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- [00:01]
A
From the American Academy of Pediatrics. Social media. For many parents, it's a topic that causes fear and dread. But a new set of strategies helps us think about it differently.
- [00:14]
B
So really seeing it as a toolbox where there may be some sharp edges and some particular tools that you want to provide your child a little more education about, but really viewing it in that kind of value neutral way versus good or bad.
- [00:30]
A
Welcome to Healthy Children, the podcast for parents from the American Academy of Pediatrics. I'm Dr. Edith Bracho Sanchez. I am a pediatrician and a mama figuring it out. This is a judgment free space where all questions are good questions and the answers will hopefully be even better. So let's get started. Today we're talking about social media and I'm so excited about our guest. Dr. Megan Moreno is co medical director of the AAP center of Excellence in Social Media and Youth Mental Health. She is also interim chair of the Department of Pediatrics at the University of Wisconsin Madison where she runs the social media and adolescent health research team. Megan, welcome. I've been looking forward to this.
- [01:17]
B
Thank you so much. I have been looking forward to it too.
- [01:20]
A
Megan. There are so many conversations that we can have today about social media, the positive impact, the negative impact, its role in the youth mental health crisis. I mean, really, social media, so many things. It seems though that the discussion around media and social media specifically these days, it's that it's bad. And sometimes the message that we as parents receive is that we're kind of doomed. Right? So I wanted to start this conversation with you by asking you, how do we bring back the nuance and give parents a little bit of hope and a little bit of agency that some of this we can actually influence?
- [02:01]
B
Oh, I absolutely love that as our starting point and I think that we can hold to that as a theme of our discussion is inviting parents to really view social media as a toolbox that is available, highly used by teens. But I think we're also in a place that we can acknowledge that many parents are also accessing and using this toolbox and so really seeing it as a toolbox where there may be some sharp edges and some particular tools that you want to provide your child a little more education about, but really viewing it in that kind of value neutral way versus good or bad.
- [02:49]
A
Megan, I mentioned in your introduction that you are the co director for the center of Excellence in Social Media and Youth Mental Health. I wanted to pause for a second and ask you to tell us a little bit more about that because it is really new and parents may not have heard about it, or pediatricians who are listening may not have heard about it. So what is it and what are you all hoping to accomplish through this center?
- [03:16]
B
Oh, I really appreciate that question. And I want to begin by acknowledging that the center is really a collection of amazing people doing this work, including our AAP staff and also my co medical director, Dr. Radesky, who is a developmental behavioral pediatrician and really brings that expertise in child development and how that relates to media use, whereas I'm an adolescent medicine physician, so I really focus on the teens and young adults. What we really want to do with the center of Excellence is be able to be a trusted source of information and being able to be creating resources that can reach adolescents as well as the people who care for them and provide care for them. So that would include parents, guardians, caregivers, that would include educators, coaches, mentors, and that would include pediatricians and providers who care for teens. And one resource I want to highlight is that we have a question and answer portal. So if you go in and Google aap, Center of Social media, or you can't even remember the wording, it'll still get you there. And we have a question and answer portal where you can submit a question that you have and we will look at the evidence and provide you an evidence based answer to that question.
- [04:43]
A
I love that. And I cannot wait to use this library for myself as a mom, as my child gets a little bit older, but also to be able to give it to families as a resource. I mean, put your questions here, you know, give it to the experts, bring your questions to the experts who are really thinking about this. And every day this is what you guys do. So I'm really just so, so excited. And I think the way that we talk about media, whether it is in small kids or in teens and preteens, which is, you know, really the age group that we're mostly talking about today. Looking for that framework and looking for a way to set up the communications, the conversations and the guidelines that we should be using in our own homes is so challenging and important at the same time. I know that you and your team at the center have a new model to help us with this challenge. It is the 5C's model. I would be lying to you if I told you that I remember what all the 5Cs are, but I would love to go through them.
