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.