April Khadijah Inniss, MD, MSc
Robert Wood Johnson Foundation Clinical Scholar, 2012-2014
Clinical Lecturer
University of Michigan
Department of Pediatrics & Communicable Diseases
Given rapid changes in the media landscape with newer
technologies like tablets and smartphones, limiting young children’s
entertainment screen time remains a challenge—and not just for parents, but for
the pediatricians charged with assessing children’s exposure and counseling
families.
In 2010, the American Academy of
Pediatrics (AAP) issued guidelines discouraging any screen time for children less
than two years of age, and no more than two hours daily for older children. In 2013, the AAP released updated
recommendations that reaffirmed the principles in the 2010 guideline, and offered
practical ways families can manage media use, such as keeping media devices out
of children’s bedrooms, and keeping family routines like mealtime screen-free.
To understand parents’ attitudes
and behaviors in relation to these recommendations, the C.S. Mott Children’s
Hospital National Poll on Children’s Health surveyed a national sample of 560 parents
with young children (1-5 years old).
Some of our findings weren’t
surprising at all—many kids are still getting too much screen time (25% of
parents surveyed reported average daily screen time of 3 or more hours for
their young children). However, a couple
key findings stood out to our research team because they seem to hold the most
practical application to how we counsel our young patients’ families.
More parents are
limiting screen time by location, rather than time. Parents reported the
strategies they are already using to limit entertainment screen time. About one-half
(53%) of parents of young children limit the locations where children can use
media devices (i.e., not in their bedrooms or at mealtimes). About one-quarter
(28%) of parents report having a combination of location limits and time limits
(Figure 1). Only 6% of parents report
limiting the amount of screen time for their children by setting a daily time limit.
So, while the AAP speaks of
screen time limits in terms of hours, we
found that most of the parents that we
surveyed are thinking more about limits in terms of location—suggesting that
this approach may be more practical than watching the clock!
Parents’ views about reasonable screen time differ by the
age of their children, and do not necessarily match the AAP recommendations. Among parents of children younger than two years old,
only 12% think that no entertainment screen time is reasonable. In contrast, among parents of children 2-5
years old, 88% say that two hours or less of daily entertainment screen time is
reasonable.
This finding suggests
that targeting parents of children under 2 years of age should be a major
priority for education about potential adverse effects of too much screen time.
In sum, I think most of us in Pediatrics have observed how
quickly new devices are emerging and evolving, and how entertainment screen time
is therefore playing a progressively larger role in our young patients’ daily
lives. We know that parents ultimately
want to do what’s best for their children, but many still struggle in the area
of limiting entertainment screen time.
Based on these findings, perhaps we can better assist these
families in the following ways: 1) intentionally targeting families sooner (specifically
those caring for children 0-2 years of age) with education and other practical
tools to keep their young ones engaged, and 2) counseling families vis-à-vis strategies
other parents just like them are using to limit screen time (i.e. emphasizing
things like screen-free bedrooms and mealtimes).
*All findings reported
here are statistically significant (p < 0.05). Only some findings are presented here; full
manuscript is in preparation highlighting other findings will be submitted for
peer-reviewed publication.
