Media Use and Vision in Children

Transcription

1 Media Use and Vision in Children Yin C. Tea, OD, FAAO Nova Southeastern University, College of Optometry Raymond Chu, OD, MS, FAAO Southern California College of Optometry at Marshall B. Ketchum University Please silence all mobile devices and remove items from chairs so others can sit. Unauthorized recording of this session is prohibited.

2 Disclosure Statement: Nothing to disclose

3 Pediatric Media Use Guidelines

4 Committee on Public Education Media Education Pediatrics 1999 Aug; 104 ( ) 2011 Council on Communications and Media Media Use by Children Younger Than 2 Years Pediatrics 2011 May; 128 ( ) 2016 Council on Communications and Media Virtual Violence Media and Young Minds Pediatrics. 2016;138(1): e Pediatrics. 2016;138(5): e Media Use in School-Aged Children and Adolescents Pediatrics. 2016;138(5): e

5 Media Education: AAP Policy Statement 1999 Concerns about media use: Amount of time spent with media Impact of media violence on aggressive behavior Sexual content in the media Tobacco and alcohol Obesity and school performance Value of media education 9 recommendations were provided: #3 urge parents to avoid television viewing in Children under the age of 2 yrs

6 AAP Policy Statement 1999 Media Education: AAP Policy Statement 1999 avoid television viewing for children under the age of 2 yrs Frequently misquoted by media as NO media exposure for children < 2 yrs of age Pediatrics 1999 Aug; 104 ( )

7 Media Use by Children: AAP Policy Statement 2011 This revised policy statement Addressed previous 10 years of research on the effects of media on young children Clarified the rationale for the position of AAP on media use by children <2 years Provided updated recommendations for families, clinicians and researchers The AAP believes there are significantly more potential negative effects of media than positive ones for this age group

8 Brown A; Council on Communications and Media. Media use by children younger than 2 years. Pediatrics. 2011;128(5): American Academy of Pediatrics (AAP) discourages media exposure for children younger than 2 years.

9 Wen LM, Baur LA, Rissel C, Xu H, Simpson JM. Correlates of body mass index and overweight and obesity of children aged 2 years: findings from the healthy beginnings trial. Obesity (Silver Spring). 2014;22(7): Study of 2-year-olds found that BMI increased for every hour per week of media consumed

10 Is handheld screen time use associated with language delay in infants? For each 30-min increase in handheld screen time, researchers found a 49% increased risk of expressive speech delay. Birkin et al. May 6, 2017 Presented at Pediatric Academic Societies Meeting

11 Use of Mobile Media, over Time

12 TV hours among school-aged children have decreased in the past decade for children < 8 yrs. 8+ yrs, average daily TV time remains over 2 hours per day

13 AAP Policy Statements 2016 Council on Communications and Media Media and Young Minds Media Use in School-Aged Children and Adolescents Virtual Violence Pediatrics. 2016;138(1): e Pediatrics. 2016;138(5): e Pediatrics. 2016;138(5): e

14 AAP Policy Statements 2016 For children younger than 18 months, discourage use of screen media other than video-chatting.

15 AAP Policy Statements 2016 For parents of children 18 to 24 months of age who want to introduce digital media, advise that they choose high-quality programming/ apps and use them together with children.

16 AAP Policy Statements 2016 For children 2 to 5 years of age, limit media to 1 hour or less per day of highquality programming.

17 AAP Policy Statements 2016 No screens 1 hour before bedtime

18 Gaming design involves behavioral reinforcement meant to achieve a maximum duration of engagement

19 Violence vs. Aggression Virtual violence increases aggressive thoughts, feeling, behaviors. Pediatrics. 2016;138(1): e

20 Playing video games that use human or other living targets or award points for killing, may teach children to associate pleasure and success with their ability to cause pain and suffering to others.

21 The exposure of adolescents through media to alcohol, tobacco use, or sexual behaviors is associated with earlier initiation of these behaviors. Drugs and Alcohol

22 Twenge JM. IGen: Why Today s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy Completely Unprepared for Adulthood. New York, NY: Atria Books; Incidence of depression and suicidal ideation increases with screen time and social media exposure.

23 Depression U-shaped relationship between Internet use and depression, with increased risks for depression at both the high and low ends of Internet use

24 Blue Light and Vision

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26 ereaders

27 In young children, more than 65% of blue light is transmitted to the retina. With increasing age, the yellow filters of the lens increase and absorb most of the blue light.

