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An Open Letter: Let's Get More Sophisticated on Screen Time Policy

Rather than taking an approach that makes parents feel guilty whenever their children engage with screens, we need to support and build skills in parents that support children to help them understand how we best use and manage children's engagement with screens and technology.
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Dear American Academy of Pediatrics (AAP),

Respectfully, we need to have a talk about screentime.

More specifically, we need to have a talk about your screentime policy. The one that you first developed in the 1990s advising avoiding screens for children under two years of age and less than 2 hours for all children and teenagers. It is the policy that results in statements on your own website like these:

Television and other entertainment media should be avoided for infants and children under age 2. A child's brain develops rapidly during these first years, and young children learn best by interacting with people, not screens.

Children and teens should engage with entertainment media for no more than one or two hours per day, and that should be high-quality content.

This is a policy that, given the respect your organization commands and the weight of experience and knowledge of your researchers, has been widely adopted by psychologists, early childhood professionals and teachers as the foundational point of discussing children, technology and media. It has also been misinterpreted as "no screen time" - as you have pointed out in one of your own policy reviews. But it is no longer the 90s and your screen time policy is one that an increasing number of people have a problem with. It unnecessarily feeds parental guilt and doesn't respect the contexts in which we are supporting the learning and development of our children.

I do not question the quality of your research and the breadth at which your members understand the development of children's brains, the role media plays in children and young people's health and well-being and your commitment to the well-being of child populations. I respect the work that you do and understand that none of it is taken lightly and that your organisation has a responsibility to the health and wellbeing of all young children. The AAP speak directly to the best and most current research available and that what science understands from fields such as neuroscience and child development guides your policy on screentime and media.

All that said any policy is of little value unless it considers context. And, your screentime policy appears to want to ignore the reality of the world we live in today. A world full of screens where how we manage children's positive engagement, rather than non-engagement is far more important.

Today's context can look something like this:

I am a sole mum who works full time and is picking up her eldest from after school care and two under 5 aged children from daycare. It is 5pm and there is a lot to do between now and bedtime. We had take away last night and I could do it again tonight and spend some time playing with my three children, or I could get home and put on the TV and cook them a healthy meal with the vegetables I have in the fridge. But that will mean my 2-year-old will be watching over and hour of screens today? What do I do?

I am a native Spanish speaking immigrant from South America and I've found employment in a small rural community and have not found any native speakers to connect with. I have been ensuring my child maintains her Spanish by talking to my parents over Skype and listening to books I have downloaded on my phone. Sometimes, because I am under stress and need a break she is doing this for two hours a day. She also watches her favorite TV show for 30 minutes a day.

The reality of our lives is that parents and society relies on media and screens for a host of reasons. We use it as a babysitter for respite, we use it for learning, children with disabilities use screens to communicate and young children use it to develop agency and effect choice or to be creative. Not all screens are created equal anymore. And a policy that puts a time limit above everything else isn't serving us well.

The AAP screen time policy, despite being reviewed on at least a couple of occasions since 1999 remains the same. I know you have a body of research and evidence to support this position, but that does not change the fact it is deeply out of touch with the way the world works for children and young people and the families they live in. Any good research needs to consider context and it appears that when your advice is placed in the busy lives of family homes it doesn't stack up.

As you rightly point out, "Media is everywhere. TV, Internet, computer and video games all vie for our children's attention." We have screens in our pockets, in waiting rooms and on any number of portable and stationary devices in our homes. Our teenagers use them to learn, at school, for many more hours than your prescribed 1-2 hours a day. Parents are referring to their phones to check appointments, do their banking, or organize a play date all in front of the eyes of our children thereby modeling the importance and interest in the "dreaded" screen.

I suggest that the context of our lives is making your advice irrelevant because as parents we can't engage with advice that puts a vast majority of us in the screen time sin bin. And, as a consequence parents are trying to navigate the space as best they can without the support of trusted health professionals. The current policy only serves to provide health professionals with a holier than thou stance that none of us can keep up with and as a consequence not allowing us to move the conversation forward. A conversation that others, even those involved with the development and review of your policy are questioning.

Like, Dimitri A. Christakis, MD, MPH, whose article in the May edition of JAMA Pediatrics questions whether we need a rethink of your screen time policy. He writes, "[w]hile many of you wait for us to build an evidence base before this technology too is supplanted by some new one, I believe that judicious use of interactive media is acceptable for children younger than the age of 2 years." His arrival at this point is discussed at length and still highlights the challenges and importance of supporting parents and communities to understand the ways we can best support child development and well-being. The key word here being "judicious".

It is the same word used by Mami Umayahara, an early years program specialist for UNESCO, who in a June 2014 article looked at the research and pointed out, 'In fact, when used judiciously, ICT can support different aspects of learning and development processes of young children, including language, creativity and problem-solving skills'.

Rather than taking an approach that makes parents feel guilty whenever their children engage with screens, we need to support and build skills in parents and the communities that support children to help them understand how we best use and manage children's engagement with screens and technology.

This is a much more difficult task when an organization like the AAP present a policy that focuses too heavily on the simplistic notion that the amount of time a child spends on the screen is our main concern. The AAP's excellent advice after this initial statement in the screen time policy discusses on the importance of quality content, the value of the joint use of screens and technology between child and parent and the value of that within a broader space where parents engage with children through reading and play. But, it is lost behind the call for 30 minutes of screens for two to three year olds.

We can't afford for these important messages to be overwhelmed by discussions that fit into a dichotomy of screens and technology as being bad, where other forms of engagement and play are good.

You may not be aware, but your screen time policy is used across Western nations as the standard when it comes to children and screens. I am writing from Australia and maternal and child health professionals and early childhood experts all offer your policy as parenting advice around the use of screens. It makes it very difficult for these professionals to consider the idea that screens may have some beneficial use or to consider that some ways of using screens are better than others. This lack of sophisticated discussion is in part driven by the simplicity of the approach your policy takes to screens.

It means those trying to explore more nuanced approaches where quality content is identified and shared with parents, where ways in which you can engage with your children in digital environments and connect it to non-screen-based play or where technology is a launching pad into a world of books and literacy have a more difficult task. They are required to break through the "screen is bad" rhetoric that your policy is interpreted as.

And yet, parents are offering screens up to their children everyday. Children are using tablets and phones and watching television. And, there is still the challenge of supporting parents to engage in positive media practice with their children, still seeking to understand what is quality content and what isn't and how this can be used in positive ways to support their child's development. Why? Because they are busy struggling with the feeling that their child shouldn't have the screen to begin with. It isn't good enough.

So, how about a review in 2015? We are overdue for a change.


Daniel Donahoo