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childmind.org-Social Media Effects on Teens

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National Association of School Psychologists (NASP)

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The nature of the loss (i.e., expected vs. sudden) will impact the way caregivers address the loss of a family member. While grief is often characterized by sadness, emotional pain, and introspection in adults, children's grief reactions will vary depending upon their developmental level. More specifically among preschoolers one might observe regressive behaviors, decreased verbalization, and increased anxiety. Among elementary school aged children one might observe decreased academic performance, attention/concentration, and attendance; irritability, aggression, and disruptive behaviors; somatic complaints; sleep/eating disturbances; social withdrawal; guilt, depression, and anxiety; and repeated telling of the event. And among middle and high school age youth one might observe decreased academic performance, attention/concentration, and attendance; avoidance, withdrawal, high risk behaviors or substance abuse, difficulty with peer relations, nightmares, flashbacks, and emotional numbing or depression. The death of a family member may be further complicated by the child's relationship to the deceased as well as to the surviving parent (e.g., if mom and dad are divorced). Cultural factors are important to consider when working with family members after a loss. Some families will be more open to discussing the loss whereas others based on cultural/religious beliefs may choose and request that the loss "not be addressed at all."

Strategies for Families Dealing With an Anticipatory Loss (E.G., Terminal Illness)

With anticipated loss, children may have had to endure weeks, months, or even years of watching their loved one deteriorate, in some cases both physically and mentally, which can significantly disrupt children's academic, behavioral and social/emotional functioning. Thus, family members should be extra vigilant to such changes. Instead of being punitive, try to address the changes through consulting with a school-employed or community-based counselor or psychologist. There are generally four phases of anticipatory grief: depression, extreme concern for the dying person, preparing for the death, and adjusting to changes caused by the death. But again not every child travels through these four phases in a linear process as with grieving in general.

Ambiguous loss is often also a factor with anticipatory grief. As children watch the changes in their parents and loss of physical/cognitive capacities, they need to continuously adapt to both their own "new role in the family" (e.g., possibly becoming a caretaker), as well as to the changed roles in the entire family system (e.g., financial changes due to parent being unable to work; parent's compromised ability to take care of children's everyday needs).

Strategies for dealing with "ambiguous loss" while the loved one is still physically alive but psychologically changed or absent often include adaptive creative arts therapies to encourage children to talk more about their experiences. Although most of these strategies are appropriate in therapeutic settings, some may be adapted for parents and family members to use at home.

Narrative therapy or helping your children "tell their own story" about their experiences can be useful. This can be done by helping your children consider "two choices" to end a story, and have them choose the one that represents a more adaptive way to deal with his or her feelings. Alternatively, if children are unable to tell their story, you can use animals or inanimate objects to personify people as these may be less threatening.

Some activities appropriate for the home wetting include "bibliotherapy"; for example, reading books such as:

Charlotte's Web (EB White, 1952) which deals with the "cycle of life"

"The Last Lecture" (Randy Pausch, 2007) is both a book and a YouTube video in which a terminally ill professor imparts his parental wisdom to his children through a "lecture" with life lessons. This can help engage children in a family discussion about anticipatory grief.

Using art projects where you ask your children to "draw" their feelings about the terminally ill family member may also be useful.

It is recommended that when seeking mental health support for ambiguous loss, the entire family be included; when possible include siblings, parents, and/or other important people in their lives.

Encouraging children to make decisions, such as whether or not they wish to take part in funeral services (when age appropriate) is recommended.

Strategies for Families Coping With Sudden Loss of a Loved One

Reactions among children may be extremely variable in cases of sudden unexpected death or loss. It often depends upon the nature of the "sudden loss" (e.g., if the sudden loss was violent or illness related death). There are generally four phases of grief: but not every child travels through these four phases in a linear process.

1. Shock and Numbness (stunned, difficulty thinking clearly)

2. Yearning and Searching (restless, angry, guilty, bewildered)

3. Disorientation and Disorganization (extreme sadness, possible continued guilt and anger)

4. Reorganization and Resolution (accept the loss)

Suicide or drug overdoses, which are sudden and unexpected losses, may often be especially difficult for family members to cope with because of the stigma associated with these types of deaths. Especially in these instances, it is important to encourage children to talk about the death openly at home. Saying "we are not going to talk about this" will likely interfere with the grieving process. Parents should look to community resources for specialized support groups that include others dealing with a similar loss.

"Survivor guilt" may be a reaction to sudden loss. It is important that this be recognized and acknowledged when we hear statements such as "I wish it were me instead." Survivor guilt may also manifest itself in excessive self-blame. It is important to recognize and try to understand with these feelings, but also let the affected family member know that it was not their fault. For example, following a suicide death surviving family members should be told that ultimately the only person responsible for the death was the deceased.

References

Bowlby, J. (1980). Loss: Sadness and depression. (Vol. 3). New York, NY: Basic Books.

Boss, P. (2010). The trauma and complicated grief of ambiguous loss. Pastoral Psychology, 59(2), pp 137-145. doi: 10.1007/s11089-009-0264-0.

Brown, J. A., Jimerson, S. R., & Comerchero, V. A. (2014). Cognitive development considerations to support bereaved students: Practical applications for school psychologists. Contemporary School Psychology. Advance online publication. doi:10.1007/s40688-014-0018-6

Dogan-Ates, A. (2010). Developmental differences in children's and adolescents' post-disaster reactions. Issues in Mental Health Nursing, 31, 470-476. doi:10.3109/01612840903582528

Mayo Clinic Staff. (2014). Complicated Grief. Retrieved from: http://www.mayoclinic.org/diseases-conditions/complicated-grief/basics/definition/con-20032765

© 2015, National Association of School Psychologists, 4340 East West Highway, Suite 402, Bethesda, MD 20814, 301-657-0270, www.nasponline.org

Please cite this document as:

NASP School Safety and Crisis Response Committee. (2015). When grief and loss hits close to home: Tips for caregivers. Bethesda, MD: National Association of School Psychologists. Bethesda, MD: National Association of School Psychologists.

Contributors: Benjamin S. Fernandez MSEd, Victoria A. Comerchero NCSP, Jacqueline A. Brown NCSP, Catherine Woahn, NCSP

Note. Schools and community agencies may adapt this handout to local needs for educational and student support purposes as long as proper credit is given to NASP.

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When Grief/Loss Hits Close to Home: Tips for Caregivers

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The nature of the loss (i.e., expected vs. sudden) will impact the way caregivers address the loss of a family member. While grief is often characterized by sadness, emotional pain, and introspection in adults, children's grief reactions will vary depending upon their developmental level.

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childmind.org-44 Childrens Books About Mental Health

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childmind.org-Social Media Effects on Teens

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childmind.org-Cómo afecta el uso de las redes sociales a los adolescentes

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Now that you're settling into the reality that the images we saw from Charlottesville were from 2017 and not the days of Jim Crow, it's time to get proactive about parenting during the Trump Era. Though you might have hoped that your children would grow up in a different world from where you came from, the swamp has arisen and racism, anti-Semitism, xenophobia, Islamophobia, homophobia, transphobia and misogyny are alive and slithering along the ground.

So what should you say to your children post-Charlottesville? Now is not the time to tiptoe around tough topics or give your children unclear messages about your values and beliefs or the realities of what happens when bigotry and terror suddenly escalate, as Deandre Harris and Heather Heyer tragically experienced over the weekend.

These dos and don'ts will help guide your parenting in this time of unhooded White supremacy.

Do put on your own mask first. Make time to de-stress and let your blood pressure go down. Your children will pick up on your anxiety if you don't.

Do reflect on your experiences with bias and bigotry. Many parents struggle with what to tell their children about difficult topics because they don't want to pass along their own baggage and unresolved issues. Consequently, many adults are more skilled in not talking about uncomfortable topics than in talking about them. Thinking about your history with these issues will help you clarify the values you want to convey and the behaviors you want your children to demonstrate.

Do protect them from your own internalized bias. Media and society convey relentless negative messages about people of color and others who are pushed to the margins of society. Like smog, everyone inhales them-even you. Take the Implicit Association Test, which measures unconscious, or implicit, bias you hold around race, gender, sexual orientation, mental health and other dimensions of the human experience. Becoming aware of how we really feel helps us recognize and interrupt harmful behaviors. Also take the bias cleanse MTV developed with the Kirwan Institute for the Study of Race and Ethnicity.

Don't wait for your children to initiate the conversation about what happened in Charlottesville. Ask them what they've seen and heard. Reassure them that they and their loved ones are safe and that you will take care of them. Use age-appropriate language, explaining to younger children that sometimes people are mean and unfair to different groups of people and you don't like it. You can address societal issues like racism and anti-Semitism more directly with teens; books and online resources can help provide context.

Do ground your children in a worldview that includes their spirituality, family traditions, heritage, cultural values and self-respect. It's never too early to start. The story you tell your children about who they are must be stronger than the story they hear from the people who don't care about them and much of the media, which traffics in negative messages and stereotypes about people with marginalized identities.

Don't perpetuate the myth that we live in a colorblind society. Everyone is not treated the same, and race and color do matter and America is a not meritocracy where they will succeed if they just try hard enough. Even if you believed this in the past, those ideas lack credibility today. If you need to do an about face, say so and explain why.

Do teach your high-school student about institutional and systemic racism. From the racist policies, practices and procedures that institutions engage in that advantage White, straight, cisgender, able-bodied people and disadvantage the rest of the world to the value system that underpins it all, they need an education. Racist systems are built to oppress. For example, Black and Native American students, LGBTQ students and students with disabilities are all disproportionately more likely to be suspended from school than other students, often for developmentally appropriate behavior. Understanding the various dimensions of racism and bias will help keep your young adult from internalizing structural factors as either their own or their identity group's deficiencies.

Do proactively discuss encounters your children may experience with racists and other bigots. If you wait until adolescence when you think they can handle the subject, your children will likely have been experiencing macro- and microaggressions for years without you to help them process. For example, the excessive disciplining of Black children by teachers and staff has been documented in preschool. Importantly, if your child is bullied, harassed or told that they are not welcome at their school, notify the administration immediately. Help your children understand that federal civil rights laws protect them from hate speech, violence and bullying.

Do counteract messages that children of color aren't as smart or innocent as their White counterparts. Many schools begin sorting students into academic levels in the third grade. Racial hostility toward Black boys from both adults and their peers increases significantly during the tween years. And research shows that by the time a Black boy turns 10, White adults often perceive him as being up to four years older than he is and less innocent than other children. A study released in June revealed that Black girls ages 5 through 14 are viewed as more sexually mature and less innocent than their White peers. These misperceptions leave children vulnerable to mistreatment. Teach them early that they are just as good and worthy of positive interactions as everyone else.

Don't shut down your teenager's urge to debate you on difficult social issues. Many people of color, American-born and immigrant, find this behavior disrespectful, but as long as your young person maintains a respectful tone, consider leaving room for constructive pushback. This back-and-forth is rewarded in most schools and helps to develop critical-thinking skills. In a world where they will often be marginalized and underrepresented, asking questions teaches young people that their opinions matter and that you will consider their perspectives. Bonus: If you listen, you will gain insight into what's on their mind.

Do role-play to help them practice what to say during stressful encounters. Help them create a loose script they can use in various scenarios-from a classmate telling them to go back to their country, to a teacher making an Islamophobic remark, to a transphobic street bully. Having a default response will soothe a bit of the sting.

