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What Parents Need to Know About Media and Their Child 2021 VERSION
Page 1: FDWG 2021 - Front Matter

W h a t P a r e n t s N e e d t o K n o wA b o u t M e d i a a n d T h e i r C h i l d


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[email protected]

© Boston Children's Hospital 2021. All Rights Reserved.

For permissions contact Digital Wellness Lab

300 Longwood Avenue, Mailstop: BCH3186Boston, MA 02115

[email protected]

The Digital Wellness Lab at Boston Children's Hospital is an educational entity that exists to provide carefully researchedhealth information. All information included in this guide is for educational purposes only. For specific medical advice,diagnoses, and treatment, consult your health care provider.

Connect with us!

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How to use this guide

Use this guide to learn aboutthe media-related healthissues that are top of mindfor parents today. We'veincluded tips that arepractical, easy, and based inscience, to help your child ofany age use media wiselyand in ways that promotewellness.

What 's ins ide


Infants and Toddlers.........................


School Age..........................................











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~Michael Rich, MD, MPHDr. Rich is the founder and director of the Digital Wellness Lab at BostonChildren’s Hospital, where he is known as The Mediatrician.

Dare to hope! As we venture toward the “new normal,” this Family Digital Wellness Guide is here tohelp you and your loved ones healthfully navigate through 2021.

One year ago, we shifted virtually every human endeavor online. Some, like business meetings,were quick. Other essential activities, like education, were solved more haltingly, with stumblesalong the way. But we did it. We met challenges by reinventing each human endeavor, one by one.Work and school went remote, sometimes side by side at dining room tables. We watched - andcreated - the news stream. Online birthday parties, proms, graduations, weddings, funerals – wedid it all. And we did it together, with our families. We reached out, in unprecedented ways, todistant families and friends, binding together against uncertainty. Kids used screens andsmartphones, previously toys, as power tools – and after a day of remote schooling, many turnedthem off to get physical.

Conceived as a reference guide to child development in the Digital Age, the 2020 Family DigitalWellness Guide was unexpectedly timely, providing advice and strategies to families who foundthemselves facing school closures, business shutdowns, childcare and health uncertainties. Itprovided useful strategies for using interactive media in effective, balanced and mindful ways.Translated into Spanish and Chinese, it addressed digital inequities and bound our global villagemore closely together, even as we were physically distanced.

Together, we have experienced and learned much. Knowledge we have gained, and up-to-datescientific research, is incorporated in this ”new normal” edition of the Family Digital WellnessGuide. Organized by developmental stage from infancy to adulthood, it examines key transitions ofeach stage as they are affected, and reflected, by the screens we use and how we use them.Recommendations to optimize your child’s well-being are encapsulated in practical “protips” foreveryday life. Thank you for asking The Mediatrician - we answer questions here and empower youwith “ice breakers” to address those trickier parenting situations from a place of knowledge andlove, opening the doors to caring, respectful family conversations.

Raising children to be healthy, happy, smart and kind is both daring and hopeful in a rapidlychanging world – the Digital Wellness Lab is here to help.

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Babies develop rapidly in their first years andcontinually learn from the people and things aroundthem. It is during this stage of development thatchildren first smile, babble, toddle, take their firststeps, and say their first words. With so many brainconnections being formed, it is important thatcaregivers talk to babies and provide them withlove. Creating an environment that encouragesexploration and allows infants to learn is key. Whilethere are many programs and apps marketed forbabies, very few are based in science. Whenchoosing videos and apps, look for research-supported media that interests and engages yourchild in healthy ways.

Infants and Toddlers


Ages Birth to 2

The AmericanAcademy ofPediatrics (AAP)recommends thatchildren under 18months avoid usingscreen media otherthan video-chatting.

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Educational TechnologyProtip: Rely on reputable, science-based,educational organizations and parentingwebsites for recommendations and reviews onvideos, games, and apps that are best suited toyour child’s age and developmental stage. Besure to use new technologies with your toddlerto see how they engage with it, if it issupporting their interests, and if it helps themlearn new skills.

Science says: While many videos, apps, andgames are labeled as educational for babies,few have research to support these claims.While toddlers can learn from some highquality media, infants lack the braindevelopment needed to make sense of screencontent.

Science Says...


...from music to videochat, media are powerful tools, and howbabies use them affects their health and development

ContentProtip: Although it is best not to be distractedby screens while your infant or toddler ispresent, watch only non-scary and family-friendly shows when they are around. Babiesare very sensitive to your emotions and canbecome upset or scared along with you.

Science says: Babies pick up on your emotionalchanges and may become upset with you,connecting that feeling with whatever is in theirenvironment at the time. Toddlers may even bescared by unexpected news stories, such asthose about environmental disasters oranimals. When you watch media with toddlers,be aware of their feelings, and comfort andreassure them that they are okay. Stopwatching it if your baby continues to be scaredor upset by it.

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MonitoringProtip: Password protect your devices andfamiliarize yourself with the apps you show toyour toddler.

Science says: Automated ads and videos canplay while your child is on a device. Try tooversee your child's media use wheneverpossible.

Music and Movement Protip: Make physical activity fun by singingsongs, dancing, and playing musicalinstruments with your baby or toddler.

Science says: Music is a wonderful way to helpyour child develop fine and gross motor skillsand become physically active. Encourage yourchild to clap their hands in different rhythmsor bang a drumstick on a pot. Babies can usethe muscles in their mouths to coo along withyou to a favorite song, while toddlers willenjoy singing with the radio or a streamingservice. Dance with your baby and encouragetoddlers to show how well they can balancewhile swaying to their favorite beat!

Parental Media UseProtip: Set aside your cell phone and play withyour child at the playground. Make sure youare fully present when supervising your childin these environments, free from mediadistractions.

