Digital diet for your family

little boy using phone

Children are growing up in media-rich environments that include television, computers, phones, tablets, video games, and other mobile devices. Although these technologies open doors to a wide range of education and fun, there are risks associated with overuse, especially for young children.

Researchers found that increases in media use during childhood led to increases in BMI; fewer minutes of sleep per night; delays in cognitive, language, and social development; and poorer executive functioning.

The American Academy of Pediatrics (AAP) recommends that children younger than 18 to 24 months have no screen time at all. At around 18 months, the possible exception becomes video chatting with relatives and friends. From about 1½ to 5 years, the AAP recommends allowing no more than one hour of screen time. After age 5, the recommendation is that screen time decisions be made factoring in the educational value and interactive quality of the activities, and that screen time doesn’t interfere with sleep or exercise.

Under the age of 2 years, children’s brains are developing fast. They need communication, hands-on exploration, and social interactions to help develop cognitive, language, motor, social and emotional skills. They are not able to generalize images from a TV or iPad to a real-life experience.

Preschool-age children are developing higher-level skills, including task persistence, impulse control, emotion regulation, and creative, flexible thinking. These skills are best taught through unstructured play and parent-child interactions.

Remember that all children are learning from their family members’ examples, so think about your own screen use. Increased use of mobile devices by parents is associated with fewer verbal and nonverbal interactions with their children. Over 40 percent of parents report that their children ask them to put down their devices, and about half indicate that screen time takes time away from reading and other activities.

Of course, tablets and phones are a good way to calm your child in the airport or while checking out at a store, but try to avoid using media as the only way to calm your child. Finding the right balance of real-life interactions and technology is important for children to learn and grow.

When you do use screens in your home, make them interactive:

  • Pause a video and talk about what you see.
  • Use the same toys, or do the same activities as what is on screen.
  • Apply information to real life.
  • Sing songs from shows during those routines at home.

Experts recommend a Digital Diet for children, customized to your family. Consider the following ideas for creating rules and sticking to them:

  1. Earn screen time by completing a non-screen activity:
    • Worksheet/summer homework page
    • Real play with siblings for 20 minutes
    • Exercise or outdoor play for 20 minutes
    • Completing a household chore
  2. Require siblings to agree on a show before watching.
  3. No screens before or after certain times (e.g., not before breakfast, not after dinner, etc.).
  4. Avoid screens in the evening, as this is related to poorer sleep.
  5. Create media-free zones in your home (e.g., no technology at the dinner table).
  6. Don’t leave the TV on in the background.

For the American Academy of Pediatrics Policy Statement on Media and Young Minds, visit:

Additional information can be found here.

– Kellie Bouren, M.A., CCC-SLP, Speech and Language Pathologist, Children’s Speech and Language Pathology Department, Beaumont Health

Breaking digital addictions

girl holding smartphone while looking out window

Did you see the recent study from Harvard noting that increases in Facebook use correlated with decreases in well-being, even after controlling for baseline levels of use? This was the case even when the study participants were “liking” and posting, rather than merely “lurking” on social media. The authors conclude:

“The full story when it comes to online social media use is surely complex. Exposure to the carefully curated images from others’ lives leads to negative self-comparison, and the sheer quantity of social media interaction may detract from more meaningful real-life experiences. What seems quite clear, however, is that online social interactions are no substitute for the real thing.” – Shakya & Christakis, 2017 (emphasis is mine)

In previous posts, Phubbers and the iPhone Effect and Stuck in Cyberspace: The hidden dangers of Internet addiction, we discussed the power of technology to pull us out of our everyday lives and even put our relationships at risk.

Nonetheless, we all see the benefits of using computers and smartphones, and even television and video games can have valued uses. Ideally we want a balanced relationship with our technological gadgets. Remember that overuse of technology is a habit, and like all habits, it can be hard to break. Also, we often handle social anxiety by retreating into our digital worlds; this doesn’t help us build relationships or deal with discomfort.

