Do As I Say, Not As iDo

Blogs, articles, and pediatric literature abound – some say too much, some too little – with analyses of children’s viewing behavior and effects thereof: hours per day, bedroom TV, violent video games, Baby Einstein, obesity, ADHD, etc.  However, focusing on where, when, and how much time children spend on the screen time stage too often misses grownups directing the show.

The lens seems to be shifting.   For example, my last post examined an evolving New Normal paradigm, where parents, not advocates, pediatricians, or even Big Bird, define the terms of healthy media use.  Another cited a study highlighting the prevalence and effects of background television – readily applied to background smartphones – on play quality and parent-child engagement.  This “ecological” context, involving parent-child symbiosis rather than children in isolation, makes sense.  Parents buy the TVs and gadgets, coordinate daily schedules, download the apps, and critically, set the rules.  The first 3 years are a time of intimate yet intense togetherness, which is why naps and baby “learning” videos are so popular.

It is well-known that children imitate their parents, often adorably, sometimes not so much.  Children want to do what their parents do, and watch what their parents watch.  The academic term for this is social learning theory, which any grandparent will tell you is more than a theory.  Humans are social animals and learn through communication and imitation.   Thus, parents are a child’s first, most beloved teacher, whether encouraging first steps or words, serving as engineering consultant on block towers, or rifling through college preparatory flash cards.  Equally (or more) importantly, parents teach by example.   This can be good example – petting the dog, responding affectionately, walking outside – 0r not-so-good: texting at the park, checking email at dinner between bites of Stage 1 peas, or keeping one eye on The View during tummy time.


Whatever it is, children are watching every move, taking careful notes in their preverbal brains.  If parents are only partially paying attention to them, they’ll see this as normal and disengage (or act out) accordingly.  If parents seem more interested in the phone than the swing set, they’ll want to go “whee” on the phone.


Lovely day for a picnic!

As they saying goes: the apple doesn’t fall too far from the Apple Store.

A new study in last month’s Pediatrics recounted findings of a team of researchers in PA who surveyed 1550 parents of children 0-5, 6-11, and 12-17 about viewing behavior, both of themselves and their children.  Parent viewing was found to have the strongest association with child viewing (23 extra child minutes per hour of grownup time), eclipsing even TV in the bedroom, a well-established driver of excessive viewing and associated health risks.  As child viewing increased with age towards the current 8+ hour/day US average, grownup viewing increased even more.  Implications for grownup obesity, ADHD, sleep problems, and workplace productivity are compelling, but beyond the scope of this blog.  Cited screen time likely understates actual viewing, too, as surveys tend to involve “social acceptability bias,” where respondents are reluctant to report behaviors they sense are outside of healthy guidelines.

Screen Shot 2013-08-14 at 9.13.20 AM

Table from the Pediatrics study

That’s a lot of screen time and not enough books and blocks!

The study also found that co-viewing, which is recommended by the AAP as a means to promote pro-social parent-child interaction, tended to involve children watching what grownups want to watch rather than the other way around. Potential for parent-toddler discussion of budgetary quagmire in DC, A-Rod performance-enhancing drug use, and the Kardashians, yes, but not what the AAP had in mind.  The inappropriate content problem was ironically blunted by cited rationale for placing a TV in a child’s bedroom: to free up time and resources for grownups to watch their own shows.  This motivation has been cited repeatedly in studies on bedroom television.


We love Ellen, but…

Altogether, this raises a critical, yet agonizing issue: parenting.  It is always easier to discuss what children should do, rather than what parents should do.  Parents don’t want anyone to tell them what to do, even their doctors.  After all, they are grownups.  Thus, the essence of pediatrics: part viruses, part parental psychology, with viruses generally easier to manage.  However, above and beyond anything else that a child encounters in their lifetime: parenting matters.  Good parenting is the supreme vaccine, antibiotic, mood stabilizer, performance-enhancing drug, and safety shield.

Parenting has always mattered, and if it seems harder nowadays, it is.  Everything is so much faster, busier, and available: self-inflicted wounds of the wired age.  Many of us recall a time when we didn’t have any rules other than to stay off the roof and be home before dark, unless the plan was chasing fireflies.  This mode now seems unrealistic, if not surreal.  With so many new electronic options for us and our children – even if not especially good ones – we need new rules, befitting the New Normal.  For the first 3 years, I propose these:

1) Unplug.
2) Apply old rules.
3) Have fun.