Don't be silent on issues of misogyny, xenophobia, homophobia, ableism, religious intolerance or other racial or social-justice issues. Model for your children that they should not put up with bigotry, whether it's directed at them or others. Then arm them with strategies they can use in different environments-from using a script to stand up for themselves, to seeking a trusted adult to intervene, to making signs and rolling to a direct action.

Do teach your adolescent to be aware of their surroundings. While they probably experience love close to home, not everyone will appreciate them as they travel more independently and with less supervision. Teach them to recognize the iconography of Neo-Nazism, White supremacists, the so-called alt-right and other hate groups. If you have a college-bound student, read and share the Southern Poverty Law Center's publication about how the alt-right operates on college campuses.

Do teach older students media literacy. This will help them dissect biased images and messages, debate stereotypes, stand up for themselves and manage the conflict and stress that can arise when others challenge their identities. Also talk about critical consciousness theory, so they understand how oppression and privilege shape the world and their place in it.
Hilary Beard is creating a world where everyone can thrive. She is the co-author of "Promises Kept: Raising Black Boys to Succeed in School and in Life" and "Health First!: The Black Woman's Wellness Guide." Follow her on Twitter @HilaryBeard.

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The Dos and Dont's of Talking to Kids of Color About White Supremacy - Colorlines

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A primer for talking to children about racism-and systems that perpetuate it-in the aftermath of the violence in Charlottesville.

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Talking to Kids about Racism and Justice - Oakland Library

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Tips for Parents on Media Coverage of a Stabbing

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Gives information to parents and caregivers about media coverage following a stabbing. This tip sheet describes what parents can do to help their children, media exposure after events, and talks about what it is like when a family is a part of the story.

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This 94-page activity book, from the NICHD and the National Black Child Development Institute, provides information and resources that can help parents instill a sense of safety in their children during times of crisis, through creative activities that encourage communication. The book is part of an effort to give parents tools to help their children handle crises.

Preferred Citation:
Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS. (2012). An Activity Book for African American Families: Helping Children Cope with Crisis (03-5362B). Washington, DC: U.S. Government Printing Office.

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An Activity Book for African American Families: Helping Children Cope with Crisis

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This 94-page activity book, from the NICHD and the National Black Child Development Institute, provides information and resources that can help parents instill a sense of safety in their children during times of crisis, through creative activities that encourage communication. The book is part of an effort to give parents tools to help their children handle crises.

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Experts say diversity and discrimination are subjects that need to be addressed with children.

Cite this

American Psychological Association. (2016, March 9). Talking to kids about discrimination. https://www.apa.org/topics/racism-bias-discrimination/kids

Discussing discrimination can be hard enough for adults. Talking to kids about the subject can be especially daunting.

People can be discriminated against for any number of reasons, including age, gender, weight, religion, income level, disability, sexual orientation, and race or ethnicity. According to the 2015 APA Stress in America Survey, most Americans feel they have experienced discrimination. However, experiences of day-to-day discrimination are most likely to be reported by racial and ethnic minorities.

Unfortunately, many people are uncomfortable discussing racial differences. But when it comes to talking to children, experts say diversity and discrimination are subjects that shouldn't be ignored.

Children notice

Many people are hesitant to talk to their kids about differences because they don't want to draw attention to them. But whether you talk about those differences or not, kids notice when someone looks different than they do. They also notice when certain groups seem to be treated differently than others.

Studies show that even infants can distinguish skin tones. By early childhood, kids begin to have more favorable opinions of people they perceive as "the same" as they are-even if the similarities are meaningless. In one study, for instance, researchers randomly assigned 6-year-olds to either a green group or an orange group. Later, the kids were more likely to remember positive things about the kids in their own group, and negative things about kids in the other group. ¹

When parents avoid talking about differences and discrimination, experts say, children learn that the topic is taboo. Children might come to believe the differences they notice are more important than they really are. And they might be hesitant to ask questions, missing opportunities to challenge and correct stereotypes.

Discussing differences, on the other hand, can help kids appreciate diversity and better recognize discrimination when they see it. In one experiment with 8- to 11-year-olds, researchers read children storybooks that either downplayed racial differences (referred to as a "color-blind" approach) or talked about the value of diversity. Later, when listening to stories that featured examples of racial bias, the children who had read the "color-blind" books were less likely to recognize that bias. Kids who learned about diversity, on the other hand, were better at identifying examples of discrimination. ²

The stress of being discriminated against

All children can benefit from talking openly about diversity and bias. But for kids in groups more likely to be a target of discrimination, such conversations can be even more critical.

Perceived discrimination has been linked to physical and mental health problems including anxiety, depression, obesity, high blood pressure, and substance abuse. Many of these problems are believed to stem from the chronic stress associated with being a potential target of discrimination. ³

Discrimination-related stress can also affect how kids feel about themselves. It might prevent them from speaking up in class, or from participating in activities that are important to them.

But talking openly with children can prepare them for dealing with discrimination, and help them keep discrimination-related stress in check.

Discussing discrimination

How can you talk to your children about diversity and discrimination? Here are some guidelines to keep in mind.

Don't expect to have "the talk" about discrimination. It shouldn't be one conversation. Rather, let the discussion be open and ongoing.

Parents often avoid talking about hard subjects (including sex, underage drinking and discrimination) because they're personally uncomfortable. Keep talking anyway. The discussions get easier over time.

Use age-appropriate language children can understand, and don't give kids too much information at once. The conversation will get deeper and more nuanced as they get older.

Learn to respond to children's questions about differences and bias as they come up naturally. Help children feel that their questions are welcome, or they might come to believe that discussing differences is taboo.

Help children understand the value of diversity. A diverse set of experiences and viewpoints boosts creativity and helps kids (and adults) better understand the world around them. On the other hand, discrimination hurts everyone-not just the targets of discrimination. When people are discriminated against, we can miss an important opportunity to learn from them.

Take opportunities to raise discussions based on what you see around you-in real life, books, television shows and even video games. You might ask: "There aren't many female characters in this video game. What do you think of that?" or "Do you think that show accurately portrays LGBT characters, or does it rely on stereotypes?"

Help kids learn how to deal with being the potential target of discrimination. Plan ahead by developing healthy comebacks or responses to hurtful discriminatory statements. For example: "What an unkind thing to say." "Excuse me? Could you repeat that?" "I disagree with you, and here's why..."

If you hear children say something discriminatory, don't just hush them. Use the opportunity as a conversation starter to address their fears and correct their misperceptions.

Challenge your own assumptions and behavior. Do you laugh at racially insensitive jokes? Do you cross the street to avoid passing people of a different ethnic group? Children learn from your actions as well as your words.

Broaden their horizons. Think about the diversity of your own friendship and parenting networks and the places where you spend time. When kids are exposed to people from diverse backgrounds, they have more opportunities to learn about others and discover what they have in common.

Thanks to psychologists Diane Hughes, PhD, and Howard Stevenson, PhD, who assisted with this article.

References

¹ Dunham, Y., and Emory, J. (2014). Of affect and ambiguity: The emergence of preference for arbitrary groups. Journal of Social Issues, 70(1), 81-98. Doi: 10.1111/josi.12048

² Apfelbaum, E. P., Pauker, K., Sommers, S. R., & Ambady, N. (2010). In blind pursuit of racial equality? Psychological Science, 21(11), 1587-1592. doi: 10.1177/0956797610384741

³ Pascoe, E. A. & Richman, L. S. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin 135(4): 531-554. Doi: 10.1037/a0016059

Recommended Reading

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Experts say diversity and discrimination are subjects that need to be addressed with children. Cite this American Psychological Association. (2016, March 9). Talking to kids about discrimination. https://www.apa.org/topics/racism-bias-discrimination/kids Discussing discrimination can be hard enough for adults. Talking to kids about the subject can be especially daunting.

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Talking to Kids about Racism and Justice - Oakland Library

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childmind.org-Why Watch TV With Your Tween or Teen

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Kids of all ages are obsessively playing Fortnite on their phones, computers, PlayStations, Xboxes and Switches. When they're not playing Fortnite they might be watching streams of other people playing it on Twitch or Youtube. The game's almost hypnotizing popularity has many parents worried.

Sarah, mom to nine-year-old Henry, says that Fortnite is different from other games. "He has played other video games, but he hasn't been so enamored by anything like this before. It's not like a sports game on the Xbox - it's really addicting." She mentions a friend whose ninth grader stays up to 3 and 4 in the morning playing. Brian, father to another nine-year-old, describes walking outside and hearing neighborhood kids screaming about near misses on a Fortnite game like it's a World Cup final.

"We're hearing from a lot of parents worried because their kids seem even more glued to this game than others, and tearing them away from it for homework or dinner is becoming an issue," reports David Anderson, PhD, a clinical psychologist at the Child Mind Institute. "We're also hearing about kids developing behavior around the game that could get them into trouble."

What makes Fortnite so appealing to kids? And how can parents keep them from getting so sucked into the game that it's unhealthy?

When people are talking about Fortnite, they are most likely talking about Fortnite: Battle Royale, which is the version of the game where up to 100 players battle to the death, with the winner being the last player standing. The game is similar to the ultra-popular Minecraft in that part of the object of the game is construction. In Fortnite players can build forts from materials they find in their environment. They can also loot supplies and equipment from defeated players, random supply drops, and from chests they find sprinkled around the game map.

"My favorite part of the game is the surprise of finding where the chests are and what's inside them, or what's flying around or what your opponents have if you kill them" says Rusty, a 10-year-old Fortnite player. "Often it's a weapon. Sometimes you get a good weapon, sometimes it's a bad one. You can get shields that protect you, you can get bombs, ammo, sometimes you can get materials."

These surprise rewards can hold a strong appeal for kids. The excitement of finding a chest - and the possibility of what might be inside - is one such strategy that reinforces a person's desire to keep playing and keep getting rewards.

Another feature that makes Fortnite enticing is the near-miss: When your character is killed on Fortnite, you get to see the health bar of the person who killed you. Often you will see that your opponent was also close to dying, so the game feels like it was very close. The near misses are tantalizing, and you're compelled to keep playing.

It's a technique that's used in other combat games, along with Candy Crush, which tells players when they just missed getting to the next level. Researchers studying the effect of these near-misses found that they triggered a substantial urge to keep playing.

"There's something about really trying to win against a group of people and feeling like you're getting better and better and closer and closer," says Sarah. "It almost seems like it's gambling, like a slot machine. It hooks these kids and they feel like they need to keep playing."

"With a game like Fortnite, you're losing frequently, but you also have so much potential with every game," agrees Dr. Anderson, adding, "Not to mention that you don't have to wait too long to start the next game." Each game is about 20 minutes long, and anyone who has ever binge watched a television series knows how quickly time passes with each successive episode.

One of the biggest draws of Fortnite is its social component. Kids can play with a friend or in a squad of friends. Rusty plays with his neighbor, and says they try to help each other out during the battles. If playing a game is fun by yourself, it's naturally going to be more fun if you're playing with friends. It also sets up some compelling expectations - and potential conflicts with parents. If you've set a time to play with a friend, you're going to want to keep that appointment. If your friend wants to play the next game, you won't want to let them down.

"With Fortnite, if you're not on when your friends are playing, you've missed it," notes Dr. Anderson. And for kids, feeling left out is one of the worst feelings there is.

