Children, Adolescents, and the Media

Recommendations for Pediatricians and Other Health Care Providers

• Become educated about critical media topics (media use, violence, sex, obesity, substance use, new technology) via continuing medical education programs.

• Ask 2 media questions and provide age-appropriate counseling for families at every well-child visit: How much recreational screen time does your child or teenager consume daily? Is there a TV set or an Internet-connected electronic device (computer, iPad, cell phone) in the child’s or teenager’s bedroom? In a busy clinic or office, these 2 targeted questions are key. There is considerable evidence that a bedroom TV increases the risk for obesity, substance use, and exposure to sexual content.^1,21–26

• Take a more detailed media history with children or teenagers who demonstrate aggressive behavior; are overweight or obese; use tobacco, alcohol, or other drugs; or have difficulties in school.

• Examine your own media use habits; pediatricians who watch more TV are less likely to advise families to follow AAP recommendations.²⁷

Pediatricians Should Recommend the Following to Parents

• Limit the amount of total entertainment screen time to <1 to 2 hours per day.

• Discourage screen media exposure for children <2 years of age.

• Keep the TV set and Internet-connected electronic devices out of the child’s bedroom.

• Monitor what media their children are using and accessing, including any Web sites they are visiting and social media sites they may be using.

• Coview TV, movies, and videos with children and teenagers, and use this as a way of discussing important family values.

• Model active parenting by establishing a family home use plan for all media. As part of the plan, enforce a mealtime and bedtime “curfew” for media devices, including cell phones. Establish reasonable but firm rules about cell phones, texting, Internet, and social media use.

Recommendations for Schools

Community-based pediatricians, especially those serving in an advisory role to schools, are influential voices in school and neighborhood forums and can work to encourage a team approach among the medical home, the school home, and the family home. So pediatricians, especially those serving as school physicians or school medical advisors should:

• Educate school boards and school administrators about evidence-based health risks associated with unsupervised, unlimited media access and use by children and adolescents, as well as ways to mitigate those risks, such as violence prevention, sex education, and drug use-prevention programs.

• Encourage the continuation and expansion of media education programs, or initiate implementation of media education programs in settings where they are currently lacking.

• Encourage innovative use of technology where it is not already being used, such as online education programs for children with extended but medically justified school absences.

• Work collaboratively with parent-teacher associations to encourage parental guidance in limiting or monitoring age-appropriate screen times. In addition, schools that do use new technology like iPads need to have strict rules about what students can access.

Pediatricians Should Work With the AAP and Local Chapters to Challenge the Entertainment Industry to Do the Following

• Establish an ongoing dialogue with health organizations like the AAP, the American Medical Association, the American Psychological Association, and the American Public Health Association to maximize prosocial content in media and minimize harmful effects (eg, portrayals of smoking, violence, etc).

• Make movies smoke-free, without characters smoking or product placement.¹¹

Pediatricians Should Work With the AAP and Local Chapters to Challenge Manufacturers of Products With Public Health Implications (Tobacco, Alcohol, Food) to Do the Following

• Make socially responsible decisions on marketing products to youth; betterment of their health is the ultimate goal.

Pediatricians Should Work With the AAP and Local Chapters to Challenge the Federal Government to Do the Following

• Advocate for a federal report within either the National Institutes of Health or the Institute of Medicine on the impact of media on children and adolescents that would establish a baseline of what is currently known and what new research needs to be conducted.

• Encourage the entertainment industry and the advertising industry to create more prosocial programming and to reassess the effects of their current programming.

• Issue strong regulations—self-regulation is not likely to work—that would restrict the advertising of junk food and fast food to children and adolescents.

• Establish an ongoing funding mechanism for new media research.

• Initiate legislation and rules that would ban alcohol advertising from television.¹¹

• Work with the Department of Education to support the creation and implementation of media education curricula for schoolchildren and teenagers.

Lead Authors

Victor C. Strasburger, MD, FAAP

Marjorie J. Hogan, MD, FAAP

Council on Communications and Media Executive Committee, 2013–2014

Deborah Ann Mulligan, MD, FAAP, Chairperson

Nusheen Ameenuddin, MD, MPH, FAAP

Dimitri A. Christakis, MD, MPH, FAAP

Corinn Cross, MD, FAAP

Daniel B. Fagbuyi, MD, FAAP

David L. Hill, MD, FAAP

Marjorie J. Hogan, MD, FAAP

Alanna Estin Levine, MD, FAAP

Claire McCarthy, MD, FAAP

Megan A. Moreno, MD, MSEd, MPH, FAAP

Wendy Sue Lewis Swanson, MD, MBE, FAAP

Former Executive Committee Members

Tanya Remer Altmann, MD, FAAP

Ari Brown, MD, FAAP

Kathleen Clarke-Pearson, MD, FAAP

Holly Lee Falik, MD, FAAP

Gilbert L. Fuld, MD, FAAP, Immediate Past Chairperson

Kathleen G. Nelson, MD, FAAP

Gwenn S. O’Keeffe, MD, FAAP

Victor C. Strasburger, MD, FAAP

Liaisons

Michael Brody, MD – American Academy of Child and Adolescent Psychiatry

Jennifer Pomeranz, JD, MPH – American Public Health Association

Brian Wilcox, PhD – American Psychological Association

Staff

Veronica Laude Noland