is causing concern for parents about how best to guide use of this omnipresent technology.
Over the last 10 years, digital media has evolved rapidly. In 2011, 10% of children aged younger than 2 years used mobile devices, a number that grew to 38% in 2013. By 2015, 97% of low-income children aged younger than 4 years used these devices, with 75% owning their own device.
This rapid increase in children’s use of digital media is causing great concern for parents who question how best to guide their children in the use of this omnipresent technology.
“Digital media is a highly polarized topic in our society, especially regarding how it might be affecting children,” says Jenny Radesky, MD, FAAP, assistant professor, Developmental Behavioral Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan. “Therefore, it is important that pediatric providers try to meet parents and families where they are and understand their motivations for using media and how it fits into their day.”
To help pediatricians discuss these issues with parents and children, Radesky says that it is important to talk about positive and negative effects of digital media on the developing child.
In a session titled “Digital media and children: The good, the bad, and the unknown” that Radesky presented at the American Academy of Pediatrics (AAP) 2018 National Conference and Exhibition in Orlando, Florida, on November 6, she reviewed the rapid adoption of mobile and interactive media and both the positive and negative influences on early childhood development as well as recommendations for parents to help navigate the best use of this technology with their children. In addition, she highlighted several areas that remain unknown about the effect of digital media on children. Her talk focused on children aged from birth to 8 years.
The good and the bad
Among the good aspects of digital media for children, Radesky said in her session, are apps that provide well-designed content that has been shown to improve developmental outcomes, such as content from Sesame Street, Between the Lions, and Blue’s Clues. She cited evidence from a randomized trial of Daniel Tiger’s Neighborhood, an app for preschoolers, that showed that when viewed with parents, the content improved social-emotional abilities such as the ability to calm down and control anger. She also cited the benefits of video chat that allows parents to stay connected with their children.
Her own personal favorite positive uses of digital media, she said, include skyping; learning about things you wouldn’t have access to in real life; dancing to music; making stop-motion videos; finding the right program for the right emotion; and movie night.
Radesky focused much of her talk on the bad aspects of this technology and its effect on sleep, executive functioning, parent-child interaction, and inappropriate content/design. She cited data showing that earlier introduction to digital media is linked to lower executive function and social skills; that parent-child interaction is reduced when the TV is on (this can lead to less sustained/complex play and fewer language-enriching play activities that affect vocabulary development); and poorer sleep associated with longer duration of viewing digital media because of increased arousal, with sleep particularly disturbed when children view violent content.
To this last point, Radesky emphasized the need to be aware of inappropriate content/design of many digital media. In particular, she discussed a concept called “persuasive design” in which technology is designed to interact and manipulate human psychology. Such design offers social rewards, token rewards, and variable reinforcement that take advantage of subconscious biases to grab one’s attention and rouse emotions.
A main goal of Radesky’s talk was to help parents understand this concept of persuasive design to be able to help guide their child toward appropriate content. She says that pediatricians need to “empower the parents to avoid manipulative design that is not helping them as a parent.”
To assist parents, Radesky recommends that pediatricians talk about mobile device use if and when it occurs during the office visit (by parent or child) so that they can discuss how the interactive media is affecting attention, emotions, and thinking, and help raise awareness of how to create a better “tech-life balance” within families.
Finally, during the office visit, Radesky encourages pediatricians to provide resources to parents to help them establish a good balance with the use of digital media in their family, and provide information on the AAP Family Media Use Plan (www.healthychildren.org/English/media/Pages/default.aspx) and Common Sense Media (www.commonsensemedia.org/) websites as visual aids.
The rapid-fire pace at which changes have occurred regarding media in the last 25 years astounds even the most up-to-date pediatric clinician. Placed in the context of the fact that the first iPad was released in 2010, in 2011 fewer than 1% of children aged younger than 8 years owned their own tablets, and yet by 2017 nearly half-42%-of children had a tablet of their own.
This growth in any other dimension of our medical lives would be called an epidemic and panic would ensue, yet the amount of research dollars spent examining the incredible impact of media on child development pales in comparison.
In her presentation, Dr. Radesky explores both sides of the media puzzle: the positive impact on learning and exploration as well as the potential negatives of cyberbullying and digital media addiction. She also expands on the recent phenomenon of “persuasive design” in which marketing tries to attract the user to engage in more media time; for example, the “people who liked this also liked” technique. This presentation is based on the recent AAP Policy Statement on “Media and Young Minds,” which Dr. Radesky co-authored with Dimitri Christakis, MD, MPH, FAAP.1
1. Council on Communications and Media. Policy statement: Media and young minds. Pediatrics. 2016;138(5):e20162591.
Marilyn C. Augustyn, MD, is associate professor of Pediatrics, Boston University School of Medicine, Boston, Massachusetts.