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Stop Arguing About Screen Time! (with your Middle Schooler) Peter Della Bella, MD Clinical Assistant Professor, NYU School of Medicine Fellowship Supervisor,

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Presentation on theme: "Stop Arguing About Screen Time! (with your Middle Schooler) Peter Della Bella, MD Clinical Assistant Professor, NYU School of Medicine Fellowship Supervisor,"— Presentation transcript:

1 Stop Arguing About Screen Time! (with your Middle Schooler) Peter Della Bella, MD Clinical Assistant Professor, NYU School of Medicine Fellowship Supervisor, NYU Child Study Center Private Practice, New York & Montclair March 3, 2014

2 Intro Middle school intro and your biggest concerns What is screentime? What’s good and bad about screentime? Is all screentime the same? Vignettes & warning signs Behavioral psychology Suggestions Screen hygiene 5 tips to know where you are getting somewhere Your plan for this week

3 Late childhood/Early teens Less supervision and more freedom Still highly impressionable/naïve You still have some control over screen access and content What are your worries? First exposures to sex, bullying, harrassment, and overtly violent media Becomes the preferred mode for self-soothing YOU WILL BE SETTING THE PATTERN NOW

4 Vignettes Luke can’t wait to get home from school to play Minecraft. He talks about Minecraft to his friends and adults, he is up until late at night playing and spends really excessive amounts of time on weekends. When you tell him to stop, he protests that he is right in the middle and can’t stop now or he’ll “die.” and gets really angry if you insist. He pleads for more time, and when you give it to him, he takes more time than you give him. And even THEN, he is unappreciative and even more angry. Rachel comes home and sits on the sofa. She is clearly interacting with her friends: texting, laughing at cute animal pictures and the selfies that she and her friends are passing back and forth between each other using Snapchat. She also is on level 244 of Candy Crush. She seems happy and can do this for hours. At night, she willingly goes into her room at a good time, but the light stays on for hours.

5 WARNING SIGNS They seem depressed in real life, happier on-line They’re using screen time destructively They’re overweight They’re extremely irritable when you ask them to shut down They always talk a lot more about what’s on the screen than things in real life They sneak or lie in order to get more screen time You catch them in their rooms when they’re supposed to be asleep

6 Why Limit Screentime? Because they can’t Displaces opportunities for real social interaction Displaces physical activities and hobbies Disallows opportunities for self-regulation skills Cuts into sleep, …family routines,…reading,…

7 Think of the use of electronic devices as an addiction… …big trend in addiction medicine is harm reduction

8 STRIKE A BALANCE

9 Behavioral Psychology Basics The vast majority of behaviors are learned. Whether adaptive or maladaptive, these behaviors serve a function POSITIVE REINFORCEMENT (reward) social, tangible goods, internal NEGATIVE REINFORCEMENT (escape/avoidance) social (escape from demands), internal

10 Behavioral Psychology Basics Noncompliance, aggression, and tantrums have all been found to occur due to social positive reinforcement (rewards) or negative reinforcement (escape/avoidance).

11 Behavioral Psychology ABCs ANTECEDENTS BEHAVIORS CONSEQUENCES

12 Behavioralism in the Home No need to yell Not much need to argue You just need to be mindful of the antecedents and control the consequences A ounce of prevention… Strength in numbers Clearly communicate the limits Precedents are easier to set than to reverse Be aware of what you reinforce Consequences, consequences, consequences

13 Elisabeth Kubler-Ross 5 Stages of Grief Denial Anger Bargaining Depression Acceptance

14 Vignettes Luke can’t wait to get home from school to play Minecraft. He talks about Minecraft to his friends and adults, he is up until late at night playing and spends really excessive amounts of time on weekends. When you tell him to stop, he protests that he is right in the middle and can’t stop now or he’ll “die.” and gets really angry if you insist. He pleads for more time, and when you give it to him, he takes more time than you give him. And even THEN, he is unappreciative and even more angry. Rachel comes home and sits on the sofa. She is clearly interacting with her friends: texting, laughing at cute animal pictures and the selfies that she and her friends are passing back and forth between each other using Snapchat. She also is on level 244 of Candy Crush. She seems happy and can do this for hours. At night, she willingly goes into her room at a good time, but the light stays on for hours.

15 Suggestions – dealing with antecedents (1 of 2) Establish a family home use plan Parents unite and conquer Remember: You have all the power! The right tone is: balance Meet with your child together and lay down the new rules explicitly Communicate your monitoring plan and the consequences Remember: portable devices are the most accessible and least controllable! Ground rules Nothing in the bedroom, nothing at the kitchen table Stationary is always better than mobile Collect all mobile devices at night Suggestion: use time as the arbiter. Define all screens the same.

16 Suggestions – dealing with antecedents (2 of 2) Work on Re-establish non-electronic bedtime rituals Using limited time forces them to make choices The longer you delay the purchase, the better Control access. If you can’t, control the opposite Make available alternatives: they’ll scoff at them at first Breaks and screen holidays are good, but don’t do it capriciously. On vacations, consider a screen holiday.

17 Suggestions – more antecedents Talk to the friends’ parents… Decide on if you have to install monitoring/shut off devices Decide on whether you want to reward with additional screentime beyond their standard (but keep it small).

18 Suggestions – dealing with consequences Reward /punish screentime problems by altering screentime! Don’t punish screentime problems by taking away NON-electronic activities Remember the Kubler-Ross Stages Expect relapse and trickery! – Sneaking off, tech shifts, going to friends’, smaller devices If they get nasty and surly, calmly take time away from tomorrow, and tell them the behavior you expect Teach them to self monitor! Always stick to your guns When it gets really bad – take it away!

19 “4 Ways to Say No” No with an explanation No with a redirection No with feeling No and go

20 Screen Hygiene No screens when it is inappropriate socially: dinner, company,… No screens as a tool for avoidance or emotional regulation No screens in the bedroom Screens are not a substitute for babysitting Limits: time, access. Supervise. If they are extremely irritable when you make them get off, they were on too long.

21 5 SIGNS YOU’RE GETTING SOMEWHERE They don’t have a screen with them all the time They have life activities that have nothing to do with screens They can play with others without screen time They’re picking up books, playing chess (the antivideo game), or have a hobby They tell you to limit your screen time! You can bust on them (or yourself) re: screens, and they can laugh about it.

22 American Academy of Pediatrics 2 questions at every well child visit – How much recreational screen time does your child use daily – Does your child have a TV/web-connected device in his/her bedroom? Establish a Family Home Use Plan

23 Family Home Use Plan Time Devices Content Location Monitoring Consequences

24 Your Family Home Use Plan…


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