Yes, our advice about TV makes sense

Over at Slate, Farhad Manjoo has one of those irritating, self-consciously counter-intuitive essays that seem to define the site.  He goes after pediatricians for our advice about television for toddlers, which he thinks (according to his subheader) doesn’t make sense.  He shares the following:

At my 1-year-old son Khalil’s doctor visit last month, our pediatrician told us to stop letting him watch TV. Also, no more iPhone, iPad, or computers. Like all babies, Khalil goes gaga for any sort of screen. The sight of an electronic device quiets him instantly, and if you hand him the gadget, it will reliably captivate him for 10 minutes or longer, far more time than he spends with any other kind of toy.

Ever since he was born, I’ve taken advantage of this effect judiciously but regularly, usually to get out of a jam. In his earliest days, I’d lay him on the couch in the morning and watch TV while he drifted off to sleep. When he got older, I’d give him my phone to calm him down in the car or at the supermarket. When he was about 6 months old, I began lobbying my wife to let him have an old laptop as a toy. (I was rebuffed.) And just before he turned 1 year old, I discovered that TV was an ideal way to distract him while feeding him dinner. He’s always been an insufferably picky eater—he’ll kick and scream and spit out much of the food we try to push into his mouth. But if I sit his high chair in front of the TV, his resistance melts: He’ll accept whatever nuggets I offer and will barely even fuss when it’s something self-evidently nasty. (Seriously, pureed salmon?)

First, let me share my sympathy about the feeding thing.  My own son has found an especially shiny button of mine to push called “mealtime,” and manages to drive me berserk regularly when I try get him to eat.  Knowing that I could probably get him to choke down more food by playing videos he likes makes that option seem awfully appealing.  But Manjoo hardly starts on a strong note by telling us that television stupefies his son so effectively that it extinguishes his age-appropriate response to blatantly unpalatable foods.  Doesn’t his own story raise questions about how developmentally appropriate something is if it overrides a child’s normal behaviors?

Before I go any further, let me clarify my own advice on this subject.  In keeping with the American Academy of Pediatrics’s recommendations, I counsel parents to expose children under two to as little television as possible.  I tell them that interacting with them in the real world is much more developmentally salubrious than anything on television.  But I also tell them if they see a little bit of television from time to time, it’s really not a big deal, and almost certainly harmless in small doses (such as Manjoo describes in his opening paragraph).  It’s important mainly to avoid allowing television viewing to become habitual.

I have no intention of plopping the baby in front of the TV for hours on end. My kid spends, at most, 30 minutes a day with a screen, and we’ve cut down his screen time even further since our doctor’s prohibition. At the same time, I’m skeptical of the blanket rule against screens. Sometimes they can’t be avoided, and letting the baby watch or play with a screen can be immensely helpful. The other night I wanted to watch the Republican presidential debate—would it have ruined my son to have let him play in the living room while the TV was on? (I think he would have agreed with Herman Cain’s tax plan.) Or what about when I give my kid the iPad to play with while I take a shower—is that really so bad?

No, probably not.  I have no doubt watching the Republican debate would have had no negative effect on the kid at all.  [Must… fight…urge to make… cheap… political joke.]  I suspect most of my colleagues would give similarly measured advice.  But that doesn’t change the concern that regular television exposure is probably not good for toddlers, particularly if it is prolonged.

Manjoo goes on to discuss some studies commonly cited in support of this recommendation, but mixes up the results.  I don’t want to quote a lengthy and unwieldy passage, so you can click here and read what he writes yourself.  My objection to Manjoo’s analysis is that he writes about several studies that measured very different outcomes at different endpoints as though they contradict each other and paint a muddier picture than they do.  Further, he quotes one study’s author in a way that undercuts the whole point of the essay:

Christakis’ research suggests an escape hatch in the blanket prescription against TV: If you need to plop your kid in front of the tube, make sure you flip the channel to PBS (or the Republican presidential debate). There are some caveats here. Christakis points out that while educational TV isn’t detrimental, there’s no evidence that it’s beneficial for your child. The more time your baby spends watching Sesame Street, the less time he has to do other things that we know are good for him, like looking at picture books or playing with three-dimensional objects. [emphasis added]

In general, Christakis says, babies’ exposure to TV is comparable to the effects of secondhand smoke. “We know for a fact that some exposure has a detrimental effect, and as a parent, you should try to minimize this exposure,” he says. “But that doesn’t mean that if you’re seated next to someone who’s smoking in a restaurant that you should grab your children and run. Ten minutes, 20 minutes, 30 minutes of exposure to secondhand smoke or to television isn’t going to cause your child any harm—it’s really much more about not making it a regular practice.”