Science says: Parents who are distracted byphones or other media while watching theirchild play may miss important opportunities toplay and interact with their child.

Parental Self-CareProtip: Make sure to practice self-care andtake time for yourself in order to manage thestress that comes with being a new parent.

Science says: Parental burnout, or feelingstressed, overwhelmed, and exhausted when itcomes to caring for your baby, is real and canlead to parental neglect and abuse. Make sureto check-in with yourself about how you’refeeling, and reach out to a loved one or aprofessional if you find you need help. Be sureto take time for your physical and mentalhealth, including getting enough sleep, goingoutside for walks, and connecting with friendsand family. Social media, including onlinegroups and forums, helps many new parentsconnect and share hard times, celebrate happystories, and feel less alone.

Reading Protip: Read to your infant or toddler in yourlap daily. Point to pictures to match them upwith words, make animal sounds, and explainwhat they are seeing and hearing. If readingfrom a device, such as a tablet, avoid clickablefeatures, as these can take away from yourchild's ability to follow what is happening in thestory.

Science says: Reading to your child helps themdevelop language skills and increases theirunderstanding of the world. Cuddling themwhile reading will help them associate readingwith happiness and strengthen the bonds youare forming.

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Screen TimeProtip: Schedule media use based on yourchild's internal rhythms and attention span.Use screen media with your baby or toddlerand watch them closely. You will know whentheir attention wanders—that’s when youshould shift to another, non-screen activity.

Science says: Using screens can take valuabletime away from infants and toddlers who couldbe exploring their world in ways that supporttheir development. Parents who use mediawith their baby are able to explain what ishappening to their child and help them learnfrom the experience.

SleepProtip: Create a quiet, device-free environmentfor rest, as this can help your infant or toddlerget the quality sleep they need. Turn offvideos, loud devices, and bright screens beforenaps or bedtime to minimize sleep disruptions.

Science says: Daily screen viewing, such asusing a tablet or smartphone, can cause yourtoddler to stay up later, delay when they fallasleep, and lose overall sleep time.


1 month

3 months

6 months

9 months

1 year

1.5 years

2 years

16 hours/day

15.5 hours/day

15 hours/day

14 hours/day

14 hours/day

14 hours/day

13.5 hours/day

13 hours/day

Recommended Hours of Sleep

Age of Infant or Toddler

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Smartphones do emit some electromagnetic radiation, and while there are mixed data onpotential dangers, the best evidence indicates that the greatest risk involved is if the phone isheld against the head, rather than looked at from a distance, as is done through video chat.

There is what scientists call a “video deficit” for very young children. This means that it takesmore repeat viewings of the same content for infants and toddlers to learn an action from ascreen than it does for them to learn it from a person who is physically with them.

As early as 6 months of age, babies are able to tell when a person on a screen is interactingwith them in real time as opposed to the passive screen images they see when they watch TVor a video. This means that babies can start forming relationships through video chat,especially if the chat is helped by the adult who is physically present (i.e., telling your baby theyare talking to grandma, pointing and waving at the screen together, and narrating the action)

At 12-25 months, babies learn better from real-time interactive video chat with adults thanfrom educational videos or shows. This is likely because video chat allows an adult to react tothe individual child and tailor their actions to best suit the child.

Is it ok for my baby to video chat with family and friends?

Many of today's parents face this question. Here’s what you should know:

Although video chatting is not the same for your baby’s social-emotional and brain development asbeing with loved ones in person, it is much better than no contact with them at all and can helpthem build meaningful relationships.


What parents ask most about their infants and toddlers

Ask the MediatricianTM

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Ice BreakersWhen you see something concerning, here are ways to get theconversation going.

How to talk to youryoung child

Infants and toddlers arerapidly developing theirlanguage skills at this stage.You can help them learn newwords by pointing things outand naming them. The moreyou talk to your child, themore language they will learnand understand.


Say, “Let’s make silly faces and play peek-a-boo together through the screen!” If yourchild is tired or fidgety or nothing isworking, then wave and say “bye bye."

Your baby is losing interest in videochatting with a loved one…

The best thing for babies is to interact withother people face-to-face. Make sure yourbaby is getting plenty of focused time withpeople without devices around.

Your baby is interested by the bright lightsand noises coming from smartphones and

tablets that are nearby…

Say, “It looks like you need a break. Let metake the baby for a bit. Later, let’s come upwith a schedule so that each of us can getsome quality 1-1 time with our baby andalone time.”

Your partner seems overly tired, upset, ordistracted when caring for your baby…

If you see this... Do this...

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Ages 3 to 5

Preschoolers are very curious about the worldaround them and are motivated to explore andlearn through play. They are becoming moreindependent and interested in kids and adultsoutside of their immediate family. The interactionsthey have with their family, other people, and theirenvironment will contribute to shaping theirpersonality and how they think about the world.Children this age are quickly developing language,cognitive, and social skills. Media can be awonderful tool to help preschoolers further developthese skills, provided parents help to balance mediause and set expectations that work for each child.

Be mindful of"educational"marketing claims aboutTV shows, apps, andother media, as theseclaims are oftenunregulated andfrequently notsupported by research.

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Science says: Commercials for snacks andprocessed foods with low nutritional value buthigh calories influence kids to eat in unhealthyways. Children who become familiar with foodbrands and mascots (often cartoon or kid-friendly characters) will request and choosethose branded foods more often, increasingtheir risk of becoming overweight or obese.

Joint EngagementProtip: Use media actively with your child.Point to different objects on the screen. Askquestions about what is happening. Praise andencourage their interactions with media, allwhile cuddling your child.

Science says: Parents provide significantverbal, emotional, and physical support whenthey join in on their child’s media use andinteract with them. This mentoring helps themenjoy and learn more from their media use.

