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Media and Young Minds: Policy Statement
Media and Young Minds: Policy Statement
developmentally healthy activities. Policy statements from the American Academy of Pediatrics benefit
from expertise and resources of liaisons and internal (AAP) and
external reviewers. However, policy statements from the American
Academy of Pediatrics may not reflect the views of the liaisons or the
organizations or government agencies that they represent.
INTRODUCTION The guidance in this statement does not indicate an exclusive course
of treatment or serve as a standard of medical care. Variations, taking
Technologic innovation has transformed media and its role in the lives into account individual circumstances, may be appropriate.
of infants and young children. More children, even in economically All policy statements from the American Academy of Pediatrics
challenged households, are using newer digital technologies, such automatically expire 5 years after publication unless reaffirmed,
revised, or retired at or before that time.
as interactive and mobile media, on a daily basis1 and continue to be
the target of intense marketing.2 This policy statement addresses the DOI: 10.1542/peds.2016-2591
influence of media on the health and development of children from 0 PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
to 5 years of age, a time of critical brain development, building secure Copyright © 2016 by the American Academy of Pediatrics
relationships, and establishing health behaviors.
FINANCIAL DISCLOSURE: The authors have indicated they do
not have a financial relationship relevant to this article to
disclose.
INFANTS AND TODDLERS
FUNDING: No external funding.
Children younger than 2 years need hands-on exploration and social
POTENTIAL CONFLICT OF INTEREST: The authors have
interaction with trusted caregivers to develop their cognitive, language,
indicated they have no potential conflicts of interest to
motor, and social-emotional skills. Because of their immature symbolic, disclose.
memory, and attentional skills, infants and toddlers cannot learn from
traditional digital media as they do from interactions with caregivers,3
To cite: AAP COUNCIL ON COMMUNICATIONS AND MEDIA.
and they have difficulty transferring that knowledge to their
Media and Young Minds. Pediatrics. 2016;138(5):e20162591
3-dimensional experience.4 The chief factor that facilitates toddlers’
PEDIATRICS Volume 138, number 5, November 2016:e20162591 FROM THE AMERICAN ACADEMY OF PEDIATRICS
Downloaded from http://publications.aap.org/pediatrics/article-pdf/138/5/e20162591/1061988/peds_20162591.pdf
by guest
learning from commercial media 5 years of age11,12 and continue studies have used a 2-hour cutoff
(starting around 15 months of age) to create programming that to examine obesity risk, a recent
is parents watching with them and addresses evolving child health and study of 2-year-olds found that BMI
reteaching the content.5,6 developmental needs (eg, obesity increased for every hour per week
prevention, resilience). Evaluations of media consumed.21 It is believed
The interactivity of touchscreens
of apps from Sesame Workshop and that exposure to food advertising22
enables applications (apps) to
the Public Broadcasting Service (PBS) and watching television while
identify when a child responds
also have shown efficacy in teaching eating (which diminishes attention
accurately and then tailor its
literacy skills to preschoolers.2 to satiety cues)23 drives these
responses, thereby supporting
Unfortunately, most apps parents associations.
children at their levels of
find under the “educational”
competence. Emerging evidence Sleep
category in app stores have no such
shows that at 24 months of age,
evidence of efficacy, target only rote Increased duration of media
children can learn words from live
academic skills, are not based on exposure and the presence of a
video-chatting with a responsive
established curricula, and use little television, computer, or mobile
adult7 or from an interactive
or no input from developmental device in the bedroom in early
touchscreen interface that scaffolds
specialists or educators.2,13 Most childhood have been associated with
the child to choose the relevant
apps also generally are not designed fewer minutes of sleep per night.24
answers.8 Starting at 15 months of
for a dual audience (ie, both parent
age, toddlers can learn novel words Even infants exposed to screen
and child).2,14 It is important to
from touchscreens in laboratory- media in the evening hours show
emphasize to parents that the higher-
based studies but have trouble significantly shorter night-time sleep
order thinking skills and executive
transferring this knowledge to the duration than those with no evening
functions essential for school
3-dimensional world.9 However, screen exposure.25 Mechanisms
success, such as task persistence,
it should be noted that these underlying this association include
impulse control, emotion regulation,
experiments used specially designed arousing content26 and suppression
and creative, flexible thinking, are
apps that are not commercially of endogenous melatonin by blue
best taught through unstructured
available. light emitted from screens.27
and social (not digital) play,15 as
Many parents now use video-chat (eg, well as responsive parent–child
interactions.16
Child Development
Skype, FaceTime) as an interactive
media form that facilitates social Digital books (also called “eBooks,” Population-based studies continue to
connection with distant relatives. books that can be read on a screen) show associations between excessive
New evidence shows that infants and often come with interactive television viewing in early childhood
toddlers regularly engage in video- enhancements that, research and cognitive,28–30 language,31,32 and
chatting,10 but the same principles suggests, may decrease child social/emotional delays,33–36 likely
regarding need for parental support comprehension of content or parent secondary to decreases in parent–
would apply in order for infants and dialogic reading interactions when child interaction when the television
toddlers to understand what they are visual effects are distracting.17 is on37 and poorer family functioning
seeing. Parents should, therefore, be in households with high media use.37
instructed to interact with children An earlier age of media use onset,
In summary, for children younger
during eBook reading, as they would greater cumulative hours of media
than 2 years, evidence for benefits
a print book. use, and non-PBS content all are
of media is still limited, adult
significant independent predictors
interaction with the child during
of poor executive functioning in
media use is crucial, and there
HEALTH AND DEVELOPMENTAL preschoolers.38 Content is crucial:
continues to be evidence of harm
CONCERNS experimental evidence shows that
from excessive digital media use, as
switching from violent content
described later in this statement. Obesity to educational/prosocial content
Heavy media use during preschool results in significant improvement
years is associated with small but in behavioral symptoms, particularly
PRESCHOOL MEDIA AND LEARNING
significant increases in BMI,18 may for low-income boys.12 Notably,
Well-designed television programs, explain disparities in obesity risk the quality of parenting can modify
such as Sesame Street, can in minority children,19 and sets associations between media use
improve cognitive, literacy, and the stage for weight gain later and child development: one study
social outcomes for children 3 to in childhood.20 Although many found that inappropriate content
• Turn off televisions and other income families and in multiple 2. Chiong C, Shuler C; The Joan Ganz
devices when not in use. languages. Cooney Center at Sesame Workshop.
