Docs update screen advice, say toddlers can FaceTime

The American Academy of Pediatrics, amending earlier advice, now says it’s OK for babies to Skype or Face Time with grandma and grandpa, and for older children and teens to do some of their socializing, learning and playing online – as long as they put down their devices long enough to sleep, exercise, eat, converse and otherwise engage in rich offline lives.

Those are some highlights from a new set of guidelines from the nation's leading group of pediatricians, published online Friday by the journal Pediatrics. They replace simpler longstanding recommendations that children under age 2 avoid all screens and that older children and teens use digital media for no more than an hour or two a day.

The doctors still ask parents to set limits on when, where and for how long kids can be plugged in – but acknowledge that electronic media are pervasive and have benefits as well as risks.

Time on computers, phones, tablets and other devices “is not evil, it does not need to be avoided,” said Megan Moreno an associate professor of adolescent medicine at Seattle Children’s Hospital, and a guideline author. “It just needs to be balanced with all the other things kids need.”

The pediatricians stuck with a no-screens recommendation for children younger than 18-to-24-months old – with one exception: video chatting. Talking with distant family members via services such as Skype and FaceTime can help build relationships, the doctors say. But, they say, there’s little evidence babies can understand or benefit from watching TV, using apps or engaging in other online activities.

If parents want to introduce shows and apps to children ages 18-24 months, the guidelines say, they should watch and play with them. From ages two to five, the doctors recommend a one-hour limit and urge parents to keep participating, and to choose only “high-quality programming,” from sources such as PBS Kids and Sesame Workshop.

“We are not backing away from the idea that unplugged, unstructured time, getting out in the backyard and discovering things on your own, is crucial for a child’s development, and we don’t want that to be displaced,” said Jenny Radesky, a guideline author and assistant professor of pediatrics at the University of Michigan.

For older children, the guidelines are more nuanced and no longer include a specific time limit. But they urge families to use a new online planning tool to carve out media limits in a day that should include at least an hour of physical activity and adequate sleep (8 to 12 hours, depending on age), as well as unplugged family time.

Such limits will reduce risks, such as obesity, lost sleep and impaired school performance, while allowing kids to connect online with friends and family and learn about the broader world, Moreno says.

The doctors also recommend that parents:

• Ban screens an hour before bed and in bedrooms overnight. The light and noise can disrupt sleep.

• Discourage use of entertainment media during homework time. Such multitasking has been shown to interfere with learning.

• Designate media-free places and times (such as dinner time) for all family members, including adults.

• Continue to watch what kids watch and talk to them about online bullying, sexting and other hazards.

The guidelines are “doable and balanced and reasonable and fit the reality of 2016,” said James Steyer, founder of Common Sense Media, a non-profit group that the pediatrics academy endorses as a source of reliable information on content for children.

For Nanea Hoffman,  a mother of two from Santa Clara, Calif., the guidelines sound  “more realistic and more helpful” than the old time limits. Her children, ages 11 and 18, have grown up in a world where “technology is just another tool,” and a way to connect, "even if it's just sharing a funny meme," she said.

"It's not isolating," she said. "It's not like it was when we were kids, when you would zonk out in front of the TV with a bowl of cereal."