Whose media advice do parents heed?

How much parents adhere to medical professionals’ advice about their child’s media use depends on whether their pediatrician or the American Academy of Pediatrics (AAP)-or both-is the source of the advice. Of the 1454 respondents to a nationally representative telephone survey, 24.9% of families with children aged between 8 months and 8 years relied on the AAP when making media decisions related to their children, whereas another 29.1% said that for this they looked to their pediatrician. About 14.9% of families reported that they depended on both their pediatrician and the AAP for media advice.

Current AAP recommendations in this area include having no television set in the child’s room; limiting screen media exposure to 2 hours a day for children aged older than 2 years; allowing no exposure at all for any child aged younger than 2 years; and having parents watch screen media with their child.

With regard to not having a television in the child’s bedroom, parents who reported relying on the AAP for media guidance were 1.8 times less likely than parents who relied on their pediatricians to have a television in their child’s room. Adherence to guidelines about limiting screen time in keeping with the child’s age were not linked to a particular source of advice nor was the likelihood of adhering to the guideline for an adult always to be present. However, parents who relied on the AAP for advice actually were more likely to have put the guidelines into practice than parents who relied on a pediatrician.

Parents of firstborn children were more likely to listen to both their pediatrician and the AAP in making media-related decisions (Lapierre MA, et al. Clin Pediatr. 2014;53[12]:1166-1173).

Commentary: Well, the good news is that more than half of families look to either the AAP or their pediatrician for advice about their children’s use of media. However, according to this study, too few who rely on their pediatrician follow the doctor’s advice, and more who look to the AAP act on its recommendations. This is contrary to other recent articles on the subject of anticipatory guidance showing that pediatricians’ advice changes actions in the home.

The difference may be in study design. The researchers don’t describe how families taking advice from the AAP get that advice. Do they seek it out on the AAP website or in AAP literature? If so, this may be a select group of parents who actively sought advice and will be more likely to comply. On the other hand, the investigators don’t report how many of the families were given advice by the pediatrician. It may be that this topic wasn’t covered in anticipatory guidance, or if it was, it may have been passively received rather than actively sought by the family. These families will be less likely to act.

I am happy for families to get good media advice from any legitimate source, and, at least for now, I am going to remain optimistic that pediatrician guidance leads to implementation of good practices in the home. -Michael G Burke, MD

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.