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Introduction
Pamela Hurst-Della Pietra, DO
Digital media is ubiquitous in most children’s lives.1 This fact compels us to determine how
electronically mediated communications influence children at all ages and developmental stages.
By understanding these effects, parents, teachers, clinicians, and policymakers can help fulfill their
shared responsibility of improving the well-being of children.
In response to this need, I established Children and Screens: The Institute of Digital Media and
Child Development 4 years ago. Children and Screens promotes research on the effects of digital
media on children, and supports the creation and use of objective, research-based guidelines and
policies. This endeavor began with a series of one-on-one conversations with leaders in media
effects research and related fields. These discussions informed Children and Screens' subsequent
collaboration with the National Academy of Sciences, which culminated in the Arthur M. Sackler
Colloquium “Digital Media and Developing Minds” held in October 2015, where nearly 200 of
the world’s leading media researchers in all disciplines gathered to share their knowledge. This
supplement builds on what transpired at that event. It describes the current state of youth media
effects research and points the way to the necessary next steps in this field.
Children and Screens' President and Board of Advisors asked members to lead interdisciplinary
Working Groups and co-author articles to address specific, predefined topics within 3 large
domains. Topics were chosen on the basis of core areas of inquiry that have already or are
currently in the process of framing the evolving field of children and media. The Working
Groups consisted of 107 Children and Screens members and 33 additional experts from diverse
disciplinary and institutional perspectives who were invited by Working Group leaders on the
basis of their particular competencies, with recommendations from Children and Screens members
who expressed interest in participating. Children and Screens communicated to all Working Group
leaders its strong desire for objectivity, appropriate balance, and range of expertise. As a result, this
supplement reflects contributions not only from pediatrics, but also from the fields of psychiatry,
psychology, neuroscience, physiology, sociology, anthropology, communications, education, law,
public health, and public policy.
Founder and President, Children and Screens: Institute of Digital Media and Child Development, Setauket, New York and Clinical Assistant Professor in Health Care Policy and Management,
School of Health Technology and Management, Stony Brook Medicine, Stony Brook, New York
DOI: https://doi.org/10.1542/peds.2016-1758B
Accepted for publication Apr 19, 2017
Address correspondence to Pamela Hurst-Della Pietra, Children and Screens: Institute of Digital Media and Child Development, c/o KWM CPAs, LLP, 125 Jericho Tpke,
Suite 300, Jericho NY 11753. Email: pam@childrenandscreens.com
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2017 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The author has indicated she has no financial relationships relevant to this article to disclose.
FUNDING: This special supplement, “Children, Adolescents, and Screens: What We Know and What We Need to Learn,” was made possible through the financial
support of Children and Screens: Institute of Digital Media and Child Development.
POTENTIAL CONFLICT OF INTEREST: The author has indicated she has no potential conflicts of interest to disclose.
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PEDIATRICS Volume 140, number S2, November 2017:e20161758 SUPPLEMENT ARTICLEChildren and Screens' Working stage, and much investigation is still in childhood and adolescence,
Groups undertook 2 tasks. The first required, particularly to determine LeBourgeois et al10 observe that the
was to conduct comprehensive, the direction of causality (ie, whether “pervasive use of screen-based media
transdisciplinary literature reviews heavy multitasking with media is a likely contributor to widespread
in each subject area. The second was is causing the observed neural, sleep insufficiency.” Robinson et al11
to offer research and policy proposals cognitive, psychological, and learning report on obesity, stating, “Current
that highlighted concerns and differences, or whether individuals evidence suggests that screen media
challenges ahead regarding youth who exhibit these differences are exposure leads to obesity in children
media effects research from their more prone to media multitasking). and adolescents through increased
perspectives as recognized experts eating while viewing, exposure to
in the field. The analysis, conclusions, Psychosocial Effects high-calorie, low-nutrient food and
and recommendations contained in beverage marketing that influences
Five Working Groups specifically
each article are solely a product of children’s preferences, purchase
deliberate on psychosocial effects
the individual Working Group and requests and consumption habits,
research. Uhls et al4 address how
are not the policy or opinions of, nor and reduced sleep duration.”
social media influence identity
do they represent an endorsement Romer and Moreno12 consider the
development, aspirational
by, Children and Screens: Institute of relationship between digital media
development, and peer engagement
Digital Media and Child Development and 4 classes of risky behavior: (1)
for adolescents (ages 13–18 years).
