12 to 18: Coming of Age Online

00:00 Introduction

02:18 Ronald Dahl, MD

Drawing on 30 years of experience in interdisciplinary research on adolescent development, moderator Ron Dahl, MD, Director of the Institute of Human Development and a Distinguished Professor in the School of Public Health at University of California, Berkeley, kicks off the conversation. Dr. Dahl begins by outlining the important developmental processes in adolescence, including identity development, as well as how media can influence social learning and emotion management.

06:32 Paul Weigle, MD

Sharing insights from both practice and research, Paul Weigle, MD, Child & Adolescent Psychiatrist at Natchaug Hospital of Hartford Healthcare, co-chair of the Academy’s Media Committee, covers “risky business” of adolescence – such as sexting, pornography use, and cyberbullying. He also explains how the teen mental health crisis and adolescent media consumption has escalated due to the COVID-19 pandemic. Dr. Weigle concludes by sharing tips for parents on how to encourage healthy screen habits with their teens.

20:53 Sophia Choukas-Bradley, PhD

Turning the conversation to social comparison, a common concern in adolescence, Sophia Choukas-Bradley, PhD, Assistant Professor of Psychology at the University of Delaware and Director of the Teen and Young Adult Lab, discusses the role social media plays in body image, especially for teen girls. While the unrealistic standards that flood social media can be harmful to teens, Dr. Choukas-Bradley emphasizes that social media is not all bad, if used carefully and in the context of strong offline social support. She shares activities that parents can do with their teens to identify stressors on social media and develop online behaviors that promote health and well-being.

34:21 Edward Spector, PsyD

In his Maryland-based private practice that doubles as a comfortable homage to videogames, Edward Spector, PsyD, a nationally-recognized expert in digital addiction, discusses the treatment of compulsive tech usage. Dr. Spector reiterates the impact of the pandemic on screen use, especially excessive video game usage. He outlines the evaluation process for and complexity of gaming disorder diagnosis, and offers suggestions for alternative activities that parents can participate in with their teens to foster connections and promote appropriate screen use.

46:35 Michelle Garrison, PhD

Reminding us of the importance of good sleep habits, Michelle Garrison, PhD, a Research Associate Professor at the University of Washington with a joint appointment in the School of Medicine and the School of Public Health, speaks about the individual variability of digital media effects on sleep and the life changing impacts of body signal awareness. She proposes several skills that parents and teens can use to manage bedtime habits and promote healthy digital media use.

1:00:44 Joani Geltman, MSW

Offering practical strategies for effective parental conversations with teens, Joani Geltman, MSW, parenting expert and Adjunct Faculty at Curry College, Geltman uses personal stories and role playing to empower parents to engage with teens about screen use.

1:13:00 Group Q&A

Answering questions from the live audience, the panel discusses why adolescents are particularly vulnerable to digital media’s effects, sharing their personal experiences with teens to help them understand struggles with technology, and encouraging parents to be sensitive to the diverse emotions teens are experiencing. Dr. Dahl wraps up the discussion by asking each panelist for one key takeaway for parents and families.

[Dr. Pamela Hurst-Della Pietra]: Hi everyone. Thank you for joining us and welcome to today’s Ask the Experts webinar, “12 to 18: Coming of Age Online” addressing adolescent use of technology. I am your host Dr. Pam Hurst-Della Pietra, Founder and President of Children Screens: Institute of Digital Media and Child Development. A non-profit organization I started almost a decade ago. Today we explore tweens and teens and the complicated and often dependent relationship they have with their apps, phones, tablets, video games, movies, videos, social media, and more. The researchers, clinicians, and parent experts you will hear from today will share the most up-to-date scientific knowledge and evidence-based advice on mental health, digital addiction, sleep health, social comparison, pornography, sexting, cyber bullying, multitasking, and other critical issues impacting adolescents today. Some of you submitted a question when you registered for today’s webinar. Our panelists will answer as many as they can. You can submit additional questions by typing them into the Q&A box at the bottom of your screen. We’re recording today’s workshop and we’ll upload a video to YouTube within a week. While you wait for this video to be shared you’ll receive a link to our YouTube channel where you can watch recordings of our past 42 webinars. Now it’s my great pleasure to introduce to you today’s moderator Dr. Ronald Dahl. Dr. Dahl is a pediatrician and developmental scientist with 30 years experience in interdisciplinary developmental research. His research teams have contributed extensively to advancing understanding of child and adolescent development, behavioral emotional health in youth, adolescent brain development, and the clinical public health and policy implications of this work. He currently serves as The Director of the Institute of Human Development and Professor in The School of Public Health at UC Berkeley. He is past president of The Society of Research on Child Development and the founding director of The Center for the Developing Adolescent. Welcome Ron.

[Dr. Ronald Dahl]: Thank you so much. It’s exciting to be here and be discussing such an important set of issues that affects so many young people growing up today and so many of the adults caring for them with an amazing panel. I’m particularly happy that you introduced this as tweens and teens because I think some of the most important information coming from research that helps to inform these complex issues points to the transition from childhood into adolescence which is often starting by 9-13. So when we say teen we sometimes can discount the importance of those earlier years moving into adolescence when autonomy is emerging and more independent and habits are being formed in new ways. As we’ll talk about very important social emotional learning is occurring. The most important message I want to emphasize in framing this discussion, is thinking about adolescence as an amazing period of growth, learning, development, and opportunity. We have such a tendency to focus on the problems that emerge and the risks. We also should be recognizing this is an incredible time of learning. What we’ve learned from brain development that I think is most important here is that learning and brain development are inextricably intertwined. I’m not just talking about learning facts and remembering them. The complex kinds of learning, particularly social learning, about self and other, about how to navigate complex social situations, how to manage our emotions that get stirred up and intensified in adolescence. This window of time which is awkward and challenging as parents and as individuals to figure out who they are in relation to other people is also formative for so many important healthy patterns for the rest of our lives. And increasingly, the social context in which young people all over the world are having these learning experiences. Whether exploring who they are in relation to others and how to develop skills and master control over themselves and navigate conflicts is happening through digital technology. The focus of what we really want to emphasize today is how do we increase the likelihood that that kind of learning can be a positive and healthy set of experiences and minimize the harmful versions of learning that can easily occur as we all know through these platforms and technologies. A couple key points I want to make as the frame before we move into the panelist,  is one of the most important aspects of development is this increased desire for autonomy and sensitivity to admiration, belonging, and respect. We all have those wants and needs across the lifespan from young childhood through all of adulthood, but those become intensified around the onset of puberty as moving in adolescence. That can be a source of the challenge, when they want more independence in their own phone and more access to social media, but that also that motivation can create a window. Having young people earn their autonomy by showing that they can make responsible decisions, by demonstrating the behavior that they have the control to be able to have that autonomy can be a really nice frame on partnering as parents with our children as they’re in the space. Finally, to really keep a perspective, what are they doing when they’re online and when they’re interacting with screens? Are they actually doing things that can promote healthy social emotional learning about self and others and exploration? Are they connecting with others? Are they creating things? Are they contributing in ways to other people’s lives and reflecting and learning on that? Or when are they doing things that are caught in algorithms of distraction or passive observation, or negative ways of thinking, or being self-critical that are undermining healthy social emotional development? Those complex differences of positive and negative experiences will be the focus of a lot of expert input and practical advice from the panel today. I want, we will start with Paul Weigle who’s a Child and Adolescent Psychiatrist at Natchaug Hospital at hartford Healthcare. He teaches on the clinical staff at the University of Connecticut School of Medicine at Quinnipiac Medical School. He’s a distinguished fellow of The American Academy of Child Adolescent Psychiatry and serves as co-chair of the academy’s media committee as well as The National Scientific Advisory Board for Children and Screens. Paul, looking forward to your comments. 

