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AAP Changes Advice for Parents on Screen Time – Finally

Last updated on March 2nd, 2018 at 12:42 pm

Happy child staring tablet.This May, the American Academy of Pediatrics (AAP) convened an invitation-only Growing Up Digital: Media Research Symposium. This two-day event brought together leading social science, neuroscience and media researchers, educators, pediatricians, and representatives from key partner organizations. The problem they were to address: the most well-known of guidelines discouraged “screen time” for children under age 2 and limited “screen time” to two hours a day for children over age 2 …a bit archaic considering they were written prior to the introduction of the 1st iPad and the proliferation of apps aimed at young children. We even discussed the two-hour limit here at Pediatric Safety in a post called “Do we Shut off the TV until they Reach 2?”  As I’m sure you can imagine…we disagreed.

So in May, the AAP met to evaluate available data, identify research gaps, and consider how to provide thoughtful, practical advice to today’s parents based on the evidence.  Not surprising – by the end of the meeting – new recommendations emerged.  (Note: a detailed overview of the meeting with recommendations for pediatricians, educators and parents is available here).

In a summary article entitled “Beyond ‘turn it off’: How to advise families on media use” presented in the AAP News by authors Ari Brown, M.D., FAAP, Donald L. Shifrin, M.D., FAAP and David L. Hill, M.D., FAAP,  the following 12 key messages for parents emerged:

  1. Media is just another environment. Children do the same things they have always done, only virtually. Like any environment, media can have positive and negative effects.
  2. Parenting has not changed. The same parenting rules apply to your children’s real and virtual environments. Play with them. Set limits; kids need and expect them. Teach kindness. Be involved. Know their friends and where they are going with them.
  3. Role modeling is critical. Limit your own media use, and model online etiquette. Attentive parenting requires face time away from screens.
  4. We learn from each other. Neuroscience research shows that very young children learn best via two-way communication. “Talk time” between caregiver and child remains critical for language development. Passive video presentations do not lead to language learning in infants and young toddlers. The more media engender live interactions, the more educational value they may hold (e.g., a toddler chatting by video with a parent who is traveling). Optimal educational media opportunities begin after age 2, when media may play a role in bridging the learning achievement gap.
  5. Content matters. The quality of content is more important than the platform or time spent with media. Prioritize how your child spends his time rather than just setting a timer.
  6. Curation helps. More than 80,000 apps are labeled as educational, but little research validates their quality (Google Scholar). An interactive product requires more than “pushing and swiping” to teach. Look to organizations like Common Sense Media (www.commonsensemedia.org) that review age-appropriate apps, games and programs.
  7. Co-engagement counts. Family participation with media facilitates social interactions and learning. Play a video game with your kids. Your perspective influences how your children understand their media experience. For infants and toddlers, co-viewing is essential.
  8. Playtime is important. Unstructured playtime stimulates creativity. Prioritize daily unplugged playtime, especially for the very young.
  9. Set limits. Tech use, like all other activities, should have reasonable limits. Does your child’s technology use help or hinder participation in other activities?
  10. It’s OK for your teen to be online. Online relationships are integral to adolescent development. Social media can support identity formation. Teach your teen appropriate behaviors that apply in both the real and online worlds. Ask teens to demonstrate what they are doing online to help you understand both content and context.
  11. Create tech-free zones. Preserve family mealtime. Recharge devices overnight outside your child’s bedroom. These actions encourage family time, healthier eating habits and healthier sleep.
  12. Kids will be kids. Kids will make mistakes using media. These can be teachable moments if handled with empathy. Certain aberrations, however, such as sexting or posting self-harm images, signal a need to assess youths for other risk-taking behaviors.

Congratulations parents!  While “official AAP recommendations” will likely not arrive until 2016, you may rest easy knowing what I’m guessing you have always known – that it is what your child is doing more than how much time they are spending in front of a screen that matters…and the fact that you care…and are asking the questions…and are monitoring…is half the battle.

