Coping with Screens: What Parents Need to Know About Technology and Mental Health

02:42 Dr. Paul Mitrani, a child and adolescent psychiatrist and clinical director at the Child Mind Institute, served as moderator of an esteemed interdisciplinary panel of researchers, clinicians, and parenting experts. The experts offered their own real-life experiences, data, and recommendations on how to help children and teenagers manage the digital world in a way that maintains and improves their mental health, behavior, connectedness, and wellbeing this summer and beyond.

03:58 Our first panelist, Dr. Sarah E. Domoff, is a clinical child psychologist and director of the Family Health Lab at Central Michigan University, where she also serves as the principal researcher. Having researched problematic media and mental health extensively, she elaborated on what science is telling us about the negative and positive impacts that digital technology can have on mental health, and she provided tips to prevent the misuse of social media and promote healthy use. Dr. Domoff detailed what confers risk, why content and time of day matter, and how individual risk factors play an important role in whether an online activity can be beneficial, neutral, or harmful.

18:16 Bringing her clinical experience to the fore, Dr. Tracy Asamoah, a child analyst and psychiatrist, explained that most of the current research on mental health effects focuses on anxiety and depression. She outlined warning signs that parents may notice and discussed which changes in behavior are developmentally typical and which may indicate a mental health concern. While reminding parents that digital media use offers many benefits, she also discussed why social comparison, feeling left out, and bullying online can be so much more pervasive and problematic than when they occur offline. To best help teens access the benefits and counter the negatives, she laid out a plan that parents can follow to “create a safe space for open communication” between parents and their teens and tweens. She also discussed how to take advantage of co-viewing and set clear expectations in a family media use plan, including helping teens learn to self-monitor and self-regulate.

39:42 Finally, Dr. Elizabeth Dexter-Mazza, a licensed psychologist and certified Dialectical Behavior Therapist (DBT), shared her expertise about wellbeing and showed how to implement some mental health strategies at home during COVID-19. She focussed on practicing mindfulness and self-care to help kids not only manage stress, but also develop the skills they need to self-regulate, build wellness within, and develop resilience. She presented various practical tools to help parents and teens alike, from reframing language choices, being intentional, and shifting from judgemental reactions to more effective responses that eliminate confrontation, promote rapport, and stimulate children’s critical thinking skills.

[Dr. Pamela Hurst-Della Pietra]: Welcome everyone to this week’s Ask the Experts workshop. I am Dr. Pamela Hurst-Della Pietra, founder of children and screens institute of digital media and child development and host of this popular workshop series. Thank you for being here today, and thank you in advance to our fantastic panelists who will no doubt impress you with their advice and experience. As many of you know, children screens is one of the nation’s leading nonprofits that focuses on digital media and child development. We advance and support science by providing grant funding and hosting interdisciplinary conferences and retreats. In addition, we bring together researchers, clinicians, educators, public health professionals, and more for public conversations about how the digital world is impacting your family’s childrens’ and teens’ mental, physical and cognitive well-being. This summer and fall we are hosting weekly workshops so that you too can be part of these important dialogues. Today’s workshop will focus on one of the most important challenges of our era: how digital media is impacting young people’s mental health. especially during the covid crisis. We hope that the research advice and ideas we share with you today will help you support your children and teens as they navigate this very difficult summer and upcoming school year both on and off screen. Our panelists have reviewed the questions you submitted and will answer as many as they can. If you have additional questions during the workshop please type them into the q&a box along with your city and state and country at the bottom of your screen. We have nearly 500 of you here today. We will answer as many questions as time permits. We are recording today’s workshop and hope to upload a video on youtube in the coming days you’ll receive a link to our youtube channel tomorrow where you can find videos from our past webinars. It is now a great pleasure to introduce our moderator Dr. Paul Mitrani, clinical director and a child analyst and psychiatrist at the child mind institute. He has extensive experience evaluating and treating youth with complex mental health problems including depression, anxiety, ocd, adhd, sex gender dysphoria, and autism spectrum disorder. Dr. Mitrani is also certified in pediatrics with a focus on chronic medical conditions in relation to typical psychosocial development and co-occurring mental health and learning disorders. Welcome Dr. Mitrani. 

 

[Dr. Mitrani]: Thank you Pam. It’s an honor to be here, and I want to thank everybody else for joining both the panelists and the viewers in the audience. This is a really important topic and we want to make sure we give it the time that it needs because you know technology’s here right we can’t avoid that um it’s something that we’re going to see ongoing and especially in covid so many things are now online. So the discussion is really about kind of how technology use social media you know video games is really impacting mental health um because there are positives and there are negatives and we want to be prepared for kind of the future that’s coming and it’s already here um i’d like to start off by introducing our first panelist, Sarah Domoff. She’s a licensed psychologist and associate professor in the department of psychology at central michigan university and research faculty affiliate at the school of public health at the university of michigan she also established the problematic media assessment and treatment clinic at the center for children families and communities at cmu, where she trains clinicians school personnel and other providers in promoting healthy digital media use among children and adolescents. She’s going to talk to us today about what science really is telling us about you know screen time, screen use, and mental health and also provide some useful tips on how to avoid the negative impact that that use can have so with that i’m going to let sarah take over. 

 

[Dr. Domoff]: All right well thank you very much, and a special thank you to children and screens for putting on uh this webinar and the series of webinars. I’m going to share my screen to get the slides up. Give me one second. Can you see this all right? Awesome, well thank you again for having me here today. I’ll be speaking about what the science really tells us about childrens, screens, and mental health, and end with some quick tips for those in the audience for preventing social media misuse and promoting healthy digital media use. 

 

[Dr. Domoff]: So the sciences of screens and mental health you know we’ve seen across multiple studies, nationally representative studies, and longitudinal studies that greater social media use is associated with greater internalizing symptoms such as depression, anxiety as well as poor subjective well-being. In addition to internalizing symptoms such as some of those mood concerns, we’ve seen that hours spent using digital media and technology also leads to increases in adhd symptoms such as inattention and hyperactivity as well as dysfunctional behaviors on days in which youth use different types of digital media such as going online and going on to social media. These are really concerning trends, and we’ve seen this across different countries including the united states, and we really want to wonder you know how do these associations come about how may risk emerge and that’s really where the science is coming in, and there’s been a lot of great studies over the past several years really looking at you know what are the mechanisms? What is it about social media use that may confer risk for youth? One thing that I’ll definitely address today is that content matters, so social media is visual. What you see, what children see impacts them and just as we know with pro-social or educational content leading to positive gains for youth, we also see that negative content which I’ll outline for you leads to some risks for youth and teens. In addition to knowing what youth are engaging with on social media, we have to also consider the timing of use and the context. So when do teens use screens and how may that confer greater risk for mental health concerns? We also want to highlight their individual risk factors here, so each child may have different risks and families you all know your children best and so we have to consider what may be some individual risk factors for your child in using different types of digital media? Again I’ll highlight some of the research on these individual risk factors that everyone should consider. So let’s talk about content. Social media especially with instagram and snapchat it’s very image focused. It’s photos. Sharing photos! So we know a lot about what it does for teens when they see idealized images if they see pictures of people that are idealized and they’re internalizing messages about what beauty is about where they fit in this world, and so one of the big findings related to content is related to image focus or social comparisons that adolescents engage in when they see pictures of others online. Specifically research has found that there’s greater disordered eating symptoms in both boys and girls when they consume social media and we actually see that greater number of social media accounts also associates with greater risk for disordered eating such as meal restriction and excessive exercise. So when you see content that idealizes images or idealized bodies that can really impact how they see themselves and what they feel they need to do to fit into these societal ideals. On the other end in addition to internalizing concerns related to content that you see, being victimized online through experience in cyber bullying obviously has a major impact on the mental health of adolescents, and we found that cyber bullying is associated with greater depression symptoms, suicidal ideation, and likelihood to be in a physical fight. And so both content that you see passively on social media looking at these perfect images to actually experiencing intimate interactions that are negative can both have negative impacts on adolescents mental health, and so that’s why content really matters and knowing how youth use social media and what they see is really critical for parents.

