Mental Health: Screens and Sanity: A Pediatrician’s Guide to Managing Recreational Media
Column Author: Trent Myers, MD | Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine
Column Editor: Sara Anderson, MD, MPH | Clinical Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine
Recreational Screen Time: What’s Healthy and What’s Hype?
Most parents have a love-hate relationship with screens. They provide quick entertainment, educational tools, and a reliable way to keep your child from climbing the furniture during a Zoom meeting. They’re also a major source of stress, guilt and arguments.
When families feel like screens are becoming problematic, pediatricians are often the first line of defense. Most caregivers intuitively know “too much screen time is bad,” but they’re often unclear about how much is too much, what kind of media is appropriate, and how to implement limits without triggering a family mutiny.
This article provides practical, evidence-informed guidance for managing recreational screen time in children, using current recommendations from the American Academy of Pediatrics (AAP).
Infants and Toddlers (0–2 years)
Recommendation: Avoid screens altogether before age 18 months, except for video chatting.
Between 18 and 24 months of age, families can introduce high-quality media — but only if they’re watching with the child and actively helping them engage. Fast-paced cartoons, solo screen time and overstimulating content should be avoided.
It’s worth reminding families that early exposure to technology doesn’t provide any developmental advantage. Early overuse of technology may cause developmental problems by displacing developmentally meaningful activities.
Preschoolers (2–5 years)
Recommendation: Limit to one hour per day of high-quality programming; co-viewing encouraged.
This developmental period is when most of the screen-time battles begin. Encouraging parents to select age-appropriate, slower-paced and educational content — and to watch with their children — can help mitigate negative effects. If the app, show, or game includes loud noises, flashing lights, or rapid scene changes, it’s probably not helping that child’s attention span.
It’s also important for parents to avoid using screens as a primary calming strategy. While occasional use (e.g., long flights, medical procedures) is understandable, routine reliance on screens can interfere with a child’s development of self-soothing strategies.
School-Aged Kids and Teens (5–18 years):
Recommendation: Set consistent daily limits and expectations for media use. Content matters significantly. Prioritize sleep, exercise, academics and in-person social engagement.
This age group is more nuanced, so rather than offering a specific hourly limit, the AAP encourages pediatricians to help families set individualized plans based on a child’s age, needs and developmental stage. Ongoing conversations about online safety, respectful communication and digital boundaries are crucial — especially for teens. Encourage parents to remain involved and curious about their child’s digital life without being too intrusive.
It is important that house rules about screens remain consistent with only occasional exceptions, and that parents do their best to model appropriate media use behavior. I’ve heard it said that “if you don’t model what you teach, then you’re teaching something else.” If children complain that their friends don’t have the same rules about screens, having a phrase to use as a mantra can be helpful to avoid power struggles. In our house with our 7-year-old boy, we say “different family, different rules.”
The AAP recommends the following:
- No screens for at least one hour before bed.
- No devices in bedrooms overnight.
- No entertainment media while doing homework.
- Encourage daily physical activity (one hour or more) and adequate sleep (eight to 12 hours).
- Establish media-free times and zones, such as mealtimes and car rides.
If parents aren’t sure where to start, suggest using:
- AAP’s Family Media Use Plan: healthychildren.org/MediaUsePlan
- Common Sense Media: commonsensemedia.org, a trusted resource for evaluating age-appropriate content.
- Monitoring apps: Bark, Aura, TeenSafe, or WebWatcher are considered helpful apps to monitor a child’s electronic device. See the following website for additional information: https://www.commonsensemedia.org/articles/parents-ultimate-guide-to-parental-controls
Clinical Takeaways for Pediatricians:
- Normalize parental guilt and redirect it toward actionable, developmentally appropriate screen use goals. Work collaboratively as a team to get things moving in the right direction.
- Content matters! Encourage families to be familiar with the content of electronic media their child is consuming and make sure it is appropriate for the child’s age and maturity level.
- Emphasize that screens are not inherently bad, but that intentional use matters.
- Be proactive in offering tools. Refer families to websites like commonsensemedia.org and the AAP’s Family Media Use Plan to help them structure home screen habits.
Thoughtful engagements with technology that prioritize healthy childhood development underscore successful clinical recommendations. Much like nutrition or sleep hygiene, healthy screen habits are a cornerstone of child wellness in the digital age.
References:
- Screen time and children. American Academy of Child & Adolescent Psychiatry. Updated June 2025. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx
- Family media plan. American Academy of Pediatrics. https://www.healthychildren.org/English/fmp/Pages/MediaPlan.aspx
- Media and children. American Academy of Pediatrics. Last updated June 4, 2021. https://www.aap.org/en/patient-care/media-and-children/
- Common Sense Media. https://www.commonsensemedia.org/
- The AAP parenting website. Healthychildren.org. https://www.healthychildren.org/English/Pages/default.aspx