Q: When we hear that children should not be exposed to more than 1 hour of screen time per day, does that mean that all media are created equal?  For example, are watching a movie, watching an age-appropriate TV show, and playing an interactive children’s website game all the same? What are the concerns about and benefits of each?
Needing Guidance on Guidelines in Madison, WI

A: Dear Needing Guidance,

This is an important series of questions. First, let’s talk about the one-hour limit you mentioned. The American Academy of Pediatrics recommends that children over age two be limited to one to two hours of media per day.  This recommendation largely reflects the fact that kids are only awake for about 14-16 hours in a day and in order to keep them healthy, there are a lot of things that need to take place during that time frame.  After family meals, physical activity and play, and school and homework, there is rarely as much as an hour left for entertainment media. So part of the goal of this limit is to help keep media in its place—as a "bonus", if there's time after all the important business of life has been taken care of. 

The other reason for the one-hour limit is in what research has shown about overweight — that after two hours of media per day, there is a consistent relationship between the number of hours of screentime (of all kinds, whether it teaches kids to read or teaches them to shoot their opponents) and a heavier weight.  Keeping media below two hours a day can help avoid this effect.

The second part of your question is that once you have limited all screentime to one hour a day, does it matter what that hour includes? Absolutely. As you imply, all media are not created equal. Any media content your children are exposed to should be not only appropriate, but also effective for their age. That is, in order for them to get the most out of their media experience, make sure that the content addresses something they're interested in or that they're trying to figure out—whether it’s learning to count or learning what it might be like to have a baby brother.

To address the third part of your question — In terms of media format,
I would say that the more interactive it is, the more effective it will be at teaching whatever it teaches. For example, video games are more effective teachers than TV shows because the player directly affects what happens on screen.  However, there’s no hard and fast rule about which format is preferable. A TV show that asks your children to sing and dance along will give them more of an opportunity to learn than a website that asks them to passively receive the information or story it offers. Whatever kind of media they use, though, remember that media are teachers; they will learn whatever is being shown, so choose content wisely.

Enjoy your media and use them wisely,
The Mediatrician

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