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Melanie Cole (Host): Today's children grow up immersed in digital media, which can have both a positive and a negative effect on healthy development. Here to tell us a little bit about that is Ryan Thill. He's a Licensed Professional Counselor at Northwestern Medicine Behavioral Health Services in St. Charles. Ryan, what's happening with our kids in the digital world? Is this, in your opinion, making them smarter, more worldly? Is it positive? Is it both? And how much time are they really truly spending on digital media?

Ryan Thill, LPC (Guest): Well, good morning, Melanie. Thanks for having me. You know, our adolescents are really heavily involved and connected to their electric devices, and for the past number of years - probably a good past five to eight years - we've had a lot of research that's kind of been trickling out just about how much time are they really spending on electronics, and some of that's really hard because the adolescents don't necessarily differentiate when being interviewed about is this just a cell phone? Is this an iPad? Is this an iPod Touch? Is this my video game system, or is this a computer that we're using?

And one of the other things that kind of makes it complicated is that a lot of our school systems now give our students electronic issued devices. And so the research has really worked hard to distinguish between what is educational time versus what is recreational time, and then when it is recreational time, what are adolescents doing with that, and what is its impact that it's having?

Host: Well, I appreciate you distinguishing between the difference between what they get from school, and the homework that they might have to do on a Chromebook or something versus their recreational use of that kind of thing. Talk about the teenage brain for a while, because we all know that they go into a sort of different stratosphere when they're teenagers, and their brain actually is different than ours.

Ryan: Right, so the human brain goes through two massive changes during its lifespan. And so one is during toddler years, and then one is during adolescents, and the brain develops back to front. And so when we're looking at the brain, just very basic structures, we have the brain stem and it kind of wraps around starting from the back all the way up to the front, and this is why our kids grow in their bodies, and then we see this later emotional and cognitive maturation, and that's because especially that cognitive maturation really happens in the frontal lobe, and that is the last thing that gets developed, unfortunately for our parents of teenagers, who probably know that quite acutely.

And so what happens is, is our adolescents really struggle with this emotion regulation because that amygdala is located on your brain kind of right by where your ears are, and so we have a lot of time from where that maturation hits that frontal lobe, and they really struggle with that self-regulation and that emotional regulation, and with really understanding what is and is not appropriate, and just how to use your brain for what we would use for like judgment situations.

Host: Well, speaking of judgment situations, what kind of an impact do you feel that all of this use is having on our kids, whether it's physical, because we've seen the childhood obesity epidemic happening, and kids and video games, the emotional impact, the social impact. Tell us what it's doing to our kids.

Ryan: Well, so we take into account that brain development- so that emotional part of that brain, that amygdala is going to get developed before the frontal lobe is, and so this is why our teenagers do emotionally reactive things, and then you look at your teenager and you say, "What were you thinking?" And they kind of give you that deer in headlights look that is really frustrating for us parents. And the problem is that emotionally, when they get emotionally charged by something, they have a hard time correctly discerning what that situation is.

There was a research study done a while ago on adolescents and how they perceive human emotion on faces, and a good majority of adolescents got emotions wrong. They misread anxiety or fear as anger, and that's in face-to-face conversations. And now when we add in screen time, where a lot of their communication and a lot of their interaction is via a screen, well now adolescents have to take a guess as to what is the emotionally charged content of whatever is going on, and adolescents frequently guess wrong. But because it is so instant, and there's this instant gratification with our dopamine receptors that happens, this is what teenagers like these days. This is what they go to because it's instantly gratifying, but they also have such a hard time correctly discerning and then also emotionally regulating just due to their lack of brain development because they just have an immature brain that it's really becoming problematic for the mental health world.

Host: Well it certainly is, and the American Academy of Pediatrics recently changed up their definition of screen time, because it used to be just watching television, but now it's so much. And as you already said, homework is a part of that screen time, but not considered on the limiting part. Can we as parents, Ryan - the million dollar question - can we limit the recreational time? Because we can't really affect the school time, but can we limit the recreational time as parents? Is it possible?

Ryan: It's a battle, and I live this battle at home, and the American Academy of Pediatrics has really been firm from what I've seen on this, is just that children ages three to eighteen, no more than two hours of recreational screen time per day, which is probably going to be earth-shattering for anybody that has a high school student, and tries to start out with that conversation of, "Hey, we're going to cut your time down to two hours." Probably not going to go very well because they're not used to that.

The problem is, is that when we see students that use their screens for more than two hours, there's a definite negative effect on their mental health, and then we as parents have the responsibility to kind of be the bad guy here and really help our teenagers understand that this is not what's best for them. Teenagers really struggle in understanding what they have, what's best for them long-term, again because that frontal lobe is not developed.

And so long-term thinking, consequential thinking is really hard for them, and so helping them to understand, "Hey, getting out of the house, going to hang out with your friends, being involved in after school activities, being involved in sports or other extracurricular activities at school, and having a job," these are essential things that teenagers don't do as much today as they did say fifteen, twenty years ago. And it's very clearly- research is coming out that is very clearly having a negative effect with their mental health.