AttentionProtip: Avoid having TV or videos on in thebackground while your child is playing. Whenyour preschooler is using media, help themfocus on one thing at a time and avoid gettingdistracted by other apps on the device orthings around them.

Science says: Increased screen time, includingbackground TV, has been associated withmore attention problems in preschoolers anda higher risk of being diagnosed withAttention-deficit/hyperactivity disorder(ADHD) criteria.

EatingProtip: Avoid having your preschooler watchshows or videos, interact with apps, or playgames that advertise candy, sugar-sweetenedbreakfast foods, and other unhealthy foods.

Science Says...


...from TV to tablets, media are powerful tools, and howpreschoolers use them affects their health and development

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Limit SettingProtip: Set clear, consistent, and realisticexpectations for your preschooler's screenmedia use. Use timers, settings and other built-in tools to help make the transition from ascreen to another activity a smooth one.

Science says: Parents often allow preschoolersto use screen media when they need to do anactivity that does not involve their child, suchas taking a phone call or preparing a meal. Letyour child know that when you are done withyour task, they will need to be done usingscreens and will move onto the next activity,such as playing with you or eating. Setting atimer on your phone, within the app, game, ordevice your child is using can be a helpful wayto transition your child from using screens.

Mental Health/COVID-19Protip: Create and stick to a healthy dailyschedule or routine, even through stressfultimes such as a pandemic. This includes setwake-up times, mealtimes, bedtimes as well ashaving time for play and relaxation.

Science says: Stressful situations, such as theCOVID-19 pandemic, can cause preschoolers tofeel disconnected, worried, or sad. This has thepotential to negatively impact their mentalhealth. Providing your preschooler with a dailyschedule and healthy routines can help lessentheir fears and concerns, help them feel loved,and provide them with a sense of security.Make sure to establish morning routines -including a set time to wake up, brush theirteeth and eat a healthy breakfast -- and createplay routines. These can include time for afavorite video, TV show or game, as well astime outside, time to connect with friends orfamily (even through videochat). You can alsoconsider setting up a bedtime routine.

MonitoringProtip: Password protect devices and limit yourchild's access to only those apps you pre-approved to prevent them from accessinginappropriate content. Turn on safe-searchmode and disable ads where possible. Savelinks to your child's websites and place theirapps in a folder on your phone so they caneasily find their favorite games and webpages.

Science says: Password-protecting devices andlimiting what your preschooler has access tocan help make sure that they aren't exposed tocontent that may frighten or confuse them.Parental controls work best when used openlyand honestly. Letting your child know why thereare parental controls in place can help buildtrust and communication with them.

Motor SkillsProtip: Leave the devices behind and take yourchild on a walk, visit a playground, or help themride a bike or tricycle.

Science says: While using a smartphone ortablet can help your child develop fine motorskills, (such as writing), using screens usuallydoes not provide opportunities for preschoolersto develop gross motor skills such as running,balance, and coordination.

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PlayProtip: Make time for your child to play bothinside and actively outside. Let them choosehow to play and join your child when you can.

Science says: Play is an important part of apreschooler's healthy development. Playingwith your children, and letting them direct theplay, can help improve their memory.

Reading Protip: Make reading a part of yourpreschooler's daily routine and have themchoose stories that interest them, whether byvisiting a library or looking online for anebook.

Science says: Children who like to read tend toread more, which makes them better readers.Preshoolers who read or are read to arebetter prepared for school, with better literacyand language skills (such as spelling andcomprehension).

90% of Americanparents say theirpreschooler watchesTV, 64% say theirpreschooler uses atablet, and 62% saytheir preschooler usesa smartphone.

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SleepProtip: Create nap and nighttime routines thathelp prepare your child for rest. Turn off allscreens at least 1 hour before bed. Read abook or tell stories before they fall asleep.

Science says: Using screens before bedtime ornaptime can excite kids and keep them fromfalling asleep. The "blue light" that comesfrom TVs and other screen devices can disruptyour child's natural sleep cycle, making itharder for them to fall asleep and wake upnaturally.

Social Emotional LearningProtip: Play games that teach your child howto recognize, label, and manage theiremotions. Consider using a "mood meter" tocheck-in with your child each day or work withthem to create a “calm down kit” for whenthey feel frustrated. You can also discuss yourchild’s favorite characters from games,movies, shows or books and talk about howthey deal with their emotions.

Science says: Learning social-emotional (SE)skills (such as working through difficult tasks,and cooperation) with the help of a parent canhelp preschoolers understand emotionalexpressions along with ways to label andmanage them. Mastering social emotionalskills at a young age can also lead to improvedmental health, greater involvement incommunity activities, and better physicalhealth.

Social Skills Protip: Choose TV programs for your child thatthey enjoy and that will help them learn.Watching TV shows or movies beforehand canhelp you determine whether they willpositively affect your child’s development.

Science says: Well-designed programs forpreschoolers can improve their social skills,pro-social behavior, language capabilities, andcritical thinking.


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In-person conversation: Your child will focus their attention on the screen, missing out on whatcould be valuable vocabulary building, social-emotional development, and bonding with you.

Developing self-calming behaviors: Instead of learning how to use their thoughts andimagination to regulate emotions, your child is learning that their boredom can be eliminatedthrough instant gratification from a screen.

Observing and experiencing the world: Preschoolers are continually taking in the environmentaround them to learn about the world and how to behave in it. By focusing on a screen, theyare missing out on seeing and interacting what is around them.

Is it wrong for me to give my preschooler my tablet or smartphone to useunsupervised?

We are still learning about how children are affected by the screen media they use and how theyuse them. What we do know is that the best way for children to use these devices is with a parentor other caregiver. Handing a young child a device to calm them or keep them entertained isproblematic because of what the screen time displaces or takes time away from:

Remember there are plenty of alternative activities that don’t involve a screen. Encourage yourpreschooler’s imaginative play, talk to them on long car rides, play games that help them identifynumbers, colors, or even help them read!


