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ENJOY YOUR MEDIA...AND USE THEM WISELY
by Michael Rich, M.D., M.P.H.

“Will educational baby DVDs make my baby smarter?”

“What should I do about video games on playdates?”

“How can I manage media use with kids of different ages?”

If you have questions like these about media and kids, you aren’t alone. Media are everywhere. And with conflicting reports about how they affect children, it can be difficult to figure out which risks are real. It’s true that American children spend an average of nearly 6.5 hours every day with television, the Internet, video games, cell phones, movies, and popular music—more time than they spend in school, with their parents, or engaged in any activity except sleeping. But is there a problem with that? Or are we, like our parents before us, left clueless and irritated by our children’s media and the way they use it?

The simple answer is that something is happening here. Many of today’s children are overweight, are not sleeping enough, or are struggling in school. And there is now significant and growing evidence that both the amount of media and the content they see and hear are associated with these leading threats to their physical, mental, and social health.

At the same time, though, children are learning to read, learning about lands and cultures from across the globe, and developing higher-order thinking skills. Research has shown that high school seniors who viewed educational television at age three are more motivated to achieve, have better social skills, are more creative, and earn better grades than those who watched general programming or no television at all.

So what is a parent to do? Media are thoroughly integrated into many aspects of our lives, so it seems impossible to isolate our kids from them entirely—and I don’t think that’s the answer, anyway. Instead, teaching them how to understand the messages they see and hear and to use media in healthy and thoughtful ways is a more realistic and useful approach. I urge parents to understand how media affect children, ask questions about relationships between media use and health concerns, and find practical strategies for addressing them.

At the Center on Media and Child Health at Children’s Hospital Boston, we aim to help parents do exactly that. We compile the best research available, conduct research of our own, and figure out the most effective recommendations to make to parents based on that work. This is exactly the same approach pediatricians take when talking with parents about issues like nutrition and safety. Just as you feed your child vegetables so she gets the vitamins she needs, and just as you put her in a car seat to protect her on the road, use these five recommendations to make her media experience as positive as it can be.

1. Understand your child’s developmental stage.
Children see, understand, and make meaning of the world—including media—very differently than you do. This is true throughout childhood but is especially true in the early years. Between birth and five years of age, their brains are changing rapidly in response to the environment around them. For that reason, infants, toddlers, and preschool-aged children need to be in an environment that encourages their brains to develop in the most useful ways possible.

Infants and Toddlers
Babies learn best through establishing relationships with other people, interacting with the physical environment, and playing in an open-ended, problem-solving way. The optimal media for children of this age, therefore, are those that encourage one or more of those three things.

For example, reading to or with your baby is a great way to cuddle up and spend good, focused time together. Reading can also encourage babies to experience all of their senses, especially when board books or touch-and-feel books offer new textures for babies to explore.

Screens, however, provide none of the three essential elements. Although infants and babies will watch them, they do so because they see something moving and changing, not because they understand what’s going on—their brains are still learning to separate out important sensory (in this case, visual) information from “noise.” And there is no evidence that children learn effectively from screens earlier than the age of two-and-a-half.

Preschool-aged children
Three- to five-year-olds are, of course, at a different place in their development. They have learned to talk and walk, and they are exploring the world using their own two feet and their growing knowledge of language. Play is central for them—it’s how they learn about the world, and it’s how they exercise their capacity for learning. They also need lots of time and attention from you, and they need room to stretch their imaginations. Therefore, media that encourages these things is optimal for kids of this age.

Reading books to and with kids is still a great use of media at this age, again because it’s time with you and exposure to increasing numbers of words. Music can get them dancing, singing, and clapping (which is also true of babies), thus helping them learn the capabilities of their bodies and enjoyment of this art form. Unlike for babies and infants, there is evidence that three- to five-year-olds can and do learn from screens, within the limits of their (still very short) attention spans. But if you use them, they should be only one of many activities in a preschooler’s day.

2. Content matters.
All media are educational—it’s just a question of what they teach. Characters in a TV show where siblings learn to share their toys can serve as positive role models for your own kids. On the other hand, cartoons or videogames where violence is used to solve problems teach kids that they should use force to get what they want.

