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Tuesday Aug 18, 2015

Put the iPad Down: Find Ways to Cut Back on Screen Time

Screens are unavoidable. Even if we minimize the number of electronics in our homes, they are ubiquitous in our communities. It is becoming more common to see televisions in restaurants, large screens in retail stores and on the streets for advertising, tablets in airport terminals and even small drop-down screens in vehicles.

As a new school year starts, parents are faced with the realities of schedules, homework and extracurricular activities. How do all these screens fit in with everything else?

Unfortunately, the average American child spends seven hours a day(www.aap.org) looking at various types of screens. Seventy-five percent of teenagers own a cell phone(pediatrics.aappublications.org), and more than half of adolescents access some form of social media more than once a day.

The AAFP and the American Academy of Pediatrics(pediatrics.aappublications.org) (AAP) recommend no screen time before 2 years of age, and no more than two hours a day for children 2 and older. This means that the time your child spends playing games on your phone while you're waiting in line or watching cartoons while you shower or cook dinner quickly add up. Before you realize it, your child's screen time can easily exceed the recommendation. The same is true for the families we care for in our practices.

Why do the AAFP and AAP make these recommendations? Too much screen time has been shown to increase problems in school, obesity rates, sleep and eating disorders, and attention problems. Violence on television and video games has been shown to increase aggression and desensitize people to violence. Additionally, adolescents are subjected to new kinds of social pressure that never existed before, such as cyberbullying and "sexting."

How powerful is the effect of media on children? It's telling that some leaders in the tech industry are stricter about their children's use of media devices -- including their own products -- than the average parent. When Apple released the iPad in 2010, co-founder Steve Jobs told a reporter with The New York Times(www.nytimes.com) that his young daughters had not used the device and certainly were not allowed to have their own. The same story, published last year, highlighted the fact that many industry leaders don't allow electronic media on school days or in their children's bedrooms (a practice that aligns with an AAP recommendation).

As families prepare for kids to go back to school, many physician practices see an increase in demand for physicals. This offers a perfect opportunity to address screen time with our patients and their parents. How do we counsel families and limit (or restrict) our own kids' screen time, given the myriad of opportunities to engage with devices in our culture?

We start by disconnecting ourselves. As role models, our children are watching us all the time. As we all know, the "do as I say, not as I do" adage is not the most effective method of parenting. So lead by example. As a recent NYT blog(well.blogs.nytimes.com) suggests, reserve your screen time for parts of the day when your children aren't around or awake. Make sure that those transition times -- going to school or coming home -- are special, "electronic media-free" times so you can talk about your day together and connect on a person-to-person level. Consider deciding as a family to have "screen holidays" once a week, or with some regularity, during which time no one checks email, looks at Facebook or plays video games. This time can be used to enjoy reading actual books, playing board games or playing outside.

Another incentive to put down the electronic leashes is that they distract us from paying attention to what really matters. In the same blog, Catherine Steiner-Adair, Ed.D., attributed a 20 percent increase in accidental injuries treated in pediatric ERs to adults failing to focus on the children they were supposed to be watching.

How screens and electronic media change our brains is a commonly debated topic, and more research is needed to determine how this affects us and our children. The recommendation to limit screen time remains a worthwhile goal because it enables us to spend more time doing things we know promote good health and well-being: preparing fresh meals, riding bikes, reading books and having conversations with our children.

And so, I leave you with a challenge (and you should consider challenging your patients): Can you go one whole day without looking at a screen?

Margaux Lazarin, D.O., M.P.H., provides comprehensive family health services, including osteopathic manipulation, at a community health center in the Bronx, N.Y. She is actively involved in teaching residents and medical students to deliver evidenced-based care to underserved communities.

Posted at 10:05PM Aug 18, 2015 by Margaux Lazarin, D.O., M.P.H.

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