By: Tiffany Munzer, MD, FAAP
Fears about kids and screens have been with us since the 1950s, when TV burst on the scene as an exciting new way to spend time. But today's digital world is far more complex. It's not just about "screen time" anymore. Digital media is everywhere—phones, tablets, TVs, apps, games and even AI tools are woven into family life. It's an entire digital ecosystem that shapes how kids learn, play, and connect.
Beyond screen time limits
Screens and connected devices can offer some solid benefits for young people, including educational, social and creative outlets. But many platforms are designed to keep users engaged for as long as possible and influence behavior. Features like autoplay, endless scrolling and targeted ads aren't built with children's well-being in mind. These "engagement-based designs" compete for attention and can crowd out sleep, play and family time.
As pediatricians, we recognize the positives but remain concerned about how digital media affects children's growth, health, safety and well-being. We've
updated our guidance to help families navigate the complex digital media landscape and move beyond simple screen-time limits and focus on quality, context and conversation.
Understanding the "digital ecosystem"
Concerns about
social media,
online bullying and too much screen time are still with us. But there's a new understanding that the digital world is bigger than these issues. All of us—kids included—spend time in a digital ecosystem that includes:
Our employers, schools, sports teams, community groups and more all require us to jump online many times a day. We're part of the digital ecosystem, which is why navigating it safely matters so much—especially for kids.
What are the specific dangers for children?
Digital media have become a way for people and companies to make profit. Because of the business model that drives companies, there is more incentive to:
Keep kids engaged with screens longer with algorithms that understand and shape kids' desires, endless scrolls and rewards that keep them playing.
Collect more data and information from kids with short, tasty bites of content that can quickly learn about kids' preferences.
Tempt them to buy and try exciting products
Push tips for being more popular, more appealing or more successful
Seen in this light, it's not hard to fathom why apps would reward kids just for signing in—or algorithms designed to keep them scrolling for hours on end.
Is there proof that the digital world endangers kids?
Parents see the harm directly when
kids can't sleep,
can't concentrate or
can't walk away from screens. But to fully understand the risks, it's helpful to see what social and scientific studies reveal.
Early childhood (0-5 years)
Infants under 18 months learn best from real-world interactions. Heavy solo screen use can affect their developing language and social skills, for example. Outcomes depend on how many hours a day little ones spend on digital media and how adults use screens to calm or entertain them. But misuse of digital media can cause:
Delays in language, thinking, social skills and fine motor development
Unhealthy sleep
Less time spent learning with their loved ones, reading, moving around and for exploration—all needed for healthy growth
More angry outbursts
Less opportunity to develop patience and self-control
School-aged kids (6-12 years)
In this group, misuse of digital media has been linked with:
Unhealthy sleep
Poorer school performance
Weaker attention control
Difficulty with language and cognition (thinking)
Weakened eyesight in kids who already have vision problems
Lack of healthy exercise
Less time spent with friends and family
Exposure to calorie-dense foods
Higher risks for weight gain and related health risks, like heart disease
Teens (13-18 years)
Effects vary and more studies are needed, but teens may face harmful effects of algorithms or digital design features that encourage compulsive use. These algorithms and designs can also expose them to inappropriate content that promotes self-harm or eating disorders, for example.
Negative effects might include:
These outcomes can lead to school struggles,
depression and
anxiety. Teens who spend hours and hours online also face serious risks for sexual harassment, racist attacks and hate speech based on religion, social class, looks, body size and more.
How can we protect our kids from digital dangers?
It's not always easy for families to set healthy limits on digital media—and that's not just a parenting issue. Many families face big challenges, like long work hours, lack of child care, or few safe places for kids to play. These pressures make screens harder to avoid. That's why solutions need to go beyond individual choices.
Protecting kids online isn't something parents can do alone. Creating a healthier digital world takes teamwork. Families, health professionals, educators, tech companies, and lawmakers all have a role to play in building a digital ecosystem that puts children's well-being first.
Health care professionals must take an active role in screening for digital health symptoms, offering child and family support, and treatment wherever it's needed.
Political leaders must pass laws that spell out the responsibilities of tech, media and content companies in protecting childhood health.
Makers of digital devices, platforms and systems must embrace child-centered design that prevents harm to children and teens. This is similar to the safety standards that apply to car seats, trampolines, bikes and countless other products kids use.
Educators from preschool through college can model healthy digital use. Safe online portals and virtual classrooms can point to positive digital experiences that expand and enrich kids' lives.
Community groups can foster conversations on digital health and recommend free or low-cost resources for families and parents.
Tips for helping your child navigate the digital ecosystem
- Check out these
conversation-starters from the AAP Center of Excellence on Social Media and Youth. They can help you talk with school-aged kids and teens about how to recognize (and resist) online ads and influencer marketing, keep sensitive information private and much more.
- Create a
Family Media Plan. Use the free AAP tool to set boundaries around digital media that fit your family's routines and values.
- Talk often. Discuss ads, influencers and privacy. Help kids spot marketing tricks and keep personal info safe.
- Seek out quality content that puts kids first. Stories that model social and emotional skills, help with school subjects like reading and math, and foster free play are all beneficial.
- Watch and play
alongside your kids. This is the best way to know what they're consuming and how they're responding. Having a shared family tablet instead of separate tablets for everyone can encourage co-watching.
- Delay personal tablets. Shared devices encourage co-use and make it easier to monitor content.
- Think carefully before handing kids their first phone. Studies don't point to a specific age that's safe, but consider your child's understanding of the digital world. If they are mostly truthful with you and other adults and deal with social situations— including conflicts—in safe ways, they may be able to navigate life with a smartphone. Not sure? The AAP
PhoneReady questionnaire offers more help.
- Model healthy digital habits. Kids notice what we do. Put your own phone down during meals and bedtime. Kids copy what they see. Show them how to take breaks, put phones away and enjoy offline time.
- Carve out screen-free time for the whole family. The goal is to make room for sleep, exercise, reading, play, homework and family. Consider creating screen-free zones. Bedrooms and mealtimes are great places to start—especially an hour before bed.
- Use parental controls. Keeping track of family digital habits can help you set limits that keep everyone in balance. Paired with your Family Media Plan, this makes digital health a shared goal.
Remember
Digital media is here to stay, but with open conversations, paired with thoughtful planning and choices, you can help make technology work for—not against—children's well-being.
More resources
About Dr. Munzer
 Tiffany Munzer, MD, FAAP is a developmental-behavioral pediatrician and digital media researcher at the University of Michigan. She is an executive committee member of the American Academy of Pediatrics Council on Media and Communications and lead author of the AAP "Digital Ecosystems, Children, and Adolescents" policy statement.
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