 

[Dr. Domoff]: In addition to the content so what you see on on social media when teams use social media is a major factor in understanding potential harms. So for example, we know that you see teens up at night on their phones not wanting to put them away going to bed with their cell phones um and especially during this pandemic sleep disturbances are more likely to happen just because of all the stress and the lack of structure. So you can imagine that teens unfettered access to the world on their phone can really disrupt their sleep and really delay sleep and actually when we look at how does social media use or problematic phone use link to mental health concerns or poor functioning at school the next day, we see that relationship explained by disrupted sleep. So social media use and poor school function is related to or explained by disrupted sleep. Depressed mood, we know how important sleep is for mental health and for self-regulation of emotions. We see that if you disrupt sleep with phone use that will lead to a more depressed mood the next day as you can imagine. Then finally, when we have disruption in sleep um kids are more likely to be impulsive and not think before they act. We also see the link between social media use and aggressive behaviors and delinquency mediated or explained by disrupted sleep.

 

[Dr. Domoff]: So far i’ve talked about why content matters when you use social media or go on online matters, but there’s also individual risk factors and i think these are really important to highlight as we’re talking about mental health concerns and anytime we have a major societal concern such as a pandemic or all the stress related to some of the the challenges that come with social distancing. You can see how certain individual risk factors may exacerbate risk for some youth. So specifically I want to highlight that youth who engage in what we call like social comparison. Looking at others online, comparing themselves to what people are doing, or how they look um as well as passive scrolling, so not really engaging with the social media that links to greater risk. So we want to know when we’re working with teens or if we have teens what are you doing on social media how are you engaging with it because that can really give us some insight into when problems may emerge and of course that leads us to upgrade news because that means that we can target that for intervention and help teens who already are engaging in social comparison and feel really distraught or anxious about what they’re seeing online. Another big important term for everyone to consider is fear of missing out or fomo. We also see in looking at the links between social media use and some negative mental health outcomes that part of the mechanism is this fear of missing out so seeing other people do things that you want to do and not wanting to be excluded. It’s a really important concept especially when working with adolescents or teens because social connection is so critical so if you hear from your teen or from adolescents that like i feel like i’m gonna miss out on something if i’m not always online if i’m not constantly checking if i don’t respond quickly enough you can imagine how that just generates some anxiety and distress. Then importantly, we have to also consider co-morbid or pre-existing mental health concerns, and so some of the research has actually shown that having greater depressive symptoms links to too much use. We don’t really know which one comes first but we know that they make things worse together, and so if we can really target other pre-existing concerns and how that may kind of show itself and in your teen’s use of social media. That’s also a great you know way to address potential problematic use and try to help teens use social media in healthier ways.

 

[Dr. Domoff]: So to summarize um there’s a lot of research out there we know from longitudinal studies and in large national studies that social media use is linked to some greater mental health concerns. But this relationship is complex, and I hope with defining the content, context, and user engagement with social media, it kind of highlights to you all how we need to consider these different factors in examining how social media use may negatively impact the mental health of teens. So the complexity, I want to end on a positive note here. The complexity of the impact of social media use I think brings positive news forward, because not all youth are negatively impacted by social media and by identifying the ways in which social media can be harmful we can specifically target that in the interventions that we provide in our clinics or that you as parents can consider and really help scaffold your child’s use of social media or digital media in ways that benefits them. So you’ll hear plenty of tips today from the other speakers but I hope this kind of gives you a framework for what we know about screens and how it may be impacting adolescent mental health.

 

[Dr. Mitrani]: Thanks sarah. So obviously there is a lot of research going on right now to try to figure out the impact that screen use has and the specific mechanisms like you mentioned that are actually going to result in kind of a positive impact versus a negative impact and the more we know about that the better we can intervene. One of the things that a lot of people have been wondering is within the realm of covid that we all live right now, so it’s really made a big shift as far as online use right because now remote learning not being able to socialize with friends like we used to so i’m wondering if you could speak about the additional impact that covid may be having on a lot of the things that you spoke about.

 

[Dr. Domoff]: That’s a great question, and we’re doing a lot of research right now examining how youth are impacted by the coronavirus and this increase in screen time. Obviously screen time will be increasing because everything’s moved to online, but where I see problems potentially emerging that I would highlight to you all is really connected to structure and routines and new content that youth are exposed to during this time. So one, structure. Oftentimes with the school year we have a structure in place that we have a bedtime, a wake-up time, and a time for you to get out of the house and go to school. Obviously with the social distancing and the remote learning, those external structures are not there. So when that happens, there seems to be a kind of free use of screens. And so it’s really important especially in times when our country’s in crisis is to give children and teens structure and still try to provide them with a routine, so that you can better manage extra screen time, but then also keep them on a schedule that promotes healthy sleep. That is, that is so critical. Then secondly, I know other another panelists will be discussing this in more depth, but the content that youth are exposed to on social media related to the coronavirus related to economic stressors that can be overwhelming and really anxiety provoking if they don’t have an opportunity to talk about what they’re hearing, what they’re learning on social media and news that’s being shared with them. So you know in in terms of best practices trying the best that we can to keep a structure and then making sure that we do our due diligence and talking to our teens and children about what they’re seeing whether it be news shared on social media or news on on regular television that is something that is going to be coming up more often and parents should be ready to have those conversations because children are exposed to this content like it or not basically. 

 

[Dr. Mitrani]: That’s a challenge for all parents right like knowing what your kids are watching because parents are spread thin too right like they have to manage a lot of things remotely as well um and then even going back to the days of tv being kind of the babysitter now it’s you know the ipad or the iphone or something like that that’s like taking that role and we don’t see what our kids are seeing as much so that’s it’s really important to focus on um so thank you for that we’re going to talk more about kind of ways to help but i want to move on to our next panelists Dr. Tracy Asamoah who is a child analyst and psychiatrist in austin texas where she sees patients in a clinical setting um but she also incorporates the philosophy of treating the whole person and incorporates digital media well-being into her practice as a part of that mission. She’s gonna basically be speaking to us about uh the clinical perspective of screen time and its impact on anxiety depression and day-to-day activities and including kind of what the cycles of use may result in in terms of like you know children and teenagers mental health so tracy let you take it from there

 