[Dr. Paul Weigle]: Thank you. Thanks Dr. Dahl. Excited to be here. I’m going to talk a little bit about risky business. That is teens, pornography, sexting, and cyberbullying over the next six minutes or so. I want to give an overview about the relationship between screen time and mental health and adolescent engagement and tween engagement with pornography, sexting, and cyberbullying. So how much time are kids spending on screens these days? This is a real moving target because it has grown so much over the last 20 years. The amount of entertainment screen time has roughly doubled for most American kids, of course the hours that they have in the day have not. And of course the greatest increases have just been in the last couple years in relation to the Covid pandemic. Some recent research indicates 10 to 14 year olds spend an average of eight hours a day, mostly on video games and streaming videos. Which over the course of years is about twice the amount of time they spend in school. Really changing the landscape of what childhood and adolescence is. Older teens spend significantly more time on entertainment screen media than these younger teens. With the rise in screen media habits with young people we’ve also seen over the last 12-13 years a steady rise in the rates of of adolescent depression and anxiety as well as self-harm, adolescent suicidal thoughts, and completed suicide. Of course again this relationship was exacerbated in the last few years with the onset of the pandemic; when we’ve seen unprecedented rates of referrals for teen depression, anxiety, self-harm, and suicidality. Studies consistently show that in general those who are spending the most time online are at the greatest risk for these mental health issues. It’s a complicated relationship but in general most studies show that the teens who are online the most are having the most problems. So with regard to pornography you know online access that young people have, and often unsupervised access, really has facilitated pornography engagement. Young people are looking at pornography more than ever before. Especially on their phones. Phones are the way that most pornography is accessed, not on computers or tablets. Your teens have likely seen more porn than you have by far. Studies show that  teens have not only seen far more pornography than their same-sex parents, and these are middle-aged teens, but have seen far more in the way of extreme content than their parents. I think as if you’re a parent of a teen you probably should go and check out the site Pornhub if you’ve never seen it before because your kids probably have. It may be shocking but it will certainly be educational. Those who look at the most porn are older teens, those with poor supervision, those with depression, and those with same-sex attraction. There’s pluses and minuses to this porn engagement. Porn has become the mode, for better and worse, of sex education for young people in our country. Teens consistently say that’s where they go to learn about sex. Of course not everything that they learn is necessarily positive and watching porn does mold the beliefs that young people have about what is normal. I’ve had you know patients tell me that they thought that slapping or choking was typical behavior during sex because that’s what they’d seen on pornography. However there can be positives to this as well. Those who watch more pornography have more tolerant views of homosexual sex which to most of a degree is a positive thing. Also watching porn can shape sexual fantasies. Even something that seems upsetting for a teen at first can simultaneously cause arousal and shape future sexual fantasies. Engagement with certain types of porn may have the potential to lead to paraphilias, sadomasochism, even pedophilia. Although the research on that is quite limited. Also teens imitate in real life what they see in pornography, both consciously and unconsciously. It has become nearly typical for older teens to ask their partner to replicate something they saw in pornography, and of course this isn’t always a good thing, because pornography typically shows casual sex. Sex outside of relationships. It typically does not include a condom. Often includes anal sex. Teens who view a lot of porn are more likely to engage in casual and condomless sex as well as anal sex. Especially concerning with violent porn, because especially among boys who view a lot of violent porn and believe that it is realistic they’re much more likely to engage in aggressive sex and sexual assault. Although the cause and effect relationship here isn’t isn’t totally clear. Now some of the effects of pornography are mitigated by parental discussion. For instance parents who talk to their kids about wearing condoms during sex the relationship between porn viewing and not wearing condoms disappears. So a parental discussion matters. Pornography is also associated with later relationship dissatisfaction, sexual dysfunction, and so on. I want to say a word about sexting which is sending naked pictures or videos, really perhaps could be called a newting, typically becoming the norm. Most college undergrads who are interviewed say that they engage, a slight majority, say they engaged in sexting as a teen. Most do it in a low risk way. That is within the confines of a pre-existing relationship, there’s not a romantic relationship. Teens who sex in this way are more likely to be older teens and straight teens, and this is less likely to turn out badly for them. Less likely to get passed around or for them to regret it. However, many teens also engage in high risk sexting, and that is sexting in order to begin a relationship outside of the confines of a relationship. So this might be, send me pictures and I’ll be your boyfriend, something like that. Younger teens and LGBT youth are more likely to sex in this way and it’s more likely to turn out badly for them. They’re more likely to regret it. Cyberbullying of course is using online platforms to cause intentional harm, intimidation, or coercion to someone who’s considered vulnerable or weaker. Of course online platforms do encourage cruelty in some ways. The aspects that do are the perceived anonymity and freedom from consequence as well as a lack of face-to-face. These are the things that encourage both intentional and unintentional cruelty. Cyberbullying isn’t rare, but it’s not universal either. 17 percent of teens say that they’ve encountered it in the last month. 37 percent said they ever encountered it. Girls are more likely to be the perpetrators and the victims. Most cyber bullying though isn’t serious, the kids may believe it’s serious, but not related to negative significant negative outcomes. But among vulnerable youth it can worsen depression, suicidality. Especially among kids who are both victims of cyberbullying and aggressors themselves, so-called bully victims. Depressed teens actually value and rely on social media the most compared to their peers but they’re also most likely to elicit negative reactions including cyberbullying, and are the most sensitive to the consequences of cyberbullying. So as a parent one thing we can do to support healthy screening habits is to provide structure in the day of our kids. That includes having enough time for sleep and for other activities where screen media sort of fills in you know what’s left over. That means setting boundaries like screen-free times and zones, like no screens at dinner or in the bedroom especially after bedtime. Sleep’s so important for mental health. Oftentimes that’s the most important screen related intervention that I make with my patients who are struggling, is to improve their sleep by getting screens out of their bedroom. Of course the biggest determinant of child media habits is parent media habits. So it’s very important for us, oftentimes we struggle with our own screen media habits, but important to be a role model. And to provide supervision especially for younger kids. Sometimes using the parental controls on iphone especially for younger kids. That said as teens get older it’s our job as parents to be less of a cop and more of a guide. Right and the way that we can do that is spending time online together. Especially with younger kids you know having those first social media experiences together and talking about and maintaining an open dialogue about tech and about relationships. Now this is easier said than done of course. A lot of teens are suspicious of us. One way that we can accomplish this is by trying to maintain a curious attitude and not be judgmental. If we hear something from our kids and we freak out then they’re less likely to come to us in the future, easy to say and hard to do, but really trying to show an interest in what the kid thinks is important and biting our tongue with the solution that comes to us immediately. Especially when the solution is no more iphone. Some recommendations for reading are Elizabeth Englander’s 25 Myths about Bullying and Cyberbullying, Peggy Orenstein’s Boys and Sex, she also has a book on Girls and Sex that’s excellent, and Raising a Screen Smart Teen by Julianna Miner. That’s it for me. Thank you.

[Dr. Ronald Dahl]: Thank you so much Paul. That was a really nice broad overview covering a lot of important issues. I think one brief reflection is as we look at these correlations between problematic behavior and screen time as you said they’re complex, sometimes going in both directions, it’s almost as if the technology is amplifying the problem as opposed to maybe creating it. It’s because someone has a proclivity to behave and now it spirals and so it really raises important questions of how to provide support and intervention to get on a more positive pattern. One question that came up from the audience that I wanted to ask you that I think it hits a chord for a lot of people is how can we get our teens to believe our concerns as parents about the negative impacts as you know the battles that go on? So I’d love to hear your advice for parents. How to navigate what’s often conflict fight oriented, not respecting each other’s opinions versus how to do it in hopefully a more helpful way. 