Fortnite certainly isn't the first game to let people play together on a team. Games like Quake and Counterstrike also let you team up with a friend. But Fortnite introduces younger kids to the adrenalin-inducing appeal of a first-person shooter game that is played in real time with friends. That's because parents are more likely to give younger kids their blessing to play Fortnite, since its cartoon graphics aren't especially gruesome.

While all this carefully crafted game design makes Fortnite fun to play, it also makes it hard to stop, so setting limits is necessary.

"We try to take a sense of the amount of free time that a child has, and what we want to know is that there's balance," says Dr. Anderson. He has a checklist of things that he calls "developmentally integral" to a child's life, that parents should make sure kids aren't missing out on. The list includes:

Seeing friends and interacting with them in real life

Participating in extracurricular activities they're excited about

Keeping up with academic classes and doing homework

Building positive relationships with family members

Getting enough sleep

A healthy allotment of screen time would be one that wouldn't disrupt these things. Rusty says he gets to play for two-hour blocks on weekends or days off from school, but never on weekdays. This schedule works for him, although he says many of his friends play every day.

You might like the idea of saving video games for the weekend, or you might agree that a smaller amount of time every day - maybe half an hour in the evening - is fine, as long as homework is done first. Whatever you decide, do continue to monitor how your child is doing, Dr. Anderson advises, and don't be afraid to modify the schedule as needed.

Parents should also monitor kids' behavior when they are playing video games, especially social ones like Fortnite, Dr. Anderson advises.

For example, he reports, "Lots of parents will come and tell us, 'My kid only has 30 minutes where they get to play this game on a weeknight, but I walk by and I hear them saying insulting and derogatory things the whole time. What do I do about that?' "

The advice he usually gives starts with explaining the difference between good natured trash talk, which is fine, and bullying, which isn't. He also recommends warning kids that the things they are saying while they are playing can have real life consequences. Someone could take a screen capture of what your child is saying in chat, or record audio, or a friend's parent could even be in the room overhearing what they are saying. Then things can escalate.

For example, Dr. Anderson warns, "I had a kid last week get suspended from school for a day over swear words and threats that they leveled against another student about Fortnite, and the fact that the other student was playing with a friend of theirs without them."

There are a few lessons here. The first is that kids shouldn't feel like the rules are different in games or online. In video games when kids are feeling competitive - or slighted - and their adrenaline is boosted, it can lead to them saying things they wouldn't normally say face-to-face. But the ordinary rules of conduct should still apply.

This is also important because the habits kids develop while playing video games can generalize into other settings, like school.

As with any discipline you enforce as a parent, setting clear limits is important.

Sarah is strict about not letting her son play Fortnite during the school week, unless it's a treat, and he knows that. After hearing her son arguing and getting upset with a friend while playing the game, she also doesn't let him play Fortnite with people he can't play nicely with. But learning more about the game has also taught her when to be a little lenient. Because there's no way to pause the game, she says she'll let her son finish if he's in the middle of a game. Her son appreciates that, and not trying to fight that particular battle helps everyone stay calm.

Brian says his son just got the game. And since he knows how wound up kids can get playing it, he made a point of warning his son that if he hears him getting overly emotional about Fortnite he'll take it away. "Over the weekend we were visiting friends and I heard one of the kids screaming upset because now that Fortnite is released on the Nintendo Switch platform, he couldn't port over the things he had earned on the Xbox," Brian says. That's the kind of outsized reaction that he wants his kid to know isn't acceptable. Normal behavior rules still apply.

Setting limits from the beginning is ideal, but things aren't hopeless if you haven't done this yet. Make sure whatever limits you do decide to establish are made clear to your child, and make sure that you stick to them. Kids will learn pretty quickly if you'll relent and give them an extra 20 minutes of screen time when they throw a tantrum, even if you only give in one out of every four times. Remember that with video games you're up against a potent competitor, and stick to your own guns.

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A Parent's Guide to Dealing With Fortnite - Child Mind Institute

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Kids of all ages are obsessively playing Fortnite on their phones, computers, PlayStations, Xboxes and Switches. When they're not playing Fortnite they might be watching streams of other people playing it on Twitch or Youtube. The game's almost hypnotizing popularity has many parents worried.

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How to Set Limits on Screen Time - Child Mind Institute

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Tips for managing your child’s screen time and setting new rules.

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In case you've ever wondered how much time your daughter spends taking selfies, a poll in 2015 found that the average woman between 16 and 25 years old spends over five hours a week. It sounds like a lot unless you've tried to take selfies yourself and know what an elaborate process it can be. Women take an average of seven shots to get one image, according to the poll; Kim Kardashian said it takes about 15 to 20. Then there are the filters, not to mention real-life alterations like changing lighting or touching up makeup. There are also apps you can use for more drastic procedures like changing your bone structure, slimming your waistline, erasing pimples, and more.

Selfies can be silly and lighthearted, of course, notes Alexandra Hamlet, PsyD, a psychologist at the Child Mind Institute. But she also recognizes the darker side, when photos become a measure of self-worth. "With makeup, with retouch, with filters, with multiple, multiple attempts, it's almost like you're never going to stack up," says Dr. Hamlet, "And that is where I think it gets dangerous."

We're used to worrying about how girls will be affected by seeing too many air-brushed images of models in magazines or movies. But now young people themselves are the models and they're wielding their own image-editing software. This leads to a lot of self-scrutiny as they try to perfect their own images, and comparisons to the pictures their peers are posting. Experts are understandably worried about what this means for kids' self-esteem.

Seeking perfection

If you've been telling your daughter that she's beautiful just the way she is, she's getting a different message when she opens up Snapchat and sees filters and lenses that alter appearances. Pictures used to be final; now we have post-production.

Dr. Hamlet acknowledges that some of the filters are fun and distort in amusing ways, but also points out there's a so-called "pretty filter" on Instagram and Snapchat. Beautifying filters are used almost reflexively by many, which means that girls are getting used to seeing their peers effectively airbrushed every single day online. There are also image altering apps that teens can download for more substantial changes. Facetune is one popular one, but there are many, and they can be used to do everything from erase pimples to change the structure of your face or make you look taller. One app called RetouchMe gives your photo a "professional retouch" using a photo editing team for under a dollar.

The possibilities can be overwhelming, particularly since girls know they are scrutinized on their appearance - as, of course, they are scrutinizing their peers.

Too much comparison

Self-esteem often takes a hit when you start comparing yourself too much to other people, which is something social media seems to be made for. One study found that frequently viewing selfies led to decreased self-esteem and decreased life satisfaction. Another study found that girls who spend more time looking at pictures on Facebook reported higher weight dissatisfaction and self-objectification.

In her book Enough As She Is, Rachel Simmons writes about pressures facing girls, including comparing themselves to peers on social media and feeling that they were coming up short. One 18-year-old girl told her, "I don't hate myself when I'm alone. I just hate myself in comparison to other people."

Thanks to social media, that time alone in your head that most adults grew up with has been eroded. Any spare moment she has, a young woman now might easily open up Instagram or Snapchat, which means that she starts playing the comparison game.

Even if the pictures a girl posts on social media get plenty of likes, she might still feel insecure - especially if she's an adolescent who is already feeling insecure and trying to make herself feel better, Dr. Hamlet notes. That's because humans tend to be very "mood consistent," she says. "It can feel icky to do something on the outside that is inconsistent with how we feel on the inside." That's why if you're feeling sad, you might be more likely to want to listen to sad music instead of watch a comedy. And in the same way, if you are feeling judgmental and negative about yourself, it generally takes more than a good selfie to pull yourself out of that trap.

Mental health consequences

While social media might not be causing a mental health disorder, it can pull some kids closer into a diagnosable range if they are already struggling. "If you're depressed or anxious, you're probably going to be comparing yourself to others more, or devaluing yourself more," explains Dr. Hamlet. "Maybe you'll be striving even harder to try and 'catch up,' which is basically an impossible feat."

The problem of selfies has even attracted the attention of various professional journals for plastic surgeons, which have been posting articles about increasing requests for plastic surgery coming from young people. A poll from the American Academy of Facial Plastic and Reconstructive Surgeons found that 42% of surgeons were asked to perform procedures for improved selfies and pictures on social media platforms. The journal Plastic and Reconstructive Surgery published an article called " When Is Teenage Plastic Surgery Versus Cosmetic Surgery Okay? " exploring the safety and ethical considerations of performing different procedures and providing "cosmetic medication" like Botox and fillers to adolescent clients.

There is even a term for kids who are fixating on their appearance because of social media - selfie dysmorphia, which is also sometimes called Snapchat dysmorphia. While this isn't a real diagnosis, it is a term that recognizes that more people are experiencing a dysmorphia, or idea that there is something fundamentally flawed in their appearance.

It also gestures to a diagnosis that is real: body dysmorphic disorder, which is a mental health disorder related to OCD. People with body dysmorphic disorder are obsessed with what they perceive to be a disfiguring flaw, like a large nose or ears, a blemish on the skin, or underdeveloped muscles. These flaws might be imagined or very minor and blown out of proportion.

While most children won't develop body dysmorphic disorder, or even so-called selfie dysmorphia, they can still exist somewhere on the spectrum of fixating on their appearance, just as they might be struggling with anxiety and depression, whether or not they are at a clinical level.

Being more mindful about social media

Parents who want to provide a healthy counterbalance to the pressures of social media can start by evaluating how they use social media themselves. Make sure you aren't talking too much about the pictures you post or see, or ask your children to take too many pictures. The occasional photo is fine, of course, but make a point of prioritizing being in the moment, too. "If you're taking your kid to a concert, don't allow them to film the whole thing and see it only through the eyes of the camera," says Dr. Hamlet. "That's reinforcing this concept that just being here is not good enough."

Dr. Hamlet also recommends that parents encourage teens to become more mindful about how they use their phones - and model doing this, too. "Before you pick up your device, understand why you're picking it up. What emotional state are you in? Are you anxious? Picking up that phone to check to see what's on social media is probably going to heighten that anxiety. The same with sadness. It's just going to make it worse."

Try having a plan for what you're going to do on Instagram or Snapchat. This might include how long you'll be using it and what you want to see. And while you are using social media, observe how it makes you feel, and be ready to put it down if it starts making you feel bad.

Building self-esteem

Prioritizing a girl's appearance is nothing new in society, but with selfies girls are getting inundated with the feedback that how they look is important. That's why it is up to parents to make sure girls are getting the message that what women think and do is even more important. Don't hold back from complimenting your daughter on her appearance, but make an effort to compliment her at least as much for the things she does and how hard she works.

While it is good for anyone's self-esteem to like the way they look, it is crucial to have many sources of self-esteem. For a young woman's long-term happiness, it will be more deeply rewarding for her to find things that she cares about and practice doing them. Dr. Hamlet calls this "developing mastery and accumulating positives in your life."

Having a personal interest in something and seeing how your skills grow with time and effort makes you feel proud of what you can do, and takes the focus away from achieving perfection, which is impossible. It also encourages girls to look inside themselves for their self-esteem (and not just to compliments from others) which is an important part of growing into a happy, confident woman.

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What Selfies Are Doing to Girls' Self-Esteem

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In case you've ever wondered how much time your daughter spends taking selfies, a poll in 2015 found that the average woman between 16 and 25 years old spends over five hours a week. It sounds like a lot unless you've tried to take selfies yourself and know what an elaborate process it can be.

