Pediatric use of screen time is something I’m a little sensitive about. I spent six months of my life working on it and for six months of my life it was all screen time, all the time. Once my portion of the project was over I swore I would never talk about screen time again, that’s how exhausted of the topic I was.

But frankly, I’m tired of seeing parents shamed for allowing their kids watch an episode or two of Daniel Tiger’s Neighborhood while they fold the laundry or make dinner. The science doesn’t support the level of derision that parents receive for even minimal uses of screen time. So when the American Academy of Pediatrics (AAP) issued new working group recommendations on screen time last week, I decided to make an exception and talk about the subject one more time.

I like to refer to subjects like exclusive breastfeeding, screen time, and the amount of time parents spend with their kids as “Modern Mom Guilt.” I think I and just about every other interested parent in America breathed a sigh of relief when the AAP let us know that screen time was one less thing parents had to feel guilty about.

If you weren’t aware, prior to last week the AAP recommended no screen time for children before the age of two years. This guidance was confusing to parents as well, since life today involves a lot of screens. We Skype and FaceTime on mobile devices with family that are miles away, we watch adorable 30 second cat videos on our iPhones and on road trips we’re able to take an entire library of children’s books with us on our iPads, Nooks, and Kindles. Life involves screens, and not all of that screen time is bad.

While my work on screen time started and ended before I was a parent, I didn’t realize how much of a divisive topic it was until I had a kid. When our kids were about nine months old I was talking to a friend about how they keep in touch with family that lived three time zones away. They said it was hard, because before their son was born they would Skype, but since his arrival they had learned how damaging screen time was for infants and toddlers so Skype was off the table.

I tried to explain that type of screen time was OK, and it was really entertainment screen time or using screens as a babysitter that resulted in the sociological deficits that pediatricians warned parents about. My friend said she’d read about how damaging screen time was on a well-known parenting blog so she didn’t want to risk it.

This is actually an example of they type of public health messaging I hate: good intentions taken to a ridiculous and potentially damaging extreme. Screen time messaging over the last five years had become black and white: All screens are bad for kids. But this simply isn’t want the research says. I applaud the AAP for bringing their guidelines up to speed with the research.

CDC Screentime 1The research divides screen time into essentially three buckets: Educational, Social, and Entertainment. It’s really the latter that researchers worry about for kids under the age of three. Things get a little more hinky with older age groups, but let’s deal with the ages 0-3 years group for right now. If you’re looking for resources on screen time for infants and toddlers, in addition to the new AAP guidelines, I’d like to highly recommend the guidelines from the group Zero to Three.

So let’s get this off the table: If you use screens to connect your nine month old to family or friends over long distance, you are not doing your infant any harm. In fact, this type of digital interaction can be beneficial to them, fostering emotional and social connections with important family members they would otherwise not have the opportunity to know.

I repeat, allowing your infant or toddler to Skype with Nana and Grandpa once or twice a week will not damage them.

But what truly divides most parents is entertainment screen time; that is, letting their kids watch an episode or two of Sesame Street or Super Why on, TV, tablet or phone. Again, the problem isn’t the use of screens full stop, it’s two factors: quantity and quality.

Your 18 month old won’t become a sociopath if he watches an episode or two of Daniel Tiger’s Neighborhood every day. In fact, there’s a growing body of literature examining toddlers that don’t have access to educational screen time and research has found a slight, but statistically significant language deficit in children without access. As always, results improve when the parent watches the show with the child and talks through the content.

So if an hour of PBS Kids programming won’t damage your toddler, where are the dire warnings coming from? Part of the issue of screen use in infants and toddlers is that they are still developing basic social expectations, for example, that when you speak to someone they react, and if they’re using a screen (unless it’s social screen time, like Skyping with a family member) that interaction doesn’t happen.  So there are valid concerns that screens, when used in excess as babysitters that this can delay or divert normal social development.

Simply put: moderation, moderation, moderation.

In addition to using screens in excess, issues also occur when the content viewed is not age appropriate. This means that sitting a child in front of the TV or iPad for hours on end, day after day, or letting them watch adult content. While Game of Thrones and The Walking Dead make for great adult entertainment screen time, it’s problematic for kids who aren’t yet old enough to process the sexual and violent content.

You may laugh, but I have known parents that have unapologetically allowed their toddlers and children to watch R-rated films. The argument is typically, “they don’t understand what’s going on, its OK.” That’s actually the problem: The kids don’t understand the content. Unable to truly sort reality from fiction, sexual and violent content can skew their view of what’s normal and what’s expected.

In addition to mature content apps, even ones labeled as ‘educational’ are also still off the table for the AAP and the science also supports this. Most apps labeled ‘educational’ don’t actually have any educational content and the level of interaction these apps require aren’t really enough to engage toddlers and kids in active learning.

You can read the AAP’s updated screen time guidelines here, but I’ve summarized some of their key findings below.

Set Limits: Monitor how much time your child is spending on screens and don’t let it interfere with real world activities.

Watch With Them: Engage in screen time with them, talk to them about what they’re seeing, ask them questions about what they’re seeing.

Quality Matters: Educational and edutainment screen time from properties like Sesame Street, Daniel Tiger and Super Why is preferable to SpongeBob SquarePants or My Little Pony. For a closer look at the science behind some of this, take a look at our previous post by a elementary school Speech-Language Pathologist, who describes components of good educational apps for kids.

Be A Good Role Model: This one is hard for me because I work from home, but parents need to know when to unplug as well. We need to know when to put our own screens away and give our kids our undivided attention.

So there you have it, tacit permission to rid yourself of this modern mom guilt as you put on Daniel Tiger while you get dinner ready.

* Editor’s Note: An earlier version of this post referred to the working group’s recommendations as “changes to the AAP’s screen time guidance.”  The post has been changed to accurately reflect that the new recommendations are from an internal working group and do not reflect a change in the AAP’s position on screen time.


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Categories: Ages + Stages, Mental, Emotional, + Behavioral Health, School-Aged Children, Science 101 + Mythbusting, Toddlers + Preschoolers