[Dr. Paul Weigle]: Yeah so and this is a conflict for so many but so many parents feel that providing boundaries around screen media is a constant battle, and that makes communication difficult. One thing I’ve learned, as a child adolescent psychiatrist, from my patients is that they often hear and understand what their parents have to say, they just and oftentimes believe it, but they would never let their parents know that. Because if they admit that you know that excessive screen media use causes issues to their parents that would put them one down in this screen media power struggle that goes on. So it is important to remember that what you do, what you do especially, and also what you say does have an effect even when our teenagers say no no no that’s not true. One way that I found has been successful with a lot of my patients is having them watch the movie on netflix The Social Dilemma with their parents. This is a great way, if kids will watch it with you, of you know of demonstrating some really important principles. Of course it is important to remember that understanding you know very often I see kids after seeing this movie who are determined to change their habits and yet they find that they fall into the same patterns over time, so understanding you know the effects doesn’t necessarily grant control but it is certainly an important first step.

[Dr. Ronald Dahl]: Thank you so much. We will probably come back to some of those issues at the end. The next presentation will be by Sophia Choukas-Bradley, who’s an assistant professor of psychology at the University of Delaware, also moving to the University of Pittsburgh, and she directs the Teen and Young Adult Lab and has conducted a lot of research on interpersonal, social-cultural influence on tech use. She has a private practice and she’s going to be talking about an area she’s really explored with some innovative research looking at social media social comparison and body image.

[Dr. Sophia Choukas-Bradley]: Thank you. Thank you so much for the introduction Dr. Dahl, and Dr. Weigle thank you for that excellent first talk. I’m going to share my slides. So I will be speaking to you for a few minutes about highly visual social media. Social media means many different things, but I am focusing on social media that include photo and video based apps, that can foster social comparison, and cause some body image concerns for adolescents. Particularly for girls. Adolescence and as Dr. Dahl said when we’re talking about adolescents we shouldn’t just focus on the teen years. It’s really important to think about the pre-teen years as well. This is a developmental period of heightened body image concerns, particularly for girls, and there are a number of different factors that contribute to body image concerns being heightened during this time. One set of processes involve cultural gender related pressures. Teen girls and young adult women and women of all ages in fact are bombarded by messages indicating that the most important aspect of being a girl or woman is one’s physical attractiveness. Many girls and women learn to internalize a third party gaze on themselves and to think of themselves almost as objects to be looked at, and to overvalue their physical appearance above other attributes such as intelligence or kindness. Biologically, cisgender girls whose sex assigned at birth is female and who identify as girls, cisgender girls go through pubertal developmental changes that involve weight gain and bring them further from the ideal body which currently according to social media standards is thin but curvy and muscular. Very hard body ideal to attain, virtually impossible for most female-bodied people. During the adolescent developmental period peers become extremely important. Adolescents spend more time with their peers than younger children do and peers are important for one’s sense of self. Dating also becomes incredibly important. This is the time in life, although dating and sexual initiation have gone down somewhat for 9th to 12th graders over the past 10 years, this is still the time in life when on average individuals initiate dating in sexual relationships. This can increase the focus on physical appearance. Finally there are cognitive phenomena, social cognitive phenomena in which adolescents experience something called the imaginary audience. You might remember this being a teen and feeling extremely self-conscious and as if everyone was uniquely concerned about how you looked as well as what you’re doing. One of the social cognitive results of all of these different social, psychological, biological, cognitive changes is social comparison. I’m going to show you a brief video. This is the ted talk of Frans De Waal which highlights how social comparison is a natural set of processes. It’s not inherently problematic. All humans engage in social comparison and non-human primates do as well. We’re just going to zoom ahead in the interest of time. Dr. Dahl please give me a thumbs up when you can hear this. 

[Video]: One on the left is the monkey who gets cucumber, the one on the right is the one who gets grapes. The one who gets cucumber notes that the first piece of cucumber is perfectly fine the first piece he eats. Then see she’s the other one getting grapes and you will see what happens. So she gives a rock to us, that’s the task, and we give her a piece of cucumber and she eats it. The other one needs to give a rock to us and that’s what she does. She gets a grape and the other one sees that she gives a rock to us now gets again cucumber.

[Dr. Sophia Choukas-Bradley]: So you’ll see the monkey on the left is perfectly satisfied and content with her cucumber until the moment that the monkey on the right is given a grape, and grapes are considered to be better than cucumbers in monkey world and in human world. Immediately the cucumber is wildly unacceptable. This shows just how quickly social comparison can lead us to dissatisfaction with what we have or in the case of body image with how we look. So although social comparison is a natural process, among girls and among adolescents, and especially girls rather, most social comparisons are upward social comparisons when it comes to body image. This is not a new social media driven phenomenon. I argue and have found in my research that social media is exacerbating social comparison processes, but they did not begin of course with social media. When it comes to mass media, adolescent girls and young women have long been bombarded by unrealistic beauty standards such that Cindy Crawford is famous for saying “I wish I looked like cindy crawford” meaning when she compares herself how she really looks to this completely fake image of Cindy Crawford she experiences body dissatisfaction. Social media affects body image by encouraging these upward social comparisons with images that are unrealistic and often simply unreal. They are carefully chosen and curated, and then they are edited with filters, blemish correctors, and even apps that allow teens and adults to reshape and resize their bodies. And really change the way they look. Adolescent girls using highly visual social media are exposed to a scrolling feed that shows a mix of peers which may feel like more realistic sources of social comparison blended in with celebrities and social media influencers, who are folks who become famous simply due to their social media presence. In one pilot study I ran, which I am now going to be running as a much larger study now that I’ve done this initial version, I showed 50 adolescent girls this fake social media paradigm that my lab created. We call it funnel and we tell adolescent girls that this new social media platform will funnel all their different social media images and posts into one platform, just what we all need, and what you’ll see is the image on the left at pre-test was rated as being less attractive than the image on the right. Across the sample, on average, adolescent girls were much more likely to spend time staring at the red shows more longer visual gaze. They spent more time staring at the more attractive image. I hoped that they would spend more time looking at this adorable golden retriever puppy but they still spent time looking at the image on the right. What about how social media might affect how girls feel about their own body image, not just comparing with others. I have developed this construct I call “Appearance-Related Social Media Consciousness” or more colloquially being camera ready. Examples are when people take pictures of me I think about how I will look when the pictures are posted on social media, and you can see these other examples as well as I share briefly. Adolescent girls report very high levels of experiences like these. They are more likely to endorse these experiences than adolescent boys, but boys report them as well. Among kids of all genders, social media related body image concerns are connected with heightened depressive symptoms and disordered eating symptoms. Of course as Dr. Dahl said not all social media is bad. I’m doing a number of studies that look at how social media can foster connections with friends, gratitude, sense of belongingness, and community for LGBTQ+ youth and representation for youth of color. I’m showing more diverse images of different bodies with different skin tones and sizes. So one question I’m really interested in and I’ve been working with Dr. Brian Galla at Pitt and with some researchers in the Harvard School of Education, to try to develop interventions that help people to align their social media use with their values, to spend more time doing what feels good and less time doing what feels bad. Anyone who uses social media can try this activity. If you’re a parent of kids you can do this with your kids or you can do it separately and then talk about it. If you don’t have kids you can do this activity on your own. The first step and by the way this is, I know I’m over time I’m wrapping up with this activity, the first step is to write down a list of all the activities you do in a typical week on social media. These are common examples that people come up with. Planning or taking photos, scrolling through your news feed etc. it differs by each individual person. This is the important part, once you have your list of your personal activities find from that list the three things you do on social media that give you the most lasting happiness, not just fun in the moment while you’re doing them ,or as we talk about neurobiologically, not the things that give us a quick dopamine hit. But that actually give us lasting happiness. Now list the three things you do on social media that are fun in the moment but don’t give you a lasting sense of happiness. List the three things you do on social media that cause you the most stress. Finally, what are the three things you’re actually spending the most time on. What we are finding in really initial work and it’s mostly anecdotal at this point, is that many people spend more time doing things that cause stress or that are fun in the moment, but don’t cause lasting happiness. We want to boost our time on things that lead to lasting meaningful happiness. Then these are the types of things you can talk about with your kids, are you spending time on social media doing those things that feel good short term but not long term or things that are stressful? Does your time on social media reflect your core values? So if you value meaningful connections with people, is your social media use reflecting that or is your social media use more about validation and status? I’ll skip these because I’ve already covered them. I also have a quick public service announcement. You may not know this but when you’re on zoom you can have other people able to see your face but hide it from yourself. An initial pilot study I did with Jen Silk at the University of Pittsburgh showed that judging one’s face on social or rather on zoom at the beginning of the covet pandemic was linked to increases over time and depressive symptoms among adolescent girls. If you are distracted by your face while you’re having zoom interaction,  turn off that self-view. You can follow me on twitter. I just joined twitter last week after years of avoiding it. Check out my lab website and my Psychology Today blog, Psych of Adolescence: The science of teens, screens, gender, and sexuality. Thank you so much 

