#AAP16 Screens and the Developing Brain: Dr. Dimitri Christakis

Our children are growing up in the iWorld. Media, screens are not all created equal.
We need to understand the environment in which our children and teens are growing and learning..media is part of the air and water they are exposed to.

There are 3 key neurocognitive functions to understand when thinking about media use in children.
Self control, working memory (ability to hold information in mind when mentally working on it) and cognitive flexibility (apply something learned in one setting and use in another setting).

Two ways media affect early environment: overstimulation and decreased joint attention. Prolonged exposure to rapid image change during the brain’s critical period of development conditions the brain to expect high levels of stimulation…and leads to inattention in later life. The more TV children view at age 3 increase likelihood of attentional problems at age 7. More cognitive stimulation (parents reading, cuddling and interacting positively with their child) is protective.

Joint attention is important and starts at 4-6 months of age– children will instinctively look back at you and share in an experience. By 18 months, children should be able to direct parents’ attention to interesting things in their environment. This is a necessary foundation for social interactions as well. Each hour of audible TV results in less verbal words..thus it is important to keep talking even when in front of a screen. Opportunities to engage and interact with children are important…even if the TV is on and knowing that social media is very much a part of our lives…

iPADs and traditional toys encourage interaction and can be interactive. But traditional TV is not. Touch screens can be tailorable and can be different when you play with it more. Toys and interactive screens quite possibly can promote joint attention and are portable. The simple act of reading to children do all these things at a fraction of the cost…however we should not think that iPADS are evil and must be looked at differently than traditional TV/screens.

Our children are growing up in a different world and thus we must adapt what we do in clinical practice. 38% of children less than the age of 2 are using mobile devices. This is true even when families in low income urban clinics…children are owning these devices at younger and younger ages.

Dr. Christakis does not recommend specific apps with the exception of BEDTIME math–it has been studied and has led to good results. This app specifically to create joint attention and a platform for parents and children do something together they may otherwise might not do. “This is the sweet spot” and “where we need to go to help parents interact with their children in constructive ways.” Bedtime Math app

Early and small studies in labs about interactive media use and children findings include:
*Infants do not transfer knowledge from apps to the real world
*Starting at about 15 months with parental “re-teach” they can start to do that
*At about 24 months kids can learn words from live video chat

More research and work needs to be done. Interactive apps can become compulsive and kids can be susceptible to spending too much time when not closely monitored. First do no harm principle still applies. What is unchanged in the updated clinical report: media use before age 2 is still discouraged. However, per Dr Christakis: “infants need laps more than apps”; no better early experience than with their parent engaged 1 on 1. We should also avoid media as a calming strategy AND limit screen time to 1 hour per day for children under the age of 5 years of age. Children this age are awake 12 hours or less and so thinking about the proportion of awake time they spend on screens should be limited. No screens 1 hour before bed.

I love this tagline: “Infants need laps more than apps!” Tag #