March 2015 Bulletin

Mobile Devices and Interactive Media: Q&A with Dr. Wendy Sue Swanson

Wendy Sue Swanson Bulletin

Dr. Wendy Sue Swanson, a pediatrician at The Everett Clinic in Mill Creek, a member of Seattle Children’s medical staff and executive director of Digital Health, and author of the Seattle Mama Doc blog, addresses questions about helping families make healthy decisions about using mobile and interactive media.

Q: What anticipatory guidance do you provide about the use of mobile devices and interactive media?

A: The most powerful message we can deliver is that digital devices and screens are enhancing our lives in many ways, but there are also some risks. When we think of young children, we have to remind parents that there’s a big difference between passive media, like videos, and interactive media, like learn-to-read apps.1

  • For children ages 1 to 3: I strongly encourage parents not to give children a device to entertain themselves with passive media. We know very young children gain little from passive media, but they can learn, discover and enjoy using interactive media with their parents. Ongoing research will help us learn more.
  • For children ages 4 to 12: Content and time are the most important issues. Parents can help select appropriate content; compassionate and educational content can encourage empathy and delight. Parents also need a clear way to determine how much media children consume. I advise treating screen time as an earned privilege that comes after homework or chores are completed without a fight.
  • For teens: Mobile devices and interactive media are changing the way teens relate to each other and the world. It’s not all negative; there are great benefits to digital tools in building friendships. It’s up to each parent and teen to decide together how much freedom to give teens and which sites they can access. The one thing I tell parents is that they absolutely need to be in the same online spaces as their teens. I encourage them to follow along over time and not give up!

I recommend that all families set aside a time each day when everyone puts away their devices. It could be almost anytime, dinner included! Once a time is agreed upon, consider it precious and protect it from all devices. There is also a great opportunity to do this when on vacation together.

We know these devices trigger dopamine surges and provide reward. I acknowledge this and let families know how hard it can be to set them aside. When it comes to digital tools, compartmentalization is key.

Q. When you talk with parents about sleep, what do you discuss related to use of mobile and interactive media?

A: I’ve talked for years about trying to keep television sets out of children’s bedrooms. Seattle Children’s experts Dr. Michelle Garrison and Dr. Dimitri Christakis have shown that watching TV right before bed can cause children to have more trouble falling asleep.2 I often explain to children and teens that the light from these screens inhibits melatonin production.

Recently, the very first study on mobile devices and sleep found that small screens are even worse than TV when it comes to sleep latency.3 There are a number of theories about the reasons: screens emit light that impairs/inhibits melatonin production,4 and mobile devices are typically held close to the face and may be more stimulating than TVs because we interact with them, which inhibits drowsiness.

Since mobile devices are a big impediment to quality sleep, I recommend setting a curfew for phones and screen time one to two hours before bed time. It’s better to get devices out of the bedroom and avoid using them as an alarm clock. Smartphones should sleep in the kitchen.

Q. What resources do you recommend for parents who want to identify educational apps for their children?

A: Commonsense Media is a great resource for parents to review ratings, learn risks and vet content with media of all kinds. What I like about this site is that they allow parents to use their own compass in terms of violence, marketing, etc., when deciding what to let their children view. PBS Kids and Sesame Workshop can also help guide media choices for young children.

References

  1. Radesky J, Schumacher J, Zuckerman B. Mobile and interactive media use by young children: the good, the bad, and the unknown. Pediatrics, 2015;135(1): 1-3.
  2. Garrison MM, Liekweg K, Christakis DA. Media use and child sleep: the impact of content, timing, and environment. Pediatrics, 2012 Sep;130(3): 492-499.
  3. Falbe J, et al. Sleep duration, restfulness, and screens in the sleep environment. Pediatrics; originally published online Jan. 5, 2015.
  4. Meeri K, Blue light from electronics disturbs sleep, especially for teenagers, The Washington Post, Sept. 1, 2014.

Third Operating Room Now Open at Seattle Children’s Bellevue Clinic and Surgery Center

Seattle Children’s now has three operating rooms (ORs) available for day surgery procedures at the Bellevue Clinic and Surgery Center. The third OR will be used primarily for procedures by General Surgery, Urology, Orthopedics, Plastic Surgery and Otolaryngology.

“When we designed the Bellevue ORs, we incorporated several features designed to improve the experience of patients and families, such as a facility that would allow parents to be with their child right up until they were wheeled into the OR and immediately afterward in the recovery room,” says Aaron Dipzinski, director of the Bellevue Clinic and Surgery Center. “We have been pleased to find that families coming to Bellevue for surgery have had an average overall rating of 93 out of 100 on our family experience survey since we opened the facility in 2010.”

Adding the third OR in Bellevue will also help improve access for more complex surgical cases at the main hospital campus.


Upcoming CME Events for March 2015

Bellevue CME: Cystic Fibrosis for the Primary Care Physician

  • Presented by Dr. Thida Ong
  • Thursday, March 26 from 6 to 7 p.m. in Room 2207, Bellevue Clinic and Surgery Center, 1500 116th Ave. NE, Bellevue
  • Refreshments will be served.
  • RSVP to Melissa Christiansen or by calling 206-987-5262

2015 Duncan Seminar: Down Syndrome – So Much to Talk About


Grand Rounds for March 2015 (CME Credit Available)

Upcoming Grand Rounds

  • March 5: Altering the Trajectory: Screening for Mental Health Problems in the Emergency Department
  • March 12: Paradigm Shifts in Childhood Arthritis: Changing Times, Changing Terms, Changing Treatments
  • March 19: Preventing Central Line Infections: Beyond the Bundle
  • March 26: Down Syndrome in Medical Settings: A Neurodevelopmental Perspective
  • See all upcoming grand rounds.

Watch Past Grand Rounds Online

  • Should Children with Disability Be Listed for Heart Transplant?
  • Improving Pediatric Dental Disease: Options and Advances
  • See all past grand rounds.


New Medical Staff and Allied Health Professionals for March 2015

Medical Staff

  • John Carter, MD, PhD, Fred Hutchinson Cancer Research Center, Hematology-Oncology
  • Sara Healy, MD, MPH, National Institute of Allergy and Infection Diseases, Infectious Disease
  • Mona Chhabra, MD, Pediatric Associates - Bellevue, Pediatrics
  • Timothy Hall, MD, Ballard Pediatric Clinic, Inc., PS, Pediatrics
  • Katie Kazmier, MD, Seattle Children's, Hospital Medicine
  • William Lombardi, MD, University of Washington, Cardiology
  • Kelle Shutter, MD, Seattle Children's, Emergency Medicine
  • Joanne Wen, MD, Harborview Medical Center, Ophthalmology
  • Todd Cooper, DO, Seattle Children's, Hematology-Oncology
  • Zheng Xu, DMD, PhD, University of Washington, Dentistry

Allied Health Professionals

  • Amy Bain, ARNP, Seattle Children's, Otolaryngology
  • Emlyn Baker, ARNP, Woodinville Pediatrics, Pediatrics
  • Amber Bock, ARNP, Seattle Children's, Hospital Medicine
  • Melanie Cutbirth, ARNP, Seattle Children's, Anesthesiology and Pain Medicine
  • Meggie Inouye, ARNP, Odessa Brown Children's Clinic, Pediatrics
  • Gwendolyn Keiser, ARNP, Pediatric Associates - Factoria, Pediatrics
  • Melissa Kindahl, ARNP, Woodinville Pediatrics, Pediatrics
  • Donna Zimburean, ARNP, Pediatric Associates - Totem Lake, Pediatrics