If these seem too simple, remember this: more than ever, in addition to being good citizens, we must uphold our end of the symbiotic bargain and be positive media role models for our children.  This can mean reducing our own viewing, turning off background TV, and disengaging from the virtual world (e.g. deferring non-urgent phone use) when together.  Not only will this reduce our children’s viewing and help them stay healthy, it is a perfect excuse to slow down, engage, and enjoy this precious time together.

Thank you for reading!
As always, comments and ideas are welcome.


Happy Summer!

An unabashed, exciting PS: Baby Unplugged books, and others from blue manatee press, are now being distributed nationwide by Independent Publishers Group.  Ask for them at your local bookstore, and if not in-stock yet, please suggest that they carry them.  Thanks again!

New Normal Childhood?

The pediatric screen time debate too often seems akin to political debate or, ironically, TV talk show.  One side waves fingers, statistics, and commandments (the AAP should consider stone tablets for guidelines), the other other fingers, iPads, and Pinterest posts.  A major challenge for the former, which I admit is mine, is that the technology we make recommendations about advances faster than scientific study thereof, assuming funding for studies is available.  Thus, we lean heavily on clinical suspicion – anecdotal evidence combined with experience and the best science we’ve got – while parents and technophilic columnists we seek to sway counter with calls to embrace reality.

It’s not so much we’re wrong, we’re told – to date there are no studies showing benefits of screen-based media for young children – but unrealistic.  Out of touch.  Abnormal.  More irony, as health care is among the most technophilic of professions.  Recall those cutting-edge pagers?


Whether inspired by evidence, nostalgia, or peer pressure, we all argue in our own language from our own ecosystem.  We defend what is normal to us.  A forthcoming Northwestern University study of families of 0-8 year-olds bears this out, describing the unprecedented generational shift underway, screen-based media playing an increasingly pivotal role our lives: super-peer, super-parent, friend, pet, teacher, coworker, confidante.  For grownups, the effect is obvious and feels simultaneously euphoric and dismal: who could live without online shopping and reservations, Facebook, texting?  For young children, this broadband redefinition of societal norms means that “normal childhood” no longer equals mud, creeks, blocks, and wandering around at the whim of one’s imagination.  It means apps, iPads, e-books, structured activities, and wandering around at the whim of a software developer’s imagination.

Old Normal Childhood

Old Normal Childhood

New Normal Childhood?

New Normal Childhood?

Consistent with this shift, 8 out of 10 families surveyed above stated that screen time was not a major source of conflict in their homes.  This makes sense, because if something is accepted as normal – Club Penguin is just baby Facebook, Leapsters are interactive textbooks  – how can it be a source of conflict?  Thus, most respondents described screen media as a benign aspect of living in the new millennium.

Resistance is futile.  Get on the space ship or wallow on the dying analog planet.


Despite general agreement that screen time has a negative impact on physical activity, 55% of parents were not concerned about media use, while 30% were concerned.   Respondents held more positive than negative views on health effects overall, diminished physical activity outweighed by the allure of “learning and creativity” (note: this reflects the potent influence of “educational” marketing described in earlier posts).  A notable exception was video games, in a parental penalty box of sorts, which I attribute to the recent spike in school violence.  Whether this overall positive view reflects evolution or an alarming numbing/dumbing of cultural standards is hard to say.  The bottom line, though, is that the American Academy of Pediatrics and  other advocacy and public health groups face major challenges to get their message across, as families – not they – set their own media guidelines, in accordance with what they see as normal.

Exactly what is considered “normal” is a moving target, defined by technological progression.  Plain books used to be normal, then e-books, then “interactive” e-books.  The neighborhood and its dubious creeks and sand piles  used to be normal, then the backyard, supervised playgroup, 3-D cartoon adventures, and the Wii.  Cardboard boxes and crayons vie in a game of thrones with “learning and creativity”-themed videos and apps.


old-school crayon – yum!