[Dr. Ronald Dahl]: Thank you very much Sophia. That was great and I particularly liked your emphasis on interventions that help young people get insights into their own uh experiences so it’s not parents telling them what they should or shouldn’t do, but really helping them gain those insights which is so you know resonant with what we understand about what’s effective in changing behavior in adolescence. Quick question, from a few people actually, the relationship between frequency or amount of body comparison experiences online and eating disorders and any insight about how to prevent that harmful path?

[Dr. Sophia Choukas-Bradley]: Yes. There is a correlation between specific types of social media experiences. Specifically, upward social comparisons related to body image that I mentioned and ASMC appearance related social media consciousness which is that construct I mentioned that I developed with my lab which has to do with imagining. How one looks to a social media audience and being overly concerned about one’s image on social media. Another example is being overly concerned about peer feedback, numbers of likes, numbers of followers etc. Those specific types of social media use have been linked to higher levels of disordered eating, and for adolescents who are vulnerable to developing full-blown clinically significant eating disorders, those experiences might increase risk for eating disorders. Overall time on social media is not consistently connected. This really reinforces the idea that we have to help kids figure out not how to avoid social media that’s not realistic in today’s world where peers are so important for adolescent development and peer relationships happen online, but how can adolescents spend more time doing those things that help them feel good, help them to foster values-aligned social connections, and how to reduce those experiences that foster problematic social comparison and an over-focus on on physical appearance. 

[Dr. Ronald Dahl]: Thank you very much. Our next panelist is Dr. Edward Spector who’s a nationally recognized expert in digital addiction. Since 2009, Dr. Spector has specialized in the treatment of compulsive tech use in his Maryland based private practice. 

[Dr. Edward Spector]: Thank you. So i’m going to talk today just about gaming disorder diagnosis and treatment. This is actually a part two from a Children and Screens panel, really a discussion that I was a part of almost a year ago or maybe more. I can’t remember exactly when it was, but it was at the beginning of the pandemic when everything was shut down. I’ll give you the cliff notes of that which was can you diagnose a gaming disorder during a pandemic? The quick answer is no you can’t and the reason is the criteria as the world health organization has created it is that you have to have a perseverative obsessive pattern of gaming that exists for over 12 months that causes clinically significant impairment in multiple domains in one’s life. So those domains might be social life, school life, work life etc. Of course during the pandemic everyone’s domains were completely destroyed by the pandemic itself so you couldn’t say well the gaming is causing that. I think now if we’re revisiting that we’re now at a point where people are going back to school, their mass mandates are starting to come down in places where there’s going to be some point where ,and maybe we’ve already hit it, where we can actually say that clinical impairment in social life or in school life is actually because of the gaming. So now we have a shift where we can start sort of saying hey this problem exists and it is because of gaming. Although I think there’s also a clinical judgment that we need to sort of recognize that there’s going to be this reawakening as we all try to form a new normal. That there’s going to be some sort of like recognition that that’s going to be hard for people. That they’re going to be slow to do certain things again. That is what we’re seeing. When people come in to see me oftentimes there are sort of four best friends that come alongside a digital addiction pattern. They’re almost always there. So we have ADHD, anxiety, depression, and autism and more often than not that is what I’m seeing underlying these problems. So often when people come in the first thing I’m doing is evaluating them trying to figure out what are the ideological factors that are bringing them to a compulsive pattern. The reason why you need to do that is depending on which best friend is in the room, and there might be multiple ones, that determines your treatment plan. It determines what you’re going to do, because it determines sort of what they’re dealing with. Oftentimes technology use is really an attempt to cope with psychological problems and of course we’ve all spent the last you know few years bathed in technology in unprecedented ways it’s never been done before. So we’re sort of in the wild west of mental health providing in terms of how to help with this set of problems. First I usually focus on doing a very thorough evaluation trying to figure out what else is going on that’s making this happen and then that usually steers us where we go. The other thing that I’m going to pivot here and just talk about more practical stuff because I think that’s most helpful and probably what people want to hear most right now, but I’m happy to talk more about any of these factors. But in terms of what I used to do pre-pandemic, that was my real go-to beginning thing to do when someone is gaming 12 hours a day or really really you know suffering is, is to start over programming them. So we would just introduce a series of things that they’re going to do every week. We’re going to, you know, sign you up for underwater basket weaving class, you know we’re gonna have you start doing taekwondo, you’re gonna go work out at the gym. We’re gonna start filling your time and that is going to eclipse your tech use in your gaming naturally. I also generally avoid the word addiction or gaming disorder. Most of the time people are very willing to come in especially if they have one of these best friends and talk about how that best friend is really manifesting in some unhealthy patterns and they’re quite comfortable and willing to talk to me about that. The minute you start sort of trying to label this as addiction people kind of lock up and it’s really usually pretty unproductive. So I generally avoid conceptualizing that way. I just got  an LL Bean catalog and it’s really funny it just says LL Bean and then it says just step outside. I’ve been just sort of really doing a lot with my clients and myself and my family about how we’re going to do this as we start going on our own journey of becoming more comfortable going out and living our lives again. I’ll give you a couple ideas of things that might work for you. Now this is dangerous to give advice to a mass audience. So any advice that I give you needs to be highly criticized on your own front.“Is this right for me? Is this right for my kid?” kind of thing. I’m gonna throw you just some ideas out there just to get you thinking about it. So one thing that I’m doing is we’re gonna, my family, we’re gonna have some time this weekend and we’re gonna watch a YouTube video about taking really good photography. You know, taking good photographs. Then we’re going to go out into nature. We’re going to go, maybe go for a hike or we’re going to find a good place we’re going to walk around maybe in pairs and we’re going to take lots of really good pictures taking from that class and kind of sort of go outside and do a bunch of stuff. See what kind of pictures we can create. Then we’re going to come back, edit photos, select our best favorite ones and then put them on shutterfly and create like an album that’s going to come in the mail. A hardcover album. This is just one example of an activity you can come up with on the weekend that will get you out there. I’ll give you one other example, I don’t know how I’m doing with time, but one other example that was done early on in the pandemic for my dear friend Wendy. She created a, it was a scavenger hunt where on Saturday, and there were a bunch of families and we’re all in her own neighborhoods, but she would list here’s like you know 15 objects that you need to find in your neighbor and take a picture and you’re going to be you know it’s a timed event. See how quickly you can get as many things as you can. There were like points for different things. We had award ceremonies. We had t-shirts saying team whatever. It was this thing that went on for weekend after weekend and it got us out and it was super easy to do. The teens really loved it. I mean it was really super fun. Let me pause there and go ahead Ron.