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Cyberbullying is the use of digital-communication tools (such as the Internet and cell phones) to make another person feel angry, sad, or scared, usually again and again. Examples of cyberbullying include sending hurtful texts or instant messages, posting embarrassing photos or video on social media, and spreading mean rumors online or with cell phones.

If you're trying to figure out whether your kid is being cyberbullied, think about whether the offender is being hurtful intentionally and repeatedly. If the answer is no, the offender might simply need to learn better online behavior. If the answer is yes, take it seriously.

Finding out that your kid has been cyberbullied is emotional for parents. You or your kid might want to retaliate, but it's best to help your kid defuse the situation, protect himself, and make rational efforts to put a stop to the bullying. Here are the immediate steps we recommend for parents:

Reassure your child that you love and support him or her.

Help your child step away from the computer or device and take a break.

If you can identify the bully, consider talking with the parents.

Consider contacting your kid's school. If bullying is happening online, it might be happening offline, too.

Empower your kid with specific steps he or she can take.

Many kids don't tell their parents that they're being cyberbullied. Kids might feel embarrassed or ashamed to let you know they've been targeted. They also might be afraid your involvement will make things worse. But, if you find out your kid has been cyberbullied, it probably means the issue is major enough for you to get involved.

Try this: Collect more facts by talking the situation through with your kid. Work out a plan of action together. Make sure you and your kid agree on what the outcome should be. Ramp up your efforts as the situation demands.

Another reason not to rush to a solution: Research indicates that peers sticking up for each other is a very effective defense against bullies. Bullies work by trying to isolate their victims. When kids rally around the target, it thwarts the bully. Encourage your kid to reach out to friends for support.

Of course, if there are any real threats to your child's safety, you should contact the authorities immediately.

Kids may not always recognize teasing as bullying. Some kids also may be too embarrassed or ashamed to talk to their parents about it. That's why it's important to talk about online and digital behavior before your child starts interacting with others online and with devices. To prepare your kid for going online or getting a cell phone, or, if you know he or she has been bullied online, offer these steps he or she can take immediately:

Sign off the computer. Ignore the attacks and walk away from the cyberbully.

Don't respond or retaliate. If you're angry or hurt, you might say things you'll regret later. Cyberbullies often want to get a reaction out of you, so don't let them know their plans have worked.

Block the bully. If you get mean messages through IM or a social-networking site, take the person off your buddy or friends list. You also can delete messages from bullies without reading them.

Save and print out bullying messages. If the harassment continues, save the evidence. This could be important proof to show parents or teachers if the bullying doesn't stop.

Talk to a friend. When someone makes you feel bad, sometimes it can help to talk the situation over with a friend.

Tell a trusted adult. A trusted adult is someone you believe will listen and who has the skills, desire, and authority to help you. Telling an adult isn't tattling - it's standing up for yourself. And, even if the bullying occurs online, your school probably has rules against it.

Social media sites such as Facebook, Instagram, and Snapchat have gotten serious about helping users who have been targeted by bullies.

If your kid is bullied on a website or in an app, go to the company's site and look for a section offering support, such as "Community Guidelines," "Safety Center," "Parent Info," "Safety Tips," or something similar. It may make recommendations such as blocking the bully or changing the setting for who can contact you.

If your kid is bullied or harassed over text message, call your mobile phone provider to report the number. You may be able to block it or change your phone number. Many carriers offer additional anti-bullying features for a fee.

If the abuse continues, you may need to enlist the help of your community: your kid's school, his or her coaches, or other parents. If the communication contains threats, you'll need to report it to law enforcement.

Until recently, parents, teachers, and news accounts have focused on the relationship between a bully and his or her target. But experts say that there are usually more kids involved in a cyberbullying scenario, making it a much more complex organism than previously thought. In fact, one of the side effects of how public bullying has become is that potentially everyone in the bully's circle of friends - both online and off-line - may be involved.

Identifying the different roles in a cyberbullying situation can help you to help your kid develop self-awareness and a sense of empathy. These skills will go a long way toward cultivating an online culture of respect and responsibility.

First, there's the cyberbully, the aggressor who's using digital media tools (such as the Internet and cell phone) to deliberately upset or harass their target - the person who's being cyberbullied. Then there are the bystanders, the kids who are aware that something cruel is going on but who stay on the sidelines (either out of indifference or because they're afraid of being socially isolated or of becoming a target themselves). But there are also kids who act as upstanders. These are the kids who actively try to break the cycle, whether by sticking up for the target, addressing the bully directly, or notifying the appropriate authorities about what's going on.

Kids may play different roles at different times. Your advice to your child will differ depending on the situation and the specific role your child is playing in whatever bullying or drama is going on.

By making kids aware that a safe world is everyone's responsibility, we empower them to take positive actions - like reporting a bully, flagging a cruel online comment, or not forwarding a humiliating photo - that ultimately can put a stop to an escalating episode of cruelty.

For more information about safe use of digital media, go to commonsensemedia.org.

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How to Help Kids Deal With Cyberbullying - Child Mind Institute

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Cyberbullying is the use of digital-communication tools (such as the Internet and cell phones) to make another person feel angry, sad, or scared, usually again and again.

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Does Social Media Use Cause Depression? - Child Mind Institute

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Is using social media making our kids unhappy? Evidence is mounting that there is a link between social media and depression. How Instagram and Facebook may be negatively affecting teenagers and young adults.

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Internet addiction. Phone addiction. Technology addiction. Whatever you call it, a lot of parents are expressing worries that their children are addicted to their devices.

Is the behavior that parents are concerned about really addiction?

What parents are alarmed about is usually two things: the sheer amount of time their kids spend on screens, and their kids' resistance to cutting back on that screen time. Getting them to put away their devices and come to dinner, engage in other activities, go outside or do their homework (without also checking social media and streaming TV shows) seems to be an increasingly uphill battle.

Kids sometimes use the word "addiction" to describe their own behavior, too. In a 2016 survey by Common Sense Media, half of teenagers said they "feel" they're addicted to their mobile device. Three quarters of them said they felt compelled to immediately respond to texts, social media posts and other notifications.

"More often than not, when people say that someone is addicted to the internet or addicted to their phone, they're using it colloquially," notes David Anderson, PhD, a clinical psychologist at the Child Mind Institute. By calling it addiction, parents are often communicating their concern that so much screen time is unhealthy, as well as their feeling that they're powerless to stop it.

There is, technically, no such thing as internet or phone addiction. Some in the psychiatric community have proposed a new disorder called internet gaming disorder, to recognize unhealthy patterns of game-playing. But it would rise to the level of a disorder, Dr. Anderson notes, the behavior only if it's extreme, and seriously impairing to a child's life.

That would mean an amount of screen time that's not only more than parents feel comfortable with, but that crowds out other age-appropriate activities, like socializing, sports, school work - even hygiene and sleep. "We would be looking at adolescents who are pushing everything else out of their lives," explains Dr. Anderson. "They are not having friendships, not engaging socially - at least offline - and they may be failing in school."

Some parents may see addict-like behavior, Dr. Anderson adds, when kids get angry if they're required to stop, insist on more screen time than they're allowed, and spend a lot of offline time thinking about how and when they will get back online. But these kind of behaviors can be prompted by many pleasurable activities, and don't constitute an addiction. "More often than not, what I see are parents who are concerned about their teenager's behavior around screens use the word addiction when it doesn't really fit."

One reason to be cautious about using the term, he added, "is that we have a tendency right now within the zeitgeist to pathologize normal adolescent behavior."

What are kids doing online?

The amount of time teenagers typically spend on phones and other devices can be misleading as a measure of whether they are unhealthily engaged. That's because many of the things kids do on those devices are age-appropriate activities that in the past have been done offline: socializing with peers, exploring personal interests, shopping, listening to music, doing schoolwork, watching movies or TV.

Texting and use of social media sites, for instance, have become important channels for adolescents connecting to others and being validated. Role-playing games allow kids to interact not only with friends, but to people around the world. A 2016 report by Common Sense Media concluded: "What looks like excessive use and distraction is actually a reflection of new ways of maintaining peer relations and engaging in communities that are relevant to them."

Is it masking a mental health disorder?

When a child seems unhealthily focused on video games, to the point of social isolation, the behavior may be, rather than addiction, a product of other mental health problems.

Dr. Anderson reports that he finds himself saying to parents, "We understand your hypothesis that your kid is addicted to games, but it may be that he is socially anxious. It may be that he is depressed. It may be that he has a learning disorder."

Dr. Anderson recalls treating a 16-year-old whose mother was adamant that he was addicted to video games. "I was doing in-home sessions with him, and it was, indeed, very hard to get him off playing Call of Duty to even have the session. But what I realized very quickly was that he had both ADHD and depression, and he had been failing school for as long as he could remember."

Call of Duty was actually a positive in his life, Dr. Anderson said, "the only thing that provided solace, a sense of belonging. He had joined a crew of people who play Call of Duty and post YouTube videos of them playing."

Once his ADHD and depression got appropriate treatment, he was able to cut back on Call of Duty, and make offline friends. "He joined the football team at school. His grades improved," said Dr. Anderson. "In that sense, it was treatment of 'internet addiction' through treatment of the actual underlying conditions."

While experts say that parents should remain skeptical of the notion of addiction, they also argue that parents should be alert for potential negative fallout from screen use. Apps and games are designed to keep us engaged as much as possible, and it can be hard for children to exercise self-control when their impulse is to keep scrolling.

There is ample evidence that intense social media use is correlated with an increase in anxiety and depression as teenagers, especially girls, compare themselves unfavorably to their peers and worry about missing out.

Research shows that excessive gaming - spending two-thirds or more of free time - is correlated with negative mental health outcomes, including higher incidence of anxiety, depression and substance use.

There is evidence that multitasking - using social media, texting, watching tv while doing homework - undermines cognitive functioning and decreases learning.

And, of course, experts note constant attention to devices comes at the cost of other activities that are ultimately more valuable, and developmentally important.

Superficial engagement

"Our brains are hardwired to like things that are novel and stimulating, and the phone captures that," notes Matthew Cruger, PhD, a neuropsychologist at the Child Mind Institute. "It's easier to engage in constantly checking your phone or playing a game than tasks that require more mental effort, though those are ultimately more rewarding for a lot of people."

Dr. Cruger sees an anaology to gambling in that checking devices is only intermittently reinforcing. "People spend a lot of time looking briefly at things, not diving down, hoping it's going to be rewarding, though often it's not."

Why would you pick up a book if you're stimulated by Instagram or Candy Crush, Dr. Cruger asks. "You still retain the capacity to apply more mental effort to things but the opportunity is lost when you're constantly superficially engaged."

"There are absolutely alarms to be sounded," concludes Dr. Anderson, "but the vast majority of kids are engaging in screen-related behaviors that may not be either pathological or damaging."

The key, he notes, is to help parents set appropriate boundaries around screens, to understand what their kids are doing online, to feel confident that they are is engaging in the right developmental tasks - online or off.

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Is Internet Addiction Real? - Child Mind Institute

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Internet addiction. Phone addiction. Technology addiction. Parents are worried that kids are hooked on screens in an unhealthy way.

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As parents, we have come to think that screen time is bad for young children - or maybe that it's an inescapable evil. We feel guilty about letting them watch what we fear is too much or the wrong kind of TV and other electronic media. But there's a mounting body of evidence that if you are actually watching along with your preschool or elementary school-aged child, screen time might not be that bad. On the contrary, as long as you are an active participant, it can have multiple beneficial effects.

