A boy makes faces while testing out the Animoji feature on an iPhone X at the Apple Store Union Square on in San Francisco in 2017.
A boy makes faces while testing out the Animoji feature on an iPhone X at the Apple Store Union Square on in San Francisco in 2017. - 
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Let's talk about screen time. Every parent is struggling with the question: How much screen time is too much? But the debate is deeper than simple time limits. Is there a right and wrong kind of screen time? Even if we answer that question, there are still the apps designed to grab kids' attention, no matter what. Researchers still don’t know how all of this is affecting our children's brains.

In the last installment of our series on the trade-offs of technology and what it means for our kids, Marketplace Tech host Molly Wood talked with Dr. Megan Moreno, a professor of pediatrics at the University of Wisconsin who studies how media use affects kids. The following is an edited transcript of their conversation. They started by discussing the latest pediatric guidelines for screen time

Megan Moreno: The first set of screen-based guidelines the [American Academy of Pediatrics] has put out that actually encourages screen time, and encourages parents and kids to be co-viewing content. So I think it really reflects that our relationships with screens is really complex and there's incredible learning opportunities. But there's also incredible opportunities to waste time.

Molly Wood: And so other than wasting time what do we know? You know, what do we really know about what digital media usage does to kids?

Moreno: I think two main areas that intersect with health that have a really strong evidence base would be sleep and physical activity. So, we know that if kids are interacting with screens close to their bedtime, or at night, that that can interfere with both the quality as well as the quantity of sleep. And that has impact on school performance, that has impact on energy levels, that has impact even on appetite and eating patterns. And then we also know that when kids use screens in ways that are sedentary, that that sedentary behavior can add up and it can get in the way of the physical activity that we know that kids of all ages need every day.

Wood: So what's interesting about that, just to play devil's advocate, is that it doesn't sound that different from when I was a kid and my brother would stay up all night playing video games, or when we just sat around and watched TV all the time instead of playing outside.

Moreno: It's not, but I think there's other potential risks that people are beginning to explore that we don't have as strong of an evidence base for. So one would be the compulsive, or problematic, or potentially addictive nature of today's screen use. You didn't really hear about people who are addicted to their TV when we were growing up, and today there's a lot of discussion and growing research around the idea of whether we can be addicted to using mobile devices. So I feel like that's an area where the evidence is growing, but we don't know enough to be able to say "OK, this is the right way or the wrong way to use your screens to prevent this."

Wood: Right. There was a study this month in the Journal of the American Medical Association that found there was a "significant association between higher frequency of modern digital media use and subsequent symptoms of ADHD."

Moreno: This is particularly salient when you think about youth, that our interactions with technology can impact the way our brains are wired.

Wood: That's the big fear. I mean, I've actually had that conversation with my son where I say, "Look, I'm not just trying to be mean, I'm afraid I might be breaking your brain if you spend too much time on this phone."

Moreno: I think many of us out there have these inclinations that using media in certain ways, it kind of feels like it's probably not good. And I think a lot of really cool studies are being done, such as FMRI studies, that show what part of your brain is lighting up when you're interacting with this media.

Wood: Yeah, that is super fascinating because the idea that it's more than just time spent looking at something and this sort of question, I mean, how much can you be influenced?

Moreno: Exactly. There's a guy named Chris Cassio who's looking at how do people interpret messages about health? So if I as a health care provider say to you, "You should go exercise," is that more or less persuasive than me showing you a picture of another patient who exercised and did well.

Wood: It feels like that gets to the heart of a lot of what's happening, certainly with the social media side of things. The idea that influencers are more effective at advertising.

Moreno: There was a study of, an FMRI study that showed that Instagram posts that had a lot of likes lit up different parts of the brain than Instagram posts that don't have a lot of likes. And if we really decide to dork out and think about [it] evolutionarily, teenagers are supposed to be learning what the social norms of their peer group are, and learn what tribe they're supposed to be with. It looks like likes on Instagram are triggering those same pathways in the brain to say, "Hey, here's what our tribe likes, here's what you should be doing." So the new aspect of social media is mapping onto these ancient parts of our brain that are meant to really help us adapt socially. But social media is a different arena for that.

Wood: Man, I could talk to a dork out on that all day. We're starting to see industry, or former members of the tech industry, get involved a little bit in trying to solve some of these problems or at least address them. The idea that this technology might be too addictive or exploit our attention. So there's, you know, the Center for Humane Technology. There's Apple starting to help you measure how much time you spend on your phone. Do you think that that is useful?

Moreno: I think that it's exciting to see people in the industry joining this conversation for sure, because I think this — I guess going back to the tobacco industry, where tobacco has a product and they know it's bad and it kills people — but this is different. This is more like a car, where here's a product that can get you places you could never have gone, but there's also risks, and potential injury risks, and how do you go and try to make that product better to avoid those injuries? So I think it's really valuable and it allows evidence that hopefully is emerging in the literature to maybe get translated into practice by that industry.

Wood: Would it be helpful if, say, the Center for Humane Technology or one of these sort of outside advocacy groups maybe funded some of this research?

Moreno: I think that might be what we might see, because I think getting media and technology research funded, for example, by the [National Institutes of Health], it has challenges. Media is something that often falls between different institutes. You know, there's not a National Institute of Media and Health at the NIH. It would fill a gap that doesn't really exist right now.

Wood: And then I wonder how much can we reasonably expect — I guess from both ourselves and our kids, right? — like a lot of this technology is very new. Even we adults don't have a very big immunity to systems that are really designed to grab our attention and hold it. And I wonder, like, how it's even possible for us to have a reasonable conversation with our kids about it too? Like, our kids are just reflecting our behavior.

Moreno: I think the fact that kids are reflecting our behavior is a huge take-home, because I think in this era of technology and so much of the technology use many of us have during the day is not very mindful. You know, you're waiting that extra 10 minutes for a dentist appointment or the bus and you just automatically pull out your phone. It's not a conscious decision. So I think that for parents having those conversations with their kids, but also being very aware of how your role-modeling. If there's 10 minutes that you're waiting for the stove to heat up, what are you doing? Are you just automatically grabbing your phone? And if you are, it's kind of harder for you to have legitimacy when you tell your kid not to do that.

Wood: Yes! I know!

Moreno: That's the hard part.

Wood: Yeah, it is. Do you have any favorite apps? Like, do you block or monitor? Do you think that that's helpful? Or is it just like teaching all of us to be smarter?

Moreno: I don't block or monitor, but I am a big fan of getting the phone out of your immediate reach and sort of prompting yourself to use those 10 minutes here or there in other ways. So I found that if, you know, one thing that's worked well for me is when I get home at the end of the day, the phone goes in a drawer. And then it's just out of sight and out of mind, and I'm not thinking about it, and I know where it is, but it's going to take some work to get to it. So I think that's the other piece is what works for one person may not work for another, so we're all in this process of learning what's going to work for us. And I do think, just to come back to where we started with the AAP's family media use plan, that it's really designed to help people be able to take suggestions of rules and try them out and see if they're working for your family. And if they're not, then try something else, because we're all kind of reinventing the same wheel.

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Follow Molly Wood at @mollywood