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Melanie Cole (Host): There’s no handbook for your child’s health, but we do have a podcast. Featuring world-class clinical and research physicians, covering everything from your child’s allergies to zinc levels, this is Kids Health Cast by Weill Cornell Medicine and our topic today is Screen Time and Social Media. My guest is Dr. Moitri Savard. She is the site Medical Director of Primary Care in Long Island City and an Assistant Professor of Clinical Pediatrics and Medicine at Weill Cornell Medicine. Dr. Savard, I’m so glad to have you and what a great topic this is. Tell us what’s happening with kids in this digital media world. Is it making them smarter, more worldly, do you feel it’s positive?

Moitri Chowdhury Savard, MD, FAAFP (Guest): Thank you so much for having me here. I’m very excited to be talking about this topic as a mother of a 15 year old and an almost 10 year old, I get it. the world has changed tremendously in the last decade. The Pew Research Center estimated last year that almost 80% of Americans owned a smart phone. When I was in college, my “portable” Mac weighed almost 20 pounds. Now the vast majority of Americans have an incredibly powerful computer in their back pocket. The access to information made possible by the internet and these devices is amazing.

On the other hand, this can promote learning and exposure to new ideas, but they can also provide increased opportunities for new connections and support via social media. On the negative side, remember how we used to know everybody’s phone number by heart? There is knowledge that we used to commit to memory that we just don’t bother with anymore as everything is just a tap away. Three are also negative health effects on sleep, attention, learning, obesity, depression, access to inappropriate content, misinformation and privacy issues.

So, whether or not it’s an overall positive is very debatable. I think kids are definitely more worldly today, but I would argue that the attention effects are not making kids smarter. There are many tasks still in the world that require a focus that is becoming harder and harder to muster.

Host: So, we’re talking about the time factor that they spend on their phones, can they become addicted to their smart phones?

Dr. Savard: Well research has shown that teenagers currently spend about eight hours a day on their phones which is way more than the recommended amount of about two hours. It is actually possible to be addicted. There have been some calls to include the term nomophobia which is the fear of not having access to your mobile phone in the DSM diagnosis manual which is the manual of mental disorders that healthcare professionals use. It’s not in there right now, but enough people are noticing that this exists.

There are ways that you can figure out if you have an unhealthy relationship with it. There are online quizzes if you just Google am I addicted to my smart phone; they have questions such as do you find yourself mindlessly passing time on a regular basis by starting at your cell phone and do you take your phone into the bathroom. Scholastic which is a very trusted teaching source for pediatricians and parents, they have a good article targeted towards teenagers that can help them break the addiction. If you Google Scholastic cell phone addiction; it’s a good article that really talks to teenagers about how they are using their phone and way to disconnect from them.

Host: So, when they can become addicted and whether or not there are some positive or a negative effect and we are going to talk a little bit more about some of the psychosocial aspects of this all; but screen time Dr. Savard, has changed over the years. It used to be that the AAP recommended no more than two hours of screen time, well back then, that was TV, now they need – I mean my daughter was doing all of her finals and her essays on her computer and they need to sit on their screens for school work and screen time is totally different. Facetime is one thing and YouTube is another and the television which they barely watch is another. How do we even determine what’s screen time anymore?

Dr. Savard: Right. Well, it has changed tremendously. Like you said, in our day it was very much just hours spent in front of the TV which is why the guidelines have changed because in the same way, my son has most of his project based assessments all due on the computer and the phone and his teachers are constantly struggling with that because they are using it as a tool, but they also recognize that that tool can be used in many different ways. Today, in addition to TV, you have video games with like mind blowing graphics, full length movies in the comfort of your home or on the go, social media with like bullying and shaming, Facetime and Skype with real time interactions and work and like school emails where an inadvertent like reply all could be a career killer.

So, screen time has made the world more accessible and also made it harder to get away from the world. I was recently at a conference where attendees were given a sleeping bag for their phones where they were encouraged to “put technology to sleep” in order to wake back up. Frankly, I didn’t do it because I needed to keep in touch with my children who were back home and take notes and pictures of the slides during presentations. But children sometimes have to make this choice and I’m using this computer or the phone to do schoolwork and sometimes it’s helpful for them to be in a space where you can actually see what they are doing.

A lot of families have computers in common spaces so that when you are doing work; you’re not aimlessly on YouTube or on social media. So, that is one way to handle the need for these devices for work that we have to do in terms of homework and other projects in school.

Host: How true. What good points. So, what age is it okay to let them start? I mean I didn’t get my kids cell phones until they were 13 years old, but by that time, they were screaming about it. So, an how also while you are answering that question, Dr. Savard, how involved should we be? Are we supposed to be looking at their texts? Are we supposed to be friends with them on social media, Facebook, Instagram, Snap Chat, whatever or do we start from a place of trust? How does that all work?

Dr. Savard: Right. So, the American Academy of Pediatrics has clear evidence based guidelines on the ages where you should have interaction with screens. It’s recommended that toddlers under 18 months not have screen time frankly unless it’s for video chatting to like say hello to grandma and grandpa. After 18 months, they recommend high quality children’s programing. This is the stuff that you and I grew up on, on PBS like Sesame Street. It’s recommended that you watch with your children in order to help them understand what they are seeing. For children ages two to five; they say limit the screen time to about one hour of high quality programming per day. Again, parents should watch with their children at this age.