or the American Academy of alcohol and other substance use,
James et al5 present the current
Pediatrics. (2) tobacco use, (3) driving, and
state of knowledge on how digital
The collective breadth of the 22 (4) gambling. Atchley and Strayer13
lives of tweens and teenagers
articles in this supplement makes consider a specific case of media
influence their sense of well-being,
categorizing them difficult. Readers behavior affecting physically risky
social connectedness, empathy,
may find it useful to group them into behavior (ie, the relationship
and narcissism. Hoge et al6 review
3 broad, overlapping categories: between mobile media and driving
the current state of research on
(1) research concerning cognitive, safety).
the connection between digital
psychosocial, and physical effects media and anxiety and depression.
on children; (2) research on how Gentile et al7 address the state of EFFECTS ON CULTURE, SOCIETY, AND
media influence family, culture, and the science behind Internet Gaming THE FAMILY
society; and (3) research focused on Disorder (defined by the American
Six Working Groups review research
particular types of digital content. Psychiatric Association as “persistent
on the social effects of media. Coyne
and recurring use of the Internet
et al,14 who describe the literature on
to engage in games, often with
COGNITIVE, PSYCHOSOCIAL, AND families, parenting, and media, found
other players, leading to clinically
PHYSICAL EFFECTS that “child characteristics, the parent-
significant impairment or distress”8).
child relationship, parental mediation
Cognitive Effects Parsons et al9 write about virtual
practices, and parents’ own use of
reality as a tool for psychological
Two Working Groups broadly media all can influence children’s
assessment, therapy, learning, and
address cognitive effects of media. media use, their attitudes regarding
rehabilitation. They identified the
Anderson and Subrahmanyam2 media, and the effects of media
need for the following: validation
describe “the developmental on children.” Montgomery et al15
studies with psychologically intact
impact of digital screen devices describe the state of privacy research
participants; large-scale randomized
including television on cognitive in the current "Big Data" era. Turner
clinical trials; guidelines for the
development.” They consider, among et al16 discuss research on digital
development, administration, and
other things, the differences between and media literacies in children and
interpretation of virtual reality–
receptive and interactive content adolescents. These authors note
based assessments; and ethical
as well as the varied capabilities that developing such literacies “is
guidelines.
and vulnerabilities of various age one of the most viable intervention
groups. In a complementary article, strategies to minimize media’s
Physical Effects
Uncapher et al3 discuss media negative consequences and maximize
multitasking and its association with Four supplement articles focus on its positive influences on beliefs,
neural, cognitive, psychological, and physical health, either as a direct attitudes, and behaviors.” Middaugh
learning differences. They make media effect or as a consequence et al17 evaluate digital media,
the point that the literature on of media-related behavior. In their participatory politics, and positive
media multitasking is at a nascent write up on digital media and sleep youth development. Their work
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S52 HURST-DELLA PIETRA“suggests a need for greater attention behaviors. Dill-Shackleford et al23 some children more vulnerable to a
to efforts to promote digital media look at how social representations particular harm or more receptive to
competencies among adolescents and in entertainment media (specifically, a particular benefit).
for greater coordination of research representations of race, sex, and These concerns have led several
on adolescent risk and adolescent other social distinctions) influence Working Groups to recommend the
autonomy and empowerment related behaviors and attitudes toward organization and execution of large-
to internet use.” the self and others. Examples scale, multidisciplinary, multivariate,
include media portrayals of beauty, longitudinal studies to be conducted
Several articles touch on equity
sexualization, and other demeaning by using more naturalistic research
issues, but 2 specifically focus on
and objectifying attributes. Collins and data-sharing methods than in
the impact of socioeconomic and
et al24 review the literature on how the past. New ways to gather vast
geographic differences. Katz et al18
sexual content affects the attitudes, amounts of real-time biological and
consider digital inequality in the
beliefs, behavior, and health of young behavioral data about large numbers
lives of low-income, immigrant,
audiences. of people and their media habits,
and minority children. Livingstone
et al19 “outline the important We believe that this collective review and new techniques for deriving
complexities and contingencies that of the literature is broad enough to meaning from that data, is an exciting
must underpin the future (research) inspire more research, practice, and possibility. Researchers can revisit
agenda” on children’s digital policy recommendations. However, long-established associations in
opportunities globally, particularly some of the suggestions garnered the literature, identify previously
with respect to education and huge support across the Working inaccessible causal mechanisms
learning around the world. Groups, and they merit specific responsible for those associations,
mention here. and use those discoveries to create
One of the suggestions is a call for specific, targeted, and effective
MEDIA CONTENT a current, rigorous, ambitious, and interventions. We can only imagine
comprehensive approach to research how negative health outcomes such
Five Working Groups organize their as attention-deficit/hyperactivity
literature reviews around specific design. Some of the studies reviewed
in this supplement focus on different disorder, addiction, violence, and
types of content. Anderson et al20 suicide will be minimized. This
focus on screen violence and note media formats and content that many
children now experience, requiring convergence of the medical and social
that “the effects of screen violence sciences promises to move media
on increased aggressive behavior further analysis about generalizable
media effects. Others employ limited effects research toward youth media
have been reviewed and affirmed policies that can be more widely
by numerous major scientific sampling, measurement, and data-
analysis methods that could benefit embraced.