Learning for young children is driven by human interactions, explains Shelley Pasnik, director of the Center for Children & Technology. She leads a team that studies how the thoughtful use of technology can enhance learning. "What young kids need are a lot of experiences that are built on contingency, so a child does something and an adult says something in response. It's a back-and-forth," she says. It's important that kids know what they do has an effect. "And they're going to get a response."

This kind of back-and-forth is called contingent engagement, and it's something that can happen with a screen if a parent is participating. As a result, The American Academy of Pediatrics has dialed back its "no screens" policy for very young kids. "But," says Pasnik, "it's not just, okay, now everyone let your kids watch TV, you know, without the social component. It's that social relationship that is so, so crucial. It's less the relationship between the kid and the screen and instead it's the child and the parent."

Pasnik's research has shown that when kids watch shows like PBS's Peg + Cat, which teaches early math skills, with parents or caregivers they retain significantly more than when they watch alone. "The more parents were involved and used the strategies, the more likely kids were going to experience the benefits of the media," she notes.

Watching media together also gives parent and child a shared language with which to communicate when they're not watching, explains Matt Rouse, PhD, a clinical psychologist. "By really being involved you can get more mileage out of those lessons and adapt and use it in everyday life."

It's the same reason why psychologists doing cognitive behavioral training with young children include parents. "We have parents join our sessions so that they're using the same terms for things," says Dr. Rouse. "Then they can use that language outside in the world so that everything comes together more seamlessly."

Adults, Pasnik says, can play an important role in modeling "active viewing" - that is, encouraging kids to actively engage with the content they're seeing on screens. "Parents talking about what they're seeing either during the experience or afterwards can be important. We're constantly translating and interpreting what we see on a screen or a particular device so the more an adult can encourage conversation around that experience the deeper the experience becomes."

S trategies that actively engage young children during screen time include asking open-ended questions. "Just encouraging conversation, to begin with," she explains, "and also knowing to pause play, for example to ask questions, to get kids thinking about what they saw."

Dr. Rouse has actually prescribed the "active viewing" of baseball games as a way of creating a closer connection within one of the families that he works with. "You don't normally think of watching TV as 'quality' time," says Dr. Rouse, "but here we're looking for opportunities for this father to just get more one-on-one time with his son,". Kids don't necessarily respond well if a parent says, "Okay, turn off the TV. Let's spend some time together." But, says Dr. Rouse, "he could use it as an opportunity to kind of join the child in what he's doing - make it an active process where you're commenting on things together or even asking questions, like, 'Oh, hey, catch me up. What's going on here?' " So it's less about what's on the TV screen and becomes more of an interactive, social experience between parent and child.

The phenomenon has been so carefully studied that clinicians actually have a term for watching TV with your kid: It's called co-viewing. "Co-viewing means you're watching the same show. Your eyes are on the same screen," explains Catherine Steiner-Adair, EdD, clinical psychologist, school consultant, author of The Big Disconnect and a research associate at the Harvard Medical School. "If you DVRed it or whatever you can push pause and say why did she just do that? Or say 'Do you think this is what it takes to be popular? If someone said that to you, what do you think you'd do? I'd be scared,' " she says.

Dr. Steiner-Adair notes that it's important not to lecture. "You don't want to be saying, 'Don't ever let anybody talk to you like that!' You can't be too intense. Instead, Dr. Steiner-Adair suggests that parents practice role-playing with children:

"What would you say?"

"What could you say?"

"What should she have said?"

"I hope you'll come tell us if anything like that happens."

"She couldn't tell her parents. I hope you'll tell us."

All of these are part of the open-ended question strategies of co-viewing. "You just want to put in those messages," Dr. Steiner-Adair advises. "None of that happens if they're in their room watching it by themselves."

Making sure that your child is watching programs that teach the kinds of lessons you'd like your child to learn is another strong argument for co-watching. As kids get a little older, they begin to reflect on the behavior and decisions of characters on shows they watch, Pasnik says. "To go back to Peg + Cat, for example, it's not just that kids are learning ordinal numbers and recognizing shapes. They're also seeing how the lead character, Peg, deals with frustration when she is challenged in the way she approaches a problem. She counts backwards, you know, 5, 4, 3, 2, 1.".

What Peg is doing is demonstrating emotional self-regulation, modeling for kids how to manage strong feelings. "We heard back from parents that kids are relating to that character not just at the mathematical level but they're also picking up that same technique of self-regulation."

When parents watch with their kids they can use strategies on the shows in the real world to coach kids on emotional regulation. It's good for parent and child to be working from the same playbook. And PBS kids programming is crafted, with adds Dr. Rouse, "forty years of research on child development and the effect of different kinds of media on child development."

Geoffrey Perry, a fifth grade teacher at The Dalton School in Manhattan, sheepishly admits that he and his husband Gary have let their son Anthony watch cartoons on his iPad since he was little. "We had to get to work really early and he was really difficult to motivate and get dressed and get fed before we had to take him to daycare and then kindergarten and school," Perry explains. "So the deep dark pact we made with the devil was to let him watch a cartoon on his iPad, and that was like his morning cup of coffee. And so I'm watching with him while I'm making breakfast and having my coffee."

Anthony's secret vice was a Barbie cartoon. "They sort of poke fun at the whole Barbie thing. They make fun of the fact that they can never can wear flats and that she's had like 75,000 careers and no one knows her age," says Perry. But Perry also found that he could talk to Anthony about the messaging in the show. "I'm always asking questions so that he sees some of the stereotypes and some of the sexist stuff that's being said. Some of the soft cue sexism that he might unconsciously pick up."

These days Anthony has graduated to sit-coms - mostly, says Perry, the Disney kind where you can "pretty much pull the standard characters off the shelf. There's the geeky nerd - usually Asian or Indian - there's always some sassy black girl, there's always some ditzy blonde girl. And we do talk about those things. You know, 'Why is the smart one always Indian and Asian?' " Anthony is not allowed to watch in his room or alone for that matter. "There's always interaction while he's watching," Perry says.

Co-viewing from a relatively young age also sets up a precedent that screen time is something that kids and parents share - a precedent that can be valuable when kids get near adolescence, and could be resistant to sudden parental intrusion into their programing.

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The Benefits of Watching TV With Young Children - Child Mind Institute

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Learn how to make screen time a valuable learning experience for your child by watching together and interacting with the content of electronic media.

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Many parents worry about how exposure to technology might affect toddlers developmentally. We know our preschoolers are picking up new social and cognitive skills at a stunning pace, and we don't want hours spent glued to an iPad to impede that. But adolescence is an equally important period of rapid development, and too few of us are paying attention to how our teenagers' use of technology - much more intense and intimate than a 3-year-old playing with dad's iPhone - is affecting them. In fact, experts worry that the social media and text messages that have become so integral to teenage life are promoting anxiety and lowering self-esteem.

Young people report that there might be good reason to worry. A survey conducted by the Royal Society for Public Health asked 14-24-year-olds in the UK how social media platforms impacted their health and well-being. The survey results found that Snapchat, Facebook, Twitter, and Instagram all led to increased feelings of depression, anxiety, poor body image, and loneliness.

Indirect communication

Teens are masters at keeping themselves occupied in the hours after school until way past bedtime. When they're not doing their homework (and when they are) they're online and on their phones, texting, sharing, trolling, scrolling, you name it. Of course before everyone had an Instagram account teens kept themselves busy, too, but they were more likely to do their chatting on the phone, or in person when hanging out at the mall. It may have looked like a lot of aimless hanging around, but what they were doing was experimenting, trying out skills, and succeeding and failing in tons of tiny real-time interactions that kids today are missing out on. For one thing, modern teens are learning to do most of their communication while looking at a screen, not another person.

"As a species we are very highly attuned to reading social cues," says Catherine Steiner-Adair, EdD, a clinical psychologist and author of The Big Disconnect. "There's no question kids are missing out on very critical social skills. In a way, texting and online communicating puts everybody in a context where body language, facial expression, and even the smallest kinds of vocal reactions are rendered invisible."

Lowering the risks

Certainly speaking indirectly creates a barrier to clear communication, but that's not all. Learning how to make friends is a major part of growing up, and friendship requires a certain amount of risk-taking. This is true for making a new friend, but it's also true for maintaining friendships. When there are problems that need to be faced - big ones or small ones - it takes courage to be honest about your feelings and then hear what the other person has to say. Learning to effectively cross these bridges is part of what makes friendship fun and exciting, and also scary. "Part of healthy self-esteem is knowing how to say what you think and feel even when you're in disagreement with other people or it feels emotionally risky," notes Dr. Steiner-Adair.

But when friendship is conducted online and through texts, kids are doing this in a context stripped of many of the most personal - and sometimes intimidating - aspects of communication. It's easier to keep your guard up when you're texting, so less is at stake. You aren't hearing or seeing the effect that your words are having on the other person. Because the conversation isn't happening in real time, each party can take more time to consider a response. No wonder kids say calling someone on the phone is "too intense"- it requires more direct communication, and if you aren't used to that it may well feel scary.

If kids aren't getting enough practice relating to people and getting their needs met in person and in real time, many of them will grow up to be adults who are anxious about our species' primary means of communication - talking. And of course social negotiations only get riskier as people get older and begin navigating romantic relationships and employment.

Cyberbullying and the imposter syndrome

The other big danger that comes from kids communicating more indirectly is that it has gotten easier to be cruel. "Kids text all sorts of things that you would never in a million years contemplate saying to anyone's face," says Donna Wick, EdD, a clinical and developmental psychologist. She notes that this seems to be especially true of girls, who typically don't like to disagree with each other in "real life."

"You hope to teach them that they can disagree without jeopardizing the relationship, but what social media is teaching them to do is disagree in ways that are more extreme and do jeopardize the relationship. It's exactly what you don't want to have happen," she says.

Dr. Steiner-Adair agrees that girls are particularly at risk. "Girls are socialized more to compare themselves to other people, girls in particular, to develop their identities, so it makes them more vulnerable to the downside of all this." She warns that a lack of solid self-esteem is often to blame. "We forget that relational aggression comes from insecurity and feeling awful about yourself, and wanting to put other people down so you feel better."

Peer acceptance is a big thing for adolescents, and many of them care about their image as much as a politician running for office, and to them it can feel as serious. Add to that the fact that kids today are getting actual polling data on how much people like them or their appearance via things like "likes." It's enough to turn anyone's head. Who wouldn't want to make themselves look cooler if they could? So kids can spend hours pruning their online identities, trying to project an idealized image. Teenage girls sort through hundreds of photos, agonizing over which ones to post online. Boys compete for attention by trying to out-gross one other, pushing the envelope as much as they can in the already disinhibited atmosphere online. Kids gang up on each other.

Adolescents have always been doing this, but with the advent of social media they are faced with more opportunities - and more traps - than ever before. When kids scroll through their feeds and see how great everyone seems, it only adds to the pressure. We're used to worrying about the impractical ideals that photoshopped magazine models give to our kids, but what happens with the kid next door is photoshopped, too? Even more confusing, what about when your own profile doesn't really represent the person that you feel like you are on the inside?

"Adolescence and the early twenties in particular are the years in which you are acutely aware of the contrasts between who you appear to be and who you think you are," says Dr. Wick. "It's similar to the 'imposter syndrome' in psychology. As you get older and acquire more mastery, you begin to realize that you actually are good at some things, and then you feel that gap hopefully narrow. But imagine having your deepest darkest fear be that you aren't as good as you look, and then imagine needing to look that good all the time! It's exhausting."