What parents ask most about their preschoolers

Ask the MediatricianTM

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Ice BreakersWhen you see something concerning, here are ways to get theconversation going.

“Let’s play that game you like together, orwe can read your favorite story.” If yourchild is still having a difficult time, ask themif they would like a snack, or if there isanother activity they would like to do.

Your child is about to have a meltdownafter their demands for a screen have been


“Those are some silly sounds coming fromthat book! What is it about? Let’s read ittogether and find out!”

Your child is more interested in the funnysounds and animations available in their

reading app than the story…

“There are a lot of changes happening inthe world, but you are safe and loved. Let’stalk about some of the things you miss, andmaybe how we can do them using tech.”

Your child seems worried or anxious aboutchanges brought on by the COVID-19


If you see this... Say this...


How to talk to yourpreschooler

Start conversations when you andyour child are in good moods (notfeeling angry or hurt) and whenyou're both open to listening. Besure to say exactly what youmean, encourage your child totake turns talking and listening,and give them your full attention.Let them know that you love themand that you value what they say.


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School Age

Six- to ten-year-olds are learning how they fitinto the world through school, hobbies, friends,and family. As kids this age branch out andbecome more independent, they begin to choosethe types of media they like, including videogames, devices, TV shows, and books. That said,parents play a key role in helping shape kids'choices, including what they use, watch, play, andconnect with and how they do so. While it'simportant to encourage kids' independence andempower their decision-making, caregivers needto be there to help them focus on their schoolwork, balance their activities, and monitor whatthey're doing online.

Ages 6 to 10

The primary goal of theChildren's Online PrivacyProtection Act (COPPA) is toplace parents of young childrenin control over whatinformation is collected fromtheir young children online. As aresult, many websites and socialmedia apps require users to be13 or older, or have their useoverseen by a parent.

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CyberbullyingProtip: Look for signs that your child may be atarget of cyberbullying, such as hiding theirphone when you walk by, losing interest inschool, feeling sad, and withdrawing from friends and family. Ask your child about thekinds of things they see online and talk aboutwith friends. Teach them how to act withkindness, both on and offline. Many schoolshave anti-bullying policies, so talking with yourchild's school can help.

Science says: Kids who are cyberbullied(bullied online through text, games, and apps)are at greater risk for depression, anxiety, andeven suicide. Cyberbullying can lead to schooland behavioral problems such as poor gradesand acting out. The negative effects of beingcyberbullied are more severe than traditionalbullying and can last into adulthood.

AdvertisingProtip: When your child sees an ad andrequests what is being advertised, use keyconcepts of media literacy to help explain howads and commercials are designed to get themto want to buy things. Together, talk throughquestions such as, who created the ad? Whydid it attract their attention? And, what values,lifestyles and points of view are and are notrepresented in the message?

Science says: Advertisers target children withlots of commercials, everything from sneakersand toys to unhealthy foods and snacks high infat, sugar, and calories. Your children may alsostart becoming familiar with online influencers,who are also often paid to advertise differentproducts and services on social media. Helpingyour child think critically about howadvertising tries to change behaviors, helpsyour child understand the purpose of ads, andempowers them to make informed decisions.

Science Says...


...from apps to video games, media are powerful tools, and howchildren use them affects their health and development

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Educational AppsProtip: Look for apps that support your child’slearning in ways that are meaningful to them,allows them to be focused and engaged (notdistracted), and that can be used with others,such as yourself or their teacher.

Science says: Because the “educational” labelin most app stores is not standardized it isdifficult for parents to know what apps arebest for supporting their child’s learning.Looking for apps that meet the “Four Pillars ofLearning”, which are 1) Active Learning, 2)Engagement in the Learning Process, 3)Meaningful Learning, and 4) Social Interaction,can help parents choose educational apps thatare best suited for their child.

EngagementProtip: Choose platforms that are created foryour child's age group, and create accountstogether. Log into these accounts to see howyour child is doing, and talk to them about whothey are connecting with, the kinds of contentthey enjoy, and what they like about each appor account.

Science says: Interactive media can help kidsmake and maintain friendships, and meetpeople of different races, religions, and genderidentities. Talking to your child about theironline interactions keeps communication openand lets your child know you are there forthem.

HomeworkProtip: Set up a “school area” at home, whereyour child can do their school workuninterrupted. Make sure you know theironline class schedule, and/or homeworkassignments– this way you can check-in onthem when they are not in the middle of anonline class, and also help them stay focusedand on task with their independent work.


Science says: Creating a quiet place for kids tofocus on remote learning can help them stayfocused during online classes. However, kidsoften "media multitask," or use more than onedevice at a time, such as watching a video whiledoing their homework. While kids may thinkthey're getting more done in less time, thereality is that it will take them longer tocomplete their homework, they will make moremistakes, and they won’t retain as much of whatthey learn. Checking in on them, and what is ontheir screen, can help them stay focused onsingular tasks.

Mature MediaProtip: Read reviews, check ratings, and watchpreviews for video games and shows before yousay it's ok for your child to play or watch them.Make sure you feel good about what your childwill be learning from these media.

Science says: Kids who watch violent or sexualTV and videos, or play mature video games, maybe influenced by the content. This can includethinking that violence is an okay way to solveproblems, substance use is fun, or that casualsex is popular and consequence-free.

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Mental Health/COVID-19Protip: Regularly check-in and talk to yourchild about how they are feeling and copingduring the COVID-19 pandemic. Ask themabout their thoughts on coronavirus andwhat worries them, while also reassuringthem that they are ok, and that you are therefor them. Be sure to check-in on how schoolis going, especially if they’ve transitionedfrom in-person to remote learning.

