It’s time for pediatricians to change our advice about media

Television—screen-time in general, really—is a problem for children. Kids who watch too much of it are more likely to be overweight. Violent programming and video games can make kids more aggressive, sexualized programming can make kids more likely to have sex early, fast-paced programming can mess up executive functioning in preschoolers.

Because of our worries about the effects of television, the standard advice of pediatricians has been: turn it off. We say that children under the age of 2 shouldn’t watch any television at all, and everybody else shouldn’t watch more than two hours.

The problem is, people aren’t listening to us. As I wrote in a commentary in the journal Pediatrics, it’s time to change our messaging—and our approach.

The reality is that for the most part, families think of television as fun—and convenient. It makes their children happy to watch it. It frees the parents up to make dinner, do chores, or do whatever else they need or like to do that’s hard to do with children underfoot. Lots of parents like TV too—and they look back on their childhood of watching it and say, hey, we turned out OK.

But it’s more than that. Increasingly, we are becoming a digital world. Our life is so much about screens these days. The Internet is a huge part of our life—and where we watch a lot of programming. Video games are ubiquitous. We can even watch programming and play video games on our phones.

Screens are here to stay. But that doesn’t have to be bad—if we can find more ways to make the screen time work for children, instead of against them.

In a really interesting study just published in Pediatrics (that my commentary was about), a team of researchers led by Dmitri Christakis worked with families of preschoolers. They didn’t tell them how much TV their children should watch; instead, they concentrated on what they should watch. They educated them about the effects of violent, sexual and other inappropriate programming—but more than that, they gave them suggestions of shows that are good for kids to watch. The programming they suggested was “prosocial”: programming which showed children how to behave nicely with other children, shows like Dora the Explorer and Sesame Street.

The parents listened. The kids watched less inappropriate content, more prosocial content—and what was even more amazing was that the behavior of the children got better. Only by a little bit—but it was better. The programming actually helped.

This is a really great study—because it gives us a whole different way of looking at things. It gives me hope.

I am not saying that we still shouldn’t encourage people to shut off the television or the Internet or the Wii or whatever screen their child is in front of. Kids need exercise. They need to play. They need to use their imagination, they need to read, they need to get outside. But if kids are going to be in front of screens, it’s in their best interests if we pay more attention to—and put more energy into changing—what they watch.

We could do much more when it comes to educating parents about the effects of different kinds of programming. It’s my experience that lots of parents either don’t realize how violent some programming is, or don’t understand the effects it can have on children. Very few have heard about, let alone understand, the effects of fast-paced programming or sexualized content. “How many hours of television does your child watch?” can be a real conversation-stopper, especially when people are reluctant to tell us the truth. “Let’s talk about what kind of shows your child watches” may be more likely to get the conversation going.

More than that, though, we need to move away from don’t-watch-that to do-watch-this. Parents want their children to be well, and I’ve found people to be very open to suggestions. Common Sense Media is a fantastic Web site that has lots of information for parents, with reviews and suggestions about all things media, including movies, TV shows, video games and apps. It also has suggestions to help teach children to be good digital citizens—which is something we really do need to teach. The Center on Media and Child Health here at Boston Children’s Hospital also has a lot of great information.

And even more than that, I think that we need to put some real energy into working with the media, instead of against them. Let’s work to create partnerships, share what we know about child development, and give them specific messages and information that they can work into their programming, messages and information that could help children and families. It won’t be easy, but it’s worth a try.

As I said in the commentary, “if you can’t beat ‘em, join ‘em.”

One thought on “It’s time for pediatricians to change our advice about media

  1. Dr. Claire, very topical. Reading this reminded me of Diane Levin’s recent post on the unintended effects of too much screen time ( and the book she co-authored aimed at parents, preschool teachers, and early childhood educators, “Facing The Screen Dilemma: Young Children, Technology and Early Education” (

    Looking for more as I finished your post, I happened across your friend, @SeattleMamnaDoc, Wendy Sue Swanson and her recap of the same report ( I would suggest those who have read this post to go there for “5 Tips On Making A “Media Diet” For Your Young Child.”

    Thanks again, Doc!

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