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Interactive Media Use at Younger Than the Age of 2 Years: Time to Rethink the American Academy of Pediatrics Guideline?
Abstract
In 2011, the American Academy of Pediatrics (AAP) reaffirmed its original statement on infants and media, leaving the 1999 recommendation essentially unchanged stating "we discourage the use of media by children under the age of two." 1 Although published in October 2011, the policy statement had been completed much earlier owing to the lengthy internal review process of the AAP. 1,2The timing is notable because the iPad debuted in April 2010, meaning that the statement was drafted with no knowledge that such a device would ever exist.Now, 3 years later, we still know surprisingly little about how iPads and other interactive media technologies affect children's cognition-research is simply unable to keep up with the pace of technological advancesand these devices are increasingly popular.The salient question then is whether the discourage media verbiage of the 2011 statement should be applied to them.I should disclose that I am a member of the executive committee of the AAP Council on Communications and Media and a co-author of the 2011 statement but that I speak only for myself in this Viewpoint.I should also point out that much of the science underpinning that recommendation is based on research with which I have been involved.Although I and others are currently studying the effects of these new technologies, it will be years before we have robust data about their effects.Accordingly, I want to offer my opinion on what the recommendation regarding them should be based largely on theoretical, rather than empirical, grounds.By way of background, I believe that there is a direct and an indirect pathway by which media affect child behavior and development.The direct pathway is based entirely on the content viewed and its formal features.4][5] The indirect pathway is mediated by displacement.Simply put, there are only so many hours in a day, and time spent with media (even educational programming) comes at the expense of some other-potentially developmentally salubrious-activity (eg, playing or reading).To be sure, an iPad (or other interactive device) can function as nothing more than a video screen in which case the data acquired from research on televisions surely applies.But if it is being used in the context of one of the thousands of interactive applications currently designed for children, there are significant theoretical and practical differences that warrant consideration.
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“since most studies completed data collection before 2000, they probably lack generalisability to contemporary populations given recent and dramatic societal changes: declines in active commuting,10 in the technology being used by children10 (eg, the ubiquitous nature of new screen-based media),11 and in overweight and obesity (which appear to reduce physical activity).12”
From Timing of the decline in physical activity in childhood and adolescence: gateshead millennium cohort study (2018) · cites this paper as [11]
Citations
Cites
Early television exposure and subsequent attentional problems in children
Christakis, D. A., Zimmerman, F. J., DiGiuseppe, D. L., & McCarty, C. A. (2004) · Pediatrics · doi:10.1542/peds.113.4.708 · Cited by 926
Self-citationMedia Use by Children Younger Than 2 Years
Brown, A. (2011) · PEDIATRICS · doi:10.1542/peds.2011-1753 · Cited by 487
The Immediate Impact of Different Types of Television on Young Children's Executive Function
Lillard, A. S., & Peterson, J. (2011) · PEDIATRICS · doi:10.1542/peds.2010-1919 · Cited by 463
Nelson's Textbook of Pediatrics 17th ed
Behrman, R. E., & all, E. (2003) · Cited by 442
Associations Between Content Types of Early Media Exposure and Subsequent Attentional Problems
Zimmerman, F. J., & Christakis, D. (2007) · PEDIATRICS · doi:10.1542/peds.2006-3322 · Cited by 395
Self-citationTelevision and DVD/Video Viewing in Children Younger Than 2 Years