Sex and Sexual Health – 5 Reasons for Being Open with Kids

Last updated on October 2nd, 2015 at 11:14 am

Talking about sex and relationships with your children as they grow up can help them look after their sexual health when they start having sex.

It won’t make them want to start having sex. Here are five good reasons to be open about sex with your child.

Your Child Wants the Facts About Sex

Why-talk-about-sex-wth-kidsA survey found that one in four (25%) teenagers feels confused, worried or even scared about sex and relationships, and that most teens would like to talk to their parents or carer about it.

Teenagers see images of sex in films, magazines, newspapers, adverts, on television and on the internet, but this doesn’t mean that they know the facts. They may be receiving confused and inaccurate messages. You can help them know what’s true and what’s not.

Talking About Sex Helps Them Wait

Evidence shows that if you talk to your teen about sex and relationships, they’ll feel less pressure to have sex, which means they’re more likely to wait. Talking openly gives them the confidence to approach the topic with a boyfriend or girlfriend in the future.

It Helps Them Make Decisions About Sex

By ensuring that your child knows about contraception (the methods, how they work and where to get them) and safer sex, you are helping them to make choices when they decide to have sex.

You’ll help them avoid taking risks that could lead to unintended pregnancy or sexually transmitted infections (STIs). Every teenager should know about contraception and safer sex, whether they’re a boy or girl, lesbian or gay, straight or bisexual.

Chlamydia is a Real Risk

Chlamydia is the most commonly diagnosed STI. Seventy per cent of girls and 50% of boys who are infected have no symptoms. If left untreated, chlamydia can cause complications, including infertility.

Your teenager needs to know that condoms help protect against infections such as chlamydia and other STIs. They also need to know where to get tested. A simple urine test or swab can detect chlamydia, which can be easily treated.

Find sexual health services in your area.

You Can be the Person They Trust

Once in secondary school (middle school*), your child will be going through puberty and hearing half-truths and myths from other kids. They might think that everyone else is having sex, but the truth is that most teenagers don’t have sex until they’re at least 16 (17 in the U.S.*).

This is a great opportunity to become someone that your child can go to for information, help and advice.

For ideas on how to start the conversation on sex and relationships, see Talking to your teen.

Editor’s Note: *clarification provided for our US audience.

Healthy Sleep Tips for Children

Last updated on September 28th, 2015 at 10:47 am

Essential Sleep Habits for KidsKeeping your child to a regular bedtime routine can be difficult, but it can help improve the quality of their sleep.

For some children, irregular sleeping hours can be problematic. Setting a regular bedtime schedule can really help children get the right amount of sleep.

It’s important to devise a routine that works for you and your child and to stick to it.

“Keep regular sleeping hours,” says Jessica Alexander of The Sleep Council, a non-profit organisation that provides advice on good sleep.

“A bedtime ritual teaches the brain to become familiar with sleep times and wake times,” she says. “It programmes the brain and internal body clock to get used to a set routine.”

Relaxation techniques to aid sleep

Winding down is a critical stage in preparing your child for bed. There are many ways for them to relax:

  • A warm (not hot) bath will help their body reach a temperature where it’s most likely to rest.
  • Relaxation exercises, such as light yoga stretches, will help relax their muscles.
  • Relaxation CDs work by relaxing the listener with carefully chosen words and gentle hypnotic music and sound effects.
  • Reading a book or listening to the radio will relax their mind by distracting it from any worries or anxieties.

Here are some more relaxation tips your teenager can use to prepare them for sleep.

Avoid TVs in the bedroom

The bedroom should be a relaxed environment.

Experts say that bedrooms are strongly associated with sleep, but that certain things weaken the association. These include TVs, mobiles/smartphones and other electronic gadgets, light or noise, and a bad mattress or uncomfortable bed.

Try to keep your child’s bedroom a TV-free zone and get them to charge their phones and other devices downstairs. That way they’ll be out of temptation and won’t disturb them if a text or email comes through.