New-school crayon…app

Normal is perhaps most defined by what grownups do.  In the study above, families fell into three broad categories of plugged-in-ness:

  • 39% of families were “Media-Centric,”  where grownups spend on average 11.5 hours with electronic media, children 4.5 hours (again, these are 0-8 year-olds).
  • 45% were “Media Moderates” where grownups spend 5 hours, children 3 hours.
  • 16% were “Media Light,” with grownups spending 3 hours, children 1.5 hours.
Media-Centric, Indeed!

Media-Centric, Indeed!

Clearly, screen time – and associated health risks – increase with how normal it is considered in a given household.   If parents have TV in their  bedroom, it seems normal for children to have it, regardless of the fact that it is a powerful predictor of sleep dysfunction and child obesity.  If the TV is on all the time, it is normal background noise, not distraction for parent and child alike.  If parents text at dinner or in the car, it is normal for children, too, even if conversation suffers and the risk of traffic accidents spikes.  If grownups divide their attention between their devices and their children, it’s multi-tasking…or is it not paying attention?

Media-centric families and columnists might argue that such concerns only apply to families using the wrong type of media in the wrong way: too violent, not educational, unlimited, not balanced with screen-free activities.  To an extent they are correct: violent media is always worse than the pro-social kind, and good parenting tends to blunt all kinds of health risks.  Media-centric children who are consistently read to, taken to the park, played with, and enrolled in screen-free activities can overcome many negative effects, even thrive.  This is a major reason why screen time excess is a potent driver of socio-economic inequality – children without such opportunities and/or parenting tend to suffer – but that’s a topic for another post.

A key point of Baby Unplugged is that notions of generational shifts, new normals, and enhanced childhood do not apply to our youngest, most vulnerable population: children under 3 years old.  For them, there should be broad agreement.  As stated in prior posts, the needs and abilities of babies and young children do not evolve with the technology that is marketed to them.   They don’t understand it.  They don’t need it.  It is neither normal nor educational for them, and let’s hope it never will be.  Despite the media-centricity of the household they are born into, children under three must be immersed in the real world and multi-sensorial wonders it offers to develop a solid foundation of basic skills.  With this foundation, gradual introduction of screen-based media is more likely to be used in a balanced, healthy way.

And the longer they wait – and grownups with them – the less they will miss it!

My refrain: the first three years are incredibly fleeting.  There is no more valuable, focused opportunity to experience the world, unplugged.  We should embrace and defend this span as one of grownups and children spending time together exploring the world around them in a loving and engaged way, treasuring every moment.  What’s more normal than that?

Happy Summer!

Happy Summer!

Share your thoughts!  What is normal in your household?  How does it compare to how you grew up?   And thank you as always for reading.

Talk to Baby, Baby Talk

Let’s ignore the irony of reading and writing blog posts during Screen Free Week.  Imagine you are reading this on one of those wide-ruled tablets we used in elementary school to practice handwriting, penned in green crayon, eagerly awaiting recess, the sandbox, trees to climb…


Baby talk.  A cherished ritual, inspiring images of drooly bundles of joy cooing Mama, Dada, Ball, and/or Dog, while Mama and/or Dada coo back in singsong tones.  Baby talk is simple.  Baby talk is free.  Baby talk is perfect just the way it is.

Added bonus: baby talk is how babies learn to talk.

The anxieties felt by parents regarding their children’s development are well known.  Whether a byproduct of too much information, too many choices, too much peer pressure, or a prevailing too much, is hard to say.  But it is real, and we’ve all felt it.  Whether expressed via a well-child visit, a  gathering of friends, or on Facebook, all parents want their children to be the best they can be, if not better.  Thus, those first few words are precious, but soon we worry about the next ones.  Which should they be?  Is “serendipity” too hard?  How about “Twitter?”  How fast?  Which is first, ABCs or 123s?  What does Harvard expect by 18 months?

Anxiety is rocket fuel for consumer products, be they beauty care, vitamins, or children’s media and toys.   Marketers are smart (they probably said tons of words at 18 months), and have leveraged family angst by developing – and prominently labeling – almost everything for young children as “educational,” promising all manner of oft-unrealistic, unsubstantiated “learning.”  Thus, we buy videos for our little ones where characters sing about smart things like safari animals, or classical music, or shapes and numbers, hoping that they will learn these things.  And whereas child development is a gradual process, buying or downloading appeals to our desire for an “educational” quick fix, ergo its vast popularity.