• Eliminate advertising Learning: Is there an app for that?
• Avoid using media as the only way and unhealthy messages on Investigations of young children's
to calm your child. Although there usage of learning with mobile
apps. Children at this age
are intermittent times (eg, medical devices and apps. Available at: http://
cannot differentiate between
procedures, airplane flights) when dmlcentral.net/wp-content/uploads/
advertisements and factual files/learningapps_final_110410.pdf.
media is useful as a soothing information, and therefore, Accessed September 2, 2016
strategy, there is concern that advertising to them is
using media as strategy to calm unethical. 3. Anderson DR, Pempek TA. Television
could lead to problems with limit and very young children. Am Behav Sci.
setting or the inability of children
• Help parents to set limits by 2005;48(5):505–522
stopping auto-advance of videos
to develop their own emotion 4. Barr R. Memory constraints on infant
as the default setting. Develop
regulation. Ask your pediatrician learning from picture books, television,
systems embedded in devices that
for help if needed. and touchscreens. Child Dev Perspect.
can help parents monitor and limit 2013;7(4):205–210
• Monitor children’s media content media use.
and what apps are used or 5. DeLoache JS, Chiong C, Sherman K,
LEAD AUTHORS et al. Do babies learn from baby media?
downloaded. Test apps before the
Psychol Sci. 2010;21(11):1570–1574
child uses them, play together, and Jenny Radesky, MD, FAAP
ask the child what he or she thinks Dimitri Christakis, MD, MPH, FAAP 6. Richert RA, Robb MB, Fender JG,
about the app. Wartella E. Word learning from baby
COUNCIL ON COMMUNICATIONS AND MEDIA videos. Arch Pediatr Adolesc Med.
• Keep bedrooms, mealtimes, and EXECUTIVE COMMITTEE, 2016-2017 2010;164(5):432–437
parent–child playtimes screen free David Hill, MD, FAAP, Chairperson
7. Roseberry S, Hirsh-Pasek K,
for children and parents. Parents Nusheen Ameenuddin, MD, MPH, FAAP
Yolanda (Linda) Reid Chassiakos, MD, FAAP
Golinkoff RM. Skype me! Socially
can set a “do not disturb” option on contingent interactions help
Corinn Cross, MD, FAAP
their phones during these times. Jenny Radesky, MD, FAAP toddlers learn language. Child Dev.
Jeffrey Hutchinson, MD, FAAP 2014;85(3):956–970
• No screens 1 hour before bedtime, Rhea Boyd, MD, FAAP
and remove devices from Robert Mendelson, MD, FAAP
8. Kirkorian HL, Choi K, Pempek TA.
Megan A. Moreno, MD, MSEd, MPH, FAAP Toddlers’ Word Learning From
bedrooms before bed.
Justin Smith, MD, FAAP Contingent and Noncontingent
• Consult the American Academy of Wendy Sue Swanson, MD, MBE, FAAP Video on Touch Screens. Child Dev.
Pediatrics Family Media Use Plan, 2016;87(2):405–413
LIAISONS
available at: www.healthychildren. 9. Zack E, Gerhardstein P, Meltzoff AN,
org/MediaUsePlan. Kris Kaliebe, MD – American Academy of Child Barr R. 15-month-olds’ transfer of
and Adolescent Psychiatry
learning between touch screen and
Jennifer Pomeranz, JD, MPH – American Public
Industry Health Association
real-world displays: language cues
Brian Wilcox, PhD – American Psychological and cognitive loads. Scand J Psychol.
• Work with developmental Association 2013;54(1):20–25
psychologists and educators to 10. McClure ER, Chentsova-Dutton YE,
create design interfaces that are STAFF
Barr RF, Holochwost SJ, Parrott WG.
appropriate to child developmental Thomas McPheron “Facetime doesn’t count”: video-chat
abilities, that are not distracting, as an exception to media restrictions
and that promote shared parent– for infants and toddlers. Int J Child
child media use and application ABBREVIATIONS Comput Interact. 2016;6:1–6
of skills to the real world. Cease 11. Anderson DR, Huston AC, Schmitt
app: application
making apps for children younger KL, Linebarger DL, Wright JC. Early
PBS: Public Broadcasting Service
than 18 months until evidence of childhood television viewing and
benefit is demonstrated. adolescent behavior: the recontact