How parents and others address these messages makes a big difference in how kids receive them, however. If you don’t comment on a message, kids assume that you agree with it. So if you see or hear a message you don’t want your kids to learn, make sure to speak up and tell them what you believe should have been said or done instead.

And a word on violent, scary content: babies may not be able to understand the visual information coming from a screen, but they can feel the tension and hear the loud noises and feel fear anyway—in other words, they get the tone, if not the content. Toddlers and young children feel those things as well, but they also understand the images and they see them as real. For that reason, something that seems obviously make-believe to an adult—like Wile E. Coyote falling off a cliff—can seem real and utterly terrifying to a young child. Pay attention to how your child reacts to media, and respond to his needs.

3. Context of media use is important.
The environment in which children use media strongly influences whether media enrich or harm them. For babies and young children, media use is optimal when it occurs with other people—when Mom reads baby a story, or Dad watches an educational program with his four-year-old, pointing out characters on the screen and maybe even pausing now and then to ask the child questions about what he sees.

Also pay attention to where different kinds of media use happen. Reading stories before bed in a child’s room can be a good step toward sleep, but having a television in that space has been linked to overweight, poorer academic test scores, and sleep problems. By keeping the television in a family area (but out of eating areas, where the optimal activity is to focus on eating and connecting to each other), you can see how and how often it is being used. You can also more easily keep track of time limits. Remember that it is much easier to never put a television in your child’s room than it is to remove one that’s already there.

4. Count the amount. The American Academy of Pediatrics specifically recommends that parents avoid all screen media exposure for children under the age of two. After this age, they recommend no more than two hours of screen media per day. CMCH recommends gradually introducing a few educational programs after age two. Your child is likely to lose interest after 15 to 20 minutes, at which point, you can shut the TV off and direct her attention to a different activity.

Note that children often respond differently to screen media than to other activities, in part because they change images and sounds often enough that even young kids, who can’t focus on playing in the sandbox for more than 20 minutes, will keep watching. But kids still need a new activity after that amount of time. They need to engage in all of the other important activities of life—sleeping, eating with family, playing—and not allow screen time to infringe upon them.

5. Teach active, critical media use—it is essential for healthy development. What we feed children’s minds is as important as what we feed their bodies. Just as we vary our food diets in order to get all the nutrients we need, so we must vary our activity diets. And just as we eat for both enjoyment and nutrition, but only until our bodies tell us to stop, so should we consume media for a reason (we want to learn about dolphins or watch a sports game) and stop when we’re done.

Teach children to develop a healthy media diet, and engage them in the process of thinking about the media they use, rather than passively consuming it. One of the most powerful ways to do so is to model this sort of use yourself. For example, when you turn on the TV, do so in order to watch something specific, then turn it off and do something else. Have a varied diet of activities yourself, and involve your kids in them.

Lastly, teach your children to think critically about the messages they see in media. When you see something happen that you don’t agree with, question the behavior out loud. This will show your children that they don’t have to—and shouldn’t—take everything they see at face value.

Making it happen in your own home
As the school year gets underway, I urge you to consider how media are used in your home and how they can be positive influences on your children’s development. We would love to support you through this process. Please take advantage of CMCH’s free parent resources at www.cmch.tv, and, if you have questions or need advice about creating a healthy media atmosphere, I encourage you to write to me, Dr. Michael Rich, at cmch@childrens.harvard.edu. I answer questions from parents twice a week through our free service, Ask the Mediatrician^SM, at www.askthemediatrician.org. So go ahead and ask!

Michael Rich, MD, MPH, is a pediatrician, parent, researcher, and former Hollywood filmmaker. As director of the Center on Media and Child Health, he conducts research on the health effects of media on children, and he both offers and listens to ideas on how to raise children in the Media Age through his website, Ask the Mediatrician^SM, a twice-a-week Q&A. He spoke in Winnetka in February 2008 at an event co-sponsored by the Alliance and North Shore Country Day School. this article first appeared in the Fall 2009-Winter 2010 issue of “Early Childhood.”