Unfortunately, for young babies screens simply don’t work well, if at all.  Cute and jazzy as they may be, they lack the ability to read baby’s social and emotional cues and respond in a truly interactive, loving way.  Thus, while appearing engaged, babies largely sit and stare, developmental engine idling.  Marketers are on to this critique and now apply the term “interactive” to newer stuff like touch screens that flash and make noises, but this is a feeble surrogate for a real, caring, multi-sensorial human.





This point can not be stressed enough: to develop to their fullest potential, babies need loving humans who engage with them consistently in the real world.  Parents are a child’s first teachers.  There is no better nor more critical education.

Babies and young children learn to talk by talking.  Analog mammals that they are, it is how they evolved, and evolution takes a really long time, regardless of incentives offered by Disney.  Babies love to talk.  They need to talk.  Talking involves a complex interplay of verbal and nonverbal cues – facial expressions, emotion, reaction – which no media can offer.   And hearing and engaging in everyday conversation with their grownups is how babies learn useful words – dog, ball, Mama/Dada, spoon, unplugged – ones they will remember.  Even if they did learn from screens, unless their family is exceedingly adventurous, what use do they have for safari words?  Wind instruments?  Spanish when no one at home speaks Spanish?


The multi-billion dollar “smart baby” industry is a brilliant, profitable problem created to remedy a perfect solution.  Talking to babies as a means to learn language did not need to be fixed by Baby Einstein.


Perfect. Priceless.

As is commonly observed, babies listen before they can say.  Thus, language development begins by being talked to.  The power of talking to babies has been illustrated via a number of studies, notably researchers Hart & Risley, who in a 1995 study found a huge, unsettling disparity in the number of words heard per hour by children in welfare, working-class, and professional households.   This added up to an estimated 30 million more words heard by age 3 by children from professional families than those in poverty.   Predictably, this correlates strongly with IQ, literacy, and academic performance, creating a vicious cycle.


Of note in the context of this post for those thinking a daily dose of Eebee or Elmo is the remedy: “TV talk not only didn’t help, it was detrimental.”  Only words shared by caregivers promoted language.  This highlights the fact that screen-based media tends to interfere with – and replace – parent-child interaction.  Parents and other caregivers feel a false sense of security while their child is watching Doc McStuffins or using a “learning app,” and feel less compelled to simply talk to them (correcting behavior excepted).  And as with all screen media, “hearing words” is not the same as being spoken to.  One engages the child, the other doesn’t.  One is a path to healthy development, the other largely passes time.


Recent studies suggest that a major reason for this disparity is that many parents, especially lower socioeconomic households, do not realize how important talking to their children is.  It seems too simple.  The swirl of misleading marketing increases misconception, as does misinformation from peers and other dubious sources, creating pressure for children to “learn” via electronic media.   Ironically, this is increasingly common in higher socioeconomic households, where technology is piled on to give children a “learning” edge (and keep them occupied).  Thus, a challenge for pediatricians, grandparents, and “old-school” advocates is to overcome this media storm with reassurance that simple unplugged time together is not only cheaper and less anxiety-provoking, but best.

A recent New York Times article describes an exciting “Talk to Your Baby” initiative being launched in Providence RI, designed to address socioeconomic language inequities.   In essence, parents are being coached to do just that – consistently talk to their babies – via sharing simple everyday activities, and then monitoring their progress.  There is hope that the simplicity of the desired behavior and low price tag, coupled with evidence that it works, will prove more effective than other, more complex interventions.  Whether through shared books, answering questions, or simply describing what a parent is doing during their regular day – tying shoes, cooking pancakes, making the bed – all of those words add up to great things.  Let’s hope so.

Talk to me!

Talk to me!

For the rest of us not living in Providence, let’s join the movement towards simplicity and learning through real-world experience during the first three years.  Three cheers for unplugging, snuggling up with real books, and wandering outside with a blanket to play in the yard (a beach for lucky ones), with a ball, a pet, or a box – and talking about them!

Thank you for reading – and happy Screen Free Week!  Share your thoughts!