[Dr. Tracy Asamoah]: sorry about that i was muted for a minute thank you paul let me share my screen with everyone and get us on the same page so as dr matrani mentioned i’m going to be talking about mental health and screens, and i’m going to be talking about three clusters that i want everyone to be able to think about and the two themes that i want you to just keep in your mind as we go through is to think about the feelings or the emotions that may come up as you think about how youth engage on screens how your kids and your your teens are engaging on screens and then think about the behaviors that we might be seeing and so when i have families come into my office they’re coming because they’re either concerned about feelings or emotions that their their kids are expressing that seem to be out of the range of normal for what they have typically seen or just concerning or/and behaviors that are concerning so those are the things that i want you to focus on. oops there we go. so i’m i’m focusing as far as psychiatric symptoms primarily on on anxiety and depression that’s because that’s where most of the research that’s been looking at the different sorts of mental health symptoms that seem to come up in relationship to technology those are the areas that they seem to be looking mostly at.Ii do want to point out though that we cannot say with um with clarity that depression or anxiety are caused by time spent on screens. There is certainly a link between how kids and adolescents engage on screens whether it be those who use screens excessively you know not just you know an hour a day but using four or five six hours a day or the manner in which they’re engaging on screen so there’s most likely a pretty strong link between that and things like anxiety depression but we’re not quite at the point that we can say being on screens cause anxiety depression. so with so i wanted just to talk a little bit about what do i see or what do i hear from families when they’re concerned about their kids ex having depression anxiety and again depression and anxiety aren’t new. these are things that we’ve been seeing and working with in our families way before screens um came about but there have certainly been unique um unique concerns that have come about in relationship to how kids engage with technology and their devices and their reports of things like depression and anxiety so we’re talking about depression we’re really talking about pervasive sadness, not sadness because there was a loss like the death of a pet but really sadness that we’re not quite sure where it came from or seems to be just lingering and kids can’t get rid of it a loss of interest in normal activities, sleep disturbances, changes in their weight or their eating patterns, and and we’re really concerned thoughts of self-harm or suicidal um thinking with anxiety those are the kids who come and talk about having a lot of difficulty controlling their worries, so they’re worried about a ton of stuff and they can’t control it they’re irritable they may complain of muscle tension, stomach upset, headaches, um and sleep disturbances. And so these are some of the things that may come about when we start thinking about okay you know you’ve had your kid and and you know maybe you have a 13 year old and you finally decided it was time for them to get their their own phone and all of a sudden they’ve been using their phone for a couple of weeks and they’re getting more irritable or more grumpy, and these may be some of the things that we might want to start thinking about. The other things i see with families that happen more subtly but are things that we often see when we’re concerned about anxiety and are concerned about how springs kids engage in screens are they just maybe more isolated or more socially withdrawn so, and this is even during covid it seems like everyone is more socially withdrawn during covid because we just can’t seem to find ways to safely engage with one another, but if you have let’s say you’re 15 year old who was playing video games and he was interacting with his friends and all of a sudden he’s not doing those you know multiplayer games and he’s you know he’s really now just on his own watching youtube videos and hiding out in his room and not coming down with the family to watch tv anymore that might be something to be concerned about, or academic changes and so academic changes is always always a big red flag in the families i work with. When i see grades starting to slip and not just an isolated grade like math has gotten really hard and that grades have fallen but just a general slide, that’s a time to be more concerned. The reason that these are all really interesting and and sarah mentioned this in her talk is because it seems like there may be a couple of things going on it may be that those folks who use screens excessively may be more likely to report symptoms of depression anxiety and maybe how they’re using their screens and so if you have you know if you have your kid who all of a sudden you know he’s been into video games and all of a sudden he’s spending hours and hours day on video games it could be that he’s doing it to escape from feelings of sadness that were there before. It could be that the manner in which he’s engaging with his games are actually feeding into that sadness and so there’s a loop that can happen there. And then there was also what sarah mentioned that i think is really important is how kids engage with their screens and so and this is really relevant in social media and so when you have teens who seem to be just passively scrolling through feeds and looking at how wonderful everybody else’s life is they’re more likely to report lower self lower feelings of um overall well-being than kids who are posting and creating content or commenting um and so those are some of the things to think about with with kids who are overall reporting um symptoms of of lower well-being. and so and i’m not going to get too much into the the the social comparison and fomo because i know we heard about it in a previous talk but what i did want to point out here the things that really come up with social comparison and fomo are anxiety and and the other thing that i would throw into here are feedback that that um youth get from how people engage with content they’re putting online and so when kids are looking to see how wonderful everybody else’s beautifully curated life looks on instagram or they’re posting tik tok videos with a bunch of friends on a friday night and you realize you’re not there that’s when these things can start to trigger things like anxiety. And then the anxiety itself can feed into feeling like you’ve got to be checking and seeing what everybody’s doing and then you’ve got to be posting more content and then how many likes are you getting and how many views are you getting with your video so it can create these really damaging feedback loops um and so that’s just i didn’t want to get too much into that but i just wanted to make sure that when we think about when is it problematic what’s unique about what happens on screens i will say also that these are not new concepts social comparison and fomo have been around way before apple decided in 2007 that the iphone was a great idea. It’s just that these things are so much more pervasive with our devices. And so I wanted to talk a little bit about unhealthy relationships. And so especially in our adolescence relationship development and and figuring out their identity this is when it happens. it happens in teen years and you even start to see it in tweens and some of our younger kids so the three things that i wanted to talk about in relationship to when does it look unhealthy online and again if we if we think about you know what are the emotions that you might be seeing that should be concerning and what are the behaviors that follow we’re thinking of things like anxiety and sadness but you could also be seeing things like fear and so if we think of just as cyberbullying bullying again is not a new phenomenon but it’s different online. it’s different for some really important reasons one being that it’s pervasive kids have their devices with them all the time it can happen when they’re gaming and they’re getting comments from people online it can happen on social media and so it can be potentially something that they’re dealing with 24 hours a day, and i literally mean 24 hours a day because there are people checking their devices at three in the morning. It’s called vamping. Your teen has their device, they have their phone under their pillow, they get a notification and they check it and so it can be really pervasive. The other part of cyber bullying that i think is really important is the fact that it can be anonymous, so a child may not know who’s bullying them and it can be spread so quickly and across so many different platforms that so many people can be witness to the bullying that’s happening so it makes the victim feel i’m really vulnerable um a really important note is when you think about the emotions or the reports of negative overall well-being it’s both the victim and the perpetrators and so they’re both at risk for having those experiences. Dating violence. And this is more for some of our older teens and adolescents um again it’s the anxiety and fear that may come with experience of dating violence that now can look really different on our on our kids devices um you see things like checking feeds checking photos checking texts um it can create a lot of jealousy when an individual checks to see what their partner is doing they can use devices to try to control and monitor what their partners are doing, and so we’re looking at these feelings that are now leading to these really negative threatening behaviors. Predators i’m not going to get into a whole bunch that’s that’s a whole different topic but understand that when we think of predators online one of the big problems is that predators are very savvy at how to have access to kids and adolescents online and our youth are not always as savvy about how to avoid it, and so that’s just another sort of relationship that our our kids can be more at risk for and with all these things the things that i want you to think about if if you have a child or a teen and they’re using their device and especially for some of our adolescents but even some of our kids, think about if you see changes in their behavior or how they’re engaging at home if you see them appearing sad or more anxious or more fearful and they’ve got a new relationship or they’ve started at school and maybe there’s more kids that they can be exposed to, these are some of the things that you might want to think about. And so risk-taking. Risk-taking during adolescence is perfectly normal. This is part of adolescent development this is part of identity formation um it can be really scary even offline but online it can also be really scary. The parts of it that are unique online um privacy. So with privacy teams don’t always and kids don’t always seem to understand that their privacy is not protected in a lot of circumstances online they can also be much more hesitant to use their privacy settings and so they don’t do a lot to protect their own privacy and so that’s something that we may need to help the model um to show them and and model behaviors around that the content that they’re getting into and and we heard a lot about content before but just understand that content that kids and adolescents are exposed to can certainly lead to um feelings of fear or anxiety if they’re seeing things that are not appropriate or that are developmentally inappropriate. It can also lead to behaviors that are really concerning so if they’re viewing content about self-harm and they start engaging in self-harm behaviors that could be really concerning. And then personal disclosure. Kids and in teens aren’t great about knowing what information is okay to disclose online they don’t always understand the permanence of what they place online and who has access to it what happens with a lot of these different sorts of things with privacy content and personal disclosures they don’t know until after the fact after something negative happens the situation they put themselves into. So what you may see the the emotions you may see expressed and the behaviors could be that they feel guilty or they feel shameful or they feel anxious about what has happened as a result of how they’ve managed their privacy or the content that they’ve posted and then you can see reaction to to those situations.

 