This HelpGuide.org resource lists key features of smartphone addiction, includes an online quiz, and offers tips to help break digital addictions. Here are some of the highlights, along with a few tidbits I’ve learned through working on my own smartphone use:

  • Make technology your servant, not your master.
  • Goal is to cut back to healthy levels of use.
  • Think before you automatically pick up phone.
  • Turn off notifications on apps and games.
  • Review responses before sending.
  • Make “good habits” easier and “bad habits” harder. Remove apps or move icons off home screen
  • Keep phone away from bed (light filter).
  • Read “real” books in bed. Also, e-readers that do not emit light should not disrupt sleep.
  • Buy an alarm clock.
  • Adjust your settings to silence your phone at night. The timer/alarm will still go off and certain contacts can still call through for emergencies.
  • Realize: You don’t get those minutes back that you spent aimlessly drifting through the internet.
  • Set goals for when you can use your smartphone and use a timer to keep yourself honest.
  • Turn off your phone at certain times of the day.
  • Replace your smartphone use with healthier activities (e.g., physical activity, talking to others, reading, etc.).
  • Spending time with other smartphone addicts? Play the “phone stack” game: Everyone stacks their phones in a location out of arm’s reach, and just interacts with each other.
  • Limit “checks” of your phone. Wean yourself off compulsive checking.
  • Maybe most importantly, curb your fear of missing out, and tune in to what is going on around you. You may really be amazed at what you see and who you talk to when your face is not stuck in a screen!

– Lori Warner, Ph.D., LP, BCBA-D, Director, HOPE Center at Beaumont Children’s

Stuck in cyberspace? The hidden dangers of internet addiction

We are surrounded by cyberspace! Computers connect and help us in so many ways. We often take for granted all of the resources at our fingertips, at least until the power goes out! I’m enjoying the wonders of technology right now as I write this post on my computer and technology will allow you to read it. Technology is an amazing tool.

However, any tool can be used as a weapon. This same technology can be used for cyberattacks, cyberbullying, and even increased depression and anxiety resulting from too much negative news consumption. Too much screen time can horribly impact our relationships, health and mood.

How does this happen?

The immediate gratification from computers and mobile devices create a powerful reward loop that works something like this:

feel bored or unhappy → tap into internet or game → feel entertained/better

The reward pathways that light up in our brains when we use the internet are the same pathways that light up when we use alcohol, nicotine, or other drugs. Wow! Whether we use technology to escape bad feelings or just in a habitual way, risk factors for significant problems.

Taken to extremes, people can actually become addicted to the internet. There is scientific debate whether it’s truly considered a “mental disorder,” but we do know that psychological and social problems occur. Both China and South Korea identify internet addiction as a significant public health issue, and the United States is starting to take this issue more seriously as well.

How do you know if you or someone you love is addicted to the internet? A recent study describes signs, and you should consult a professional if you see:

  • “changes in mood,
  • preoccupation with the Internet and digital media,
  • the inability to control the amount of time spent interfacing with digital technology,
  • the need for more time or a new game to achieve a desired mood,
  • withdrawal symptoms when not engaged,
  • continuation of the behavior despite family conflict, a diminishing social life and adverse work or academic consequences” (Cash et al., 2012).

Parents know that kids need reduced screen time and lots of face-to-face, active interactions to thrive and grow. But at the same time, screens are all around us and the constant pull of notifications from emails, text messages, games and apps can leave us distracted and scattered. So how do we balance the benefit of technology with the hidden dangers of these amazing machines?

First and foremost, practice what you preach! If your phone is your constant companion, start being more mindful of how and when you use it. Specific tips for breaking digital addiction in our next post, so stay tuned!

– Dr. Lori Warner, Ph.D., LP, BCBA-D, Director, HOPE Center at Beaumont Children’s

Screen Savvy: The Value of Delayed Gratification

Older girl using iPad while little boy watches.

Cropped image. Petras Gagilas, Flickr. CC License.

How much screen time do your kids get?

If I’m being honest, mine (ages 13 and 10) get more than ideal on some many days. However, when they see me texting (not while driving!) or their dad playing a game or reading news on the iPad, it’s hard to say much about getting off the screens without looking more than a little hypocritical.

Some parents take an austerity approach. A recent New York Times article notes that Steve Jobs was “a low-tech parent”; his kids didn’t use their dad’s famous iPad and had significant screen time limitations. Parents who strictly limit technology cite concerns about exposure to inappropriate content (despite parental controls), cyberbullying, and the fear of their kids becoming addicted to the constant rush of information and potential for interaction or entertainment our electronic devices offer.

Most of us can relate to this concern. Bored? Grab the phone and play a game or check social media. Text coming in? “Better check who it is! Oh, that’s the chime of my email, I’d better open that too…” Depending on your phone settings, it can ding, chime, and beep notifications at you all day, letting you know there’s one more thing to grab your attention.