[Dr. Ronald Dahl]: Oh thank you. One of the things I would, I’d love to ask you and a bit of a reflection but also to ask you. This idea of programming other enjoyable, hopefully enjoyable, activities and structure in young people’s lives to displace the excessive use of gaming and technology. It sounds like you know right. However, I wonder whether you use other techniques, I’m sure you’re likely to, but just to help explain how doing things like motivational interviewing or really giving a lot of autonomy of choice to the young person can be so essential. Because being told what they’re going to do and what they can’t do is often quite an uphill battle. So maybe you could just talk a little bit about how you introduce this approach in ways that are really successful and are partnering with the young person to find activities to gradually displace. Could you say a little bit about that. 

[Dr. Edward Spector]: Absolutely and I’ll try not to, you know, talk for 35 minutes.So when someone comes in it’s not uncommon for them to come in really quite resistant. So they’re being dragged in. So there’s a lot of rapport building. You can see behind me my office is an homage to all things video games. They sort of come in and they understand that I game. We can talk about what they’re doing is interesting you know and I know what they’re doing, like I know these games. I’m usually quite informed by it and we sort of join on “hey this thing that you’re doing is really cool.” We also start talking about, as they get comfortable with me, how are things not going well in your life and we’ll identify those things. Usually it’s not “I’m gaming too much,” but it’s like “oh well this part of my life isn’t great.” Then we start trying to make those connections as they start to trust me. They have to trust me first. We do motivational interviewing, which is where you’re looking at why you’d be ambivalent to change. You know what do you lose if you stop gaming, and these guys lose a lot. A lot of times a lot of their self-esteem is wrapped up in what they’re doing or their whole social lives are wrapped up in the gaming world. This can be really hard just to sort of tone down or back away from because in their digital worlds they are awesome. Usually they are very accomplished, but in their real lives it’s not so much right. So getting them to bring it IRL. Bringing that self-esteem in real life is a major part of the therapy and it happens over time. You sort of pivot to bring stuff into their real life and then they start wanting the gaming less. It sort of has less sway. Also if you can really aggressively treat those four best friends often the gaming will start to correct itself. A lot of my guys come in and they’re not actively or effectively being treated for their conditions, these best friends, so once we really get them the right medications or the right anxiety treatments in place then they start needing the gaming less as a coping strategy.

[Dr. Ronald Dahl]: One question that pops up a lot, and I would love to hear how you want to take this on, is the constant question: how many hours? Where do you draw the line? If you want to share some of your personal thoughts about how you answer that question.

[Dr. Edward Spector]: I got asked this question once, I was on a panel actually with Paul, and it was at ACAP. The American Academy of Child and Adolescent Psychiatry and they asked how many hours? Right, it’s the question you get asked every if you ever do a talk with parents, how much is enough, and parents just want to zone in like give me a number and then I’m going to target that and like then I don’t have to worry about any of this subtle nuanced stuff. So I was on this panel discussion and I was on the side that got the question last. So everyone said two hours. It was like two hours, two and a half, maybe two to four hours you know and it got to me and I said I don’t know the answer to this. We don’t have good research to say; the research doesn’t really answer this question very well. What I know is that 14 hours is definitely too much, right? Then it really depends on the kid and their situation and their vulnerability. That’s my experience in clinical practice we’re making really case-by-case sort of judgments of what’s too much. So it’s very hard to have like a generalized statement, but I mean I’ll go with my colleagues for like two to four hours. It sounds great. But as we just saw from Paul’s data people are doing so much more than that. That, that’s almost like a comical number. Like who cares if the number should be two. Most teenagers are hitting eight hours. I mean it’s just like it’s the number of hours, so what I like to do is really pivot the question to the opportunity cost of what do you want to see them doing more of? What are they not doing with those hours that you wish they were doing?

That argument is to be made to the kids. They need to understand what opportunity costs. Then conveyed to them in a way where and with opportunities for them to really sort of make good on that. So that they can start doing other things. You know, take flute lessons or start learning how to rock climb or whatever they’re going to do that they’re not doing because they’re just gaming all the time.

[Dr. Ronald Dahl]: Thank you. Thank you so much. We’re gonna move on, and we go back to some of these issues in the final discussion, to Dr. Michelle Garrison who’s a Research Associate Professor at the University of Washington. She has a joint appointment at the School of Medicine, the Division of Child Mentality Psychiatry, and the School of Public Health Department of Health Services. Dr. Garrison’s research lab at Seattle Children’s primarily focuses on child and adolescent sleep and the dynamic relationships with media use, behavior problems, physical activity, and obesity.

[Dr. Michelle Garrison]: Thank you so much. I am glad to be talking to everybody today. So I’m gonna be talking to folks about screen time and sleep. We’re going to talk a little bit about how media use affects sleep, how it affects body awareness and why that matters, what goes on with parents and teens and tweens navigating bedtime media use and thinking about sleep, why the abstinence-only approach to bedtime media use is not always the best approach, and how we can go about learning and practicing skills for the least harmful bedtime media use. So we know that bedtime media use can have an impact on sleep right and that it can make it harder to fall asleep and that it can really disrupt quality. We see that not just with media use at bedtime but also with excessive daytime use as well. People often ask me, is it just about the light? Is it about the violence? Or they say maybe it affects some people that way but not so much for me. You know, there’s different things that we think about as far as what’s going on here. So we know that it’s affecting how long it takes to fall asleep, we know that it’s affecting what’s going on with sleep quality, and that in turn those affect how much total sleep we’re getting, and then affect all sorts of things the next day. Like how tired we are, how anxious or depressed we are, and also just our ability to focus and get things done. The media use does have an impact via the light that we get from the screens and that does cause disruptions in what’s going on with melatonin signaling. Which does make it hard for our bodies to feel sleepy at the right time for bed and can make it hard for us to stay asleep all night. At the same time even if you totally got rid of the effects of the blue light, there’s still other ways that media use is having an impact on sleep because media use is often faster paced than regular everyday life is. Sometimes the content can be violent or it can be really what we think of as high reward content, where we’re getting feedback or you know kind of likes or whatever right away. That can actually get us kind of in a ramped up state that can make it hard to calm down for sleep. The other thing that can happen is that it can then make it harder even just to walk away from the media use and turn it off in time to go to bed right. So not only are we going to bed later than we would be anyway, because we’re staying up using that media, but then when we do go to bed we’re having a harder time falling asleep because we’re all ramped up right. Of course there’s real individual variability in what’s going on. It doesn’t affect everybody the same way. So the kind of media use that hurts my sleep can differ from what affects yours, and it can also change even within a person day-to-day. On top of that it’s important for us to remember that sleep isn’t actually always a valued goal for the tweens and teens in our lives. So telling them oh it’s really important to cut this off because you’re not going to get enough sleep tonight is not always something that they really care about. On the other hand when we’re working with youth this age we can almost always help them identify something they do care about that will get better when they’re getting more sleep. So whether that’s getting into less fights with their parents or siblings or even their girlfriends or boyfriends, or doing better at school, or even being faster in soccer practice right. That there’s lots of different things that are downstream effects of getting more sleep. Often those are things that we can really um leverage to get tweens and teens more motivated to work with us around media use and sleep. One thing that’s really important to be aware of is that media use blunts our awareness of bodily signals. So that’s why we often are at risk for overeating during media use or on the other hand we may not realize until we’re done you know and walk away from the screen “oh i’m so hungry and i didn’t realize it” right. Likewise it’s why you know little kids have more potty training accidents while they’re watching cartoons. It’s also why the tweens and teens in our lives often don’t realize how desperately tired they are as long as they’re still looking to screen. These effects are not entirely accidental. Some media developers are deliberately strengthening these effects because it can actually keep people using media longer, and as people get more tired in their media use sometimes they’re more likely to make poor choices and to spend money on things online for example.So there’s all sorts of mixed incentives in there to be aware of. All of this combined can mean that, as some of our previous speakers mentioned, sometimes we’re engaging with media in ways that actually aren’t enjoyable or worthwhile for us. That’s true both for us as adults. I know that recently with the war going on I’ll find myself doom-scrolling and looking at all of this different news and tweets about what’s going on and then I have to stop and check like am I actually getting what I want out of my media use at the moment. So one of the things that we talk to tweens and teens about is identifying what they want most out of their media use. To check in during their media use, am I getting what I want out of this right now or am I just hitting the next button and hitting the next button because the next videos come up on YouTube regardless of whether it’s actually working for me. Of course there’s a lot of conflict sometimes between parents and teens around bedtime media use. One of the things that we know is that if parents are owning all the decisions around media use and sleep and they’re the ones kind of holding the control, tweens and teens can actually miss key developmental opportunities to learn and practice skills. Which can actually set them up for problems downstream if there’s this sudden abrupt shift in young adulthood where suddenly they have to kind of take charge of that. Which is one of the reasons why I see so many of the freshman students in my classes you know talk to me about how they’re really really struggling because they’ve never had to be the one who’s in charge of when the devices shut off at night before. So for many reasons we talk about how the abstinence-only approach to media use is not always the best. I think that in years past you know we always told families “oh you just should have a screen time blackout in the evening and not have any media use at all in the you know hour or two before bed.” That is definitely still the approach I advise with parents of younger kids and is what I do with my own younger child as much as I can. But it can actually ignore some of the benefits that evening media use can have for many youth and families. You know I talk to tweens and teens who tell me that because they feel socially isolated at school that their social media use in the evening is actually the one time when they’re feeling really really supported and it’s really beneficial for their mental health and wellness. So we don’t want to take those valuable things away. On top of that when youth are sneaking media use, they’re kind of using it you know under the covers like I used to do with my books at night or they’re finding ways to kind of get around parental restrictions on devices, that sneaking use may actually be more harmful on sleep than open use because of the increased kind of physiological anxiety that’s going on in the background whenever we’re doing something sneaky. As I said we want to have you know people have this gradual transition where they’re learning kind of year by year to take more and more ownership so that they’re really ready when they launch into young adulthood to be able to own control of their media use and their sleep. One of the things that we talk about is that there’s a bunch of different strategies that can be helpful. Often no one strategy is enough for any family and often no one strategy works for every family, but often there’s some mix and match that can be helpful.