Zimmerman, F. J., Christakis, D. A., & Meltzoff, A. N. (2007) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.161.5.473 · Cited by 394
Self-citationEffect of Block Play on Language Acquisition and Attention in Toddlers
Christakis, D., Zimmerman, F. J., & Garrison, M. M. (2007) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.161.10.967 · Cited by 101
Self-citationCortisol, contingency learning, and memory in preterm and full-term infants
Haley, D. W., Weinberg, J., & GRUNAU, R. E. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.06.007 · Cited by 84
The Immediate Impact of Different Types of Television on Young Children's Executive Function
(2011) · PEDIATRICS · doi:10.1542/peds.2010-1919d · Cited by 40
Infant Video Viewing and Salivary Cortisol Responses: A Randomized Experiment
Christakis, D., Liekweg, K., Garrison, M. M., & Wright, J. A. (2012) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2012.10.032 · Cited by 10
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Gao, C., Wang, F., Chen, J., Yu, T., & Chen, Y. (2024) · Mind Brain and Education · doi:10.1111/mbe.12431 · Cited by 4
Corkin, M. T., Peterson, E. R., Henderson, A. M. E., Waldie, K. E., Reese, E., & Morton, S. (2022) · The Social Science Journal · doi:10.1080/03623319.2022.2081441 · Cited by 4
Identifying Features that Characterize Children’s Free-Hand Sketches using Machine Learning
Thomas, X., Powell, L., Polsley, S., Ray, S., & Hammond, T. (2022) · ACM International Conference on Interaction Design and Children (IDC) · doi:10.1145/3501712.3535281 · Cited by 4
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Mohamed, N. F., Soliman, S., & -Mouty, S. M. A. E. (2021) · Mansoura Nursing Journal · doi:10.21608/mnj.2021.180676 · Cited by 4
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Koc‐Arik, G. (2024) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1368538 · Cited by 3
Impact of screen use on young children's development: a review of research and recommendation
Mączyńska, W., Dutkiewicz, J., Wijata, M., Wijata, A. M., Przybyłek-Stępień, Z. A., Bartosiński, R., Szustak, J., Kąpa, M., Szepietowski, B., Kaźmierczak, J., et al. (2025) · Journal of Education Health and Sport · doi:10.12775/jehs.2025.80.59110 · Cited by 6
Dong, C., Fotakopoulou, O., & Hatzigianni, M. (2024) · Early Child Development and Care · doi:10.1080/03004430.2024.2358343 · Cited by 9
Electronic media use and sleep in toddlerhood and preschool age
Praninskienė, R., Jusienė, R., Laurinaitytė, I., Petronytė, L., Rakickienė, I., & Urbonas, V. (2018) · Neurologijos seminarai · doi:10.29014/ns.2018.06 · Cited by 3
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Li, Q., Wei, Y., Peng, Y., Su, L., & Song, H. (2022) · Education and Information Technologies · doi:10.1007/s10639-022-11501-x · Cited by 3
Ulum, H. (2025) · European Journal of Education · doi:10.1111/ejed.70400 · Cited by 2
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Children and Mobile Media devices
Barkiya, D. S. M. (2017) · Journal of Medical Science And clinical Research · doi:10.18535/jmscr/v5i8.48 · Cited by 2
Using iPads and Mobile Technology for Children with Developmental Disabilities
Proctor, L. A., & Wang, Y. (2015) · Advances in medical technologies and clinical practice book series · doi:10.4018/978-1-4666-8395-2.ch003 · Cited by 2
Effect of Media Exposure to Language Development
조민수, 김경미, 김성구, 최세린, & yi, Y. (2017) · Annals of Child Neurology · doi:10.26815/jkcns.2017.25.1.34 · Cited by 2
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Dhar, D., Mukhopadhyay, D., Paul, D. K., & Mandal, A. K. (2026) · Cureus · doi:10.7759/cureus.101325 · Cited by 1
Preparing Early Childhood Educators
Ncube, S. E. (2026) · IGI Global eBooks · doi:10.4018/979-8-3373-6269-4.ch002 · Cited by 1
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Li, H., Wang, F., & Subrahmanyam, K. (2023) · Cambridge University Press eBooks · doi:10.1017/9781107165250.006 · Cited by 1
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Strasburger, V. C., Shifrin, D. L., & Fuld, G. (2014) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2014.745 · Cited by 1