But even the screen-shunning set knows the value of letting your kids learn to self-monitor and use technology appropriately as they grow. Like any other tool, there are wonderful and horrible things we can do with technology. One reason gadgets are so appealing is immediate gratification. Most of the time, the information we’re seeking online is available within milliseconds, and if it isn’t, we start grumbling and shaking our phones (to get them to work faster?). Part of the issue may be that we — and our kids — need to remember how to wait. Building persistence and patience are important life skills.

Taking a break from the constant stream of cyberinfo can seem boring or sluggish at first. But you quickly realize there’s a lot to see and do, conversations to have, games to play, etc. If you’re trying to limit technology, you don’t have to be all-or-nothing, simply use baby steps and gradual changes.

Here are some ideas: Next time a text or email comes in, can you wait and mindfully respond in just a little bit? After dinner, can everyone clean up together and then take a brief walk rather than immediately separating and jumping on screens?

Pick limits that work for you and your family, and get used to the fun you can have off-line!

– Lori Warner, Ph.D., LP, BCBA-D, Director, HOPE Center at Beaumont Children’s Hospital

8 Things You Should Know About Colds, Flu and Antibiotics

antibiotics

Besides sharing recent holiday cheer, many shared viruses too. Knowing when antibiotics will help – and when they won’t – is key to preventing antibiotic resistance.

“We all need to remain smart about antibiotic use, and by ‘we,’ I mean doctors, nurses and patients,” says Christopher Carpenter, M.D., director of Beaumont’s Antimicrobial Stewardship Program. “We have a program that promotes appropriate antibiotic use in the hospital and with the help of the U.S. Centers for Disease Control and Prevention and the Michigan Antibiotic Resistance Reduction Coalition we are providing materials and education to encourage appropriate outpatient use in our Emergency Center and doctors’ offices.”

The CDC offers the following facts and tips:

  1. Colds, fl u and most sore throats and bronchitis are caused by viruses. Antibiotics do not help and may do more harm than good by increasing the risk of a resistant infection later.
  2. Antibiotic resistance – the development of “superbugs” that are resistant to available drugs – has been called one of the world’s most pressing public health problems.
  3. When antibiotics fail to work, the consequences are: longer-lasting illnesses; more doctor visits or extended hospital stays; and the need for more expensive and toxic medications. Some resistant infections can cause death.
  4. Children are of particular concern because they have the highest rates of antibiotic use. They also have the highest rate of infections caused by antibiotic-resistant “bugs.”
  5. Patients should not demand antibiotics when a health care provider has determined they are not needed.
  6. When an antibiotic is prescribed, take all of it, even if symptoms dis appear. If treatment stops too soon, some bacteria may survive and reinfect.
  7. The spread of viral infections like cold and fl u can be reduced through frequent handwashing and by avoiding close contact with others.
  8. Viral infections sometimes lead to bacterial infections. Keep your health care provider informed if your illness gets worse or lasts a long time.

Memorable Moments of 2013 From Beaumont Children’s Hospital

First lady of Michigan Sue Snyder at Beaumont Children's Hospital this past March

First lady of Michigan Sue Snyder at Beaumont Children’s Hospital this past March

One of the great things about health care is there is always the opportunity for growth — whether it be patient care, advances in research, in technology or more community support. Long one of the cornerstones of the science of medicine, Beaumont researchers are finding new and innovative ways to treat many conditions and illnesses. Here are some 2013 moments:

• Beaumont Children’s Hospital expanded its neuroscience services Jan. 7 with a Pediatric Epilepsy Clinic, offering treatment options and services for infants, children and teens with seizures and epilepsy.

• Beaumont Children’s Hospital opened a Sickle Cell Anemia Center offering comprehensive, specialized care for infants, children and adolescents with sickle cell anemia and sickle-thalassemia syndromes.

• In a study published in the April issue of the journal Resuscitation, Beaumont doctors found that cardiac arrests in K-12 schools are extremely rare, less than 0.2 percent, but out of 47 people who experienced cardiac arrest over a six-year period at K-12 schools, only 15 survived. Th e survival rate was three times greater, however, when bystanders used a device called an automated external defibrillator, or AED, that helps the heart restore a normal rhythm. Th e study “Cardiac Arrests in Schools: Assessing use of Automated External Defibrillators on School Campuses,” was led by principal investigator Robert Swor, D.O., Emergency Medicine physician at Beaumont Hospital, Royal Oak, and a research team including Edward Walton, M.D., Beaumont’s director of pediatric emergency medicine.