- [05:50]
B
I love you acknowledging that because that is one thing we've heard from some of the parents we've worked with is in any given moment Most people can remember three or four, and that's absolutely okay because, you know, it may be in that moment. Those are the three to four that really apply for you. So to us, the five Cs really helps us go beyond some of the conversations that we used to be able to have, like about screen time and about how many hours a day. Those conversations just don't work in the same way anymore when your child is dividing their time between different devices or different homes. And so this is really meant to go beyond that and take a bigger picture view that's centered on the child. So the very first C is child. So understanding some of the differences in your child, maybe with their siblings, and understanding there might be different skill sets they bring to their media use, there might be different risks. They might be a kid who really has a hard time putting down that video controller. That kid's going to need a little different approach versus your other child who maybe sets their own screen time limits on their iPhone. So really appreciating and understanding what that child is bringing to their interactions with media.
- [07:06]
A
So the first one is child. Yes, and I love that it's the first one because it really should always be the place where we're starting. What else?
- [07:13]
B
The second C is content. So content gets us to a place where we're thinking about, again, going beyond screen time and saying what is on that screen. Because content that's centered on things like Sesame Workshop for younger kids, Roblox for younger kids, and other types of content which we know are really high quality. Very, very different than kind of an endless YouTube scroll or, you know, following that, an Instagram feed that just keeps feeding you content that maybe isn't the type of information you want. So really leaning into content and having the ability to talk with kids about what content do you like? How can I help you find the content you want?
- [07:59]
A
Yeah. So not all content is created equal. And we take that into account as parents.
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B
Yes. And I think it's probably advice that we as parents can think about too.
- [08:10]
A
Right.
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B
There's content we consume that helps us feel like we're learning and growing as people. And other content that's a little fluffy and that's okay too. But we kind of want to be cognizant of what we are choosing to invest our time in.
- [08:25]
A
And I love this, Megan, because I think for a while we as pediatricians have been perceived as being a little bit impractical and rigid in our. In our recommendations around media use and this approach of really taking into account that not all content is the same, I think will resonate a little bit better and be more feasible for parents to be mindful of what is the
- [08:47]
B
next C. So the third C is calm. And this gets at the idea that we understand many children across many ages engage with media as a community calming approach for them, but placing that as a 5C is really meant to nudge parents and nudge kids to think about what are the other ways that you have to calm yourself so that you're not solely relying on media as the only way that you're using to calm yourself, but building your own set of tools in your toolbox to be able to have different ways to calm yourself.
- [09:28]
A
I have a toddler at home, Megan, and I have to tell you, I don't always get it right, but I really do try. It's one of the rules that I really, really try to uphold is that I don't give media. For him to calm down, I need to teach him skills. I need to teach him the language. And if we do that, we're depriving kids of that ability to learn. Right. And the same thing applies, I'm sure, to teens. Right. Like, are we taking up that phone and scrolling mindlessly on a platform when we're feeling anxious? Right. Are we dealing with feelings by grabbing for that phone? So definitely something that I think can apply to different age groups, right?
- [10:10]
B
Absolutely, Absolutely. And I think for early teens and heading into adolescence, that's often when kids are starting to build their own ways to calm themselves and so ensuring that they have a variety of approaches they can reach for and aren't just relying on the phone for that calming.
- [10:31]
A
Yeah. What is. I don't. I don't remember now how many seats we have done. We will recap them at the end, but what is the next C, Megan?
- [10:38]
B
We are up to number four. And number four, look at us. Yes, we are making progress. Number four is crowd out. So that gets at what is media displacing. And for us as pediatricians, I think we know that the two big things we really think about, one is sleep. So the importance of kids of all ages getting sleep for their health and for their development. And so finding strategies to ensure that media isn't crowding out, that sleep time and then physical activity is another one. We really want kids to be out there and moving their bodies and growing and getting strong. And so that's another one that is really easy for us as pediatricians to lean into and make sure media idea isn't crowding that out.
- [11:27]
A
Yeah. What are you not doing because you are on a screen? What are you replacing in many ways with the screen? Right. And what's the last C, Megan?