Infants and Interactive Media Use
Strutz, K. L. (2014) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2014.742
Population-Based Studies of Bullying in Young Children
Verlinden-Bondaruk, M. (2014) · EUR Research Repository (Erasmus University Rotterdam)
Athreya, B. H., & Mouza, C. (2016) · Springer eBooks · doi:10.1007/978-3-319-12364-6_2
“An Entry-Level Field:” A California Case Study on New Media in Youth Services Programming
Martens, M. (2017) · New Review of Children s Literature and Librarianship · doi:10.1080/13614541.2017.1280354
Neurodevelopmental outcome in perinatal asphyxia: prediction and measurement
Ahearne, C. E. (2016) · Arrow@dit (Dublin Institute of Technology)
The Home Screen Media Environment of Saudi ToddlersPreprint
Alroqi, H., Serratrice, L., & Cameron‐Faulkner, T. (2021) · doi:10.31234/osf.io/a9uqx
(2020) · Érès eBooks · doi:10.3917/eres.baton.2020.01.0329
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Spektor‐Levy, O., Plutov, I., Israeli, N., & Perry, N. (2017) · IGI Global eBooks · doi:10.4018/978-1-5225-3417-4.ch076
Screen use and early child development: Risks and benefits
McArthur, B. A., & Madigan, S. L. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818872-9.00170-9
Theoretical Basis of the Erxin Scales
Jin, C., Gao, Z., & Liu, W. (2024) · Springer eBooks · doi:10.1007/978-981-99-9997-2_2
Perspectives on Preschooler Screen Time and Global Development
Binet, M.-A., Couture, M. M., Almeida, M. L., Bégin, M., & Fitzpatrick, C. (2024) · Springer eBooks · doi:10.1007/978-3-031-69224-6_6
Yukang, X., & Zhu, L. (2023) · Cambridge University Press eBooks · doi:10.1017/9781107165250.002
Strouse, G. A., & Ganea, P. A. (2025) · Journal of Experimental Child Psychology · doi:10.1016/j.jecp.2025.106291
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Tryastuthi, N. N. E., Purnamayanti, N. M. D., & Tedjasulaksana, R. (2025) · Jurnal Pendidikan Dasar Rare Pustaka · doi:10.59789/rarepustaka.v7i1.350
Azevedo, L. B., Stephenson, J. R., Hughes, A. H., Retzler, J., Reilly, J. J., Fairclough, S. J., Okely, T., Jones, D., Smith, C., Greca, J. P. D. A., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-101523
Song, H., Zhong, P., Chen, Z., Huang, T., Liu, Y. F., Dang, J., Cai, S., Stafford, R. S., Lau, P. W. C., & Song, Y. (2026) · Journal of Outdoor Recreation and Tourism · doi:10.1016/j.jort.2026.101025
Oh, S. (2026) · Korean Journal of Human Ecology · doi:10.5934/kjhe.2026.35.2.317
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Cao, X., Gao, C., Cheng, X., Zhang, X., & Wang, F. (2026) · Journal of Children and Media · doi:10.1080/17482798.2026.2697016
The Impact of Social Factors on the Talent Development of Preschool Children: A Review Study
Pournesaei, G. S. (2025) · Journal of Social Psychology · doi:10.66224/jsp.1210988
Allégations éducatives des applications mobiles destinées aux 0-5 ans
Melançon, A., & Audy, É. (2026) · doi:10.64490/kysd9848
Metadata
- Authors
- Christakis, D. A.
- Affiliations
- Seattle Children's Research Institute (US)
- Corresponding author
- Christakis, Dimitri A.
- Venue
- JAMA Pediatrics
- Publisher
- American Medical Association (AMA)
- Published
- 2014-05-01
- Volume
- 168
- Issue
- 5
- Pages
- 399
- ISSN
- 1072-4710 (ISSN-L)
- 2168-6203
- OpenAlex
- W2071347942
- Cited by
- 144
- References
- 10
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 18 · 2023: 8 · 2022: 10 · 2021: 9 · 2020: 9 · 2019: 10 · 2018: 7 · 2017: 22 · 2016: 21 · 2015: 13 · 2014: 4
- FWCI
- 102.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Child Development and Digital Technology
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Education › Educational Methods and Impacts
- Keywords
- interactive media, infants, toddlers, iPad, screen time, American Academy of Pediatrics policy, child development, displacement, educational programming, cognitive effects of media, screen-based learning
- MeSH terms
- Computers, Humans, Infant, Pediatrics, Play and Playthings, Societies, Medical, Time Factors, United States, Practice Guidelines as Topic
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