• It’s called PAWS – the pediatric advance warning score. Caregivers throughout Beaumont began using PAWS at the beginning of May to help predict if a child’s health status is likely to decline. Th e system also gives guidance for providers to follow when scores reach a particular number.

• After a successful year-long pilot at Beaumont Hospital, Troy, the Parenting Program is offering first-time parents in-room car seat safety education at both the Troy and Royal Oak hospitals. “We have one certified car seat safety technician at each hospital,” says Deanna Robb, director, Parenting Program. “They are especially sensitive to the high anxiety of new parents. Before we had this program in place, we provided families with a list of community resources, including Safety City U.S.A., but now parents can get a little more immediate security knowing how to properly use and install their car seat.”

• First lady of Michigan Sue Snyder announced her support of programs launched by the Michigan Departments of Human Services and Community Health to combat the nearly 150 fully preventable accidental suffocation infant deaths annually due to unsafe sleep environments. The announcement was made at Beaumont Children’s Hospital March 25.

• Beaumont offered the community a flu hotline to call with questions.

• At the Radiothon for Children’s Miracle Network Hospitals, a record-breaking $152,000 was raised for kids at Beaumont Children’s Hospital.

• Beaumont Health System announced a $5 million gift from Danialle and Peter Karmanos Jr. The gift will create the Karmanos Center for Natural Birth and the Danialle & Peter Karmanos Jr. Birth Center at Beaumont Hospital, Royal Oak.

Here’s to a happy and healthy 2014! Happy New Year!

5 of My Favorite FREE Health and Safety Apps

iTriage Symptoms Checker

iTriage Symptoms Checker

  1. iTriage: iTriage was developed by two emergency room physicians and is available, for free, at both the Android Marketplace and iTunes App Store. What I like best about this app is the “find a facility” portion that can direct you to the nearest ER, Urgent Care, Community Health Center and Pharmacy. The facility locator is particularly appealing to me for when we are vacationing or away from home at sporting events. Additional features include symptom checker, physician locater by specialty, medical hotlines such as poison control and suicide hotline, as well as information on medications, medical conditions and procedures.
  2. Red Cross First Aid App: The American Red Cross has several great apps including alerts for hurricanes, tornados, earthquakes, wildfires and a shelter finder available through the iTunes App Store and on Google Play. The first aid app is free and, and lists several of the most common health emergencies as well as tips and videos on what to do should one of these events occur. Also included are preparedness checklists sorted by incident and several self-tests to evaluate your current knowledge.
  3. American Association of Poison Control Centers:  The American Association of Poison Control Centers has a free app in iTunes that has several features above and beyond putting you directly in touch with the nearest call center. You can call or email with a touch of a button. The AAPCC has trained medical professionals answer questions 24/7/365 for humans and pets at no charge. Some of the things that people call about are unintentional ingestions of medication or household products, food poisoning, sunburn, potential rabies infection, drug-food interactions, herbal or homeopathic supplements, adverse medication reaction, human food ingestion by pets, snakebites and substance abuse. This app also has some games and videos that may be interesting to kids. I think this app is especially good for babysitters and grandparents to have in the event of an accidental exposure.
  4. Consumer Product Safety Commission Recalls:  Available in iTunes and Android, the Consumer Product Safety Commission, CPSC, has an app that keeps you informed of the latest product recalls. In iTunes, the list can be viewed in several different categories including child, household, outdoor, sports as well as “all” recalls. It appears that with the Android app, you can search products as well as scan barcodes to see if they have been recalled.
  5. SafeCar By NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION: SafeCar is available in iTunes and offers the following features:
  • 5-Star Safety Ratings: Buy safe by looking up a vehicle’s crash test ratings and comparing ratings for different vehicles.
  • Recalls and Complaints: Drive safe by staying on top of safety issues for your vehicles. Record all your vehicles so you can be notified by NHTSA if a safety issue becomes known; the app also makes it simple to submit complaints to NHTSA when you believe there is a possible safety problem with your vehicle.
  • Help Installing Child Seats: Ensure your most precious passengers ride safe. Quickly find and get driving directions to where you can get assistance on making sure your child seats are properly installed, no matter where you are.
  • Safety Headlines and Alerts: Receive important news and information from NHTSA, as well as recall notices on your list of vehicles.

Have another safety App you like? Share it with us here.

Erica Surman, RN, BSN, Pediatric Trauma Program Manager, Beaumont Health System