Many shows will cover topics such as bullying and caring for the environment. Pick up on these things and then bring them up throughout your interaction with your children. For children six and older, place consistent limits on the time spent on appropriate media. And make sure that there is consistent time for physical activity and sleep. As an anecdote in my house our ten year old does not get time on her iPad during the week and frankly she’s too busy. She regularly has after school activities, homework, piano practice, dinner, you have to take a shower, and she reads before bed. So, that’s like four to five hours of like prescribed dedicated activities and on the weekends, we give her some flexibility to spend a couple of hours on TV and her iPad, once we’ve gone through her to do list that usually involves household chores and some physical activity.

Also, in our house, media is not allowed at mealtime. We do allow in the car sometimes for like the music and games stuff to shorten the trip. But really if there’s like something like you want to talk to as a family in the car; we’ll turn that off for a while. And they listen. They know that we are paying for their devices and we have very strict guidelines about when they can and cannot be used.

And in terms of the phone, when do your preteens or teens get a phone? Usually you find that there is something going on in their lives or school that requires it. My son was taking the bus by himself and walking back and forth to the bus and I needed to be able to contact him so we got him a flip phone. We weren’t ready to actually go the smart phone route and we didn’t until about eighth grade when we felt like he was a little bit more responsible and able to handle the things that become open to you once you have one of these smart phones.

And in terms of social media and texting, I think it’s fine. I mean my teenager and I had a discussion about this. I think it’s nice to be able to be a friend of your teen on Instagram or whatever site that they are using so you can kind of see what their posts are about, and you can like them and promote pictures of them. I think for texts, my husband and I decided that it is important to give our teenagers some privacy. And unless like you are very concerned about something going on where they are going to hurt themselves or hurt somebody else; this is the equivalent of when we used to call our friends at home, and it would as if like somebody had picked up another line and was listening in. So, we do let them have privacy with the texts but we also kind of monitor them. Monitor their moods. Get a sense of what is going on in their lives.

We have this habit in our house where we discuss a rose and a thorn. What happened during your day? What was sweet smelling rose, what was difficult for you? And if you are finding that your child is constantly talking about something that happened, or something that’s really bothering them, or somebody is picking on them; maybe a little bit more involved in their activities and kind of get a sense is there something going on at school that you should be involved with.

Host: What great advice and I mean we know that the main message here Dr. Savard is communication is key. How do you want us to keep those lines open when they are constantly staring down at the phones and we know we have to be good role models and not do the same and know texting and driving and not sit there ate meals with our phones. But drama for these kids is common. And we need to know about it. So, give us your best advice for keeping those lines of communication open and then we’ll talk about finishing up for screen time.

Dr. Savard: Sure. I mean I think that digital drama is very common, and I think it’s helpful to put it in perspective. Share your own mean girls story and explain to them that there will be bumps in the social road and people will like unfriend you and be really just mean sometimes on social media. And I think that when you talk to your children, make sure that they have a good sense of self and who they are and what they are good at and what a good person they are. It’s important to be able to prop our children up and support them because it can be very difficult out there. Some of these behaviors like for example, the Snap Chat swipe.

Those have been shown to give the same brain response as some controlled substances. It releases dopamine and I think you have to have an open line of communication with your child, understanding that these are addictive behaviors and that looking for likes or getting those Snap Chat swipes are actually changing responses in their brain and I got to tell you, teenagers hate being controlled. So, you explain to them that their phone are actually controlling them in certain ways, and I think that that might help a little bit too.

Host: Yeah. that’s really great advice. So, as we wrap up, what would you like parents listening to know about screen time and social media and cyber bullying and sexting and communicating with our kids so that we know what it is they are doing on that screen time and it can actually be a positive thing that helps them go further and lead a healthier life.

Dr. Savard: Sure. So, I think it’s important to talk to them about what they are seeing on their devices. And regardless of how strong your filters are, or if you put in screen time restrictions, sometimes teenagers will be on somebody else’s device and see inappropriate content. Having a very frank conversation with your child about the behaviors that they are seeing online, not being real behaviors. There is violence against women and men and demeaning behavior and having an open conversation with them about this not being the real world and explaining to them how harmful this kind of behavior is.

And I think it’s important that we can use these devices to counteract some of the problems with attention. For example, there are apps that help with mindfulness. Many schools now are teaching mindfulness in the second and third grade where students really understand ways to calm their minds and control their breathing. Use that phone and download an app like Head Space where they learn these techniques and so you can like use these devices and this technology in a very positive way.

And finally, again, like you mentioned, we have to be the change that we want to see in the world. Model that behavior. As a busy family physician, I’m constantly on my phone, constantly on my computer. Well maybe there is a time and a place for that when everybody is home from school, in the evening, we’re talking about that day; those devices can go away, and everything can just wait an hour or two while we work on dinner and check in with each other to kind of see how people are. So, that kind of interaction that those discussions are invaluable. So, I just want to make sure that parents realize that they’re not going away, but they do not have to be the sole focus of your relationship with your child, that your children still want to hear from you and modelling behavior for them is the best thing that you can do.

Host: What great information and so important for parents to hear. Thank you to our guest Dr. Moitri Savard and to our listeners.

This concludes today’s episode of Kids Health Cast. Please remember to subscribe, rate and review this podcast and all the other Weill Cornell Medicine podcasts.

For more health tips and updates on the latest medical advancements and breakthroughs, follow us on Facebook and TwitterUntil next time I’m Melanie Cole.