[Dr. Tracy Asamoah]: So benefits of screen time. So for those of you who don’t know this is a an image from stranger things which my kids got me completely into in 2019 and we’re anxiously waiting for season four and i put this here because i when we talk about mental well-being online, it is not all negative and in fact there are a lot of wonderful things about screens. And and fun is a big part of it, and and so we’re on the one hand we do have concerns for instance for you know your 12 year old kid your 12 year old son let’s say is playing video games and and he loves those i don’t even i don’t have boys i have girls i don’t even know what video games to talk about and i will gate myself if i try but i’m gonna say halo because that’s the one that popped in my head and if they’re playing this game seven or eight hours a day and then all of a sudden they’re more irritable and more aggressive we can start to see the links. But on the other hand a lot of this stuff is really fun my daughter who’s 10 loves roblox and seems fine to me it seems like a fun game and so there’s fun things online. There’s also opportunities for being creative and expressive for learning and for social engagement and social engagement can be contrary to all the things i explored previously can be really healthy. It can allow for the for for enhancing offline relationships by how kids engage online and especially right now during covid where kids can’t kids aren’t seeing their friends as much as they would like to and they aren’t in all of those settings where they would typically be especially during the summer things like video conferencing and facetime and all of those different platforms allow for a greater social engagement online. And so just a few tips that I wanted to finish off with because screens are okay. They’re not always horrible. There is a lot I think of uncertainty about how our kids engage with screens but there are a few simple things that we can do to help them engage more safely. And so listening and watching are really important and so listening and watching means before you ever get on screen with your kids really work to create pathways for safe communication for being able to have conversations with your kids because when things do come up online you certainly want your kids to feel like they can talk to you that may be that you have to be able to bite your tongue while they’re telling you some pretty horrific things that they’ve seen or that they’re thinking about because you really want them to feel safe to discuss those things with you so creating those pathways for communication and the 3 Ws and how is a way that i talk to a lot of families about just what do you monitor. So knowing when they’re using it the times of day where you want to know if they’re using it three o’clock or three a.m in the middle of the night in their bed what platforms are they visiting for instance how much time are they spending on games and then tv and then they’re on youtube and using their phones to communicate with their friends so just having a sense of what that looks like, and then how do they engage are they actively engaging in positive ways or are they really just getting into the cycle of behavior where they have these negative emotions and then they’re using screens somehow to either self-medicate or to escape from that. Co-viewing content, and so you’ll get from my stranger things slide that i think co-viewing is really important it shows your kids that you’re interested in what they’re interested in it makes it more likely that they’ll want to share their interests with you um you may actually have fun with it and you can ask lots of questions. And those questions can help you learn more about what your kids are doing. And then setting expectations just really quickly putting structure around what screen time looks like in your home maybe having a family media plan that’s written out that everybody mom dad everybody in the house agrees to and creating boundaries around what’s okay and not okay, and then supporting self-monitoring and self-regulation especially in our teens and going into our transitional age you got kind of our college age kids you really want to teach them to understand how they feel what emotions they’re experiencing when they’re online when they’re playing their video games are they feeling more angry is it making them feel more aggressive when they get off do they notice that they’re fighting with their sisters or they’re fighting with their brothers more, and then self-regulation so they can start learning how to limit their use. So that was a whole bunch of information but really just wanted to give you a survey of how you can think about the emotional experience of our youth online and then some of the behaviors that we might see thank you. 

 

[Dr. Mitrani]: Thank you very much Dr. Asamoah, um so i was actually going to ask a question about content but then uh uh an audience member uh asked a similar question so i want to ask kind of both at the same time um one just talking about like how can parents find developmentally appropriate content right because i like stranger things too but like it’s not good for my youngest daughter, um you know and trying to regulate that. and the ap academy of pediatrics has guidelines but you could touch on that. And then also just in today’s world especially with the black lives matter movement um how to address kind of either racially charged or you know anti-semitic or homophobic things that people may view in different content. I agree that co-viewing is a real useful tool because you can see what your kids are taking in and then kind of ask them questions about it or see if they have questions they want to ask.

 

[Dr. Asamoah]: yeah so i’ll give um a really practical resource and then i’ll give kind of a more general tip so really practical resource that i still use. I have a 10 year old and a 13 year old. I use common sense medium which is a website that you can put in the name of a movie or a tv show or a video game and it will give you a sense of the age group that is that um can watch that content who it might be appropriate for but it will also tell you the things that you might see that might be concerning so if there’s violence or substance use that might be concerning um but it’s hard there’s a ton of content out there and it’s not always easy to know and sometimes with my own kids i just have the rule that i have to watch it first um i have to view it first or you know if i had video games i imagine it might be that i have to at least be able to see what the video game experience is and so if there’s a show that they want to watch it may be that i read about it but then i go watch an episode um and i’ve watched some stuff that i was really not all that interested in but if i was really concerned about the content that’s the way i’ve gotten around it. um with some of the racial issues that have come up, that’s a tough one because it really depends on that a particular family and what their experience and kind of what their stake in this whole issue is, and i would say always always always start by asking what do your kids think and what do they know and having an understanding of where they’re starting and then um and it varies across the age span but in a developmentally appropriate way talking to them about okay so tell me a little bit more about what you think about, and so if for some reason your eight-year-old caught a glimpse of what happened with um with george floyd on the news they saw that image and they asked you about it you might ask them so what do you think happened there what why do you think that man was on the ground what do you think the cops were doing and what do you think that meant and how did that make you feel how do you think he felt and so it’s really talking to them where they are and and allowing them to develop and process their their feelings for it, and then you filling in good information and facts to support where they are at that moment. I think that um when we think about content kids can get really overloaded i think adults can get real really overloaded i tell my families parents included at the most watch the news twice a day you have to watch it when you start your day and watch it at the end of the day and pick reliable um non-divisive sources of news if you can and try to avoid the rest of the news so i ask everybody to really limit it because i can i think it can get to toxic levels but i think that’s especially true in in our younger folks yeah and i i will also say common sense is a good resource especially with movies because it also gives you some ideas of questions or conversations you can have with your kids after viewing. 

 

[Dr. Asamoah]: Absolutely 

 

[Dr. Mitrani]: The other thing as far as some research that has been done um code like just sitting in the room while your kid is watching a movie or a tv show or playing a video game it actually activates a different part of their brain so rather than just being passively receiving things like in a movie um they actually start to think about it more critically and it’s usually because you know the oh mom and dad are here watching this with me oh that person just said something that was mean or inappropriate it makes them think about it in a different way as opposed to just taking it in right, so like even just being present is great but being actively involved is even better. 

 

[Dr. Asamoah]: Absolutely 

 

[Dr. Mitrani]: All right, so moving on to Dr. Elizabeth Dexter-Mazza um she’s a DBT certified so dialectical behavior therapist and co-author of the dvt steps social emotional learning curriculum for middle and high school students. um Dr. Dexter-Mazza is a licensed psychologist and maintains a private practice in seattle and spends most of her time working with schools to incorporate social emotional learning into their curriculum so again that’s where kids are and again hopefully they’ll be back there soon, but it’s really important to kind of help them with that. She’s going to discuss tools for parents to use at home to facilitate mental well-being for themselves as well as their children including you know practicing mindfulness or self-care which can help kids uh manage any stress including the stress that we’re all feeling right now. 

 