As Dr. Steiner-Adair explains, "Self-esteem comes from consolidating who you are." The more identities you have, and the more time you spend pretending to be someone you aren't, the harder it's going to be to feel good about yourself.

Stalking (and being ignored)

Another big change that has come with new technology and especially smart phones is that we are never really alone. Kids update their status, share what they're watching, listening to, and reading, and have apps that let their friends know their specific location on a map at all times. Even if a person isn't trying to keep his friends updated, he's still never out of reach of a text message. The result is that kids feel hyperconnected with each other. The conversation never needs to stop, and it feels like there's always something new happening.

"Whatever we think of the 'relationships' maintained and in some cases initiated on social media, kids never get a break from them," notes Dr. Wick. "And that, in and of itself, can produce anxiety. Everyone needs a respite from the demands of intimacy and connection; time alone to regroup, replenish and just chill out. When you don't have that, it's easy to become emotionally depleted, fertile ground for anxiety to breed."

It's also surprisingly easy to feel lonely in the middle of all that hyperconnection. For one thing, kids now know with depressing certainty when they're being ignored. We all have phones and we all respond to things pretty quickly, so when you're waiting for a response that doesn't come, the silence can be deafening. The silent treatment might be a strategic insult or just the unfortunate side effect of an online adolescent relationship that starts out intensely but then fades away.

"In the old days when a boy was going to break up with you, he had to have a conversation with you. Or at least he had to call," says Dr. Wick. "These days he might just disappear from your screen, and you never get to have the 'What did I do?' conversation." Kids are often left imagining the worst about themselves.

But even when the conversation doesn't end, being in a constant state of waiting can still provoke anxiety. We can feel ourselves being put on the back burner, we put others back there, and our very human need to communicate is effectively delegated there, too.

What should parents do?

Both experts interviewed for this article agreed that the best thing parents can do to minimize the risks associated with technology is to curtail their own consumption first. It's up to parents to set a good example of what healthy device usage looks like. Most of us check our phones or our email too much, out of either real interest or nervous habit. Kids should be used to seeing our faces, not our heads bent over a screen. Establish technology-free zones in the house and technology-free hours when no one uses the phone, including mom and dad. "Don't walk in the door after work in the middle of a conversation," Dr. Steiner-Adair advises. "Don't walk in the door after work, say 'hi' quickly, and then 'just check your email.' In the morning, get up a half hour earlier than your kids and check your email then. Give them your full attention until they're out the door. And neither of you should be using phones in the car to or from school because that's an important time to talk."

Not only does limiting the amount of time you spend plugged in to computers provide a healthy counterpoint to the tech-obsessed world, it also strengthens the parent-child bond and makes kids feel more secure. Kids need to know that you are available to help them with their problems, talk about their day, or give them a reality check.

"It is the mini-moments of disconnection, when parents are too focused on their own devices and screens, that dilute the parent-child relationship," Dr. Steiner-Adair warns. And when kids start turning to the internet for help or to process whatever happened during the day, you might not like what happens. "Tech can give your children more information that you can, and it doesn't have your values," notes Dr. Steiner-Adair. "It won't be sensitive to your child's personality, and it won't answer his question in a developmentally appropriate way."

In addition Dr. Wick advises delaying the age of first use as much as possible. "I use the same advice here that I use when talking about kids and alcohol - try to get as far as you can without anything at all." If your child is on a social media platform, Dr. Wick says that you should friend them and monitor their page. But she advises against going through text messages unless there is cause for concern. "If you have a reason to be worried then okay, but it better be a good reason. I see parents who are just plain old spying on their kids. Parents should begin by trusting their children. To not even give your kid the benefit of the doubt is incredibly damaging to the relationship. You have to feel like your parents think you're a good kid."

Offline, the gold standard advice for helping kids build healthy self-esteem is to get them involved in something that they're interested in. It could be sports or music or taking apart computers or volunteering - anything that sparks an interest and gives them confidence. When kids learn to feel good about what they can do instead of how they look and what they own, they're happier and better prepared for success in real life. That most of these activities also involve spending time interacting with peers face-to-face is just the icing on the cake.

Frequently Asked Questions

How does social media affect behavior negatively?

How does social media affect social skills?

How does social media affect teenagers' mental health?

Is social media harmful?

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How Using Social Media Affects Teenagers - Child Mind Institute

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How does social media affect teens? Experts say kids are growing up with more anxiety and less self-esteem due to social media. Read advice for parents from specialists in our article.

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The American Academy of Pediatrics is known to guilty parents everywhere for advising against any screen time for children under 18 months, and very cautious usage after that, with no more than an hour of "high quality programming" for kids age 2-5. But in this day and age, when media is everywhere, the pediatricians group now recognizes that it's time to go beyond "turn it off."

It's important, they note, for parents to recognize that not all screen time is created equal. Some TV shows, games and apps are more developmentally appropriate for preschool children than others. And just as important as the choice of media itself is the role you play in how your child consumes it.

What's the big deal about toddler screen time?

While many apps and television shows are marketed as being educational for young children, countless studies have shown that even the best of them cannot compete with real life activities and human interaction.

A seminal study from the University of Washington a decade ago compared the results of a group of seven-month-olds who interacted in real life with a Mandarin Chinese speaker and comparable groups who watched a DVD or just listened to audio. The group who listened to the live tutor were quickly able to distinguish Mandarin sounds from English, while the other groups acquired no recognition of the language (watch a video of Dr. Kimberly Noble describing the experiment here).

"What that tells us," says Sarah Lytle, Director of Outreach and Education at the University of Washington Institute for Brain Sciences, "is at least in the very early age children need that live human experience and the technology is not an adequate substitute."

Dr. Lytle highlights several factors that make social interaction far more effective for small children. "If you're looking at the screen," she says, "you don't get the speaker's eye gaze in the same way you would if the person was sitting right in front of you. People on the screen can't be responsive to you and do that back-and-forth exchange like a live human."

She also notes that whatever is on the screen is in two dimensions. "As adults we go back and forth between two dimensions and three dimensions very fluently. For kids that's actually a really difficult task and it takes them a long time until they're able to really go back and forth and match what's in two dimensions on a screen with what's actually in three dimensions in the real world."

Body learning

Another thing parents should keep in mind about toddler development, explains Matthew Cruger, the director of the Learning and Development Center at the Child Mind Institute, is that gross motor skills come before fine motor skills. "Using apps and TV viewing tend to be sedentary activities," he notes, "so it's not an opportunity for them to use their bodies to explore and to integrate thinking as much as something that involves some physical movement."

Susan Schwartz, a learning specialist at Friends Seminary and the Child Mind Institute, elaborates. "When children manipulate objects - real life, whole body movement with 3D objects - there is more visual and tactile input to their brain so that they are interacting in a more holistic way. So while they are learning the motions to swipe on a phone or match a picture on an app, they're not developing that whole body understanding of where they are in space, how they're interacting with materials." For parents who are looking for educational activities for toddlers, playing with blocks actually teaches a more valuable and developmentally appropriate lesson.

Toddler screen time should be interactive

Experts say that parents looking for educational value in programming and apps should preference ones that have some sort of interactive element. When it comes to young children, Schwartz explains that for something to be truly interactive, the child must be "able to understand the rules and directions fairly easily, depending on the child's developmental level."

Dr. Cruger notes that toddlers tend to do better with slower-paced programming. "They need more time, more practice and more opportunities for learning, so things that are fast and quick or brief really don't match their style of engagement. Or their style of cognition."

Schwartz also recommends multi-sensory experiences: "There should be multiple inputs of stimulation - they're looking, they're listening and then they're swiping. Or they're taking a picture of something that's real and they're doing something with it."

Parents are the interactive element

But perhaps the most important form of interactivity is what happens with parents as they participate in toddler screen time. "Simple screen time just with the child watching the show or playing with the app," notes Dr. Cruger, "is far less valuable than when it also involves direct interaction with the parents."

"The new buzz term," says Dr. Lytle, "is joint media engagement, which means you're going to interact with your child around screens just like you would interact with your child around any kind of media, whether it's a book, or art material."

Parents needn't feel guilty about every moment of screen time, she adds. "If you need to take a shower and the kid is going to watch TV for 20 minutes, totally fine. There's no evidence that's going to in any way harm their development. But I think if you want that to be an educational experience, understand that you need to be with the child, watching the screen with them and asking those kinds of deeper scaffolding questions and really engaging in that media experience with the child."

And of course screens can be used for young children to interact with real people. "One of the great uses of iPads or iPhones is communicating with friends and relatives who do not live nearby," says Schwartz. "This is a great use of technology."

Apps should be open-ended

An open-ended, responsive, choose your own adventure-style app is more likely to have educational benefits than one that is linear, experts agree. The play should be child-led, rather than app-led.

Dr. Lytle cites the classic saying that any toy that your child is playing with should be 10 percent toy, 90 percent child. "As with toys, that's something we would suggest in an app. Things that are more open-ended allow a child to really create and be creative and interact with the app."

She recommends that parents check out Common Sense Media's rating system for TV shows, movies and apps. Independent reviewers evaluate whether they are age-appropriate, if there are any caveats in terms of content, and how educational they are. "I think that it demystifies things a little bit," she says, "and gives parents a clearer picture of what's going on."

Detailed reviews on the site discuss the learning activities an app offers, the quality of content, the pacing, and the level of difficulty. They even offer topics for family discussion about the programming.

Entertainment for entertainment's sake

So much pressure has been put on parents to find educational apps and TV shows for their kids that it's easy to lose sight of the fact that it can also be simply a form of entertainment.

"I think that it's completely fine if media is entertainment," says Dr. Lytle. "We just need to understand and manage expectations around which circumstances are which. Certainly media that's entertainment is fine for kids as long as the amount of time is moderate and the content is appropriate. Just like many adults like to watch TV to unwind at the end of the day, it can be a fun treat for kids too, and that's okay."

Dr. Cruger notes that the social stories in children's programming can be very interesting to kids, and worth reinforcing by parents in conversation. " Daniel Tiger might be a good example of that, with messages about sharing, about working together, that are really great."

Don't be afraid of quiet time

There's a lot of pressure on parents to fill every minute of their child's day with engaging, educational activities, and apps and TV seem like an easy way to fill that quota. But "I don't think kids need to be busy all day long," says Schwartz.

"I think that quiet time is important. A child can sit with a book and there's something to be said for learning to turn the page, deciding if the book is right side up or upside down, they're making their own stimulation as opposed to the phone being on and stimulating." There's developmental value in kids having to figure out their own entertainment once in a while, rather than having it all fed to them.

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Can Toddler Screen Time Be Educational? | Child Mind Institute

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The American Academy of Pediatrics is known to guilty parents everywhere for advising against any screen time for children under 18 months, and very cautious usage after that, with no more than an hour of "high quality programming" for kids age 2-5.

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Parents used to just worry about kids watching too much TV, or playing too many video games. We still worry about those things, but now the screen time list has gotten much longer. Phones, tablets, apps, social media, texting - they all can captivate kids (and adults) starting at a very young age. What's a parent to do? Going back to bed isn't an option, but taking a deep breath and encouraging rational moderation is. Here are some tips, broken down by age group, to get you started.