Sometimes having family or peer compacts on shut off times where there’s agreements that you know not just that you as this one kid have to turn off your devices at 10 pm but we’re all going to agree that as a family or that there’s a social group that’s all going to agree that together; sometimes that can be really helpful. Using blue light blocking glasses can be really helpful, even professional video game players use these now so I sometimes use that as a selling point. And although they make really expensive ones they also make really really cheap plastic ones that work just as well. Having less media multitasking can definitely have an impact as well. Using just one media device at a time instead of a bunch. Using slower paced media right. So the kind where we can look away from something for a minute  and you know still be able to pay attention to what’s going on elsewhere in the room. Non-violent media, you know using strategies like turning the sound and the alerts off can actually really help decrease the impact that our media use is having on our sleep. So one of the things that we talk about is that if we can, you know, help the tweens and teens get in touch with their body and mind responses to media use, and to check in the moment right. What’s going on as far as how my media use is affecting my body right? Is it working for me or is it working against me all right? So here is a big quick video from one of our current projects that we’re using to train some of the middle schoolers in our current study on how to kind of take more charge around how their media use is affecting their sleep.

[Video]: At first when I started check-ins I would start at my head and feel my way down. Now, I usually focus on my breathing because I know if my breathing feels off or higher then I might have a hard time going to sleep later. Now that I’ve noticed my breathing I think I should change something so I can sleep later. Last time I tried to change the show I was streaming to something slower paced and it didn’t work. This time I’m going to try something different so I think I’ll try turning off my laptop and just focusing on my phone instead of both.

[Dr. Michelle Garrison]: One of the things we found in our work is that encouraging tweens and teens to actually experiment on themselves and to collect data around what’s working for them or isn’t working for them is really empowering and sometimes really helps motivate them to make some of the changes that we’re hoping that they’ll make. On top of that we really want to encourage people to plan ahead for transitions and the time it takes to relax again right. That if we’re planning out the evening and thinking about when the screen time needs to end we want to buck it in some time that it’s going to actually might take 15 minutes to relax again, for example, after that media use is over rather than expecting that we’re going to be able to relax right away. For some tweens or teens it may take even longer, especially those of ADHD or anxiety. We have found that brief guided meditations may be helpful with this and that’s one of the things we’re examining in our current study. Also kind of what’s going on in terms of who you’re using the media with can have an impact as well. So when media use happens with siblings or parents that actually can be positive that it can be easier to stop media use for bed when we’re using it with family. It may even have a less of an impact on sleep than media you saw on our own. On top of that we know that tweens and teens pay a lot of attention to our media use patterns as parents. So if i’m asking my kiddo even as a six year old you know to say oh it’s really important that you don’t have bedtime media use well my kiddo notices if i’m the one who’s now on my ipad in the evening right. So we make a compact that we’re going to work on these skills together. It can have a huge impact on how engaged and motivated and willing to make changes the youth in our lives really are. And of course as they get more in touch with their own goals and responses and they can make better decisions for their sleep they can get kind of better you know better meet their own goals with their own media use, and of course it can be great for our sanity as parents as well. Then one of the things that we see is that then they’re able to earn a little bit more ownership around the decisions around their media use and their sleep each year. Which helps prepare them for that young adulthood transition. So thanks everybody very much. Especially to some of my colleagues and those who supported some of this work.

[Dr. Ronald Dahl]: Thank you so much. For the sake of time maybe if you could give a brief comment on how to balance the adolescence anxieties about social media being left out with you know being effective with your promoting the bedtime routines. 

[Dr. Michelle Garrison]: Yeah you know it can be a real challenge. I mean I think that when one of the things I’ll sometimes hear from tweens and teens is that there’s actually a concern that if they’re if they’re the ones who log off first and the rest of their peer group is on that there’s fears that they might be at increased risk for cyberbullying. Sometimes that actually is a legit concern. So sometimes getting you know parents of a peer group together so that several kids are making that decision all together and it’s not just one kid who feels like they need to make that change can be really really powerful.

[Dr. Ronald Dahl]: Good, that’s a good practical suggestion. Thank you, we’ll probably come back to some related issues at the end. Now I want to introduce Joani Geltman as a prominent parenting expert with four decades of experience working with children’s teens and parents. She works as a therapist, parenting coach, adjunct professor, public speaker, writer, and blogger. She’s the author of a best-selling book A Survival Guide to Parenting Teens:Talking to Your Kids About Sexting, Drinking, Drugs, And Other Things That Freak You Out. Looking forward to hearing you reflect on things for helping parents in this space. 