[Dr. Dexter-Mazza]: so great thank you so much um paul and to children and screens for hosting this webinar and having me on today. Let me get my screen share up for all of you here. um so really what I wanted to spend some time talking about today is how I talk to parents um through our weekly live streams and the skills that we’re teaching kids to use in schools as part of similar to what tracy said how do we educate the whole child versus just educating the academic child and kind of our upstream approach to getting skills in for self-regulation, building wellness and resilience in kids early. And you know now because of covid many of us parents have become the teachers we’ve become the schools and so wanted to provide some of the skills that we teach in school to parents so that we can start using those as home at home not only to teach our kids but I think they’re just as important that we all use them as well as a parent of three kids um i’m constantly grateful for the dbt skills that I have and my ability to teach them to the kids as well. So really the first thing I want to talk about is mindfulness. We hear mindfulness is the buzzword right now, and we hear about it in schools all the time and we’re saying we hear it in the media it’s always like be mindful you have to be mindful. So what does that actually mean um and most people when i talk to them they think about mindfulness as this idea of to calm down, to meditate, to do yoga, and I want to talk about that mindfulness is so much more than that. Mindfulness is about being aware in this moment without judgment and what does that look like when we’re working with ourselves with our kids that I really focus with families and parents on recognizing when your emotions are running the show right since we’re talking about mental health here i’m going to really kind of focus it a little bit on emotions, but let’s get aware of what we when we’re in what we call emotion mind. When my feelings are running the show, when they’re making the decisions, and what i’m really working on for myself and teaching my kids how to do is how do they get themselves to wise mind where they’re finding a balance between reasonable mind what they think to be, right. They’re bringing in reason and logic with their emotions and making effective decisions from that spot I know as we’ve kind of been talking about regularly already this morning when i see my kids on a screen and i’m not sure what they’re doing my emotions go up immediately like what are they doing now what youtube video are they doing now and I have to regulate. I have to get myself into a centered spot of wise mind and be able to communicate to them okay let’s do a check-in right now. What are you doing on your screen? While i’m really practicing being non-judgmental in my thoughts and in my tone with them that’s part of really one of the goals i’m looking for and because i’ve taught my kids and i think it’s important that parents can teach their kids this vocabulary of emotion mind and wise mind and reasonable mind we can have those conversations whether it’s about I’m an emotional mind and me reacting to them on screens or you know when they get off screens and i have them get off screens and we know their irritability goes up as their brain gets more tired from the cognitive um capacity that they’re using to play these video games and watch these youtube videos you know to be able to say to them when they’re done you know and they’re irritable or they’re yelling or they’re upset about something like is this an emotion minded reaction, are your emotions running the show right now, what can we do to get you into wise mind, right, to get you more into a centered place because that’s more active mindfulness versus how do you calm down how do you relax um and that’s a big part of what how we teach mindfulness to them, and I think it’s helpful for parents to have some of that language and common language in families um you know other ways that I think about mindfulness that can be very helpful is this idea of focusing for us as parents and for our kids how to just do one thing in the moment right i think in this time of screens we’re often you know doing multiple things like this idea of multitasking and i want them to do one thing like when you’re doing school especially during covid in the spring and now potentially into the fall on screens how do you stay in your virtual classroom and do the schoolwork your need to do while not getting distracted easily but whatever by whatever notification pops up on your screen or whatever potentially hidden um um screen you have open that has your video game or your youtube screen on that i’ve learned that my kids can do that they can have multiple desktops open at the same time so I can’t actually see what they’re on you know and that pull to kind of respond to those notifications to check on that. That’s where mindfulness of doing one thing in the moment becomes really helpful, and practicing that practicing i always talk about that difference between there’s the urge to do a behavior and then these the action, action of the behavior and mindfulness is noticing that pause between the urge and the behavior so we help them go um hone in on that also practicing for ourselves as the parents and for the kids to using non-judgmental language right that that’s bad or that’s horrible to really describing um what they’re thinking about in more detail non-judgmentally. When they you know I hear often from kids you know online school sucks right as it just gets this negative reaction which is the more we use that judgmental language the more it fuels the intensity of our emotions so if we can practice getting away from those short hands for good and bad that will help to get us back into wise mind and decrease that emotion intensity i think of judgments as like lighter fluid on the emotional fire and we want to bring that down some and then the other thing i think when we’re being mindful and it’s really about getting really intentional here is asking ourselves is this effective, and by effective, I mean we’re asking ourselves is this behavior that i’m doing in line with my long-term goals. Is it what i want right now, or is it what i want most, right, because often when we’re in emotion mind we’re fueling the behaviors of what i want now and not thinking about our long-term goals and so by practicing some of these just mindfulness strategies, we can get a lot more intentional about what we’re trying to do in the moment um and this is where i think it’s really important as parents we become models for our kids on what we’re trying to get them to do with building some of this initial self-regulation um talking to them about what they’re doing on screens at any time but this also relates not just to screens to many behaviors as we said earlier we’re trying to teach them self-regulation, so that when they go off to college when they go off to high school they’re being more effective in this. So mindfulness of really being in the moment, practicing being non-judgmental, and being intentional about what your goals are in this moment can be really helpful. The next strategy I want to talk about um that kind of comes into how do we really start strengthening our relationships with our kids and again practicing being more intentional is this idea what we call dialectical thinking, right. Really the first part of this is about how do we get away for ourselves and for modeling for our kids from all or nothing thinking right this is so much of just kind of developmentally where people are in life everything is bad all of this everybody’s doing this i’m the only one who’s not we talked a lot about fomo already this morning, you know when all my friends are out socializing. Mom and dad, why won’t you let me go out, right, I’m the only one everybody else is doing this and so dialectical thinking first is about how do we get away from that all or nothing thinking and describe the specifics again non-judgmentally of what we’re looking for. And I think when we can not talk in those extremes we’re starting to lay foundation for looking at multiple perspectives and then kind of the big thing that I think I tell parents all the time is if you take nothing from any of my talks I hope you take this. Is this concept of replacing the word but with and i think of butt as a giant eraser is that it erases anything that came before it um and puts us on the defense you know my kids are and people say all the time they’re like oh i know there’s a but coming like you just said something really nice to me but and you’re ready to land a big blow right so when we hear that but we get defensive we put our armor up so i want you to think about how do you replace that um when kids say you know all my friends are socializing you know coming back to well some of your friends are socializing and here’s why we’re not socializing as a family, right. your all your friends get to be on screens and play halo or fortnite or whatever video game of the month is, and here’s why this isn’t in line with our family values. It just lands differently and it opens up a lot more conversations for multiple perspectives so just to getting back to being mindful and intentional of noticing for yourself when you use the word but try to notice it and replace it with the word and and see how it can facilitate some of your um conversations a little bit differently with your kids you know i also think it comes back to this idea of perspectives I was just thinking during the earlier talks that when I talk to kids about um screen time use and the impact on it I always want them to hear about different perspectives and i’m always asking them like do you think as a kid are you the consumer of technology or are you the product of technology, and trying to explain to them that I actually think they’re the product they get to use all these free apps so that technology gets to sell their information to the advertisers. They’re making money off of them and it shifts their perspective when we can open up more of that conversation for them to know that they’re the product not the consumer so kind of being able to open that is another piece I want to share with all of you. And then um again briefly in our short time we talk a lot about self-care and now more than ever during covid i think we’re all struggling for figuring out what self-care looks like and what does it look like as a family and one of the skills that we teach we call them the please skills, and these are the skills about how do we decrease our vulnerability to take to our emotions by taking care of our body. I often said these are like the common sense skills that we all know we should do and whenever i give workshops or i’m teaching in a class I ask everybody how many of these do you everybody does all of these every day and it’s usually like less than 10% of the audience because we all know we should take care of ourselves when we’re sick and how many of us still go to work or send our kids to school even though they have the sniffles, we know they’re not at their optimum functioning and we send them out to take care to do things anyway so being aware of that I think is important. So when you’re sick take care of yourself, you know, rest when you need to rest don’t lay down and then watch tv for five hours, right, but being able to address our own physical health. um right here with the topic you know we talk about the l stands for limiting screen time right and different types of screen time it’s back to that idea of moderation it’s not that we can’t have any screen time at all but moderating it and moderating the different types of screen whether it’s video games or tv or actively working doing school work you know how do you limit it and moderate it because like i said earlier as and everybody else has said when our kids get have too much screens and they come off that irritability is up, and that’s because their brain is tired and it just can’t function at such a high capacity, you know we need to eat a balanced diet, um we need to eat regularly throughout the day and eating healthy foods and fueling our bodies that way. Avoid over-indulgence. This can be avoiding mood-altering drugs but also like too much of anything is problematic for kids this can be caffeine, too much chocolate, too much sugar, right help not to um have all of that on a regular regular and excessive amount of time each day and then finally it’s um this idea of balanced sleep and um i think sarah talked about this earlier but we’ve got to have some structure to our sleep schedules especially during this time of summer where we’re off schedule a little bit um and we don’t want too much sleep or too little sleep so making sure that we have this in our family, and then exercise daily right we all need to move our bodies 20 to 30 minutes a day, and setting that up and finding um the way to do that consistently this poster that’s on the slide here this was made by one of our families that um participate and watch regularly our parenting live stream from one of the talks we gave and this is up in their kitchen so their family sees it every day about what they want to work on, and like I said earlier these are easier said than done on a consistent and regular basis and they are one of those things that helps us to decrease that vulnerability, that’s going to help us with we’re starting to experience increased anxiety or depression especially during covid, right. This helps take some of that vulnerability down and it’s important as a family we can all be addressing this not just these are things our kids have to do but these are things that as parents we have to do and model for our kids and work together on all of that. um I could talk for another probably 30 minutes and give you lots of more strategies and things to talk about um but i know we have a limited amount of time so I’ll just put this last slide up here that if you want more of these resources more of these skills where you could find them on our youtube channel we taught all like 27 lessons to our kids during school from home in our living room this year and um taught the entire curriculum to them and then put it on youtube so there’s lots of strategies that we can use to teach kids how to um self-regulate manage their screen time but also just manage their behaviors more mindfully, and then do the same as parents. Okay i’ll stop there because I know you have questions paul

 

[Dr. Mitrani]: Thank you very much yes that was great everybody thank you very much for your presentations so one of the questions i had going back to that idea of self-regulation and one of the frequent complaints we get from parents is that you know screen times take up too much time and they’re playing too much, right. It’s usually two things they’re playing too much or they’re online too much and whenever you try to set a limit or stop them um then you get a big reaction right. So in in regards to the self-regulation I mean what kind of tips would you have for parents to kind of help change that pattern, because one of the things that happens is the more that happens the more it becomes a pattern if you don’t intervene in a progressive way then it ends up being a bigger problem. 