Science says: Having open, honestcommunication with your child about whatthey are experiencing during the COVID-19pandemic, from school closures, to their ownhealth concerns can help them cope andprevent feeling overwhelmed by anxiety,sadness and stress during this public healthcrisis and beyond.

Physical ActivityProtip: Make sure your child is able to bephysically active every day. This can be assimple as taking a walk around theneighborhood or visiting a park. Indooractivities, such as doing an online yogacourse, having a dance party, or playing anactive video game are other great ways foryour child to stay healthy and active.

Science says: Kids who spend more than 2hours a day passively using screens (such aswatching a show), have a higher risk of beingoverweight or obese. This is most likely dueto a combination of screen use and a lack ofphysical activity. Encouraging your child to bephysically active each day and providingopportunities for them to actively play canhelp reduce their risk of becoming overweightor obese.

Scary MediaProtip: Comfort your child if they become scared or confused by what they see onlineor on TV. Let them know that they'll be ok,and remind them that you're there for them.

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Science says: Scary news stories, movies, andimages online can frighten kids and lead themto become overly worried about their safetyand the wellbeing of others.

SleepProtip: Make and stick to a bedtime routinethat includes having your child stop using allscreen media at least one hour before they goto sleep.

Science says: Science says: Using screensbefore bed, such as playing a video game orwatching a TV show, can excite kids and makeit harder for them to fall asleep. The "bluelight" from TVs and other screens can disruptthe body's natural sleep cycle, resulting inyour child getting less sleep and struggling towake up on time. On average, school agechildren need 9-12 hrs of sleep each night.

Social Emotional LearningProtip: Help your child practice self-management, social awareness andresponsible decision-making skills byproviding them with opportunities toparticipate in different activities. Let yourchild take part in supervised risk-takingactivities where they also demonstraterespect for others, such as organized sports.Watch movies, shows and sports with yourchild and point out instances that celebratediversity, inclusivity and kindness.

Science says: Children become more andmore independent and emotionally intelligentover time. Six- to ten-year-olds aredevelopmentally able to form stable peerrelationships, build cooperation skills,regulate their emotions, and become betterat solving difficult social problems .


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What are the goals of the program and how will using laptops help students achieve these goals?Will the laptops be used at school, at home, or both?What is the expected role of parents in encouraging positive, productive use of this tool?Are there measures in place to ensure that students don’t access potentially harmful content?

My child is being given a laptop for school – what should I do?

Many parents in similar situations share your concern. The first step, though, is to determinewhether there is truly a problem to be solved. To do that, have a discussion with your child’s teacheror other members of the school administration to get a better understanding of the how the schoolhopes to use these laptops to teach or enhance the curriculum, how they plan to teach safe andhealthy internet use, and what measures they have in place to ensure student safety.Given the past year, (and even before the pandemic) many school systems rolled out deviceprograms before fully considering either the positives or the potential negatives that can come withit. When discussing the laptop program with educators or school administrators, it may be helpfulto ask the following:

When having these conversations, you may want to ask about how you and other parents can getinvolved and stay current with the technology your children are using so you can best support theirlearning process. This will bring parental concerns to the awareness of the school’s administrationand offer the suggestion that parents and educators work together to ensure that students areusing the laptops safely and in ways that benefit their learning.


What parents ask most about their school-ages child

Ask the MediatricianTM

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Ice BreakersWhen you see something concerning, here are ways to get theconversation going.


What is the video you are watching? “Canyou tell me what you like about it? Maybe wecan find one like it that isn’t so graphic andwe can watch it together.”

Your child is watching a video containinggraphic content that concerns you…

“It can be tough learning in different ways,let’s take a break from the screen for a whileand we can talk about how school is goingand what we can do with your teachers tomake it better.”

Your child is having a difficult time withremote learning…

“I’ve noticed you’ve been inside a lot morerecently, let’s take a walk outside, or go toyour favorite park and talk about how wecan be better about getting some activeoutdoor time!”

Your child is spending more time indoors andbeing less physically active…

If you see this... Say this...

How to talk to your child

Start conversations when you andyour child are in good moods (notfeeling angry or hurt) and whenyou're both open to listening. Besure to say exactly what youmean, encourage your child totake turns talking and listening,and give them your full attention.Let them know that you love themand that you value what they say.


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Eleven- to thirteen-year-olds are in the initialstages of puberty; as a result, they begin tothink differently about school and learning andplace greater importance on their friendships.Tweens are becoming more independent whilealso caring more about how others see them.Your tween will begin to show preferences fordifferent types of media, including those theirfriends are into. Despite these changes,however, caregivers must remain involved intheir child's activities, know the media theirtweens are using, and continue to talk aboutand monitor their child's online accounts anddevices.


Ages 11-13

At this stage, tweens beginto develop logical thinking,reasoning, and judgment,but they still need parentalguidance when facingchoices about their mediause.

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CyberbullyingProtip: Have open, honest conversations withyour tween about what they are seeing anddoing online. Ask specifically aboutcyberbullying and if they or a friend hasexperienced it. Be sure your child knows thatyou are always there for them.

Science says: 1 in 5 tweens has been exposedto cyberbullying in some form, as the target,bully or witness. Although tweens fear losingtheir devices, over half who experiencedcyberbullied said telling a parent was useful instopping the cyberbulling. Many tweens findthat telling someone they are being bulliedmakes them feel safer and lessens thenegative psychological impact of cyberbullying.

Body ImageProtip: Actively listen and show that you careabout how your child is feeling about pubertyand how their body is changing. Talk with themabout images on social and other media asthese often set unrealistic ideals, and helpthem understand that these images are oftendigitally altered or filtered so that people lookmore ‘beautiful’ than they really are.

