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Mark Bertin, M.D. Headshot

TV Reality or Reality TV for Children?

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Statistician Nate Silver predicted the last two presidential elections through the following logic: Multiple polls were calling the election a toss-up because President Obama's slight lead fell within the margin of error. In other words, it was fairly likely by any individual measure that his lead was no better than chance. However, that same slight lead was present in almost all the individual polls. What were the odds of all of them skewing the same way? Very, very low. Obama wins.

I woke up this Sunday to two different commentaries on media and children. In one, the New York Times published a group commentary from their critics about movie violence. One writer acknowledged that media might actually influence society in some way, another commented on the inappropriateness for kids of many commercials. The other essays didn't seem concerned about the issue much at all.

All of the reporters skirted the large volume of research showing that media content really does influence child behavior. The relatively unconcerned view they took, not in any way unique to the Times, serves as a clear example of a common misperception. While this type of research is inherently challenging to conduct and there may never be a single definitive study, we already have plenty of information about the impact of screen time on children. It's not neutral, and has been shown to be detrimental many times over.

While any individual publication can be picked apart and perhaps even dismissed, it is highly unlikely that dozens would skew the same way. Every month in the medical journals, new papers suggest that without skillful management from adults, media influences children for the worse. Not only behavior but poor sleep, attention problems, obesity and even long-term adult lifespan have been linked to screen time. Much like Nate Silver's view on the elections, the odds are poor that study after study would randomly reveal these negative effects.

Media Management Matters

The second commentary I saw last weekend was from the American Academy of Pediatrics (AAP). A new study showed that simply changing the content of programming for preschool-age children altered their behavior for the better. Alongside that publication was an AAP statement reiterating the fact that in spite of public discussion suggesting there is an open question, a clear body of evidence defines the negative effects of media on children. Since educating parents to cut down on screen time has not made enough of a difference, perhaps the discussion needs to skew towards managing media content instead.

In reality, it is not surprising that a product designed to sell (which includes any device, show, movie or game available) influences our children. The whole point of marketing is to grab attention, hold it and create purchasing habits. While the public view often seems to be that there's no proof media does anything to kids, within the field of pediatrics that is not the understanding at all. There is a clear consensus that media and marketing does, in fact, influence children's behavior and lifestyle. And not for the better.

Two or three generations ago, anyone raising the point that smoking might not be the healthiest activity for people would have been dismissed. Public consensus at that time was that everyone had the right to smoke wherever they chose, and nothing could be done about it anyway because smoking was an entrenched part of public life. That's where we stand with media today: Screen time and unfiltered content seems unavoidable and like an inalienable right, but accumulating science says we need to use it differently than we do to stay healthy... particularly regarding a young and developing brain.

Most of us are going to watch television and use computers and carry smartphones. None of that is going anywhere, and in reality none of it needs to since media on its own is not the cause of any particular ill in society. But at the same time, for almost any measure of well-being screen time shifts the curve for the worse. It may not cause issues for any individual (plenty of people play violent games and live normal lives), but it affects our general health and may influence specific people differently. For example, a small but significant subset of teens could be significantly affected by on-screen violence. Figuring out how to manage screen time and content for children is a complicated issue, but not a non-issue in our world.

Media isn't inherently 'bad' in any way. It's not an exact parallel to smoking (although in fact, exposure to on-screen smoking does impact teen choices), since electronics can actually be helpful in our lives as well as a source of benign entertainment. Yet to raise healthy kids in the modern in the world, both as families and as a society we need to accept that media does in fact have an effect on our children when we do not manage it well. We must recognize that media impacts child development, and set clear limits that protect children and promote their overall well-being.

Some basic media guidelines for early childhood:

- Parents decide how much time is appropriate in front of a screen every day. General guidelines are one to two hours or fewer each day, with none before two years of age whenever possible.

- Parents monitor content, using neutral rating systems like those created by Common Sense Media* (as opposed to the industry guidelines, which are self-monitored and not particularly useful)

- Parents model healthy lifestyle themselves -- turn screens and phones off during family meals, play time, down time and in the car. What role do screens play in your home? Actively protect time for imaginative play, social play, reading, exercise and whatever else you value.

- Limit marketing as much as possible. Watch shows without commercials, use digital recorders, buy non-branded products and discuss with children the intent of commercials to influence their choices.

*I am on the editorial board of Common Sense Media, a voluntary position, and have no financial relationship with their non-profit.