 

[Dr. Dexter-Mazza]: Yeah, I think the number one thing about teaching that self-regulation is moving upstream and doing prevention and having conversations before you get to if we’re just constantly coming to our kids and say get off screens right now then we’re having a reactionary response. We want to have conversations at the dinner table um like sarah and tracy said earlier what are our expectations as a family and values around screen time usage, and here’s what i’m we’re gonna do like you have a limited amount of time during the day to use screens. How you choose to use that you know we can discuss what you can do and can’t do so that you’re not surprised when I turn it off or when I ask you to get off i think another really important thing that parents do to help model self-regulation is giving um kids cues that like in five minutes you need to be off of this game right rather than coming straight down and saying okay time to turn it off because if somebody tells me to do that like if I’m reading a book and I’m in the middle of a sentence and they stop reading come do this right now I’m going to want to finish my paragraph I’m probably going to have some response to not being able to have some closure on the activity I’m doing so i think we also have to be mindful of giving them those warnings like you’ve got five more minutes you’ve got one more minute and then i need you to shut that off and that’s a huge strategy that so we’re teaching the kids how to start to wind down in that self-regulation. I also think um doing things intentional as a family um is about building mindfulness so like one thing my family does um is every night at dinner we go around the table and we say two things that we’re grateful for that day, two or three things that brought us joy that day, and I’m doing that with them every day to build intention them to get more intentionally mindful about things that bring them joy every day i’m trying to find active ways to strengthen their mindfulness skills and so doing things like that increase their ability to be more mindful later when they’re playing these video games and they’re noticing it’s coming up to time to get off how can they make those more mindful effective decisions

 

[Dr. Mitrani]: No that, that’s great and it goes back to the communication right like kids being told something do this now they’re less likely to react or do it the way you want to um if you give them a warning. The other thing is a lot of parents tend to do myself included is you’re not giving a reason right like so if like i need you to get off the screen right now because we’re supposed to go to grandma’s when we went to grandma’s um you know like giving them a reason helps them understand better as opposed to just do this and then them not being as likely to go. 

 

[Dr. Dexter-Mazza]: Absolutely! Rationale is so important for them to understand why especially as they’re growing into their teens and tweens and teens we want them to be more critical thinkers right. We don’t want them to just passively take everything everybody tells them to do so as we’re providing this rationale, we’re helping strengthen those critical thinking skills as well.

 

[Dr. Mitrani]: Great well again, thank you um so there were a bunch of questions submitted prior to the panel as well as some during. uh the first one I want to get to is just related to a lot of questions about how much is enough or how much is too much um and there’s there’s the american academy of pediatrics guidelines just to go over those um like really 18 to 24 months old they really don’t encourage it at all unless it’s video chatting or like watching it with them and we talked about co-viewing before um so that’s just something to keep in mind like less than two years old you want to limit it as much as possible um from two to five years old they’re saying like they should really limit it to one hour a day of high quality programming again you should be watching it with them and you should doing as much as you can with it one of the questions that came up though was how can you find the time to kind of look at everything content-wise and kind of set up those parameters so i don’t know if any of you guys want to touch on that.

 

[Dr. Asamoah]: I can i can touch a little bit on that i mean it’s a tricky one. it’s i think it’s tricky now with all of us at home and a lot of families having to um manage working from home and also their kids in places that they can’t see, and one of the strategies I tend to use and I think this gets maybe to what liz was talking about a little bit is i try to focus less on just figuring out all the ways to tell the kids if they have to limit what they’re doing and take it away and I really try to fill their time with other things so for my own kids letting them do some cooking, time outside, um reading a actual book, um hanging out with each other, and just being bored because believe it or not being bored is okay um, and and also having been and even with my my 10 and 13 year old having them start to monitor their own time even if that’s using an app and saying okay so let’s talk about what seems like a an appropriate amount of time to be on your device, all right so let’s monitor that. Let’s see how long you’ve been on it let’s check in about it so really having conversations and finding ways that they can have some agency and how that is done, but as the parent you having in your head what the structure in the framework work around that looks like um. At the end of the day though if you really feel like your kids are having a hard time regulating and self-monitoring then doing things like having a place i call it for my family’s that i work with a landing pad or a launching pad where you charge your devices they’re all kept and every and unless i see them there then i have to assume you’re on it and if you’re on it then we’re going to start counting that as your time but if i see it there then i know you’re doing something else and if you want to use it then you know maybe we have to talk about you you’re letting me know when you’re taking it from the landing pad so those are some strategies that i like to work with families on.

 

[Dr. Mitrani]: yeah that goes back to the idea of um you know developmental checklist or wellness right like what do you want your kids to be doing it goes back to even the please chart right like you know kids should be getting enough sleep they should be getting a healthy diet they should be physically active and if school is going on or they have other activities that they should be doing you want them to be doing those activities, right. Screen time is something else that they could be doing but you want to have a nice balance and there is actually growing research on kind of like the goldilocks theory related to this, right. Kids that have like no screen time don’t do as well as kids that have some screen time but the kids that have some screen time also tend to do better than those that have too much, right, and you really need to figure that out for your child another 

 

[Dr. Dexter-Mazza]: really quick i think the other thing is to be flexible as a parent to know when you have to switch strategies like for during co during fall spring in school, you know the kids we had our computers and laptops all on the table so they’d come downstairs they’d get on the computer and then we hit summer and they were doing the same thing, but I’m like but what are you getting on the computer for and realizing like computers had to be put away at night so that it’s not this automatic cue to come down and get on it first thing, because I think our brains and our bodies were getting trained to do that so being able to shift that’s part of teaching them some of that mindful awareness of what is your automatic behavior cause i think as a lot of us as adults we do that you wake up you check the news on your phone, you check your email, right and for us getting to model that for them as well yeah 

 

[Dr. Domoff]: I’m just going to piggyback off um Dr. Asamoah also mentioned before um a resource common sense media and so that is something that i recommend families check out um during our assessments and we try to help families identify what are some behaviors they want to change around their media parenting practices. Something that they found really useful is just being able to go to this this page and and see reviews of the different products as well as guides for families so best movies to watch when you have kids of all different ages or what are some pro social um or educational um video games that kids can play that are more beneficial for them than others, and so there’s so many resources online in shortcuts and I’m really optimistic about behavior change around screen time, because um we’re using technology to our benefit and I think if we can use the online resources to our benefit um that can really mitigate some risk and 

 

[Dr. Dexter-Mazza]: I think as we get older just to come back to common sense media because i think it’s really important also using it to teach the kids to go to it first as part of their research and coming to ask for permission to watch something, right we’re teaching them some of that responsibility so I use it for kids go to there first. I want you to know that you did your background work before you come to me.

 

[Dr. Mitrani]: um and so because this question does come up i didn’t see it specifically asked but you know a lot of times parents want to know about parental controls that they can put on devices um and yes they exist you know whether it’s disney circle or net nanny or you know cujo like boomerang those are all useful tools but i mean kids are i mean kids are smarter than us like they’ll find a workaround and really you just have to go to google and it’s like how do i turn off disney like my daughter was going to my my wife’s phone getting into the app and turning off like the protections on her thing so kids will find a way, so the bigger issue I always tell parents is you want to build the trust, right you want them to have the skills that they were going to be able to self-regulate and see what’s appropriate or not or ask permission or watch it with you, because that communication is going to have a better impact long term 

 

[Dr. Domoff]: Can I say one quick thing about that just to kind of piggyback what you’re saying um one thing that’s really helpful is to talk to kids before problems occur saying okay if this were to happen what will you do. How would we talk about and importantly will there be consequences because for some youth they don’t know what will happen if they tell their parents x y or z has happened to them online, and so if you can say this is our plan this is how we’re going to make sure you still have social connections, but then these are things we’re going to take to make sure that you’re safe online.

 

[Dr. Mitrani]: So another question that came up was um you know there is still controversy as far as the research that’s out there you know the statistical significance of these effects on youth um so you know uh Dr. Domoff if you want to touch on that. 

