No TV For 2 Year Olds

Glowing boxes of any sort are not appropriate for those aged two and under, the American Academy of Pediatrics has recommended.  Such devices would include televisions but also computers, game stations and the like, since children this young are totally unable to appreciate their content but can compromise their development by watching.  Well!  Rick and I agree in this week's podcast, that's undoubtedly the strongest statement yet and certainly provides both parents and pediatricians with clear and unequivocal guidance.

The new recommendations cite statistics that 90% of parents report that their 2 year olds or younger children are watching some form of electronic media, and that by the ripe old age of 3 some one-third have a television in their bedroom!  Parents say they feel good about the exposure because their children watch programming deemed 'educational.'  On average, these very young children are watching televised programs one to two hours a day, sometimes alone.  So why is all this exposure problematic?

Exposure to media in children younger than 2 years of age delays or precludes the acquisition of other cognitive abilities children need, the Academy of Pediatrics says.  Development occurs along a fairly predictable continuum, and when very young, children cannot follow dialogue or appreciate the sequential nature of different shots.  The 2 year old and younger set is also unable to discriminate between what happens on a screen and reality.

Television viewing decreases the amount of time parents and infants are interacting with each other, the report states.  Such 'face time' is directly related to vocabulary building for the child, so language acquisition may be delayed.  Less playing is also seen, either with parents or other siblings.   Even when media is turned off, children who have been exposed to lots of it spend less time in focused play.  Wow.  This is turning out to be almost as damning as cigarette exposure!

The report contains many more study references and concerning findings, but the guidelines sum it up very well:  television viewing for those 0-2 years of age is not recommended.  Parents should be aware that their own viewing habits will inevitably influence their childrens' development, behavior, and eventual viewing habits, with long term impact on how well kids do in school as well as socially.  Parents should realize that even solitary unstructured play time is preferable to media exposure for this age group, as it encourages creative play, problem solving, and self-reliance.  So there you have it.

Pediatricians need to get into the act by asking parents about media use in their household and reiterating the recommendations.  Only 15% of parents cited in this report say their pediatrician has asked about media use in the household.  Finally, pediatricians should recommend that parents read to children regularly.

While we're unloading on parents, another topic this week includes an update on ADHD management, also in Pediatrics, a look at appropriate intervals and technology for screening mammography in Annals of Internal Medicine, and a good news study in NEJM on the first kind of effective malaria vaccine.  Until next week, y'all live well.

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