ADHD AND MEDIA 8/30/2012. Outline. Media and Child Development Media research Pros and Cons Media and ADHD Common Sense Solutions

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1 ADHD AND MEDIA Mark Bertin, M.D. Developmental Pediatrics Media research Pros and Cons Brain Development & Neuroplasticity Brain Development & Well Being Focused attention correlates with happiness (Harvard study) Rapid sequential attention Do you want to get used by media... Media research Pros and Cons (and Neutrals)... or use media wisely and with intention? 1

2 Are media concerns like the dated perspective rock and roll is evil... or more like smoking is just fine? Marketing and Children Science of habit formation Average preschooler sees nearly commercials, not counting product placement Marketing exposure increases materialism in unhappy children (Opree, et al, 2012) Increased impression that buying things leads to happiness Marketing Marketing affects a lifetime Brain development & neuroplasticity / habit formation Once shopping habits develop, they are very hard to break Is it real or Memorex? Kids don t know. Potential benefits of media and technology... Assistive technology Learning & education Engaging children Entertainment Babysitting (giving parents a needed break) Media and infancy Disrupted social interactions Decreased length Decreased talking Parental interactions & communication style, TV versus reading (Nathanson, 2011) Media and toddlers/pre-kindergarten... Attention Spongebob study (Lillard, 2011) Attention training studies Early exposure linked to lower academic achievement scores Aggressive behavior Good night Mommy. Good night, Daddy. 2

3 Media and toddlers/pre-kindergarten... Food choices Play studies Novel v imitative pretend play and product placement (Fletcher Neilson, 2012) Effect on creative play Language development - neutral or disrupts (Chonchaiya, 2008) Sleep and preschool: More appropriate content, better sleep (Garrison, 2012) Media and school age children Behavioral effects Academic studies Self-esteem (Tin, et al 2012) Sleep studies Television and irregular sleep patterns (Thompson, 2005) Television before bedtime disrupts sleep Nutrition Media and teens Research summary Alcohol Teens and binge drinking (Hanewinkel, 2012) Sexuality / early sexual behavior General increase in sensation /novelty seeking behaviors influenced by movie content (O Hara, et al 2012) Smoking Profanity Increased screen time correlates with decreased life expectancy (Katzmarzyk, et al, 2012) Media research Pros and Cons (and Neutrals) ADHD and Child Development A disorder of self regulation Less likely to monitor time, prioritize, resist impulses, etc A disorder of motivation Seeking excitement... Lifestyle and Health ADHD influences lifestyle Finding time for exercise, maintaining routine Eating & food choices Media and snack choices (Roberto, 2010) Media and habits worse across the day (Lipksy 2012) 3

4 Well-being Passive v active mental activity Body image Message of consumerism Marketing affects behavior. ADHD... Media caters to short attention span ADHD is a disorder of executive function... Kids are less likely to transition attention, monitor time, make wise choices about use, etc. Possibility of video game addiction Don t let the market define how you live. Pause and make a proactive choices. Attention and Executive Function Increased hours of media may correlate with decreased executive function Self-regulatory/EF skills correlate with future success Self-regulatory/EF skills are the core impairment in ADHD Spongebob study 9 minutes decreased EF skills in preschoolers Tools of the Mind research play builds executive function Reading study reading promotes theory of mind, social skills (Mar, et al) Research in media shows: Risk of aggressive behavior Risk of academic problems Risk of attention problems Risk of obesity / poor eating habits Risk of sleep issues Research in ADHD shows: Risk of aggressive behavior Risk of academic problems Risk of attention problems Risk of obesity / poor eating habits Risk of sleep issues Media research Pros and Cons (and Neutrals) 4

5 Children with ADHD have a developmental delay in self-regulation (not attention alone) Benefit from guidance/limit setting around daily living Managing modern media use is demanding for anyone Teaching self-care Well-being is promoted by: Strong self-regulatory skills Free play Social play Imaginative play (video is passive) Reading Family time Exercise Nutrition Sleep A foundation of modern parenting: Teach children to use media instead of being used by it. ADHD and Child Development A great babysitter (and there s nothing wrong with that) Balancing a parent s need to get things done or take a break versus... lifetime habit formation for an individual child or family/ First protect and schedule what you value: Unstructured play Social play with family members Family meals Exercise Reading Etc... How much media time? AAP: None before two, then two hours or less daily total One hour is plenty through early childhood Set boundaries early (Chistakis 2006) Avoid background television (disrupts play and interactions) 5

6 How much media time? Model boundaries yourself TV at night Phone during social time / meals Consider scheduled media free days... or media free weekdays in general Multi-tasking doesn t work How to monitor content? Monitor: Story content Violence Sexuality Product placement Keep electronics out of the bedroom How to monitor content? Industry guidelines are meaningless (AAP) Use Common Sense Media or other independent sites Neighbor s choices may not be able to guide yours Discuss with parents of friends (when possible) How to approach marketing? Limit access as much as possible (DVDs, DVRs) Buy non-branded items when possible Marketing influences decision making Advocate when possible Avoid ads in schools, on buses, targeted at young children... Discuss, discuss, discuss How to manage social media? It s becoming the norm Limit access entirely in young children Monitor online presence Discuss, discuss, discuss A simple crush can lead to school-wide embarrassment If your grandchildren or future boss were to see this... How to deal with teens? Discuss (again) & model appropriate use Establish guidelines (and build them into data plans) Set limits when appropriate Discourage multitasking / encourage time management Set a nightly electronics curfew 6

7 Summary Media has many potential benefits (and is fun), but also has many risks when unmonitored. Managing media is a vital life skill... and more challenging for children and adults with ADHD. Resources Common Sense Media The Shallows Nicholas Carr (requires reading it s a book) idisorder Larry Rosen (requires turning pages it s a book too) Establishing clear limits and guidelines as early as possible allows intentional, skillful use. 7