organizations.” They specifically
look at how media violence affects from new, child-centered, mobile Pediatricians have long understood
viewers’ sensitivity to violence and investigative techniques that are that quantity, quality, variety, and
the pain and suffering of others, becoming available. It is reasonable the time, place, and manner of
attentional capacity, academic to suspect that these limitations, consumption all matter in the context
performance, impulsive aggression, along with the dynamic nature of of what children eat. Researchers
and cognitive skills. Englander et al21 a newly emerging field and the for this supplement have suggested
review research on digitally mediated complexities inherent in child that the same is true for children’s
social cruelty (cyberbullying) and development studies themselves, media diets,25,26 although measuring
note the need for more research may explain the large number of the duration of children’s media
to be conducted on how such correlational findings. exposure continues to be important.
behavior differs fundamentally Evolving media formats, content, and For example, questions persist about
from its offline counterpart. They portability; changes in family and the consequences of substituting
further observe that “the lack of community structures; and changes screen time for other activities
a consensual, nuanced definition in children’s bodies and brains as and the best use of screen time.
has limited the field’s ability to they develop necessitate parallel Lately, suggestions have been that
examine these issues.” Lapierre inquiries into the medium-, content-, examining children’s total non-
et al22 consider the influence of context-, and audience-specific screen time may be a more useful
advertising on children through effects. Working Groups are calling measurement.
off-line and online channels and as for more research on the question In October 2016, the American
a means of promoting children’s of variable resiliency or differential Academy of Pediatrics issued
commercial and health-related susceptibility (ie, what makes important, revised screen time
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PEDIATRICS Volume 140, number S2, November 2017 S53guidelines. Salient changes to the taking parents (and siblings) into likelihood of clinical interventions,
previous recommendations include account. They model positive and product innovations, evidence-based
the following: negative media behaviors and serve regulations, and a comprehensive
• Video-chatting by 18 months or as the authors and enforcers of media national youth media effects policy
younger,27 which is in contrast time and type limits. Parents also are informed not only by the past but also
with the 2013 guidelines the source of frontline intelligence for by children’s current and future needs.
discouraging any screen media clinical caregivers and potential allies
Considering the many references
exposure for infants and toddlers for schools striving to realize the
to policy in this supplement, we atthe Working Group on Games for Michael Rich, MD, MPH, of Harvard childhood and adolescence. Pediatrics.
Health, whose article has been Medical School, the Harvard T.H. 2017;140(suppl 2):e20161758J
published elsewhere; Brown et al and Chan School of Public Health, and 11. Robinson TN, Banda JA, Hale L et al.
the Working Group on Guidelines Boston Children's Hospital, who Screen media exposure and obesity in
for Parents, whose targeted contributed to choosing the topics children and adolescents. Pediatrics.
recommendations will be validated addressed here; and Steven Price 2017;140(suppl 2):e20161758K
through field research; Espejo et al for his assistance in connection with 12. Romer D, Moreno M. Digital media and
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S56 HURST-DELLA PIETRAIntroduction
Pamela Hurst-Della Pietra
Pediatrics 2017;140;S51
DOI: 10.1542/peds.2016-1758B
Updated Information & including high resolution figures, can be found at:
Services http://pediatrics.aappublications.org/content/140/Supplement_2/S51
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Downloaded from www.aappublications.org/news by guest on November 3, 2021Introduction
Pamela Hurst-Della Pietra
Pediatrics 2017;140;S51
DOI: 10.1542/peds.2016-1758B
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/140/Supplement_2/S51
Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it
has been published continuously since 1948. Pediatrics is owned, published, and trademarked by
the American Academy of Pediatrics, 345 Park Avenue, Itasca, Illinois, 60143. Copyright © 2017
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