New American Academy Of Pediatrics Screen Time Recommendations Still Don't Make a Passing Grade

New American Academy Of Pediatrics Screen Time Recommendations Still Don't Make a Passing Grade
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In October, 2016, the American Academy of Pediatrics released new screen time recommendations for children, both toddlers and older kids. In many respects, the new policies are an improvement over the old. Gone is the nonsensical 2-hour a day screen time maximum for older kids that had been widely quoted for years. And the AAP appears to have acknowledged that screens are often integrated in our lives in ways that are productive rather than harmful. However, the new screen time recommendations also reveal just how fraught the entire enterprise of giving these recommendations is. The AAP continues to provide biased and one-sided coverage of many issues related to media effects, and continues to rely on authors with potential conflicts of interest to write their policy statements.

Further, implicit in these new recommendations is the fact that the AAP had simply been wrong for many years in what they had been telling parents, but this goes unacknowledged. As such, recommendations by the AAP appear to constitute little more than an attempt by a professional guild to remain politically and socially relevant on an issue for which they increasingly appear to be functioning as society’s nervous nanny rather than a neutral and objective scientific body.

In fairness to the AAP, some of the new recommendations aren’t bad. Particularly for older kids, the recommendations basically boil down to...balance screen time with other activities and make sure your kids get adequate sleep and exercise. Most of these recommendations are so vanilla and common-sense that they probably didn’t require a policy statement at all.

The recommendations for younger kids are probably a bit more controversial as these are where some time limits persist. The AAP recommends avoiding screens prior to 18 months, then gradually introducing media with parental interaction. Only 1 hour of screens a day is suggested until age 5. Let’s admit most parents are going to ignore most of this and as well they should. The scientific foundation for these recommendations is shaky at best. For instance, the AAP continues to rely on some older studies suggesting screen time was associated with cognitive and language delays, and fails to inform parents that some of these studies were later debunked. For instance, one older study suggested that screen use was associated with language delays. However, when psychologist Brent Donnellan and myself reanalyzed this data, we found that evidence for this conclusion was lacking. In fact, toddlers with no screen time at all (following the AAP’s guidelines) were actually more language delayed. Although correlational in nature, the data suggested that children of parents who followed the AAP’s recommendations were worse off than those who ignored them. The bottom line is that the black/white age and time recommendations the AAP provides have little basis in fact.

Further, the AAP ignored evidence from a paper published in their own flagship journal suggesting that screen time had minimal impact on children’s emotional development. Selective citation of frightening research and ignoring research that might suggest media isn’t so bad has been a long-standing criticism of the AAP. Unfortunately, they appear resolute in their ways.

The AAP also continues to provide biased coverage of morally valenced issues such as whether watching content such as sexual themes or violence on screens is associated with problematic behavior in youth. Increasing evidence suggests that such content has little to no impact on youth. However, the AAP continues to persist in frightening parents with nonsense claims about effects. That’s not to say every kid need watch Game of Thrones, but rather that parents would benefit from a nuanced discussion of these research fields, not one-sided scaremongering. This persistent problem the AAP has with providing one-sided and, frankly, dishonest coverage of media effects research is a real blemish on the credibility of this organization. Why should parents take their recommendations seriously, if they seem constitutionally unable or unwilling to be honest about real debates and inconsistencies in the research field?

The AAP also appear to be incapable of acknowledging when they’ve been wrong on media, which has been arguably more often than not. Despite increasingly doubts about effects in the scientific community, the AAP’s policy statements on media violence continue to fear-monger. A 2011 policy statement suggesting that “Facebook Depression” was a thing remained on the books despite it having been directly repudiated by one of the authors they cited to base their conclusions on. It seems the AAP relied on citing incorrect newspaper coverage of some studies rather than examining the studies themselves. The AAP has, at other times, supplied scientific urban legends such as the claim from a 2001 policy statement that there were 3500 studies of media violence with only 18 not finding evidence for effects (this wasn’t remotely true and the source for these numbers is apocryphal. The AAP had cited a pop psychology book rather than counting studies themselves.) I’d argue that sloppiness in their policy statements has been more the norm than exception for the AAP...sloppiness at a level we wouldn’t expect from undergraduate students, let alone a professional body.

Part of the problem appears to be that the AAP continues to rely on authors who are heavily invested in the “harm” view of media effects to write policy statements. I am not suggesting such authors are acting in bad faith, but for some of these scholars their professional reputation, grant funding, and perhaps even books to be sold benefit from a one-sided view of media and screen time effects. Many of the recent policy statement authors cite their own studies rather liberally, not exactly a sign of disinterest. It’s human nature for people to prioritize positions that convey benefit to themselves, but this also precludes an objective scientific review. It’s a pretty blatant conflict of interest for the AAP to allow scholars to write policy statements that clearly advance their own careers.

So what should parents, pediatricians and policy makers do with the new AAP recommendations? Ignore them as they generally have in the past. It’s true, the current recommendations are better than what’s come before. But this seems to be due more from pressure from both parents and researchers noting that the previous AAP recommendations were basically rubbish (and unrealistic), rather than any real effort at reform. And this reveals the fraught nature of policy statements in general...they often reflect the political, financial and social agendas of the groups that produce them rather than any objective scientific truth. That’s the only way to explain the one-sided way such groups cover disputed research fields. We have to remember that groups like the AAP are professional guilds designed to protect their own interests and those of their members. That doesn’t mean they’re always acting in bad faith, but it does mean they are not unbiased sources of information. Ultimately, there probably is no “one size fits all” guideline for what’s best for individual children and their families. Efforts to force the existence of such recommendations likely do more harm than good.

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