[Joani Geltmen]: Hi. So glad to be here. Thanks Ron for that introduction. I wanted to give you three very practical tips. You have heard amazing theory, I’m just sitting here taking notes and I’ve just learned so much from all these amazing experts. What I want to do is is help you walk away with some very concrete ways of having these very difficult conversations with your kids. They don’t want to hear what you have to say. They are absolutely not motivated whatsoever to hear anything that you have to say. So it is creativity and it is, parenting to me is an art form, it’s a way of thinking how you know my goal is to get my kids to listen to me, how am I gonna do that? So that’s what I’m gonna give you today. So the first thing that I call it is sort of my three magic words and it’s starting your sentences with I get it. Everybody loves to be understood. There is nothing that feels better in life to feel understood. Oftentimes because as parents and especially coming off of two years in a pandemic you are imagining whether you’re a teacher or a parent, grandparent whoever is on this call today you are at a low point. You have done you don’t have as much resilience as you had two years ago. You’ve been through your bag of tricks of how you can get your kids to do what you want them to do and there’s nothing left, you know the bag is empty. So this I get it is a way of acknowledging your kids point of view without agreeing with them. Especially around issues like social media and porn and  sexting. So I thought I would tell you just a quick little story about an experience I had with a parent whose son was around 11-12. He was kind of a shy kid. He wasn’t really social yet, wasn’t into his phone. Wasn’t one of those because it was on 24/7, and the mother and the son were watching tv one night which is just a lovely thing and he was sitting on his phone texting. The mother was actually happy because she felt like oh maybe my kids are not quite as integrated into his classroom and his and his friends. He decided after he’d been texting for a while they’d want to take a shower and so he left the phone on the table and the mom was like here’s an opportunity. So she picked up the phone and she you know she kind of was thinking oh and if he’s talking to a girl. She opened it up and it said you know it was from a girl and it was hey what’s up what are you doing? He had written i’m jacking off. Now obviously not jacking off sitting next to his mother on the couch. When the son came back after the shower of course the mother completely freaked out. What else would any parent do “oh my god what did you say you know did we teach you to do this” and she called me and she was “Joanie I’m nauseous.” She just had no idea what to do and she had just basically screamed at him for 15 minutes and taken his phone away. I said to her you know that’s part one, obviously you were going to have a gut reaction to something that you never in your life experienced before and would not expect to experience with your son. I said but now here’s part two and part two is understanding where did that come from. What might have motivated him? So what we want to do is not just get mad at the behavior. If your kids are on their phones too much, if you can’t get them away from their video games, if you find inappropriate you know sexy pictures or texts on their phone. If you just address the behavior and get mad and do a punishment, kids know they’re going to get their phones back. There’s not a lot of motivation for them to really think about their behavior. So I said, you know, I want you to think about what might have, you know, what might have precipitated something that seemed so out of character for him. I said you know he’s a kid who’s not experienced yet in social interaction with a girl and he was probably feeling pretty insecure. He probably got some memo somewhere that you know girls like it if you talk dirty to them. So his first inclination to what are you doing is obviously not I’m sitting on the couch talking to my mom but you know here what do you think about if I write this. So I said I want you to go back to him now and I want you to start a sentence with “I get it” and I want you to say you know “I get honey how this might have happened.” So now you want to get him to feel not ashamed, not humiliated. You want to get him to at least want to have a conversation with you and not feel that you are so disappointed in him. That you know kids feel that shame and humiliation. So when you want to have a difficult discussion about whether it’s whatever part of social media or any part of adolescence truthfully is to start from a place of understanding. “You know what honey I’ve been thinking about it and I get how um how important your friends are to you, I get that when you leave school you want to make sure that you’re not missing anything that’s going on.” As opposed to “why are you on your phone so much? How many times have I told you you can’t do your homework and you can’t do phones at the same time?” So normally that conversation becomes a conflict. If you can start off in sort of joining with them I get this is important to you and I get you like doing it. Okay so there we figure out a way that you can both do it and get you know your homework done better or whatever it is that you need them to do. So using and I get it is also a way for you to step back, to take a deep breath, and not immediately go into how could you, why have you, why haven’t you. And that of course is gonna make any kid not respond to an introduction to a conversation like that. Okay so I get it as number one. Number two is tone of voice. You’ll remember that your grandparents have probably had said to you know it’s not what you say it’s how you say it. With teenagers they are super super sensitive to tone of voice to a pitch. You know when you’re up here and you’re you know your neck is all red and you know you’re this way I mean that are you know that’s a red light for them I’m not going to respond to you. If you can have a difficult discussion in a calm tone of voice and this takes a lot of work, you’re not always going to be able to do it. Because you’re often really really really upset but if you can at some point go back and be conscious of being in a lower register, being in a quieter voice, allowing your kid to know. Your kids can feel judgment and criticism. You know it’s like a dog who can sense fear. It might not be from the words that are coming out of your mouth because your mouth might be saying how was your day today but you were saying with sarcasm because you knew they had a quiz and they were on their phones all night as opposed to hey so how’d it go today. You know or hey can we have a discussion about what I see going on. You know I just picked out your phone and I just saw xyz on it and you know so tell me about that. Which is very different then I just saw this in your phone and that’s it. Then there’s no communication going on. So I get it, tone of voice, and the final thing is don’t go on the lecture circuit. So as parents we’re always thinking we need to teach our kids lessons. And unless there is some you know magical message in what we’re saying then somehow it’s not enough. And we tend to talk too much you know not you know it’s never oh you know I was succinct I didn’t say too much enough. It was you’ve said too much and your kids have stopped listening. If there’s a discussion that you know you’re you want to talk about sexting you want to talk about video game addiction you want to talk about you know you found naked pictures of some girl you know maybe you opened your daughter’s phone and and she was you know she’s been sending um you know suggested pictures out into the you know into the outer sphere there. You know you rather than saying do you know going into a whole lecture about do you know what could happen to you and who could see this and you all the information that you want to give to them you need to find another way to do it. Maybe if you’re worried about you know you know that the kids at their school are all you know there’s been a lot of sexting and there’s been messages back and forth from the school. You know maybe you say oh my god I read this you know you’re sitting at the dinner table you’re driving home from soccer practice and you start by talking about something that has nothing to do with your kid. Oh gee I was at the gym today and this woman was telling me that you know her son. She checked his phone and she found all these pictures of girls you know taking pictures and mirrors and I don’t understand what that’s about. Can you tell me what that is? You know, tell me about that. So that you may engage your child as an expert in social media. You might be able to get that conversation in a way that is not as threatening and judgmental before you end up having to talk with them about some particular incident. Or maybe there isn’t an incident but you’re worried there might be. So you know if you find yourself going kind of like I am right now if you find yourself going on and on and on you’ve lost them you know way back at the beginning. So newspaper articles if you see something in the paper, some story about xyz happened and bring that to them and say oh I just read this. Do it in a way that if you were talking to a friend and you were saying oh my god have you heard the story. Now you’re talking to them like you’re really interested in what they have to say to you. When you get into lecture mode you have shut it down. You know you have said what you have to say is not of value to me. Your kid wants to be valued. They want you to feel that what they have to say is important. You can learn from them. They’re the ones right now that have the expertise. You have the fear and so and you have the experience of life and so we want to find a way to join those two pieces. So I just want to let you know that I do have a parenting blog. It’s at Joani Geltman blogspot.com. There’s hundreds and hundreds of just very practical tips on there and of course the book. So thank you for giving me this opportunity.

[Dr. Ronald Dahl]: Thank you so much. I really like the way you frame those three practical suggestions but underneath each of those is a really deep set of insights into young people’s sensitivities. So we focus on behaviors, we focus on as adults and parents trying to, you know, push away the behaviors we think are unacceptable, but part of what’s implicit in what you’re saying is their feelings. You know whether they’re feeling diminished, whether they’re whether you feel that they’re being respected, whether they feel understood, whether they’re being valued. Those are powerful . It’s the famous Maya Angelou quote: people will forget what you said, they’ll forget what you did, but they’ll never forget how you made them feel. That is amplified in adolescence with their self-consciousness and sensitivity. I want to ask you this question and then actually I want to ask it in a way that actually can help us transition to the general discussion for all of us to think about it in relation to the areas we’re talking about. Which isn’t the space of the vulnerabilities and opportunities because of those sensitivities to feelings. So whether we’re telling them what they shouldn’t do with sexting, whether we’re telling them to get off the phone because it’s past their bedtime. We’re trying to focus on the information we’re giving them, but what we’re making them feel is criticize, diminish, that they don’t make their own decisions, they don’t know how to make judgments. So I’d love to hear from each of us, whether it’s bedtime or parenting, how do we think about the particular vulnerabilities of young people’s amplified self-consciousness and sensitivity to being valued and criticized and admired? How do we help shift it to the opportunity frame rather than just conflict trying to control their behavior in the negative emotion activating frames? So Joanie you want to start with you and then I’d love to have other people pop in with thinking about that general theme relation to the topics that they’re focusing on.

