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Adverse effects: 1) increased television viewing 1-3 hours/day vs < 1 hr/day increased likelihood of aggressive & violent behavior in adolescents by 50%. [1] 2) may increase risk of attention deficit hyperactivity disorder (ADHD) [2] 3) three studies conclude that television has adverse effects on children's academic performance 4) recreational television viewing time, is associated with increased mortality & increased cardiovascular risk regardless of other physical activity [4] 5) increased risk of obesity [6] 6) young adults who are sedentary & watch a lot of television have worse cognition in midlife [7] 7) adults > 50 who watch > 3.5 hours of television daily may be at increased risk for cognitive decline [9] 8) watching television for several hours a day is associated with poor health outcomes in black adults [10] Management: - children < 18 months of age: no television [7] - 18-24 months: high-quality content & apps only (PBS Kids) - watch with children [7] - children under age 2 years should be discouraged from having any screen time - 2-5 years: limit high-quality screen time to < 1 hour/day [7] - parents limit children's screen time to <= 2 hours a day - children under age 2 years should be discouraged from having any screen time - children should not have TVs or internet-connected devices in their bedrooms or in the kitchen [5,6]

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References

  1. Journal Watch 22(9):72, 2002 Johnson JG et al Science 295:2468, 2002 Anderson CA & Bushman BJ, Science 295:2377, 2002
  2. Journal Watch 24(10):83, 2004 Christakis DA, Zimmerman FJ, DiGiuseppe DL, McCarty CA. Early television exposure and subsequent attentional problems in children. Pediatrics. 2004 Apr;113(4):708-13. PMID: 15060216
  3. Borzekowski DL, Robinson TN. The remote, the mouse, and the no. 2 pencil: the household media environment and academic achievement among third grade students. Arch Pediatr Adolesc Med. 2005 Jul;159(7):607-13. PMID: 15996991 - Hancox RJ, Milne BJ, Poulton R. Association of television viewing during childhood with poor educational achievement. Arch Pediatr Adolesc Med. 2005 Jul;159(7):614-8. PMID: 15996992 - Zimmerman FJ, Christakis DA. Children's television viewing and cognitive outcomes: a longitudinal analysis of national data. Arch Pediatr Adolesc Med. 2005 Jul;159(7):619-25. - PMID: 15996993 - Chernin AR, Linebarger DL. The relationship between children's television viewing and academic performance. Arch Pediatr Adolesc Med. 2005 Jul;159(7):687-9. No abstract available. PMID: 15997006
  4. Stamatakis E et al. Screen-based entertainment time, all-cause mortality, and cardiovascular events: Population-based study with ongoing mortality and hospital events follow-up. J Am Coll Cardiol 2011 Jan 18; 57:292. PMID: 21232666
  5. American Academy of Pediatrics.Policy Statement. Oct 2013. Children, Adolescents and the Media. http://pediatrics.aappublications.org/content/early/2013/10/24/peds.2013-2656.full.pdf+html
  6. Daniels SR, Hassink SG The Role of the Pediatrician in Primary Prevention of Obesity. Prediatrics. June 29, 2015 PMID: 26122812 http://pediatrics.aappublications.org/content/early/2015/06/23/peds.2015-1558
  7. Hoang TD, Reis J, Zhu N et al Effect of Early Adult Patterns of Physical Activity and Television Viewing on Midlife Cognitive Function. JAMA Psychiatry. Published online December 02, 2015 http://archpsyc.jamanetwork.com/article.aspx?articleid=2471270
  8. Young K, Sofair A, Chavey WE Pediatrics Group Offers New Media Use Guidance for Kids. Physician's First Watch, Oct 21, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org - COUNCIL ON COMMUNICATIONS AND MEDIA Media Use in School-Aged Children and Adolescents Pediatrics Oct 2016, e20162592; PMID: 27940794 - Chassiakos Y, Radesky J, Christakis D et al, COUNCIL ON COMMUNICATIONS AND MEDIA Children and Adolescents and Digital Media Pediatrics Oct 2016, e20162593 PMID: 27940795
  9. Fancourt D, Steptoe A Television viewing and cognitive decline in older age: findings from the English Longitudinal Study of Ageing. Scientific Reportsvolume 9, Article number: 2851 (2019) PMID: 30820029 https://www.nature.com/articles/s41598-019-39354-4
  10. Garcia JM et al Types of Sedentary Behavior and Risk of Cardiovascular Events and Mortality in Blacks: The Jackson Heart Study. J Am Hear Assoc 2019 8(13): July 2, https://www.ahajournals.org/doi/10.1161/JAHA.118.010406