AAP Media Recommendation

On Monday Oct 17th, 2011 the American Academy of Pediatrics came out with their most recent policy statement featuring recommendations regarding media use and children under age 2.  Click here for a video from the statement release and click here for a copy of the actual Policy Statement published in Pediatrics on Oct 18, 2011.

Before I go too far, what is the American Academy of Pediatrics?  According to their website, the American Academy of Pediatrics is “an organization of 60,000 pediatricians committed to the attainment of optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults.”  The American Academy of Pediatrics (AAP for short) comes out with many recommendations related to child health and development in a variety of areas including: Sudden Infant Death SyndromeADHD, and of course Media (all links are to their press releases regarding their recommendations).

In 1999, the American Academy of Pediatrics came out with their first recommendation regarding children’s media use (focusing appropriately for that time, on television and videos).  For those who need a quick recap of what the world was like in 1999 when this statement came out here you go. Who Wants To Be a MillionaireFriends, and ER ranked in the top 3 most watched television shows (see Nielsen Ratings and The Classic TV Show Database). As for children’s television shows: Teletubbies first aired in 1997 and The  Baby Einstein Company was founded in 1996 by a stay-at-home mom and former school teacher.   In 1998, Nickelodeon first aired SpongBob SquarepantsBlues Clues first aired  in 1996, and Dora the Explorer became a regular series on NickJr in 2000.  (Just for as a reference point Sesame Street began in 1969).

This 1999 Media Education statement provided pediatricians with 9 recommendations including recommendations for what pediatricians should recommend for parents. Among the recommendations, pediatricians were urged to “become educated about public health risks of media exposure” and to “urge parents to avoid television viewing for children under the age of 2 years” (AAP 1999, page 342).  A dozen years later, the AAP has released a statement focusing on recommendations specifically for children under age 2.

The release of this statement has caught the attention of quite a few large media outlets, many academics, and a considerable number of parents.  In reaction to the press and parent comments I have seen, I want to address a few key points from this new Policy Statement.

First, I want to comment on what these policy statements are.  The AAP makes these recommendations primarily for pediatricians (and of course parents too).  These statements attempt to recap all of the scientific studies related to the topic.  Note, these statements are NOT the findings from one study conducted by the AAP, these statements are compiled based on a search of related research conducted by a range of researchers.  I keep seeing parents comment about the “AAP’s study”, this document is NOT a study, it’s a policy statement based on some research.

Second, while many research studies are included in this document, many of the studies referenced are correlational, not experimentally controlled studies which would be necessary to determine causation (See previous post Science: Cause and Correlation).  When research finds a positive correlation between two things that means they just change in the same way. For example, height and weight are often correlated: the taller you the more you weigh and often times the more you weigh the taller you are. Does that mean that if I am currently 5’3” and want to 5’8″ that I should start gaining weight?  Nope- that would only work if there was a CAUSAL direction between weight and height.  Get it?  This is an IMPORTANT distinction to understand when reading the research that was used to back up this AAP recommendation.  There may be fundamental differences between children who watch a lot of television compared to children who don’t and those differences may actually be the forces that are driving the findings like language delays, etc.  Importantly, one study that the AAP statement references by Linebarger and Walker (2005) explicitly states that lower language scores were RELATED to viewing certain programs at young ages, meaning that it could be that kids who had lower language scores were more attracted to or interested in these types of programs.

Third, the world infants and toddlers live in today is very different from the pre-DVR, pre-Ipad, and pre-iphone days infants and toddlers were born into 12 years ago (when the 1999 statement was released).  It’s shocking that the AAP failed to recognize or discuss the media of today when the number of infants and toddlers using newer media technology like iPads continues to grow.  Recent research by PlayScience reports almost 80% of children age 2-5 have access to smartphones and 19% to tablet computers.  The entire policy statement focuses on the same media from 1999: television and videos and fails to discuss the realities of the media children are using today which are increasingly interactive and increasingly present in their daily lives.

Finally, the news needs to be careful with how they report this and the potential fear factor they are causing in parents.  Media is a part of almost all Americans lives.  Televisions and screens are everywhere from restaurants to gas stations, from taxis to new cars, and in classrooms and homes.  We live in a screen-filled world. Absolutely, parents should be careful of EVERYTHING their children are exposed to including but not limited to: media, music, unhealthy foods, unsafe playgrounds, germs and diseases… the list goes on.  Media is a part of that and parents should be concerned to some extent and they should be aware of the research that has been conducted, but unfortunately, this policy statement and the media’s reaction and reporting of it are failing to give parents complete, accurate information that allows them to make the best decisions for their children.

Example of a toddler's art created on an iPad

My last comment is probably the most important.  Clearly, parent interaction and real-world experiences are key to healthy child development. No one is advocating that children should only learn from screens or interactive digital devices.  But most of research that has been done today has been conducted on a small group of children and with very little regard to the context in which children are watching/using screens.  We don’t know much about infants use of newer interactive media like tablets or touchscreens.  We do not know the influence of media for all types of children.  I could imagine that for a single mom working two jobs the benefit of having her child sit in front of Sesame Street or play an educational ipad game for 20 minutes while she calms down after an emotionally exhausting day at work could have benefits well beyond the potential consequences discussed in this AAP policy statement.  I could also imagine that technology could be used to enhance learning by providing pictorial examples of things children don’t have access to (like images or videos of Lions in the wild), etc.

At the end of the day parents need to make smart decisions for their families based on the information that is available to them.  Knowing the potential consequence of media exposure is important but so is being able to understand where it can be potentially beneficial even for very young children.

References:

American Academy of Pediatrics (1999).  Committee on Public Education. Media Education.  Pediatrics, 104, 341-343.  http://aappolicy.aappublications.org/cgi/reprint/pediatrics;104/2/341.pdf

American Academy of Pediatrics (2011).  Policy Statement: Media use by Children younger than 2 years.  Council on Communications and Media.  Pediatrics, 128, 1-6.  As of October 19, 2011 available for free form this link: http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-1753.full.pdf+html

Linebarger D.L, Walker D. (2005).  Infants’ and toddlers’ television viewing and language outcomes. American Behavioral Scientist, 48(5):624 – 64. http://abs.sagepub.com/content/48/5/624.abstract

New York Times Comments by Parents regarding the AAP’s new recommendation http://community.nytimes.com/comments/www.nytimes.com/2011/10/19/health/19babies.html?sort=oldest&offset=2

PlayScience http://playsciencelab.com/LabReport/MobilePlaygrounds_LabReport.pdf

Related Resources/Blogposts

Children’s Technology Review Hey Doc, What About My Child’s iPad?

Moms With Apps Updated Policy Statement from the American Academy of Pediatrics

The Washington Post The AAP reaffirms no screen time for young children even though few parents listen

New York Time Parents Urged Again to Limit TV for Youngest

New York Times Comments to Parents Urged Again to Limit TV for Youngest

Boston Globe Trying to Gauge the Impact of Growing Up Digital

Huffington Post David Kleeman Children and Media: Pediatricians’ Monolithic Myth 

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