Science says: Tweens are often exposed to alot of information online and through othermedia, both true and false, about how bodies"should" look and what they can do to"improve" their appearance. Certain bodytypes are often idolized, when in reality bodiesare incredibly diverse. There are many onlineaccounts, websites, and influencers that makeyouth feel inadequate by encouraging them tolose weight or build up muscle, harming boththeir mental and physical health.

Science Says...


...from streaming to smartphones, media are powerful tools, andhow tweens use them affects their health and development

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IndependenceProtip: Ask your tween about their favoriteapps and video games, what they enjoy aboutthem, and how to use or play them. Setboundaries together about your tween’s mediause, and consequences, should thoseboundaries be broken.

Science says: Tweens are more likely to havepositive communication and form trust withtheir parents when they feel that parents aremaking an effort to get to know how they usemedia and why. Tweens are also less likely toengage in irresponsible or excessive screenuse when their parents are more supportive oftheir becoming independent and self-regulated.

LearningProtip: Get to know the types of onlinelearning courses your child's school offers, orthat their teacher recommends as a way ofsupporting your tween's learning at home. Bemindful of what devices and internetconnection are needed to support yourtween’s remote learning. Ask your child’sschool for help if you are unsure that yourchild has everything they need to access aremote curriculum or course.

Science says: Remote or online learning can bea great way for some tween students to accessinformation and increase engagement. Manytweens find online learning fun, enjoyable, andeffective. That said, many homes lack access tothe internet and/or devices needed forstudents to attend online classes and completeassigned coursework.

Mental Health/COVID-19Protip: Help your tween safely balance thetime they spend using screens with otheractivities, including physical activity and talkingto friends and family. Make sure that yourtween has daily opportunities to move aroundoutside, such as taking a walk, and that youare available to talk about how they arefeeling, especially when it comes to theirexperience of living through a pandemic.

Science says: Safety precautions such asschool closures and social distancing to helpstop the spread if COVID-19 have led manytweens to spend more times on screens andless time being physically active. Higher levelsof inactive behaviors (such as watching videoson screen) and low levels of physical activitycan lead to poor school performance andnegative mental and physical health.Encouraging your tween to be safely physicallyactive, and checking in on how they are doing,can positively affect their mental and physicalhealth throughout the pandemic and into thefuture.


Research shows that tweens whose parents set boundaries aroundtheir social media use, spend less time using social media andcomparing their appearance to others on social media. In turn,these tweens have better mental health.

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MusicProtip: Get to know the music your tween likesand why they like it, strengthening your bond.

Science says: Music is important andmeaningful to tweens, particularly for moodmanagement, friendship formation, andidentity development.

Parental ModellingProtip: Remember to use media in ways thatyou want your tween to behave when it comesto their own media use. Make time forconversations without device distractions,including mealtimes, and be sure that youfollow the house rules your family sets formedia use.

Science says: How parents use mediainfluences how their children use media,including when and how often they use it.Using media together, such as watching ashow, playing a videogame or using the sameapp allows parents to be a healthy andtrustworthy role model for their children,which in turn can affect tweens’ healthybehaviors when it comes to healthy deviceuse.

SleepProtip: Help your tween end screen use atleast one hour before bedtime. Don’t usephones as alarm clocks. Establish chargingstations outside of bedrooms so they canavoid FOMO or "fear of missing out." Havetweens tell their friends they are offlineovernight.

Science says: Tweens who have phones intheir bedrooms sleep less and get poorerquality sleep. Alerts and notifications disruptsleep cycles critical for moving short-termmemories into learning centers of the brain.Stimulating content and taking in the bluelight from screens disrupt the body’s naturalsleep cycle.


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Social Emotional LearningProtip: Model empathy and kindness andhighlight when those behaviors are illustratedin the media. Utilize your tween’s favoritetelevision shows or video games to elevateand reinforce sharing and helping behaviors.

Science says: CASEL indicates that investmentin SEL has led to improved classroombehavior, better stress management, and 13%gains in academics. With increasingindependence from adults, tweens start toform group-based identities, resolve conflictswithin group situations, and can build on theirunderstanding of others to navigate complexemotional situations.

Violent MediaProtip: Limit your tweens' exposure to violentvideo games and movies. Help them avoiddesensitization by placing violence in contextwith the suffering it causes. Brainstorm non-violent solutions for problems.

Science says: Watching violent movies candesensitize tweens to violence, making themfeel that it's normal or acceptable behavior.Violent video game playing has beenassociated with aggressive thoughts andbehaviors, lower grades, less pro-socialbehavior, increased anxiety and depression.


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Is technology decreasing kids’ ability to communicate face-to-face?

While in some ways kids are connecting through the technology and media they use, hyper-focuson devices can hinder their development of social skills needed to communicate with others in-person. Teachers and others who work with children have noticed several differences in the wayyoung people communicate now as opposed to a few years ago:

1. Eye Contact: Used to communicating through a screen, many youth do not look others inthe eyes when talking to them.

2. Body Language: Digitally connected kids can lose their sense of personal space andawareness of where people are physically. They may stand at awkward distances from eachother or bump into others while walking and texting.

3. Focus: Multitasking between devices or between devices and “real life” results in skippingfrom one input or thought to another, splitting attention between experiences. Less attention ispaid to each experience and the richness of each interaction declines.

Although technology plays a role in our inability to communicate one-on-one, it is not the directcause. Our smartphones, laptops and tablets are tools and, used in healthy and safe ways, canhelp us communicate and stay connected (or reconnect) to people we love and can help us formnew relationships with others all over the world. Technology only distances us when we misusethese tools by allowing them to come between us rather than connecting us.


What parents ask most about their tween child

Ask the MediatricianTM

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Ice BreakersWhen you see something concerning, here are ways to get theconversation going.