- Limit exposure. The American Academy of Pediatrics recommends avoiding television and other entertainment media for children under 18 months. After 18 months parents can begin introducing "high quality" programming, but the AAP cautions that parents should watch with their children to answer any questions they might have. For children two to five, the AAP recommends limiting media consumption to an hour of high quality programming, again with the caveat that parents should be watching alongside.

- Start leading by example early. Even before your child has a phone or tablet of her own, show her how they should be used. Don't check your messages at the dinner table. Look at people when they're talking to you - not at your phone. Remember that your children are always watching you and young children notice everything - that's how they learn.

- Don't underestimate the value of traditional toys and open spaces. It's important for kids to experience unstructured "free play," which means that they decide what to do, and how to do it, and are playing simply for play's sake-not to get to the next level in a game, or learn some specific skill. Children should experience the fun of making up their own rules - and breaking them - as they go along. This kind of play lets kids:

Move at their own pace, instead of being driven (or hurried) along by fast-moving media

Develop creativity

Get experience making decisions

Practice sharing and working with others

Learn to be a leader and self-advocate

Apps - however educational they claim to be - are no substitute for the kind of learning that comes to kids naturally if we let it.

- Do leave the tablet at home. While they are helpful during a long car or plane ride, tablets and other devices are out of place in the stroller or car on the way to preschool. It's important for kids to have the opportunity to look around them and find entertainment (not to speak of learning) in the real world, too. And they should not be part of play dates!

- Watch things together. If you're worried that your kids are getting bad messages from the media, the best way to counteract them is to watch alongside your kids and point out when something isn't right. Call out a female character if she only seems to care about boys, or how she looks. Provide context if you are seeing unhealthy relationships (including friendships) or unrealistic beauty standards. Besides reinforcing your values, this will teach your kids to watch television and movies actively, not passively, which is good for their self-esteem. Do this during commercials, too!

- Screen time shouldn't be all the time. The AAP recommends that parents set sensible boundaries on how much screen time is appropriate for their child. Just as important: designating media-free spaces, like bedrooms and the dinner table. Establishing (and enforcing) these limits from a young age teaches kids to be healthy media consumers.

- Be discerning. Determining what is quality screen time and what isn't might not be obvious, but look out for things that:

Are age-appropriate

Engage your child's imagination

Have the right values

Common Sense Media has more pointers here. Conversely, if you don't want your child playing a particular game or watching a particular show, explain your reasons why and be specific - don't just say it's "bad."

- Don't make screens the reward (or consequence). Technology is enormously appealing to kids as it is, but when we make screen time the go-to thing kids get for good behavior - or get taken away for bad behavior - we are making it even more desirable, thereby increasing the chances that a child will overvalue it.

- Encourage other activities. There are many ways to have fun. Running around outside, playing a sport, reading books, doing crafts - variety is important for a balanced life. Encourage your kids to develop a wide range of interests. Model yourself doing this, too. Let your kids see you reading a book and making things and having a hobby. Finally, present these things as just as rewarding as screen time - not alternatives to it. Equal billing is important.

- Be prepared for them to discover porn. Even if they're not exactly looking for it, kids today can stumble onto pornography very easily. Curiosity is often a big motivator, so don't be shy about having some frank, developmentally appropriate conversations about sex. If they hear it from you then they'll be less likely to turn to the Internet for answers, and they'll be more likely to ask you to explain what they see online or hear from friends. And if they do see porn, let them know what they saw was no more realistic than any other movie.

Keep modeling good tech behavior. It's easy to let things slide once kids are older and have their own devices, but remember that the old rules still apply. Don't use your phone at the table and make sure your kids don't need to compete with a screen for your attention. Besides setting a good example, this shows them that you care and are interested, which makes them more likely to open up. Even though they're getting older, your kids still need to talk to you, not just their friends.

- Encourage privacy. Once kids have turned 13 they are allowed to get an account on Facebook and most other social media websites and apps (some kids cheat and get them earlier). Whatever age your family decides is appropriate for social media, make sure that your child is very careful about privacy. Research privacy settings with her and make sure she understands when something is public or private - or somewhere in the middle - and how that should affect what she posts. As a general rule, she shouldn't share anything online that she wouldn't be comfortable with the entire world reading. Including her grandmother.

- Yes to friending, no to spying. If your child is on social media, developmental psychologist Donna Wick, EdD, of Mind to Mind Parent recommends that you follow or friend him, and monitor his page. But she advises against going through text messages unless there is cause for concern: "If you have a reason to be worried then okay, but it better be a good reason," she says. "I see parents who are just plain old spying on their kids. Parents should begin by trusting their children. To not even give your kid the benefit of the doubt is incredibly damaging to the relationship. You have to feel like your parents think you're a good kid."

- Make it clear that naked pictures are a bad idea (and explain why). Sometimes kids think sharing photos is a way to build trust, but it can do the opposite just as easily. Your daughter might trust her boyfriend with her photos but he, in turn, might trust a close friend, and so on. Or she might trust him to delete the photos, but later finds out that he kept them on his phone, and people found them when they were scrolling through his pictures. These are some innocent ways the pictures could get into the wrong hands - there are a lot of less innocent ways they could, too. And once the pictures are out there, they can damage future relationships and job prospects, not to mention become the talk of the school.

Also, in case your kid doesn't know, if she is a minor, sharing naked pictures can get her and whoever she's sending them to in a lot of trouble for child porn, which is really not something she wants to mess with.

- Texting can be tricky. Warn kids that it's easy for people to misinterpret messages when they aren't hearing the tone of your voice or seeing the expression on your face. Jokes, in particular, might seem mean. To guard against misunderstandings and hurt feelings, it's always a good idea to make it clear when you're joking.

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Media Guidelines for Kids of All Ages - Child Mind Institute

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Child Mind Institute helps parents create healthy boundaries for kids' screen time, broken down for different age groups.

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As parents, we have come to think that screen time is bad for young children - or maybe that it's an inescapable evil. We feel guilty about letting them watch what we fear is too much or the wrong kind of TV and other electronic media. But there's a mounting body of evidence that if you are actually watching along with your preschool or elementary school-aged child, screen time might not be that bad. On the contrary, as long as you are an active participant, it can have multiple beneficial effects.

Learning for young children is driven by human interactions, explains Shelley Pasnik, director of the Center for Children & Technology. She leads a team that studies how the thoughtful use of technology can enhance learning. "What young kids need are a lot of experiences that are built on contingency, so a child does something and an adult says something in response. It's a back-and-forth," she says. It's important that kids know what they do has an effect. "And they're going to get a response."

This kind of back-and-forth is called contingent engagement, and it's something that can happen with a screen if a parent is participating. As a result, The American Academy of Pediatrics has dialed back its "no screens" policy for very young kids. "But," says Pasnik, "it's not just, okay, now everyone let your kids watch TV, you know, without the social component. It's that social relationship that is so, so crucial. It's less the relationship between the kid and the screen and instead it's the child and the parent."

Pasnik's research has shown that when kids watch shows like PBS's Peg + Cat, which teaches early math skills, with parents or caregivers they retain significantly more than when they watch alone. "The more parents were involved and used the strategies, the more likely kids were going to experience the benefits of the media," she notes.

Watching media together also gives parent and child a shared language with which to communicate when they're not watching, explains Matt Rouse, PhD, a clinical psychologist. "By really being involved you can get more mileage out of those lessons and adapt and use it in everyday life."

It's the same reason why psychologists doing cognitive behavioral training with young children include parents. "We have parents join our sessions so that they're using the same terms for things," says Dr. Rouse. "Then they can use that language outside in the world so that everything comes together more seamlessly."

Adults, Pasnik says, can play an important role in modeling "active viewing" - that is, encouraging kids to actively engage with the content they're seeing on screens. "Parents talking about what they're seeing either during the experience or afterwards can be important. We're constantly translating and interpreting what we see on a screen or a particular device so the more an adult can encourage conversation around that experience the deeper the experience becomes."

S trategies that actively engage young children during screen time include asking open-ended questions. "Just encouraging conversation, to begin with," she explains, "and also knowing to pause play, for example to ask questions, to get kids thinking about what they saw."

Dr. Rouse has actually prescribed the "active viewing" of baseball games as a way of creating a closer connection within one of the families that he works with. "You don't normally think of watching TV as 'quality' time," says Dr. Rouse, "but here we're looking for opportunities for this father to just get more one-on-one time with his son,". Kids don't necessarily respond well if a parent says, "Okay, turn off the TV. Let's spend some time together." But, says Dr. Rouse, "he could use it as an opportunity to kind of join the child in what he's doing - make it an active process where you're commenting on things together or even asking questions, like, 'Oh, hey, catch me up. What's going on here?' " So it's less about what's on the TV screen and becomes more of an interactive, social experience between parent and child.

The phenomenon has been so carefully studied that clinicians actually have a term for watching TV with your kid: It's called co-viewing. "Co-viewing means you're watching the same show. Your eyes are on the same screen," explains Catherine Steiner-Adair, EdD, clinical psychologist, school consultant, author of The Big Disconnect and a research associate at the Harvard Medical School. "If you DVRed it or whatever you can push pause and say why did she just do that? Or say 'Do you think this is what it takes to be popular? If someone said that to you, what do you think you'd do? I'd be scared,' " she says.

Dr. Steiner-Adair notes that it's important not to lecture. "You don't want to be saying, 'Don't ever let anybody talk to you like that!' You can't be too intense. Instead, Dr. Steiner-Adair suggests that parents practice role-playing with children:

"What would you say?"

"What could you say?"

"What should she have said?"

"I hope you'll come tell us if anything like that happens."

"She couldn't tell her parents. I hope you'll tell us."

All of these are part of the open-ended question strategies of co-viewing. "You just want to put in those messages," Dr. Steiner-Adair advises. "None of that happens if they're in their room watching it by themselves."

Making sure that your child is watching programs that teach the kinds of lessons you'd like your child to learn is another strong argument for co-watching. As kids get a little older, they begin to reflect on the behavior and decisions of characters on shows they watch, Pasnik says. "To go back to Peg + Cat, for example, it's not just that kids are learning ordinal numbers and recognizing shapes. They're also seeing how the lead character, Peg, deals with frustration when she is challenged in the way she approaches a problem. She counts backwards, you know, 5, 4, 3, 2, 1.".

What Peg is doing is demonstrating emotional self-regulation, modeling for kids how to manage strong feelings. "We heard back from parents that kids are relating to that character not just at the mathematical level but they're also picking up that same technique of self-regulation."

When parents watch with their kids they can use strategies on the shows in the real world to coach kids on emotional regulation. It's good for parent and child to be working from the same playbook. And PBS kids programming is crafted, with adds Dr. Rouse, "forty years of research on child development and the effect of different kinds of media on child development."

Geoffrey Perry, a fifth grade teacher at The Dalton School in Manhattan, sheepishly admits that he and his husband Gary have let their son Anthony watch cartoons on his iPad since he was little. "We had to get to work really early and he was really difficult to motivate and get dressed and get fed before we had to take him to daycare and then kindergarten and school," Perry explains. "So the deep dark pact we made with the devil was to let him watch a cartoon on his iPad, and that was like his morning cup of coffee. And so I'm watching with him while I'm making breakfast and having my coffee."