 

[Dr. Domoff]: Absolutely, so it’s a very complex association. There are many factors here that explain how digital media use may benefit or may harm youth um and that’s why I really try to highlight the content the context and the individual risk factors, because it’s not um all the same effects for all all children there’s there are many teens that use social media in healthy ways and get benefits from it and what we’re finding is that um we can give skills to teens um and to children to navigate digital media use in healthy ways um that’s what we do at my clinic, and um really a lot of these mechanisms linking digital media use to outcomes it’s connected through disrupting other activities that you should be doing, so disrupting sleep um, but then also it’s um how youth engage online, and so you may have some teams that are pro-social and they have a lot of protective factors and they can use social media in ways that benefit them to help them feel more connected to others especially during a pandemic. But then there are some youth who may be lacking some of these skills, conflict resolution skills, um coping skills, and so when we try to help them reduce their problematic social media use we are definitely working on increasing those skills to be able to navigate interactions so just as parents we want to communicate with our kids about how to um be a good sport and to build relationships. We want to take those same skills but apply it to the digital world the the world that um is now the real world for for so many kids. 

 

[Dr. Mitrani]: and the other the other piece that keeps coming up in the studies is just the inherent vulnerability in a child, right. So a child with adhd may be more prone to aggressive outbursts and video games are very stimulating so they’re going to be able to sit and focus on that like you want to get them to read a book that may be more challenging right or do like a craft project that’s more challenging so they’re going to kind of go towards things that are easier for them and more rewarding um and then they’re just their risk is higher. um one of the things related to covid is everybody’s risk is a little bit higher, you know if you had like some clinical anxiety before covid you may be having a little bit more clinical anxiety, right now, so that’s going to create a lot of um increased risk. um so Dr. asamoah I wanted to ask you about um like depression and teens another another audience member asked about like you know their 14 year old kind of doing things more online they thought it was going to help it seems like it’s making them worse so how how can we manage that and um you know whether it’s anxiety depression in teenagers to help them.

 

[Dr. Asamoah]: Sure and so, I think the number one thing is to recognize it and so it sounds like that parent is recognizing it and if that a 14 year old is really capable of starting to at least pay attention to their feelings and to monitor that and so also having them maybe recognize some of the things that aren’t working for them. If they’re using their devices to help manage those feelings it can look a couple of ways. It could be that they’re looking for information and and there are some really great resources online that that teens and youth can find information about some symptoms they may be experiencing, so do it with them. So if you’re a parent and you know that your teen is looking online for information about what they think may be issues with something like anxiety depression spend time with them and talk about it together use that as a way to improve communication. On the flip side if they’re using it to escape those feelings if they’re using their devices to kind of self-medicate and try to just kind of avoid having those feelings then a) that may be a child who needs a little bit more help and so if they’re not working with a therapist or a counselor that might be someone to help kind of manage those feelings because those feelings are certainly going to be at some point bigger than what’s happening with how they’re engaging online, but the other thing as a parent you may need to help them start to recognize that you know these certain ways that you’re engaging online aren’t helpful for you what are some tools or what are some solutions that we can come up with together to help modify that a bit what are some changes we can make because you don’t seem to be really having a great time right now you’re really struggling right now and and do you do you see that you’re struggling? what can we do a little bit differently? um and so again I always go back to you know it’s the answer is not always just automatically say well it must be the screens I got to take the screen away and figure out how to keep them off the screens. I mean even if the screens are linked to your particular kids anxiety depression just taking that screen away isn’t going to fix it. um It will certainly it will certainly feel like you’re dealing with one of the triggers but it may not necessarily fit what they’re experiencing what you really want to do is engage in a conversation and communicate and have you have awareness of what they’re experiencing and teach them to have an awareness of what they’re um experiencing internally and then having both of you look at the behaviors that are manifesting and what sorts of things you might want to modify and then having, especially a 14 year old be an active agent, and coming up with solutions around that. 

 

[Dr. Mitrani]: yeah i mean the conversations are key right because you want to have that open dialogue of all right what’s helpful about this for you and what’s unhelpful right and if they can kind of start to have that conversation then you can kind of say all right well maybe this is too much time or maybe you should only go on this you know only on twitter or you know instagram whichever one is more helpful or not um also related to that um you know we talked about fomo and all those other things like friends getting together right like seeing that online um we talk about that and parent kids come to us as parents and they say you know while they’re doing that why can’t I and the big question is the balance, right. So how can we better engage uh you know and Dr. Dexter-mazza if you could answer this um better engage kids in other activities right and even questions about imagination right like kids will stop using a screen and say i’m so bored i have nothing to do and how do we engage them in other things to build up the things that they would enjoy if they weren’t on screens.

 

[Dr. Dexter-mazza]: well I think there’s two parts to that. One is first we have to teach them how to get creative and I think this is always the balance for parents of you know over scheduling or trying to make all the plans for them when our kids are too much on screens we’re like okay well we’ve got to come up with activities like right now during summer i’m used to my kids being at camp most of the day and now i’m like camp counselor and trying to figure out what they’re going to do. Do i have structure for them every day so that i can keep them off screens. That’s helpful to a point but there’s also that point where i’ve got to let them get bored like we’ve started removing the screens in our house and they’re like we don’t know what to do and they sit on the couch and i’m like okay well this is the opportunity for you to start creating i have modeled for you for a very long time what kind of activities you could come up with and do and now you’ve got to be bored enough to for your imagination your creativity to kick in so we’re using that as kind of that launching pad but first you have to model it and you know having lots of conversations and being transparent about what you’re doing with them so that they start learning those skills as well. And then I think it is push them outside push them to do things together getting them to get creative and part of that is tolerating your own distress of letting them get bored right and because they’re going to wait us out they try to wait us out until they’re bored enough and we say fine just go play video games or go watch tv because you can’t come up with anything to do, so we have to be able to hold tight and let them be bored for a while and 

 

[Dr. Mitrani]: Even with younger kids sometimes like forced choices or you know like all right you can either go for a bike ride or you can play monopoly you know like give them an option if they need that and that’s typically for younger kids but for older kids you know we can put more on in their hands, and related to that so like just video games themselves and the negative effect that they can have on kids um you know because it’s the stopping of it that’s hard right um but it can be a lifeline right and even going back to like being on your device and that’s where we want to be very careful about what limits we’re setting right and understanding what the repercussions may be and the conversation is really important right 

 

[Dr. Dexter-mazza]: Dso one of the things i’ll sometimes do with the kids is like they’ll ask if they can play video games and it’s like well who are you playing with are you playing the video game by yourself or the two I have two boys are you going to go play together or do you want to go see if a friend is online and you and your friend will play video game together. I will give permission for that sometimes when i won’t give permission to just go play by yourself and so you can have all different pieces it doesn’t have to be yes you can play or no you can’t play but you can play under these parameters yeah 

 

[Dr. Mitrani]: and the connectedness is what we want right that’s the benefit of technology that’s what facebook was meant to do to connect people right right um and that’s that’s a good option for parents right like

 

[Dr. Dexter-mazza]: as as kids we talked on the phone a lot as a girl i talked on the phone a lot boys they play on xbox and video games and do side-by-side play that’s how they connect yeah and that’s the thing too you want to take into consideration if we didn’t have covid right now how much time would they be spending socializing with other kids right and if they can’t do that in person how can we supplement that in a creative way right like i’ve had some kids in my neighborhood like they get they play hide and seek like they don’t go anywhere near each other but if they find the other kid like at the the playground then they found it but it’s it’s something that they’re doing and again being creative in the ways that they do it 

[Dr. Dexter-mazza]: kick the can has been our socially distanced hide and seek game because nobody has to touch each other 

 

[Dr. Mitrani]: so again it’s it’s fun and that’s something kids will then start to do more if we if we facilitate it another question that came up was just related to how technology and screen time affects relationships and there have been trends in that regard um but more so for adolescents right like yeah there’s dating is down teen pregnancy is down but the types and quality of relationships has changed um especially with the advent of sexting or kind of the the proliferation of porn which was there before but now it’s more readily accessible um so i don’t know if uh Dr. Asamoah if you could speak about that or you know Dr. Dexter-mazza 

 

[Dr. Asamoah]: Sure, I’ll say a couple of things about that. Number one, there’s been some research that supports the idea that when in social engagement online is used to enhance relationships offline that those kids do find that they can actually do better and strengthening those relationships or finding other avenues to explore those relationships and I think that’s really important right now during covid because a lot of kids don’t have time to or have an opportunity to see their friends offline, but they can certainly have experiences with those friends online um i think the kids that i worry more about in my office are those kids whose only relationships are online they’re meeting strangers online and those are their primary relationships and those relationships just don’t seem to have the same benefit as offline relationships, so it can be it can be really healthy in that way. um you know I think the other piece of that is you just want to pay attention to the same sorts of cues that you would pay attention to when your kids have relationships offline you want to pay attention to the same sorts of cues online, so if you see evidence that those relationships seem to lead to negative interactions or every time they’re on if you have you know kids who are gaming and they’re doing multiplayer games they’re doing with their friends but every time they get off they’re really angry and upset it may not always be the video game it may be something about that interaction during that period of time and the same thing can happen with if you have um adolescents who are using a lot of social media can be really healthy really positive if they’re engaging in it in healthy ways but it can also be um really negative if those really if it gets into things like fomo or social comparison and and um and they seem to not be enjoying the experiences that they’re having there.

