American Academy Of Pediatrics Lifts 'No Screens Under 2' Rule

Oct 20, 2016
Originally published on October 21, 2016 12:36 pm

If there's one rule that most parents cling to in the confusing, fast-changing world of kids and media, it's this one: No screens before age 2.

As of today, that rule is out the window.

The American Academy of Pediatrics, which first issued that recommendation back in 1999, has extensively updated and revised its guidelines for children and adolescents to reflect new research and new habits.

The new guidelines, especially for very young children, shift the focus from WHAT is on the screen to WHO else is in the room. And in doing so, they raise some intriguing points about the future of learning from media.

For babies younger than 18 months, AAP still says no screens at all are the best idea — with one notable exception: live video chat. Surveys indicate that families already popularly believe that "Facetime doesn't count," or at least that the benefit of virtual visits with grandparents or other relatives outweighs the potential cost of exposing babies to the laptop or phone.

The AAP doesn't cite positive evidence that infants actually get something out of this kind of "conversation" the way that they clearly do from live social interaction. But there is some observational research that infants as young as 6 months old are emotionally engaged by playing live peekaboo with Grandma on Skype.

For infants and toddlers, age 15 months to 2 years, there is limited evidence from a couple of very small studies that they can learn new words from educational media, if and only if parents are watching alongside them, repeating what the video says and/or drawing attention to what is on the screen. In other words, treating a video or an app like a picture book is the best bet.

The flip side of this is that many studies, including this one, have actually shown poorer language skills correlated with earlier solo viewing of "educational" videos. There is also research that shows language delays in children who watch more TV and start watching earlier. In both cases, the problem seems to be media replacing interaction with people. For this reason, the new AAP guideline has changed from "avoid all screens under age 2" to "avoid solo media use in this age group."

For preschoolers age 2 to 5, there is more evidence that they have the ability to transfer knowledge from screens to the real world, including early literacy and math, and positive social and emotional skills and behaviors.

But the AAP has a strong brand preference here. It names Sesame Workshop and PBS as two trusted makers of evidence-based children's educational media, whereas of an estimated hundred-thousand "education"-branded apps in the iPad store, very few have been found to satisfy high standards for learning.

For this age group, AAP recommends no more than an hour a day of screen use. And, just as with younger children, it wants caregivers to take part in screen time:

"Co-view with your children, help children understand what they are seeing, and help them apply what they learn to the world around them."

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STEVE INSKEEP, HOST:

If you have young children, you may have struggled with this rule - no electronic media before age 2. Well, now you can feel a little bit off the hook because that rule is out the window as of today. The American Academy of Pediatrics, which first issued the no-screens prohibition has now changed what it says. And Anya Kamenetz of the NPR Ed team is on this story.

Hi, Anya.

ANYA KAMENETZ, BYLINE: Hi, Steve.

INSKEEP: This is shocking...

KAMENETZ: (Laughter).

INSKEEP: ...Because as a parent of kids who have been under 2, I mean, you focus on this a lot. And you worry about this a lot. It's hard work.

KAMENETZ: Yes, absolutely. But here's the thing, I've spoken to some of the original authors of the no-screens-before-2 rule, which came out in 1999. And they said they actually didn't necessarily have a lot of evidence for it, even back then.

INSKEEP: Wait a minute. So it's like the tooth-flossing rule, where they eventually admitted they didn't really have a good basis for that either?

KAMENETZ: I don't know if it's flossgate (ph) exactly, but the thing is that media research can't move at the same pace as media itself does. And in the last decade and a half, we have this world of ubiquitous smartphones and iPads. Family habits are changing. And so it's really, really difficult to create evidence-based recommendations. But the American Academy of Pediatrics felt that it was really important to update the recommendations to at least reflect what families are actually doing.

INSKEEP: Was the original rule just about TV?

KAMENETZ: It was. In 1999, that was the main concern, was television for young children. There - it wasn't really possible for toddlers to interact so well with computers that had keyboards.

INSKEEP: OK. I think we're getting toward the change here. If you're watching TV, you're just watching a program, for the most part. You might be doing something more with an iPad or with a computer or with a smartphone. So what's the difference? And how big is the difference?

KAMENETZ: Well, so, for babies younger than 18 months, the AAP still says that no screens at all are ideal - with one notable exception, and that is live video chat, so the Skyping-with-Grandma effect. Studies show that, you know, upwards of 90 percent of parents are taking advantage of video chat, and they believe that it doesn't count. We don't have necessarily gold-standard evidence that that's true. But there are some small observational studies that show that tiny infants as young as 6 months can actually get something out of a social back and forth over a video screen, provided that there's a caregiver in the room sort of helping facilitate that.

INSKEEP: OK. So let's see if we can understand a little bit better what these rules are. Don't use a screen as a babysitter. Don't use a TV, for example, as a babysitter. But you can do things where you interact?

KAMENETZ: Right. So moving on - if you - you know, so under the 15-month level, you really - you want to avoid everything except possibly video chatting. Fifteen months to 2 years, there are some very small studies that show that toddlers can learn, for example, new words from an educational video but if and only if there is a caregiver in the room that is helping them interpret what they see on the screen.

INSKEEP: Oh, so I can use the screen as a tool. I just shouldn't leave the kid alone with the screen.

KAMENETZ: That's exactly right. So the new AAP guideline - the bottom line is going from no screens under age 2 to avoid solo media use under age 2.

INSKEEP: Have a person there somewhere.

KAMENETZ: Yeah, that's really the focus here.

INSKEEP: Anya, thanks for the update.

KAMENETZ: Thanks, Steve.

INSKEEP: That's Anya Kamenetz of NPR's Ed team. Transcript provided by NPR, Copyright NPR.