AAP Releases New Child Media Guidelines

The American Academy of Pediatrics (AAP) recently published an updated policy statement paper on recommended limits for media usage in kids.  The new report is designed to incorporate the increase of “new media” devices such as mobile phones and computers that are making up an increasingly larger portion of the total time. The trends necessitate that primary care clinicians adapt in the way that they ask about media usage and make recommendations to families.

video games

Photo courtesy of ImageryMajestic / freedigitialphotos.net

The paper cites data from previous studies, chronicling an astonishing amount of media use among youth.  Total time per day using media for entertainment purposes rises from about 8 hours per day in 8-10 year old to a stunning 11 hours or more in teens (it is hard to figure out the math for that one while still leaving time for school).   Over 70% of youth reportedly have a television in their room, not to mention a phone or tablet connected to the internet.  As many parents of teens already know, texting 50 to 100 times per day is now commonplace and ironically, teens are now one of the demographic groups least likely to use phones for voice communication.  Teens also report that they typically have no clear rules about media use from their parents, although parents tend to give a slightly different story.  These concerns are balanced by evidence that the some forms of media can be positive and enhance learning and social interactions.

The guidelines recommend that pediatricians ask two specific questions about media usage with parents namely  1) How much recreational screen time does your child or teenager consume daily? and 2) Is there a TV set or an Internet connected electronic device in the child’s or teenager’s bedroom?  Specific recommendations about media use include the following:

  • Total media use should be less than 2 hours per day
  • Children under age 2 should be discouraged from any media use
  • TVs and internet connected devices should not be in youth’s bedroom
  • Media use should be monitored and discussed
  • Family rules about media use, such as no usage during meals, should be made (and modeled by parents)

Getting less press attention but also contained in the article are also recommendations that primary care clinicians become more actively involved in educational and political groups to advocate for specific policies and laws, such as trying to ban alcohol advertising on television similar to cigarettes.

Following the release of these guidelines, many parents on the internet responded with some skepticism that such limits are realistic.   Indeed, a potential danger is that parents will dismiss the guidelines altogether rather than try to enforce attainable limits even if they fall somewhat short of the specified numbers.  The authors have commented themselves that the recommendations are not meant to be rigidly followed each day but are rather benchmarks that can be flexibly applied.  There is also a bit of a “one size fits all” approach to the guidelines in that no differentiation is given between, for example, a 3- and a 17-year-old.  Public health messages tend to be made as simple as possible to avoid confusion, and often there is a tacit understanding that some degree of customization will be necessary.  If these quite remarkable statistics are true, however, any concerted effort to bring media use into greater balance is a welcome enterprise, with primary care clinicians needed to support children and the families to make healthier choices.


Strasburger VC, et al. Children, Adolescents, and the Media.  JAMA Pediatrics. 2013;132(5):958-61

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