New AAP ‘Screen Time’ Recommendations Focus Less on Screens, More on Family Time

When the American Academy of Pediatrics first set limits for children’s screen time in 2016, the phrase had an entirely different meaning — and connotation — than it does a decade later.

“It was created around research on TV viewing — and taking that literature and translating it into today's world is so much more complex,” says Libby Milkovich, a developmental and behavioral pediatrician at Children’s Mercy hospital in Kansas City.

For the first time in 10 years, the AAP has released updated guidance on children’s and teen’s “screen time” — though what exactly that consists of is up to interpretation.

The new technical report and policy statement aim to offer families, health care professionals, educators, policymakers and industry leaders a research-backed perspective on “digital ecosystems, children, and adolescents.”

“People really want the concrete, easy advice, and trying to communicate the nuance is really difficult; how do you communicate ‘what is digital media?’” Milkovich, a co-author of the AAP report and policy statement, says.

The guilt around screen time snowballed in the last few years, with many parents fretting over what exactly constitutes screen time — like if podcasts count, for example — with other researchers lumping interactive assistants, like Amazon’s Alexa, into the screen time category.

One of the biggest shifts from 2016 to 2026: no set screen time limit. In contrast, 10 years ago, the AAP suggested limiting children to two hours of screen time a day.

“The recommendations historically made to parents have become almost impossible,” Milkovich says.

In an age when screens are ubiquitous, from classrooms to restaurants to airplanes, it seems unreasonable for families to bear all responsibility, Milkovich says, adding that the purpose of the new policy is in part to “take away some pressure of putting it on parents and taking away the shame, when it's really all these systems and digital media devices themselves.”

Instead, Milkovich and the AAP recommend multiple avenues of attack for right-sizing the amount of exposure kids have to digital media:

• Reviewing programming to see if it’s high-quality through Common Sense Media. The AAP recommends PBS Kids and Sesame Workshop as high-quality programming — although those programs are also at risk of getting cut.
• Offering kids activities to replace screen time, like after-school sports, rather than simply cutting out screen time with no replacement.
• Sharing a family tablet, versus giving a child their own.
• Finding alternatives outside media consumption to help with emotional regulation.
• Looking into underlying causes of media usage (like boredom or social disconnection) and brainstorming alternative pathways.
• Screening for medical conditions like ADHD and depression if a child’s usage is problematic, including affecting sleep, academic performance and relationships.

The important strategy, Milkovich says, is to try and meet families where they are at. Cutting out screen time could be easier for some families than others: for example, if a child lives in an unsafe neighborhood, they cannot simply go to the park to play outside instead of watching TV.

“Some families are very passionate about, and value having, healthy digital media habits, but others have different resources and digital media balance may not be at the top of their priorities,” Milkovich says. “We can look into these really straightforward guidelines versus these big, broad conversations on the content and purpose [of media] if the families are not there.”

The AAP also recommends a “family media plan” in which family members, as a whole, tackle boundaries for media consumption. One small step that Milkovich recommends families start with is to have a device-free meal time. Sharing meals is predictive of healthy children, she says, adding that going device-free could help with social interactions and connection.

“I think my big takeaway when I talk about it with families is, it’s not ‘how to regulate screen time,’ but it’s how to use them as a family,” Milkovich says. “Parents: Make sure you’re modeling good behaviors, because that’s how kids are learning.”

The report also points toward the “5 C’s,” which was initially recommended by the AAP’s Center of Excellence on Social Media and Youth Mental Health a few years prior.The "5 C's" can help parents monitor and limit their children's screen time and media usage.

Source: Southern Med Pediatrics and healthychildren.org

The AAP plans to release its next report on screen time quicker than another decade from now, though the research has to go through years of vetting. In its next iteration, Milkovich hopes to further explore the relationship between schools and screen time, as most now implement a 1:1 device program and rely more on digital textbooks than physical.

“I think we have to navigate our role a bit as pediatricians in supporting families in school and having healthy kids have healthy digital habits,” Milkovich says. “And it’s recognizing in our role we can’t be prescriptive in telling families what to do, because we don’t know their culture, community or needs.”

The association is also working on multiple reports tackling artificial intelligence: one about AI use in pediatric medicine and the other with a broader focus, similar to the screen time report.