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30 Effects of BlueTech Lenses on Melatonin, Sleep, Mood, and Neurobehavioral Performance Ryan-Quang Van A significant increase in melatonin levels was measured with the BluTech Lenses compared to control (9.6 vs. 4.9; p = 0.036). Sleep onset latency measured by actigraphy was slightly reduced with the Blutech Lenses, but not statistically significantly different between glasses.

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32 Does the ipad Night Shift mode reduce melatonin suppression? For a two-hour exposure to the ipad: 23% melatonin suppression on regular settings 19% melatonin suppression while using Night Shift High CCT 12% melatonin suppression while using Night Shift Low CCT Changing to Night Shift mode without changing brightness settings may be insufficient for preventing impacts on melatonin suppression

33 Blocking nocturnal blue light for insomnia: A randomized controlled trial PIRS Total Score Distress Score Clear Amber P-value ± (45 152) ± (20 116) ± (31 133) ± (17 96) Sleep Parameter Score ± 6.11 (3 27) ± 6.17 (4 24) Quality of Life Score ± 4.20 (10 24) ± 4.33 (7 22) J Psychiatr Res Jan;96: doi: /j.jpsychires Epub 2017 Oct 21.

34 Media Use Summary for Parents Pediatrics. 2016;138(5): e < 18 months: Avoid use of screen media other than video chatting months: Those who want to introduce digital media should choose high-quality programming. 2-5 years: Limit screen time to 1 hr per day of high quality programs. Parents should co-view media with children to help them understand what they are seeing.

35 Media Use Summary for Parents Place consistent limits on the time spent using media, and the types of media. Make sure media does not take the place of adequate sleep (8-12 hrs) and physical activity (1 hr). Avoid exposure to screens 1 hr before bedtime. Pediatrics. 2016;138(5): e

36 Media Use Summary for Parents Designate media-free times together (dinner time) Designate media-free zones, such as bedrooms. Have ongoing communication about online citizenship and safety, including treating others with respect online and offline. Pediatrics. 2016;138(5): e

37 AAP Family Media Use Plan

38 Computer Vision Syndrome (CVS)

39 CVS Symptoms Portello et al. Blink rate, incomplete blinks and CVS. Optom Vis Sci May:90(5):882-7 Ocular Eyestrain Tired Eyes Dry Eyes Red Eyes Burning or irritated eyes Visual Blurred vision Diplopia Musculoskeletal Neck pain Shoulder pain

40 CVS in Children vs. Adults Ergonomics Adaptability Self-Awareness Higher lifetime exposure Kim et al. Association between exposure to smartphones and ocular health in adolescents. Ophthalmic Epidemiol Aug;23(4): Hu et al. Differences in children and adolescents ability of reporting two CVC-related visual problems. Ergonomics. 2013;56(10):

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42 Font Size and Viewing Distance of Handheld Smart Phones Text message, mean (Range) Web page, mean (Range) Font size (mm) 1.6 ( ) 1.1 ( ) Snellen fraction 6/19.2 (6/8.3-6/35.3) 6/15.1 (6/5.9-6/28.5) M acuity 1.1 ( ) 0.8 ( ) Working distance (cm) 36.2 ( ) 32.2 (19-60) Optom Vis Sci 2011;88:

43 Clin Exp Optom 2017; 100: Viewing distance and eyestrain symptoms with prolonged viewing of smartphones Uncomfortable Tired Blurry

44 Smartphone viewing distance and sleep: an experimental study utilizing motion capture technology Viewing distance in the sitting position ranged from cm Lying position, it ranged from cm Short viewing distance in the lying position related positively to a poorer sleep state, lower sleep efficiency, and longer sleep latency. Nature and Science of Sleep 2017:

45 Smartphone viewing distance and sleep: an experimental study utilizing motion capture technology Nature and Science of Sleep 2017:

46 Samsung Safety Screen (SSS) The app triggers a pop-up that prompts them to move the screen back to an appropriate distance. Compatible with all devices that have a front camera and run Android 4.3 and up.

47 Recommendations for children when working on computers AOA Clinic Care Publications Comprehensive eye exam for all children Build in break times Check height and position of computer computer screen Check for glare and reflections on Adjust ambient lighting in room Limit long-term exposure to bright computer monitors, especially close to bedtime

48 Ray H. Chu, OD, MS Yin C. Tea, OD

49 Please remember to complete your session evaluations on the Academy.18 meeting app Tweet about this session using the official meeting hashtag #Academy18