Gayle Schrier Smith, MD, FAAP
Tool or toy?” I have begun to ask my patients and their parents. “How do you see screen time in your home?” It occurred to me that if I wanted to influence families, I needed to consistently ask about ways in which they viewed technology and media regardless of the age and stage of their child’s life. And I needed a memorable sound-bite.
There are families who have never given much thought to media consumption. Some have a single TV, and it’s always on in the den. Others have every tech device on the market and are so busy waiting in line for the next one that the idea of ‘good’ and ‘bad’ media consumption has not even occurred to them. Most families, of course, are somewhere in the middle.
It often feels as if there are increasing numbers of families who rely on the ‘experts,’ many of whom they find through an Internet search, and I struggle with this reality. I want them to rely on face-time with pediatricians in equal measure. If parents are to consume and work to apply every bit of child-rearing advice they find, I also want them to have confidence in personal judgment, especially with respect to media and technology. Pediatricians are in a unique position to help parents answer questions like “how much screen time is OK?” And the response is rarely cookie-cutter black and white.
The AAP policy to restrict screen time completely for children under two is a big stumbling block for some parents. “Really, I can’t even have Oprah on while my toddler is in the room?” It would be useful to cultivate the parent’s ability to see how often and in what context screen time is present in family life. A careful look at the variety and quantity of screen time should be purposeful and deliberate, and in many ways may be more meaningful than simply tallying up hours spent in front of a screen.
Gayle Schrier Smith, MD, FAAP
To bring awareness to the many screens that surround us, I have begun to ask my patients and their parents, “Tool or Toy? How do you see screen time in your home, and what does it cost you?” Tools live in the world of work, learning and efficiency (something grown-ups value.) Toys define the world of fun, relaxation and play. Both have their place in healthy families, and I would argue that each role is valuable to consider if it is the intention of parents to serve up a healthy media diet. The cost of screen time is both monetary in what our devices cost, but also in the price of lost time… that face to face encounter we want to have with one another.
As I have begun to talk more about the importance of a balanced media diet, the ‘tools and toys’ image has been useful to open those conversations. The sound-bite doesn’t feel judgmental to me, nor does it feel as though I am endorsing any one view of screen time over another. I sometimes share ways in which my iPhone is both a tool and toy, but I am also honest in saying that I have begun to monitor my own ‘play’ time on it.
There is a rapidly changing landscape of available media tools and toys, and they are, to some degree, both good and bad for how they influence children. It is simply time for pediatricians to leverage our ability to engage families, and ask them to learn with us as we all expand our expertise, with evidence-based ideas tested by time and research. It is only with a meaningful and ongoing partnership that we will really understand how much screen time is enough or too much. Meanwhile, a screen time question at every wellness visit will certainly create value for families and a memorable sound- bite. “Tool or Toy” may serve as a frequent reminder that screens are both tool and toy, that they are present everywhere and should be purposefully balanced in a family’s life.