“I get frustrated with myself when I becomedistracted with my phone. It makes me feellike I’m missing out on being with you. Let’smake a house rule to have a time each daywhere none of us use our phones.”

Your tween is picking up the same distractingmedia habits you have…

“I saw a text that you sent to one of yourfriends that seemed a little mean to me. I’mnot going to take your phone away, but dowant to talk about what you sent and how itmight make your friend feel.”

Your tween has texted something cruel toone of their classmates…

“I know there’s a lot of pressure to look likethe perfect filtered and cropped images yousee posted, and that your body is goingthrough a lot of changes. Remember thatmost of what you see online isn’t a true viewof reality. Let’s talk about how these imagesmake you feel.”

Your tween is watching videos frominfluencers giving diet tips and suggesting

weight loss products or supplements to buildmuscles…

If you see this... Say this...

How to talk to your tween

Start conversations when you andyour child are in good moods (notfeeling angry or hurt) and whenyou're both open to listening. Besure to say exactly what youmean, encourage your child totake turns talking and listening,and give them your full attention.Let them know that you love themand that you value what they say.


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Thirteen- to eighteen-year-olds are changing howthey think, feel, and interact with others. Adolescentbodies undergo rapid physical changes, and manyteens begin to pay even greater attention to howthey look, often comparing themselves to the body"ideals" they see in media. Teens develop closerfriendships and romantic relationships, often usingmedia as ways to strengthen these connections.Despite teens’ healthy drive to distance themselvesfrom family, parents remain their most importantinfluence and must stay involved, helping themnavigate their media use, balance their time, andstay healthy.


Ages 13-18

The connection betweensocial media use and well-being differs from teen toteen, highlighting theimportance of taking yourteen's unique personalityinto account when guidingtheir healthy media usebehaviors

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CyberbullyingProtip: If your teen admits that they have beenbullied via text, social media, or another onlineservice, reassure them that you will not takeaway their phone, device, or video gameconsole. Ensure them that they are safe, andthat, together, you will be able to stop thecyberbullying from happening.

Science says: Cyberbullying can lead tonegative psychological, behavioral, andacademic outcomes, including suicidalthoughts, depression, low self-esteem, socialisolation, increased physical fighting, and poorschool performance. LGBTQ+ youth inparticular are more likely to experiencecyberbullying and more likely not to reportbeing bullied online. Teens often do not telltheir parents about being cyberbullied as theyfear being blamed and having their devicestaken away.

Co-viewingProtip: Ask to watch your teen's favorite movie,show, or online streamer with them as anopportunity to get to know them and whatthey enjoy, better. Remain nonjudgmentalwhile co-viewing, even if it is a video that youwould not choose for your teen.

Science says: Teens become more and moreindependent in their decision making,including choosing what media they consume.Asking to watch shows or play video gameswith them shows that you respect your teen'sindependent choices. Watching together alsoopens the door for discussion about complexissues like sex, relationships, and substanceabuse in ways that are nonjudgmental andshow that you care.

Science Says...


...from social media to wearables, media are powerful tools, andhow teens use them affects their health and development

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Media MultitaskingProtip: If your teen has problems focusing ontheir homework or other tasks, encouragethem to turn off all screen media, evenbackground media such as music with lyrics ortelevision, until their task is done.

Science says: Teens who "multitask" withmultiple screens while doing homework areless likely to retain the information they aretrying to learn, more likely to have impulsecontrol issues, and worse working memory.Teens who already have attention issues (suchas ADHD) may be more easily distracted fromtasks if they are listening to music with lyrics,watching online videos, using social media, orinteracting with any screen media.

Mental HealthProtip: Talk to your teen about how they usemedia and how it makes them feel. Createground rules together, including how muchtime to spend on media, what kinds of thingsare ok to share, and how best to interact withothers. Let them know that you will bemonitoring their social media accounts fromtime to time. If you or they are ever disturbedby something online, talk about it directly. Ifyour teen is acting sad or withdrawn, discussyour concerns with a health professional.

Science says: Media, including social media isan important part of many teen’s lives. Intenseactive use of social media (e.g., sharing andresponding to messages) does not necessarilyindicate or lead to mental health problems.Problematic use or addictive-like behaviors aswell as passive behaviors (e.g., mindlessscrolling or watching TV that is of littleinterest) has been shown to lead to poormental health outcomes in teens, includingincreased rates of anxiety and depression.Parents can help teens use media as tools topromote healthy strategies, feel connected,and improve teens' moods.

MusicProtip: Get to know the music your teen likesand why they enjoy it. This will help them tothink critically about the messages in lyrics.

Science says: Listening to music is a great wayfor teens to regulate moods. Some music issexist or degrading, some glorifies drug, alcohol,and tobacco use, making them seem risk-free.These lyrics can influence how teens treat eachother and themselves.

Online InfluencersProtip: Monitor your teen's media use and talkto them about the ads and online influencersthey see. Discuss any unhealthy beauty idealsand behaviors that are shown. Listen to howyour teen feels about them, and address howthese messages might be affecting them.

Science says: Influencer marketing can greatlyaffect teens’ attitudes and behaviors regardingnutrition and health. Teen programming oftenembeds marketing messages about appearanceideals, unhealthy nutrition, and exercise habitsthat can influence negative body image andharmful behaviors.


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Parental ModelingProtip: Develop house rules for media use withyour teen, and follow them yourself. Encouragehealthy behaviors when it comes to screens,including having sit-down media-free mealstogether and conversations that are free ofdevice-distractions.

Science says: Although your teen is becomingmore independent and may not seem interestedin how you use media, they are still learningfrom you and your actions—they still rely onyou for consistency, safety, and love.

SextingProtip: Have matter-of-fact, non-judgmentalconversations about the risks involved withsharing explicit images or content with othersonline—even if it is with someone your teentrusts and is in a relationship with. Sextingobjectifies and dehumanizes. Teach your teen torespect themselves and others.