Read more about how keeping your teen’s bedroom free of electronic contraptions can boost their sleep.

Get a comfy bed

“It’s important to create an environment that’s favourable for sleep,” says Alexander. “Keep the bedroom just for sleeping.”

The bedroom needs to be dark, quiet and tidy. It should smell fresh and be kept at a temperature of 18-24°C. Jessica adds: “Fit some thick curtains. If there’s noise outside, consider investing in double glazing or, for a cheaper option, earplugs.”

A comfortable bed is essential. Research by The Sleep Council shows that a good-quality mattress and bed frame will give you an extra hour’s sleep a night.

Dr Chris Izikowski of the Edinburgh Sleep Centre, who led the research, says people benefit from changing their bed if it’s uncomfortable. “It’s likely that long-term insomniacs and those with inadequate sleep habits would benefit most,” he says.

Download the Sleep Council’s guide to on-screen text (PDF, 1Mb).

Keep a sleep diary

One of the first things your GP or sleep expert will get you to do is to keep a sleep diary for your child as part of diagnosing any sleep problems.

“The sleep diary might reveal some underlying conditions that explain sleep problems, such as stress or medication,” says Alexander.

A sleep diary might reveal lifestyle habits or experiences in your child’s day-to-day activities that contribute to sleep problems.

A sleep diary could include answers to the following questions:

  • What were your child’s sleeping times?
  • How long did it take them to get to sleep?
  • How many times did they wake up during the night?
  • How long did each awakening last?
  • How long did they sleep in total?
  • Did they do any exercise shortly before going to bed?
  • Did they take any naps during the day or evening?
  • Has anything made them anxious or upset?

Download a sleep diary.

Sometimes, sleep problems can be a sign of a mental health problem. Read more about symptoms of depression in children.

Now, read why your child’s sleep needs change when they become a teenager.

 

10 Tips for Better Child and Family Health

Last updated on August 12th, 2015 at 10:27 am

Any changes to your child’s diet and lifestyle are much more likely to be accepted if they involve the whole family.

Use these 10 tips to help the whole family embrace a healthier lifestyle:

1. Eat at the table together – studies show that families who have regular meals at the table with no distractions (such as television) are more likely to be a healthy weight.

family bicycle safety2. Include children in family activities – such as walking the dog, washing the car, mowing the lawn, a trip to the zoo, or a family bike ride. They won’t see it as exercise, just fun. Here are more ideas for free family activities.

3. Ban “sweetened” drinks from the home – and persuade your children to drink water instead. Fizzy drinks, fruit drinks, sports drinks, milky drinks to which sugar’s been added, and even 100% fruit juice are high in calories. Children tend to drink fewer sweet drinks when they’re not freely available in the home. Find out more about healthy drinks for children.

4. Make sure the whole family eats breakfast every day. Children who eat breakfast are less likely to overeat later in the day. If time is an issue, choose speedy yet healthy items such as peanut butter on wholemeal toast, or porridge and fruit. For inspiration, here are five healthy breakfasts.

5. Decrease screen time – and put physical activity in its place. Drag the kids away from the TV, computer and games console and instead get active as a family by walking, cycling, going to the park or playground or swimming together. Here are 10 ways to get active with your children.

6. Get active on holiday. It’s the perfect opportunity to get fit and have fun. You could try a specific activity-focused break such as cycling, hiking, pony trekking or sailing, or choose a destination where you can do a variety of activities.

On a budget? Camping holidays are affordable and most children love being outdoors. There’s lots of scope for activity for children of all ages, from putting up the tent to nature hikes. Read more about family activity holidays. Use this activity planner to get children active during school holidays at home.

7. Prepare more meals at home. It takes a little longer, but this way you can control what you put in food. You can read food labels, use healthier ingredients and control how much sugar and salt you use. Here are some tasty, quick and healthy recipes that are ideal for midweek evening meals.

