Posted by Dr. Mulligan on behalf of: Ricky Y. Choi MD, MPH, FAAP follow him on twitter.

The tech revolution is transforming my life. I have reconnected with long lost friends on Facebook. I consistently find excellent places to dine within a short walking distance when I travel to a new place (or get lost). I can find obscure information in seconds or blast my latest blog post to millions of people with just a click. As a parent and a pediatrician, I wonder about the ways that these technologies can benefit children and the use parameters we should have to minimize harm.
In my house, my children engage in imaginary play with dolls, make elaborate crafts with colored paper, and read books. They also use my iPad. Through this amazing piece of interactive technology, my children have practiced the correct stroke order for Korean characters, learned where milk comes from via YouTube videos, and came to the researched conclusion that no satellites orbiting the earth are the color pink. Because my parents live 2700 miles away, most of my children’s interactions with their grandparents are over Skype video chats. So much so, in fact, calling them “grandma Skype” and “grandfather Skype” is no longer funny, it's a reality. While a second best to actually being together, the weekly video calls have supported a relationship that hand written letters and phone calls never could.
The AAP has policy positions on screen time and social media, as they relate to health, highlighting the link between excess television viewing and obesity, poor sleep, and decreased activity. In today’s world, discussions about media use are no longer talking about passive media consumption. We must now include interactive technologies such as touchscreens and body sensors. Watching TV on the couch is not the same as playing tennis with a Wii remote. And beyond setting boundaries, how should children actually use technology, and how should we as parents and health care professionals guide its use for learning?
The National Association for the Education of Young Children and the Fred Rogers Center for Early Learning and Children’s Media at Saint Vincent College have released a position statement that it is worth reviewing. They take the position that “when used wisely, technology and media can support learning and relationships.” While this position statement was directed towards educators, I find their recommendations to be easily applicable to parents - who are, after all, a child’s first teachers. They offer a thorough evidence based discussion on the range of ways that these new technologies can enhance learning. It is more than consent to “pass back” the iPad to your child in the back seat. Their guidelines are specific and inline with the AAP’s policy statements:
• No screen time for children under 2 years of age • Technology should be developmentally appropriate • Technology should be used to support specific educational goals • It should be used with specific intentionality not for the sake of using the technology itself • Parents/Teachers should seek to link on and off screen activities • Technology should augment, not impede, or be a substitute for social activity, play, and learning.
I was also pleased to find their report included a discussion on the role of technology for children with autism and developmental delay. In fact they seek the “Intentional leveraging [of] the potential of technology and media for the benefit of every child”.
This report even makes an important equity argument. Lower income families own fewer media devices and so can get left behind. Drawing an interesting parallel between “technology handling” and the importance of teaching “book handling” skills, the report argues the value of exposure of these technologies in a structured classroom environment to low income children so they learn how to both use these technologies and benefit from them. Furthermore, they suggest that together with good teaching, this could “accelerate learning and narrow the achievement gap”.
Technology has, and will continue to have, a growing role in our lives. Parents, pediatricians, and educators are clamoring for guidance on how to maximize the benefits of technology while minimizing the harm for children. This position statement is an important contribution to this discussion.