- [11:38]
B
The last C. So we're bookending with the two really strong ones at the front is the child and our final fifth C is communication. And that's really framed around ensuring there's parent or caregiver communication in an ongoing way with their child. Being able to do those touch points of how's this going for you? Is there any kind of content you've seen that makes you uncomfortable? Normalizing the idea that sometimes there might be some mistakes along the way in learning how to navigate media, just making sure this is a place that you can go to for frequent, even frequent short conversation is a lot better than trying to plan the perfect lecture to your 13 year old.
- [12:23]
A
Oh my gosh, yes, it doesn't work out. 13 year old toddlers, I mean, no matter the age, even in our day to day communications with other adults, sometimes when we are aiming for a sit down where we cover everything, it just doesn't work out. Life is not like that. So having that frequent communication that is open between you and your child is so important. I love this model as a framework, Megan, and with that framework, I want to ask you specifically about preparing kids for social media. And I know that that's a little bit of a controversial thing to say. Should we even be preparing them? Should they even be engaging? I mean, people have very strong feelings about when and even if their kids should engage with social media. Where I am these days is this is a reality. It's not going anywhere even if you delay, which I hope that you do. And maybe you can tell us a little bit about that when your child joins a social media platform. The reality is that it is part of life these days. So how do we begin to prepare? What are the skills that we should be teaching at home, whether our child is going to engage soon, in a couple of years, or just their friends are engaging?
- [13:40]
B
One of the key things that comes to mind for me is that it can be and probably should be a conversation way in advance of when that child might be ready for social media. And one thing it reminds me of is that our research team did a study a number of years ago where we did focus groups with early adolescents and asked them when is the right age to get a smartphone? And their answers and thoughts and ideas about what are the milestones a kid should reach before they get a phone. They were so thoughtful. And so I love your question. Question and part of what I want to say is I think it's a great thing to ask your child, what do you think are the milestones? What are the responsibilities? What are the ways that we're going to set you up for success when. When it's time for you to enter this next phase of how you're going to connect?
- [14:40]
A
And then in terms of concrete skills, I love that we are engaging them. And in addition to that, what are some skills that we can start to teach them in preparation for a world in which social media is a reality?
- [14:56]
B
I think our hope is that some of that framework of the five Cs can help parents think about where to have those conversations. What are the unique strengths or risk factors that that child brings to that decision? Are they a kid who in general does really well with communication, does well with coming to talk to you when they're struggling, or are they a kid where maybe you need to prompt to be able to say, is everything okay? Let's talk about if there was a situation that made you nervous. So starting to get those communication channels open and be able to understand what your child is going to bring to that context.
- [15:40]
A
Megan, very selfishly I want to ask you to give me feedback. So I'll tell you what I say to my teens in my practice. And I actually start in the preteen years, so around 10, 11, I'm really starting to ask, so are you on Facebook? Are you on TikTok? Are you on Instagram? And to my surprise, a lot of them already are. Some of them aren't and I catch them early enough. But what I then go into saying in my practice is I turn to the parent, right? And I say, how much supervision are you doing in these early years? And I sort of say, I want you to do a lot, lot, really early. And then I want you to ease it back when you see that your child is really handling this well. What are the parameters that we're putting around it? How are we given the kids language to come to you and say, I saw something that made me really uncomfortable, or I'm seeing that all the girls these days are doing this crazy thing on TikTok. What is the language that we're giving kids? So I really focus on the language, the supervision and the setting up expectations. What am I missing? What am I missing in those conversations?