8. Have healthier takeaways. You don’t have to give up takeaways completely, just make smarter choices. For instance, have mushy peas with your fish and chips and don’t eat all the batter around the fish. Order lower-fat pizza toppings like vegetables, ham and prawns instead of salami and four-cheese. And with Indian takeaways, go for tomato-based sauces such as madras instead of cream-based kormas and massalas. Read more about healthier takeaways.

9. Avoid over-sized portions. Portion sizes have increased over the years and it’s one of the reasons children become overweight. Start meals with small servings and let your child ask for more if they are still hungry. Avoid giving adult-sized plates to younger children – it can encourage them to eat too much.

10. Walk for charity. Doing regular charity walks is a great way for the whole family to get fit. Events are held across the country and are aimed at all ages, levels and abilities. Google “charity walks” to find local events.

Keep Active with Ultimate Summer Family Adventures

Last updated on July 21st, 2015 at 12:27 pm

family bicycle safetySummer is a great time to increase physical activity for you and your family. There are lots of opportunities not available in winter (depending on where you live) and the longer days give ample time to get outside. However, it can also be a time when boredom sets in as kids lose their usual school-driven routine…and the temptation of sedentary video games is usually close at hand.

This summer, my family is doing better at being active and keeping boredom at bay – thanks to an idea from my thirteen year-old son (Thanks Elliott!).  He calls it “Ultimate AdventurouSummer” (yes, the words are supposed to run together – he thinks it’s so clever!).  Basically it involves a hat (or jar) full of fun family activities that you pull from randomly on a weekly basis. We have already engaged in mountain biking, a local ropes course (Go Ape), and a family badminton tournament.  In addition to the physical activity benefits, we’ve also had a lot of fun together as a family, so it’s been great for bonding. Below is my son’s recipe for ultimate summer adventures.

Developing Ideas

  • Everyone in the family should come up with at least 5 ideas (oh, and they can’t just be the everyday activities like walking the dog or going for a family bike ride)
  • Most should be active ideas – but you can include projects too
  • Each should be feasible to do in one day or a weekend with not too much prep (we usually pick the week’s idea on Monday to do on the weekend)
  • It helps to do a little research on the ideas and activities in your area – it can be a great excuse to finally visit some local parks or activity centers
  • HOLD A FAMILY MEETING – review all the ideas and make any changes that are needed – discard any that are not appropriate (e.g. that mom and dad are not willing or able to do…bungie jumping?? – or that won’t work for the whole family)
  • Get the kids to write each approved activity on a slip of paper and pop them into the official summer fun jar or hat!

Doing the Adventures

  • Pick an idea several days ahead – you may need to do some preparation or get materials (we had to patch a tire for mountain biking) – plus this gives time for everyone to discuss and plan the adventure…which is part of the fun
  • Plan the activities – AND CHECK THE WEATHER FORECAST – you may only have a few windows for some activities depending on rain/etc.
  • Do a checklist of things you need to take with you….we’ve had to go back home a couple of times
  • Build in some flexibility – we kept an idea for just my son and husband aside for a weekend when I was going to be away
  • Go out and have fun – and get active!

Here is a sample of some of our ideas:

  • Mountain biking
  • Ropes course (ropes climbing and zipline course)
  • Badminton tournament
  • Kayaking
  • Hiking at a local state park with our dogs
  • Parcour (at a local course)
  • Frisbee golf (who knew??)
  • We also included some less active, but fun projects:
    • Science project, from our son’s Backyard Ballistics book
    • Cooking a completely new meal, including a trip to a Farmer’s Market

We’ve already seen a lot of benefits from our Ultimate Adventurous Summer. It’s actually been a lot of fun, and since it’s kid-directed to a large extent, our son has been really engaged in the activities – including the preparations. Plus we’ve all been getting active…the ropes course required a good amount of exertion, but was a lot more fun than I expected.  And we’ve created a lot of good family memories!

Talking to Your Teen About Sex and Sexual Health

Last updated on July 13th, 2015 at 10:52 am

Most teenagers would like to talk to their parents or carer about relationships and sex. It might seem difficult, but here are five ideas on how to start the conversation.