Science says: Sexting has been shown to causeteens regrets about oversharing and can lead tocyberbullying, depression, and in some cases,legal consequences.

SleepProtip: Working back from when they must wakeup, help your teen set a consistent bedtime andturn off all screens an hour before that. Chargedevices outside of bedrooms overnight.

Science says: Adolescence is a stage of rapidphysical growth and sleep is when growthoccurs. Teens need about 9½ hours of sleep.Using screens right before bed can delay theirbody’s natural sleep cycle, as media can arousethem and the blue light emitted by screenssuppresses melatonin, the sleep hormone.Device alerts and notifications disrupt quality ofsleep, affecting their learning.

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Social Emotional LearningProtip: Empower your teen to solve media andtechnology-related problems on their own.Resist the urge to step-in and offer solutionsto a difficult situation your child isencountering online. Instead, ask probingquestions to help your child solve the problemindependently. Discuss how decisions mightimpact others (positively or negatively) andwhat the pros and cons or solutions might be.

Science says: Supporting students’ social,emotional, and cognitive development relatespositively to traditional measures such asattendance, grades, test scores, graduationrates, college and career readiness, andoverall well-being. Teens start to form anindividualized personal identity and articulatea set of values that guide their behavior. Inaddition, thirteen- to eighteen-year-olds formmature relationships with others and movetowards emotional independence fromparents.

Violent MediaProtip: Know what shows, movies and videogames your teen watches and plays, andencourage your child to think critically aboutviolence they see in media. Talk about thehurt and suffering violence causes, as well asalternative, non-violent ways to solveproblems. When possible, limit your child'sviolent media consumption by encouragingnon-violent or less violent options.

Science says: Watching violent media candesensitize teens to violence, making themfeel that it is normal or acceptable behavior.Playing a lot of violent video games canincrease teens' aggression, anxiety, anddepressive symptoms. Parental monitoringand involvement can reduce teens exposureto violent content and reduce their aggressivebehaviors and negative outcomes.


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Many beauty and lifestyle media contain content focused on how their audience (regardless ofgender identity) can “improve” themselves. What teens take away from this content is that theyare inadequate– their thighs are too thick, or not muscular enough, etc. Research shows thatsome teens feel measurably worse about themselves after consuming these media.

Numerous filters, photo and video editing apps make it easy for teens to alter theirappearance. As a result, many teens manipulate their selfies and photos to look more likeadvertised beauty ideals. Teens are constantly bombarded with this altered reality on socialmedia, and research shows that teens who compare themselves to the images they see onlineexperience low self-esteem and body image issues.

Eating disorders such as anorexia nervosa and bulimia are driven by a desire to take control oflives that feel out of control. Disordered eating behaviors can be the response to bodydissatisfaction, and can be triggered by social media use, particularly when social mediafocuses on unrealistic beauty ideals.

Can media use cause teens to be unhappy with their bodies and contributeto eating disorders?

Here’s what we know about the complicated relationship between media and teen body image:

Talk about the media messages and images your teen consumes, including the images they shareof themselves. Encourage your teen to present their authentic (unfiltered) self online, and check inwith them and their doctor if you notice any unhealthy or disordered eating behaviors.


What parents ask most about their teen

Ask the MediatricianTM

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Ice BreakersWhen you see something concerning, here are ways to get theconversation going.


“I noticed that mornings are tough. Let’s try anew routine, where we all charge our phonesin the kitchen at night, and do something toscreen-free to unwind before bed, like taking abath, writing in a journal, or reading a book.”

Your teen is spending time on their phonelate at night and is having trouble waking up

in the morning…

“It’s perfectly natural and ok to want to look atthat. But remember that those are real peoplein the videos and sometimes the peoplemaking them aren’t treated very well. Also,what they show you might be really violentand not at all what sex is actually like.”

You see your teen looking at pornographyonline…

“That song you were listening to had somepretty heavy lyrics and made me concernedthat you may be feeling down. How are youfeeling, and what do you like about thatmusic?”

The music your teen has been listening tolately is mellow and filled with sad, emotional


If you see that... Say this...

How to talk to your teen

Start conversations when you andyour child are in good moods (notfeeling angry or hurt) and whenyou're both open to listening. Besure to say exactly what youmean, encourage your child totake turns talking and listening,and give them your full attention.Let them know that you love themand that you value what they say.


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Child Mind Institute childmind.org

Common Sense Mediacommonsensemedia.org

Healthy Childrenhealthychildren.org/English/family-life/Media

Media Smartsmediasmarts.ca

Youth and Mediacyber.harvard.edu/research/youthandmedia

Crisis Text Linecrisistextline.org

National Domestic Violence Hotlinethehotline.org

National Suicide Prevention Lifelinesuicidepreventionlifeline.org

The Trevor Projectthetrevorproject.org/get-help-now/

COVID-19 has created a “‘perfect storm” forincreased family violence: more time alonetogether at home, money issues, a lack ofsupport systems, and increased substance usecan all contribute to violence, abuse, andneglect. Children most at risk include those inlow-income households or foster care, withchronic disorders, existing mental healthissues, or traumatic pasts. Even if your familydoes not be experience violence or mentalhealth issues in the home, be aware thatrelatives, neighbors, friends, or children youknow may need help and support. You can useand/or share the following resources:

Zero to Threezerotothree.org

Center on the Developing Child developingchild.harvard.edu

Digital Futures Commissiondigitalfuturescommission.org.uk

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The Family Digital Wellness Guide is proudly supported by

The Digital Wellness Lab at Boston Children's Hospital is an educational entity that exists to provide carefully researchedhealth information. All information included in this guide is for educational purposes only. For specific medical advice,diagnoses, and treatment, consult your health care provider.