[Joanie Geltman]: You know I often you know I think what happens a lot in parenting is we have like parenting you know like this big overarching theme of parenting, but every one of our kids is different. Every one of our kids brings something different to the table. How you parent one of your kids is going to be different than you parent another one of your kids. So what I always say to parents is think about who your kid is, you know. What is it that they’re bringing to the table right now and to you know think about what do you think they’re anxious about right now. Every kid is anxious about something. They may have an amazing way of masking it. You know so if they’re having you know maybe they’re hating the way their body is looking puberty is you know a cruel cruel cruel friend. Social media does not help in that matter. So maybe you do have a daughter who spends hours in front of you know in front of her mirror and changing her clothes and needing more clothes and you know feeling everything about her is not right. And you keep saying you’re fine you’re fine you know you keep sort of countering you know you don’t want her to feel bad about herself. So but for that child you might want to say you know I get you feel self-conscious about the way you look and it must be really hard you know that you feel like you never quite get the right picture. So then you know then that leads to a discussion about what is the right picture and what is it that you want to say as opposed to stop spending so much time looking in the mirror you know. So it’s so I guess my advice would be who is your child? And what it is, what you know they have a big pimple that day and everybody’s posting and you know when they’re feeling really self-conscious, or you know where there was a sleepover that weekend they weren’t you know invited to. Now do you have to now do they have to make themselves seem more important by you know building up themselves and putting something outrageous on instagram because they want to show everybody I don’t care that I wasn’t invited. So you as a parent or as a teacher should think about who this kid is and what is this kid bringing to the table. Then how can I use that not to let you know to support and get in there.

[Dr. Ronald Dahl]: Just by the way you framed it, that is showing your behavior you care. Who is this kid? What’s going on? I’m curious, I care. Like that, that part of joining changes the tone. That’s a great example. I’d love to hear others in this general theme or other comments. 

[Dr. Edward Spector]: I hope I would jump in if that makes sense. I mean I was thinking as this discussion was going on there’s a song from Hamilton “Talk Less Smile More” and in parenting particularly around technology you want to have an ongoing dialogue that just keeps going on every week every day where you ask questions mostly with curiosity and non-judgmentalness if you can. And you raise things like all right so I’m not sure I totally understand that but I’m concerned about this or one reaction that I have when I hear that you’re doing that is here’s my what do you think about that. It’s a much more collaborative, sort of recognition, that we are often immigrants to technology and they are natives. They often know more about the domains that they’re in. So you start not assuming that it’s terrible but with curiosity oh this is something you’re really doing you know can you explain it to me, can you show it to me. I saw this and sort of having that approach promotes discussion definitely. Rather than having a judgment first and then regretting it and having to back it up.

[Dr. Paul Weigle]: I totally agree. Such a great talk. It makes me think that another trick that I have as a parent is that my kids don’t like to hear my judgments on their technology issues, but they love to hear about my mistakes and problems with technology. Oftentimes that can spark a great discussion that they’re invested in.

[Dr. Ronald Dahl]: Great example.

[Dr. Michelle Garrison]: Yeah absolutely. You know one of the things that some of the families and one of our projects did is that both the parents and the kids kept the sleep log for a week and a media log for a week. Then they all got together to look at the data. Of course when the teens were the ones finding the connections in the data they were so much more motivated to make changes based on that, and of course to suggest changes that their parents needed to be making. Then when it was just coming from a top-down perspective.

[Dr. Ronald Dahl]: Yeah and they’re more likely to accept influence when we accept some influence. That’s often like power sharing in all our relationships. It’s tricky tricky business with the teens. I want to come back to the emotional part, Michelle, because having spent a lot of years thinking about sleep and working with colleagues especially focusing on kids with anxiety and depression where bedtime rumination worry is such an enemy to sleep. Then they want to distract but then distraction goes to the phone and social interactions and it’s a vicious cycle. So you know and you sort of pointed at this when you were talking about like bedtime conflict. Is like the last thing that’s going to be helpful it’s going to create more negative emotion and arousal and vigilance. What when we want them to feel as in your example on your video the calmness and positive emotion and so I’d love to have you talk a little bit about how being sensitive to those emotions rather than just focusing on their behavior that they’re in bed with the you know with the phone out of the room, but then they’re feeling you know all these counterproductive emotions.

[Dr. Michelle Garrison]: Right. One of the things we do with the youth in one of our projects is really encourage them to think about how what we want to get out of our media use is different at different times during the day. That when we’re using it in the evenings, if we really are wanting to be able to calm down we want to be really thoughtful about am I actually using it in a way that’s helping me calm down? Am I using it in a way where I’m going to be calm right away when I turn it off? Or where I’m gonna actually need to budget in some time to do something else relaxing and have I thought ahead of time about what that relaxing thing is gonna be? And to really encourage them to like to take ownership of some of that problem solving you know because at the end of the day they don’t want to have a hard time falling asleep. They don’t want to be lying in their bedrooms and eating like that isn’t a pleasant experience for them either. So you know the idea that they can have some ownership around that, and it’s not just something that like this external force is doing to them can be really powerful.

[Dr. Ronald Dahl]: I realize we’re, it’s been such a great discussion, we’re winding down. I would love to ask each and any of you who want to, maybe one takeaway as you’re reflecting on the overall discussion and your own area of expertise perhaps. One brief takeaway you’d like to suggest people think about.

[Dr. Sophia Choukas-Bradley]: Social media is not all bad for teens or adults, and the trick is to figure out for each of us, adults included, how to use social media in ways that feel aligned with our values and that meet our goals. Whether it’s personal connection, better sleep, better mental health. Rather than focusing on framing all social media as bad and to be avoided.

[Dr. Ronald Dahl]: Thank you, very well said. Others? 

[Dr. Paul Weigle]: I would say prioritizing sleep really does prioritize mental and physical health.

[Dr. Edward Spector]: Uh I’d say, oh go ahead.

[Dr. Michelle Garrison]: I would obviously agree with both of them. I think one of the things I find most surprising to folks is how much of an impact media use can have on our ability to be aware of our own body’s signals. And to really be paying intentional attention to that can often be really powerful.

[Dr. Edward Spector]: So I would just repeat the two sound bites. Talk less, smile more while you’re engaging with discussions and just step outside. 

[Dr. Ronald Dahl]: Thank you. Joani you’re a mute. 

[Joani Geltman]: I would say time and opportunity. Don’t be afraid to use parental, having a senior moment, you know the parental controls. I think I agree that social media isn’t all bad and it is about time and opportunity. There is time for them to and it gives when you use parental controls. It allows the kid if you say you know “hey honey how much time do you think you need on instagram today” there not going to say 10 hours they’re probably going to say two hours. Then it’s up to them to budget that time. So then they start to learn those skills it’s you know it’s when you you know you give them an allowance and they either blow it on Monday or they you know put a little way and so Friday they still have some money left over. In the beginning they’ll they’ll use it all up in one fell swoop. Then you know they may gradually learn how to budget it. Then maybe you get to increase it because you see that they’ve learned that skill. So time and opportunity I think those are.

[Dr. Ronald Dahl]: All right wow everybody did a great job. Okay it is time to turn it over to Pam. Thank you so much for assembling this panel and organizing this and having a large audience participating. I’d like to welcome you to make some closing comments.

[Dr. Pamela Hurst-Della Pietra]: Well I just can’t thank you enough Ron. That was really truly wonderful Paul, Sophia, Ed, Michelle and Joani for joining us today and contributing to this really terrifically valuable discussion. Thank you to our wonderful audience for taking time out of your busy schedules to attend this event and for submitting your many thoughtful questions. When you leave the webinar you’ll be asked to complete a short survey. Please take a moment to share your thoughts on this webinar and ideas for future topics for us to explore. We hope you’ll join us again on Wednesday, March 23rd for “The Good The Bad and The Filtered,” a social media primer for parents. Tune in for practical app specific advice to ensure your child’s social media engagement is both safe and healthy. Thanks again for joining us today. Be safe and be well.