Indeed, I suspect that last quote is the line just about all of us would take.  We’re not advising parents to put blinders on their kids when they walk through Best Buy, we’re just recommending that it be very limited, and preferably geared to young viewers when it is viewed.  The most compelling reason for this recommendation is made in the statement I bolded above — there are many, many other activities that toddlers could be engaging in that are much better for them.  Watching a couple of hours of TV isn’t harmful per se, but it displaces other activities that are much better.

Manjoo concludes by undercutting everything he’s written before:

At first, the idea that there are some children spending most of their waking hours with the iPad sounded ridiculous to me. But then I caught myself: I spend more than half my day at some kind of screen, and when I’m away from one—when I haven’t checked my e-mail or Twitter in a while—I yearn for a fix. So why am I surprised that children are getting similarly hooked? While researchers who study kids and media say some exposure to screens isn’t bad, they’re right to point out that few American adults or babies are getting just some exposure. According to most surveys, Americans of every age group keep spending more and more time watching and interacting with electronic screens.

This explains why doctors prefer a blanket rule: We all have difficulty regulating our attraction to electronics, so opening the door for a little bit of television or gadget time for your baby might be seen as an invitation to go hog-wild. Yes, some TV won’t hurt your toddler, and, yes, playing a game like AlphaBaby might even help him. Just remember that keeping your finger on the off button isn’t as easy as it sounds. The more your kid watches, the more he’ll want to watch.

Please help me see where in this article there is any advice discussed that is not sensible.  If Manjoo’s own reporting shows that most babies watch two or more hours of TV daily, time better spent on almost any reasonable real-world alternative, how is a recommendation against doing so anything less than appropriate?  In a nation facing an obesity epidemic and with children watching excessive amounts of television (which I can verify from my own professional experience), is it not reasonable to recommend against establishing a TV-watching habit in infancy?

Should one hysterically shield one’s toddler from all flickering screens?  No.  Will a little screen time break little Kaitlyn’s brain?  No.  Is it still the best (quite sensible) advice to avoid it in favor of more developmentally appropriate activities?  Yes.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.

7 Comments

  1. Manjoo concludes by undercutting everything he’s written before:

    I have the same problem with much of what I write. However, often I can end without contradicting myself.

  2. I remember a really creepy scene at a restaurant, where a family had two young boys who were chatting, laughing, talking with their parents and the guests, jabbering excitedly at the toy airplanes they’d gotten.

    The food arrived. Mom immediately pulls two Game Boys out of her purse, and the kids latch onto them like they’re crack pipes. Mom and Dad hand-feed the boys while they play their video games, don’t say a word, don’t look to either side, don’t even acknowledge the food going into their mouths.

    It’s one of those things where you wonder how many battles were fought, for how long a time, to make this be the solution. It’s like those kids who don’t order dinner because Mom carries a bagel and a squeeze-pack of cream cheese-flavored grease, and you imagine how many times there were “it’s icky!” “eat it anyway!” “but it’s icky!” “you’re not getting anything else and you aren’t leaving until you eat it!” “but it’s ickyyyyyyyyy!”

    • … the one with the mom changing the diaper on her 8 yr old son was creepier.

  3. My main objection to those articles is that they make it sound as if you have only two options: turn on tv or give your child complete attention.

    It just is not so. The child can play with toys nearby you while you are cooking or whatever. And no, my child is not special and I’m not a super-parent.

    If you give kids time to play alone (while you are nearby and watch but do not intervene), they will learn how to do it. Most kids (not all) do have ability to play without adults if those allow them to do so.

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