Host: Well, and as parents, we know that communication is the key, so we have to keep those lines open with our kids, Ryan. Should we as parents, in your opinion, listen as it were? Be friends with them on Facebook, check their Instagram? I mean Snapchat, who knows, it disappears in a second. Do we start from that place of trust? Should we be looking at their texts? Should we get involved in all of this?

Ryan: And that is always- that's a question I always get in my office with patients who are on my case load, and their parents it is, "At what level does my student's privacy override my ability as a parent to love and protect my child, and guide my child in today's modern world?" I don't think there's a black and white answer to that. I think we're really in the world of gray, and some of it is dependent on your child.

I think for parents who have younger children, when you introduce technology, it is introduced with limits. It is introduced with this understanding of, "Hey, I'm paying for your cell phone bill, therefore I get to look at your cell phone whenever I feel like I want to, and there could be a reason or there could not be a reason."

What that helps is that extra level of accountability and saying, "Hey, you know what? You're in middle school, maybe you don't need Snapchat. Maybe you don't need these things because it's just extra drama at this point in time, and so we're just going to say no." Maybe we're going to be the uncool parents and understand that as parents of teenagers, we're going to be uncool sometimes. At the same time, having some balance to things and making sure that we are doing a really good job of investing with our kids, and even though they're in that stage where they're pushing away from us, that we still work really hard to have intentional family time. That we still work really hard to have those conversations, to have dinner time where we can hang out, or to have what I call 'forced family fun time' at least once a week where we as a family get together, and we do something fun, and it doesn't involve screens.

What this does is it provides space for our adolescents to interact and use their words with us as opposed to just sitting down at the dinner table, wolfing down food, and then going right back to screens. Or sitting down at the dinner table and just having the phone in the face, and not really engaging. By creating that extra space, parents now have an opportunity to be more involved in part of their kids' lives, which will help students feel more comfortable in talking to them.

Host: Really great information and great advice for sure, because I think that as we start to set those limits at a young age, just like feeding them healthy at a young age, they learn and it becomes part of what they're used to, but it's also important for parents to be role models, right? Because if we're texting while we're driving or if we're on the phone during dinner, then they're going to feel it's okay.

Ryan: Oh 100%. Our adolescents are still very much in this monkey see, monkey do business, right? And so I tell my parents, I said, "Look, your teenager is really just an oversized toddler, okay? They're going to look at you, and they're going to look to you for how they should behave." This is why like toddlers repeat back the things that we as parents just don't want them to repeat back, because it slipped out of our mouth, but our toddlers heard it, and they think it's funny, so they say it. It's the same thing with our teenagers. If I'm sitting down at the dinner table, and I'm more invested in the emails that are coming across my phone from work, or the text messages from my friends or something like that, what message am I sending to my student? When I'm driving in the car, what message am I sending to my student? What kind of driver do I want my child to be? Well, I really want them to pay attention to the road, especially given their lack of frontal lobe, and that kind of thing.

So I like utilizing those times, especially in the car while driving, that is a great time. You have a captive audience. Your child is trapped in the car with you, and so you have a great opportunity to let them pick the music and put it on, even if you can't stand it. To be able to start to have a conversation about their world and what's going on. "What's going on today?" And I as a parent just don't- I don't take one word answers. If they go, "Okay, fine, good," doesn't tell me anything. And I say, "Well, I want to understand. I want to know more about what's going on with you because I love and I care about you." And I think verbalizing that really kind of helps students over time be able to open up.

Host: Wow, that's really an amazing answer, Ryan. So wrap it up for us with your best advice for parents listening about disconnecting their teens, and even younger kids, from that whole mobile phone, digital media world that the kids live in today, and what you want us to know about the importance of that face-to-face time, and that one-on-one contact, and that family time. So reiterate for us and wrap it up.

Ryan: Yeah, so parents, we have an uphill battle on setting limits on screen time, and really all the research really points to two hours of entertainment screen time as it is called. So that's anything with a TV, game systems, computer, mobile electronic devices, that needs to be capped at two hours. Some of the things that we as parents can do to help this out is to naturally build in other things and other activities into our day that will naturally take our students away from their electronic devices. Things like getting outside, things like going and exercise, practicing good sleep hygiene, having good family activities that we do whether it's a game night, whether it's something that we as a family do that's fun. And helping students structure their day so there's not all of this free time where they just get sucked into screen time.

Host: Wonderful. Thank you so much, Ryan, for coming on today, and really sharing your expertise as both a Licensed Professional Counselor and a parent, because then when people hear you, they can really relate, and it helps us to give us this great information. So thank you again for joining us. You're listening to Northwestern Medicine PodTalk. For more information on the latest advances in medicine, please visit www.NM.org. That's www.NM.org. Share this show with your friends, it's great information. This is Melanie Cole, thanks for listening.