AAP News TODAY 2016 - Sunday, October 23, 2016 - 6
6 | AAPexperience.org
Changing Landscape of Media Has Multiple Impacts on Children, Teens
The complexities of children's electronic
media use and how to address the challenges and opportunities were the subject of
Friday's Pediatrics for the 21st Century (Peds
21) pre-conference program "The Medium
Is the Message: How Electronic Media Are
Transforming Our Patients' World."
A panel of experts highlighted both the
dangers of unrestricted media use and the
benefits, including how media can boost
learning, leadership and connectedness.
The rapidly changing landscape of media
belies many simple solutions for dealing
with kids who have grown up with media
and understand it better than adults do,
"We are advising 'digital immigrants'
how to raise 'digital natives,'" said Dimitri
Christakis, MD, MPH, FAAP, director of
the Center for Child Health, Behavior and
Development at Seattle Children's Research
A deeper understanding of media's effects
has informed new AAP policies on guiding
children's media use, which includes developing a Family Media Plan.
Keynoter Michael Rich, MD, MPH,
FAAP, contrasted the "no media before age
2" recommendations of 25 years ago with
today's knowledge. Media applications are
not bad or good, said Dr. Rich, director of
the Center on Media and Child Health at
Boston Children's Hospital. "(But) we have
work to do," he added, calling for more
How media affect the developing brain remains a special concern. A developing child
needs "laps, not apps," Dr. Christakis said.
Advice from other experts included the
* AAP Past President David Tayloe Jr,
MD, FAAP, said community partnerships are essential to counter children's
lack of school readiness. He cited use of
Reach Out and Read.
* Stephen Pont, MD, MPH, FAAP, of
the Texas Center for the Prevention and
Treatment of Childhood Obesity, recommended using motivational interviewing
when counseling about obesity.
* Neurologist Sujay Kansagra, MD,
FAASM, of Duke University Medical
Center, discussed circadian rhythm disorders, stating teens' nighttime use
of devices can create "social jet lag."
Melatonin can be used as a "clock shifting" medication.
* Adolescent medicine specialist Col.
Jeffrey Hutchinson, MD, FAAP, helps
youths who play violent video games
AAP Issues New Recommendations for Children's Media Use
The Academy has released new policy
recommendations to help families manage
media use that focus not only on how
much time is spent on screens but also
how media are used. It also has published
an interactive Family Media Plan
Plan) that can be used to prioritize daily
activities for each member of the family.
The policy statement Media and Young
peds.2016-2591) focuses on infants,
toddlers and preschool children, while
a second policy statement Media Use
in School-Aged Children and Adolescents
(http://dx.doi.org/10.1542/peds.20162592) offers recommendations for children
ages 5-18. The technical report Children,
Adolescents and Digital Media (http://
provides a review of the scientific literature
to support both policies.
Pediatricians are encouraged to work
with families and schools to help them
understand the benefits and risks of media.
Among the AAP recommendations for
* Avoid screen media other than video-
chatting for children younger than 18
months. Parents of children ages 18-24
months who want to introduce digital media should choose high-quality
programming and watch it with their
* Limit screen use to one hour per day of
high-quality programs for children ages
2-5 years. Parents should co-view media
* Communicate with children about
treating others with respect (online and
offline) and avoiding risky behaviors.
Dentist to Address Oral Health Questions
A lot of things go on in a child's mouth,
and parents sometimes aren't sure whether
they should see the dentist or pediatrician,
said Rebecca Slayton, DDS, PhD, a member of the AAP Section on Oral Health.
When these patients show up at your
office, you may not always have the
background to address their oral health
concerns. To get up to speed, plan to
attend a session led by Dr. Slayton titled
"Oral Health Questions: Get the Toothful
Answers from the Dentist." The Audience
Response Session will be held from 4:005:30 pm today (A2169) in Room 303 of
Moscone South and again from 2:00Photo courtesy of Rebecca Slayton, DDS, PhD
Ectopically erupting lower incisors are a
frequent finding that concerns parents.
3:30 pm Monday (A3112) in Room 307.
Dr. Slayton will begin by giving some
basic information about oral health and
discuss situations pediatricians might see
in their offices. Then, she will present
some cases and photos. Using the audience
response system, attendees will be able to
weigh in on what they think is going on
and what they would do.
"I kind of teach them about it to begin
with and see if it stuck," said Dr. Slayton,
an AAP associate member and director
of the Department of Dentistry at Seattle
The cases will be based on questions Dr.
Slayton typically gets from pediatricians
such as whether they need to do something
if a permanent tooth is erupting but the
baby tooth has not fallen out yet. Parents
often are concerned that the child will have
"shark teeth" because it looks like there are
multiple rows of teeth.
"The permanent teeth are supposed to be
lined up in such a way that as they come in,
as they're developing, they cause resorption
of the roots of
she said. "But
if they're not
lined up quite
they come in
in front of or
and the roots
Another common scenario is a child
is brought to the pediatrician's office or
emergency department after a tooth was
knocked out accidentally. Dr. Slayton will
review how to determine whether the tooth
should be saved.
Nutrition also affects oral health and
can be particularly problematic in patients
with special health care needs. A child with
autism, for example, may have oral sensitivities that limit the foods he is willing or
able to eat.
More than 850 attendees of the Peds 21 program heard from experts about what they can
do to help families navigate the digital world.
to acknowledge what they get out of
playing the games and consider other
activities to replace their use.
* Parents who feel they don't know enough
about media use and can't address it with
their children can try the learning-todrive analogy, suggested Megan Moreno,
MD, MSEd, FAAP, of the Seattle Children's Research Institute at University of
Washington. She said parents may not
understand a carburetor on a car, but
that doesn't prevent them from being at
the side of a teen learning to drive.
Dr. Moreno also described how intimately teens' identity is connected with their
Peds 21 was moderated by David Hill,
MD, FAAP, chair of the AAP Council on
Communications and Media, which sponsored the meeting supported by the Friends
of Children Fund.
Moscone South, Room 303
Repeats as A3112, 2:00-3:30 pm
Monday, Moscone South,
"Often, those foods are not the ones that
are that great for teeth," Dr. Slayton said.
"They may be OK for overall health but
dentally may not be the best."
Pediatricians could help the family find
replacement foods that are lower in sugar
and make sure the child brushes regularly
with a fluoride toothpaste. However, that
may not always be possible.
"It's definitely one of the challenges we're
still wrestling with," Dr. Slayton said.
During the session, Dr. Slayton also will
emphasize the importance of collaboration
between pediatricians and pediatric dentists.
"I try to encourage people (pediatricians)
to get to know their (dental) colleagues on
a more social level," she said, "so that they
know who they are and they can call them
up and say, 'Hey, I've got this patient who
really needs care.'"