- [16:53]
B
Oh, I love that framework and I love how you're including the parent in that discussion. I think that's so fabulous. And I completely agree with you. I think one possible metaphor for kids learning to Navigate social media and the parents role is the process of learning to drive. We know that parents are, are very, very hands on right in the car with you in the beginning and the anticipation is as you build the skills and confidence they're able to be in more of a touching base and occasional supervision role. The one other part of the conversation that I will admit that I have started to incorporate probably since COVID and this to me has become a hard part of the conversation is how is the parent doing with role modeling their own device use at home? We know that since COVID many parents have needed to do more work or be more in touch with their work at home or they built their own connections on social media that are their own place to find calm. But acknowledging that as your child reaches those early adolescent years in particular they're looking to you to say what's normal. So if you've got your phone at the dinner table and you're telling them not to, that's really not a great precedent. But I want to say these conversations are tough because we don't want this to be judgmental. We want it to be a way to reflect together and make some shared family rules and guidelines around when are we all going to put our devices down?
- [18:29]
A
I love that. And we've started to do it in our own home. We've set up times and places, usually the dinner table, usually when we're winding down for the day that we have called dividend free zones. Right. And we respect it to the best of our abilities. Life isn't perfect but we really try to respect it to the best of our abilities. And lastly Megan, you know, we do our best, we really do as parents and we hope for the best. We set up this structure, we, we prepare, we have the conversations, but sometimes things don't go according to plan. What are some signs that our kids social media use is becoming problematic and that we need to, to seek help? And where would you recommend that we go for help?
- [19:14]
B
I'm going to make a little bit of a bad joke to say that one thing about, I remember about when I was a pediatrician taking care of babies is, you know, babies have a limited number of signs of distress. They cry, they whimper. And I would make the argument adolescents actually have a limited number of signs of distress and a lot of it is becoming socially withdrawn. So not spending time with their friends, not doing the things that you know, that they Typically it is normal developmentally for adolescents to, you know, be a little less enthusiastic about spending time with parents. But the adolescent who really is struggling to come out of their room and really withdrawing from the family. Those are often the signs that something's going on and it's going to take a little detective work to figure out what it is. So I think one key thing for parents is not to assume it's social media, is to really do that detective work to figure out what, what is it that's leading to that adolescent not feeling like themselves.
- [20:15]
A
That's a really good point, Megan. Don't assume that it's social media. It could be contributing, of course, but don't assume, don't assume that it's social media. Now where do we go for help?
- [20:26]
B
I think that a great place to start is with your pediatrician. You want someone to be a partner with you and figuring out what's going on. Are there symptoms here? Are there other pieces that having that really trusted provider can help with? And I think that there's a lot of resources that you and your pediatrician can access. We talked about the center of Excellence in our question portal and also the other great resources that the AAP has, such as on HealthyChildren.org and the Family
- [20:59]
A
Media Plan, all excellent resources that I always refer to in my parenting and in my doctoring. Is that a verb? I don't know. I just made it up. But it is really just such a good place to go for information that is verified and coming from experts. Megan, this has been such a helpful conversation as we wrap this up for parents at home. What is Dr. Megan Moreno's parenting prescription for parents who are starting to be intentional and trying to prepare their kids for a world in which social media is a reality?
- [21:35]
B
I think that my parenting prescription would be for parents to lean into their expertise as parents and not worry about being technophiles or social media experts and accept that there are many resources to help, but that perfection is not the goal.
- [21:57]
A
Dr. Megan Moreno, thank you so much for joining us today.
- [22:00]
B
Thank you. It's been such a pleasure.
- [22:02]
A
And thank you at home for joining us. If you like the Healthy Children podcast, please subscribe on your favorite podcast app and help us spread the word. Follow Healthy Children on Instagram, Facebook and threads@healthychildrenaap and be sure to visit healthychildren.org, the parenting website of the American Academy of Pediatrics. Healthy Children is a production of the American Academy of Pediatrics. Our creative team includes Anne John Soess,
- [22:27]
B
Doug Nagle, Susan Stevens, Martin Laura Alessio,
- [22:30]
A
Jackie Ortega, Mary Claire Walsh, Hannah Weston, Kathy Jewell, Katherine Beard and Garrett Brown. Narc music was composed by Doug Nagorn. Single. We'll be back next week. I'm Dr. Edith Bracha Sanchez. Thanks for listening.