Dad-talking-to-teen-about-sexHowever you bring up the topic of sex and relationships, listen to what your teenager has to say. You can then use this to let the conversation develop.

For example, if they mention condoms, check that they know why it’s important to use them, where to get them and how to use them. Talking about sex and relationships with your teenager won’t make them want to start having sex, but it will help them look after their sexual health when they do.

Try to keep calm, even if what they say surprises you or you disagree. Let your child know your opinions, but reassure them that you trust them to make their own decisions. If you lose your temper or criticise them, they might feel that they can’t talk to you in the future.

Ask Your Teen About Their Friends

Ask what your child’s friends think about the subject. This can be a way of talking about your child’s thoughts and fears indirectly. For example, if you see a pregnant woman, you could say, “When I was a teenager we were scared of getting pregnant. Do your friends ever worry about that?”

You could then talk about why it’s OK not to have sex, and where young people can get contraception and condoms if they’re planning to have sex.

Talk About Sex Little and Often

Don’t have one big talk about sex. Make it an open, ongoing topic. Have lots of little talks whenever the subject comes up, and start before your child is a teenager. Let your teen know that they can talk to you about anything that’s on their mind.

One of the easiest ways to bring up the topic is during everyday activities like washing up or watching TV. This makes it less of an event. You can use the storyline in a programme, or a celebrity in the news. For example, you could say, “What do you think about the fact they’ve had sex?”

Listen to your child’s answer. You could then talk about why it’s important to use a condom and contraception to protect against STIs (sexually transmitted infections*) and pregnancy. Make sure that your child knows where they can get them. Don’t sound judgemental or critical.

Find out about talking to your pre-teen child about sex.

Find Out What They’re Learning About Sex at School

Ask your teenager’s school what they are teaching your child about sex and relationships. Ask your child what they think about this. Find out if there’s anything they don’t understand, and if their classes have raised any topics they’d like to discuss with you. You could say, “What do you think of the sex and relationships lessons you’re getting at school?”

Listen to What Your Teen Thinks About Sex

Ask your teenager how they feel about things, for example, waiting to have sex with someone they care about. You could say to them, “Do you think it’s worth waiting until you meet someone you really care about, and who cares about you, before you have sex?”

You can use this discussion to talk about the risk of pregnancy when a boy and a girl have sex, and about getting contraception ready before having sex. You can also discuss who your child thinks should be responsible for contraception. Make sure they understand that it’s up to both partners to think about using condoms and contraception.

Make Sure You Know the Facts About Sex

Sex is a large topic. It covers how our bodies work, pregnancy, relationships and feelings, types of contraception and where to get them, STIs (sexually transmitted infections*), tests, treatment and more.

If you’re confident in your knowledge of these topics, you’ll be able to answer your child’s questions more readily. If you don’t know something, say so, but let them know you’ll find out. Look up the information and share it with them, or look it up together.

There are reliable websites with accurate information. NHS Choices has lots of information for you and your teen on sex and relationships. Other organisations include:

If Your Teen May be Gay, Lesbian or Bisexual

Your child might be gay, lesbian or bisexual. If so, they still need to know about safer sex messages, including how to protect themselves against STIs and pregnancy. They might use a discussion about sex and relationships as an opportunity to come out (tell you about their sexual orientation).

Women and girls who have sexual contact with other females and men and boys who have sexual contact with other males can get and pass on STIs, so it’s important that they know how to protect themselves. See sexual health for women who have sex with women and sexual health for men who have sex with men.

If your child is gay, they still need to know about contraception. People who identify as gay or lesbian might have sexual contact with people of the opposite sex, so it’s important that they know about contraception and avoiding unintended pregnancy.

Editor’s Note: *clarification provided for our US audience.

Also, check out this very useful and well written brochure on talking to your teen about sex, developed by the US Centers for Disease Control (CDC), with additional US-focused resources.

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