 

[Dr. Mitrani]: it’s interesting with fomo too i mean any adolescent that i’ve ever asked like you know do you think people only post the best pictures or you know like the best times that they’re having they all know they do that so that whitewashing effect um but they still get affected by it right it goes back to what we were talking about like vulnerable kids and how they’re gonna kind of be affected by these things yeah 

 

[Dr. Asamoah]: And and the effect of the behavior that comes I think from it is really important, so it’s it’s not that we shouldn’t expect kids to see what someone else is doing and have a thought about it they may notice that they felt the pinged of jealousy or that they felt like oh that’s a bummer i’m sitting here at home and they’re having fun and that’s something to notice and it’s and we shouldn’t negate those emotions because those are important emotions they give us important information about what we think and how we feel about ourselves and we want our kids to be able to experience that it’s what happens downstream. it’s are they now becoming very anxious about the quality of their relationship with with other people are they feeling in general that they’re always left out is it going from oh i didn’t get invited to go hang out with them and go swimming to i never get invited to go anywhere, so it’s the degree that they experience those and and then what do they do with that then are they always on their devices checking to see what everybody’s doing and looking at how many likes they got and who commented and how many people are viewing their videos so it’s really saying that when they have these emotional experiences when they when they experience um you know seeing what other people are doing and like you said paul these very well curated things they’re looking at not just of their friends but with instagram and youtube and Tik Tok we have people getting paid to curate these really um impressive envious looking lives and then you have our kids or tweens and teens who are looking at this and saying well that must be how their lives are I wonder if that’s what i should be expecting it’s really understanding how they’re how they’re holding and using that information.

 

[Dr. Mitrani]: yeah i mean because again we all want to be seen right we all want to be valued right and that’s what people are really looking for and it’s it’s a big struggle nowadays with the technology because yeah everybody wants to be the next youtube star right and that’s something that we need to help kids understand in a better way right so that it doesn’t kind of bring them down um so we’re coming to the end of the talk so i just want to kind of put one more question out there because of covid and related to kind of what’s gonna happen with school in the fall because we talked about balance we talked about structure right setting up a routine and school is a really disruptive routine right now so as far as preparing for the fall i mean do you have any advice for anybody watching as far as how to manage remote learning and screen time and also more specifically like how it’s different for a child if they have adhd or anxiety or you know autism because those challenges are unique like the adhd kid may not be able to sit in front of the screen right the anxious kid may like it more because they don’t have to be at school where all these other people are um so if you could each kind of give a tip related to that that would be great 

 

[Dr. Dexter-mazza]: i’ll say i can start i think the first thing as parents we have to do is give ourselves grace. As many of us are trying to work from home while we simultaneously become teachers and run school from home if that’s going to be the case so give yourself grace and set up a structure and look at opportunities where you can teach the kids that here’s what you’re doing now and while you’re doing that i need to do these things um and find that balance um and have constant conversations about the struggle you know just like you said earlier paul like not fomo i think is not only a problem for the kids i think it’s for adults also and us being transparent about where we’re struggling and what strategies we have to use is the model for teaching the kids those as well. 

 

[Dr. Mitrani]: I mean that’s a great way to model things like when you say like well i’m getting really frustrated right now or you know i’m kind of worried about this and you can show your kids how you manage it but you’re also expressing it which hopefully helps them do it the same.

[Dr. Domoff]: um one thing that i i may recommend is um you know really start being proactive right now and think about what will it potentially look like worst case scenario um in the fall i know lots of schools are planning for different scenarios about partial remote learning um hybrid and whatnot um so i think really having conversations with your family members about what what can we do to start planning right now and i think a big part of what i envision we’ll be getting a lot of um calls for regarding getting help around is the screen time and structure and the sleep, so how do we start to get more of a structure in our in our homes um before the school year starts so it’s not like a huge um behavior change so you can start you know shifting the child’s bedtime back a little bit um and getting them on a routine in such a way that the behavior change is small but over time it will add up to make for an easier hopefully easier transition um in the fall and to really start planning for worst case scenarios. um we were you know shocked when we had to all of a sudden do everything at home and so now can we use this time to really prepare for worst-case scenarios and a big part of that is um developing a structure and routine so that the transition is not as dramatic or drastic 

 

[Dr. Mitrani]: yeah something else that i had done with my kids because we had gotten a survey from our school like remote learning like what your thoughts are and even asking them because all like all three of my kids kind of had a different perspective like liking remote learning versus not liking it but yeah setting the street routine like as far as what sleep schedule is going to be like what what the day is going to be like especially if it’s hybrid where some days they go to school some days they don’t yeah 

 

[Dr. Domoff]: and just one more thing um you know if your child does have an iep or 504 plan try to start having those conversations and think about what um could be feasible in the different scenarios and really maybe reach out to teachers or um administrators to kind of learn about how they’re going to help maintain um um the really the services that we need our children to receive that they get so much um from from school so i would definitely recommend that 

 

[Dr. Asamoah]: yeah and i’ll just add to what everybody said um you know in the spring we have this really messy petri dish you know we have an opportunity in the spring to say we collected a bunch of data points about for a lot of us what the worst case scenario would really look like when you’re stripped out of school and said here teach your kids for the next three months good luck and it looked like everything on the map and so i would tell families and and the way i’m talking to families now is what did you learn what did your kids learn and how can you have conversations about what worked what didn’t work who do you need to talk to at this school what other supports you need to put in place what material resources do you need what emotional resources do you need to be able to have it look different regardless of what happens in the fall um i, you know. I think we’re going to figure out what happens in the fall in the fall we’ll know when school starts what it’s going to look like so use that information that you got from the spring and try to figure out going into it what do we already know and Brene brown put it in a way that i won’t put it for this audience but i’ll call it the crummy first draft. That was our first draft. it was horrible it was it was tough um we’re going to do a second draft there’s going to be a bunch of iterations and so just use your data points to make that work 

[Dr. Mitrani]: and that the other important thing is that it’s going to help us protect our kids help them learn better and also minimize any risk that they’re going to have from being on screen all day long if it’s remote learning again right because this is a stress for them too it’s a stress for parents stress for teachers and we want to we want to really have a plan even if other people aren’t giving us plans to make sure that everybody does as well as they can and at this point i want to thank everybody again and pass it back to pam uh for closing statements 

 

[Dr. Pamela Hurst-Della Pietra]: thank you very much um for coming and for participating in such a lively and informative conversation thank you paul sarah tracy and liz for sharing your experiences and guidance with all of us, it was so helpful. Please share the youtube video you’ll receive of today’s workshop with your fellow parents teachers clinicians researchers and friends our discussions about digital media use and children’s well-being will continue throughout the summer with weekly wednesday workshops. We are off next week but hope you will sign up for our very special interactive workshop for parents on wednesday, July 29th, where 10 experts will get up close and personal as parents share what works and what doesn’t about managing screen use and other strategies for healthy parenting. Please be on the lookout for more information and visit our website childrenscreens.com to learn more. When you leave the workshop you’ll see a link to a short survey please click on the link and let us know what you thought of today’s workshop thanks again and everyone be safe and well.