Anthony's secret vice was a Barbie cartoon. "They sort of poke fun at the whole Barbie thing. They make fun of the fact that they can never can wear flats and that she's had like 75,000 careers and no one knows her age," says Perry. But Perry also found that he could talk to Anthony about the messaging in the show. "I'm always asking questions so that he sees some of the stereotypes and some of the sexist stuff that's being said. Some of the soft cue sexism that he might unconsciously pick up."

These days Anthony has graduated to sit-coms - mostly, says Perry, the Disney kind where you can "pretty much pull the standard characters off the shelf. There's the geeky nerd - usually Asian or Indian - there's always some sassy black girl, there's always some ditzy blonde girl. And we do talk about those things. You know, 'Why is the smart one always Indian and Asian?' " Anthony is not allowed to watch in his room or alone for that matter. "There's always interaction while he's watching," Perry says.

Co-viewing from a relatively young age also sets up a precedent that screen time is something that kids and parents share - a precedent that can be valuable when kids get near adolescence, and could be resistant to sudden parental intrusion into their programing.

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The Benefits of Watching TV With Young Children - Child Mind Institute

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Learn how to make screen time a valuable learning experience for your child by watching together and interacting with the content of electronic media.

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"She put all of her friends in boxes - her school friends were only for school, gymnastics friends were for the gym, and she never invited people over. But now she has no friends to call, and she's desperate to talk to anyone.
He refuses to video chat because he doesn't know what to talk about and "it's not the same."
Sound familiar? If your child was struggling with social anxiety before social distancing, it's likely that it's gotten worse. You want to help, but you're in uncharted waters and it's hard to know how.

First of all, your kids are right - it's not the same. For younger children, it's tough to play through a screen. For older children (and adults!), it's challenging to make eye contact and read social cues via video chat. You can only see head and shoulders, and even facial expressions can be hard to read, especially if the other person is moving around and reacting to things going on in their space.

But the more you practice this kind of socializing, the easier it becomes, notes Janine Domingues, PhD, a clinical psychologist at the Child Mind Institute. "It's okay to feel awkward in the beginning and get over that hump," Dr. Domingues says. "In the beginning, what we're doing is helping kids feel comfortable with feeling uncomfortable."

Depending on what's manageable for you and your family, you can experiment with some of the following strategies to help your child settle into these new social norms.

It sounds simple, but if your child is avoiding connecting with friends, ask why. They may feel overwhelmed by the amount of school calls, be uncomfortable with the format, not know what to say or worry about what others may think. Whatever the reason, don't argue. Instead, show empathy and talk about what's different or what upsets them. Just understanding your child's hesitation might reveal some simple solutions - if video chat is what they dislike, maybe a voice-only phone call would work better.

If your child resists sharing, talk about why social connections are important. Encourage them to connect with at least one person, and give examples of how your own social connections have helped you.

Still, it's important to respect their boundaries and show your child that you're on their side. "Ask them to give it a try, but give them an out," suggests Cindy Graham, PhD, a clinical psychologist in Maryland. "For instance, after a few minutes, you'll pretend it's time for lunch so they have an excuse to get off the phone if it's not going well. But if it is going well, they can say they're not hungry."

If video chats seem too daunting, don't jump right in. Instead, begin with email, texting or even writing letters. "Often their fear is getting in the way," Dr. Graham explains. "You can find a way around it by playing a game like Words with Friends where you don't have to be online at the same time. Build on social interactions this way, working towards an actual face-to-face connection when they're ready."

You can also try Marco Polo, a new app which allows you to make and send video messages back and forth. You can add filters, voice effects, draw or add text to your video, then send it to a friend. Encourage your child to make one or two videos a day and slowly increase the length or frequency, building up to a video chat.

Once your child is ready to try some real-time communication, a helpful way to practice is quick daily calls with a family member or someone else they already know and trust. "Start with grandparents because they typically have the time and really want to see their grandchildren," suggests Michelle Kaplan, LCSW, a clinical social worker. "Plus, it's generally easier for kids to ease into a new, uncomfortable format with adults they have a relationship with. You can also enlist older cousins or other willing adults - the more practice the better. Once your child is comfortable speaking to adults, then you can try it with a kid their own age."

These same guidelines apply when it comes to remote learning. If your child is uncomfortable speaking up in a virtual classroom, talk to their teacher and ask to work up to real-time participation. They might start by sending the teacher ideas ahead of time and just listening during class, with their camera and microphone off. Then they might work up text chatting in real time or talking to the class while still keeping the camera off. Going slowly, trying different strategies and giving your child plenty of time to practice can help ease the challenges of this new format.

Games can be a great tool for helping your child get comfortable with video chatting, whether with peers or adults. They give everyone something specific to focus on, help distract your child from their nervousness and turn chatting into something that feels more like play than work.

For young children, try the following games, which can last as little as a minute or two:

Scavenger hunt: "Go find something fluffy and bring it right back!" Then, the child describes the object and asks the other person to find something.

I Spy: The child shows the other person around their room and then finds what the other person spies.

Would You Rather: Be an astronaut or a basketball player? Ski or go swimming? Learn French or Chinese? Plan ahead so your child can ask questions as well, without being put on the spot.

Silly Faces and Filters: Express how you're feeling, demonstrate what you're thinking or answer questions through filters and effects.

For older children, interactive games will help your child practice turn-taking, problem-solving, partner work and spontaneous conversations.

If both people have the same game at home: One player moves the pieces on the board while the other rolls the dice or picks the cards.

If one person has the game: You can play games like Boggle with only one game owner. They'll shake it up, take a picture and send it to the other player.

If both people have two devices: Play games like UNO!, Monopoly or Settlers of Catan online with one device while connecting via video on the other.

Get creative: You don't need a board or pieces - our houses are full of useful items that can pull double duty as a game and an opportunity to help your child improve their partnership skills. For example, with just paper and a pen, your child can draw a tic-tac-toe board and the other player can tell them where to write their X or O.

Once your child feels comfortable with it, a real-time playdate is perhaps the best way to help your child enjoy interacting with peers from home. If your child wasn't interested in playdates before, you'll need to help them make connections now. Kaplan recommends asking them who they miss the most or if they can think of any kids with similar interests. Reach out to parents through your school's directory or their extracurricular activity instructor. Set your child up for success by telling the parent your child would like to play a game with theirs and how long you hope the call will last.

If your child was very rigid and didn't interact with other children outside of the places where they "belonged" (if your daughter only liked to see soccer friends at practice, for example), then work with your child's rigidity by creating a schedule. On Mondays, chat with a school friend, on Wednesdays a friend from karate, and a cousin on Fridays. Keeping things structured and predictable can ease anxiety and give your child events to look forward to.

For older kids, group chats and virtual activities such as Netflix Party or Houseparty are also important tools for socializing right now. And, according to Kaplan, this won't go away after quarantine is over. To prepare your child, discuss how to join a group conversation by creating different scenarios. If your child has been a mostly silent participant in group chats or activities, you can review their chat together and discuss where they could jump in and what they could say.

Right now, your capacity to guide your child may be limited - and that's okay! Do what makes sense for you and your family during these stressful times. Remember that your support is valuable and that even small successes are meaningful. Be patient with your child - this is hard for them, too. Always prioritize keeping your relationship positive, and know that any effort you make will benefit your child, even when social distancing is a thing of the past.

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Coping With Social Anxiety During Social Distancing - Child Mind Institute

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Staying connected can be tough for anxious kids. Here's how parents can help.

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No school. No playdates. No camps. No pool outings. The world as kids know it has been thoroughly upended and they are justifiably anxious, whether they show it or not. It's up to the adults in the room to get them to open up about those feelings so that they can be addressed. Doing so takes finesse, curiosity, and a very light touch.

Click here to see all resources related to the coronavirus crisis.

"Our job as parents isn't to provide certainty in a time of uncertainty. Our job is to help kids tolerate the uncertainty," explains Jerry Bubrick, PhD, a clinical psychologist at the Child Mind Institute.

Kids aren't stupid. Nor are they obtuse. They hear you discussing the increasingly dire COVID-19 news, they see headlines on your social media feed, and they understand that to a large extent, the stuff they once enjoyed doing is no longer in play. Playing epidemiologist isn't going to work. Kids don't need specific answers, they need broader certitude that they are loved and will be taken care of - certitude that makes the ambiguity of the moment manageable.

How to validate their feelings

"We want to teach them how to tolerate not knowing. You should let them explain how they're feeling and why, and you can help them validate those feeling by saying things like, 'I have similar worries. Let's brainstorm ideas on how we can make things better.' Instead of just giving answers, you want to have a conversation and compare notes," says Dr. Bubrick.

Getting kids, regardless of age, involved in problem-solving makes them feel empowered and like they're part of the solution. But as Dr. Bubrick points out, if you ask vague questions, you'll get vague answers, including the dreaded "I'm fine" (the quintessential conversational dead end). Dr. Bubrick's advice is to lead with curiosity and ask open-ended yet specific questions:

What did you learn about today?

What is something interesting or funny you heard about today?

What was the most fun thing you did today?

What are you most looking forward to tomorrow?

What was the toughest part of your day today?

"Bedtime is not the right time. Kids are starting to wind down for the day. Anxious kids have more worries at night. Don't lead them down the path of more worry. And don't talk to them about this when they first wake up. Find a time, a neutral time, when there hasn't been a big argument. Look for a calm moment," says Dr. Bubrick.

He suggests having laid-back discussions either during dinner, or while taking a family walk. And he relies on a simple yet clever approach that gets people to open up.

"With my kids, I suggest a game: Like a rose. It's an icebreaker and it's our thing. You start and model the game. There are three components to the rose. The petal: 'Tell me something you liked about today.' The thorn: 'Tell me something you didn't like.' The bud: 'Tell me something you're looking forward to in the future.' You have to model it to get a response."

Helping kids name feelings

If your children aren't able to articulate how they're feeling, use a feelings chart and work your way from there. Some 5-year-olds can explain, with total clarity, what upended their emotions and why. Some teens, meanwhile, can barely manage a two-word response and won't dig deeper without gentle prodding. You want to have children be as specific as possible about what exactly they're feeling.

"If you can name it, you can tame it," says Dr. Bubrick.

His final note is just as applicable to kids as to their adult minders. Don't spin out. Don't catastrophize. And remind kids that no, their friends aren't having secret sleepovers or hitting the playground. We're all stuck at home together.

"We want to help kids stay in the moment. It's so easy to get wrapped up in the unknown. All we know is what's happening to us right now. We have each other. We're connected to our friends. Let's focus on that. We'll deal with tomorrow, tomorrow," he says.

Click here to see all resources related to the coronavirus crisis.

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How to Ask What Kids Are Feeling | Child Mind Institute

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No school. No playdates. No camps. No pool outings. The world as kids know it has been thoroughly upended and they are justifiably anxious, whether they show it or not. It's up to the adults in the room to get them to open up about those feelings so that they can be addressed.

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As the coronavirus crisis continues, parents everywhere are struggling to keep children healthy and occupied. If you're anxious about how to protect and nurture your kids through this - often juggling work obligations at the same time - you're in good (virtual) company.

Here are tips from the Child Mind Institute's clinicians to help calm fears, manage stress and keep the peace.

Click here to see all resources related to the coronavirus crisis.

Keep routines in place

The experts all agree that setting and sticking to a regular schedule is key, even when you're all at home all day. But as the crisis continues and the days get warmer (and longer, sigh) that schedule will naturally become a bit looser. Still, keeping some structure is important. Whenever possible, try to make sure kids still have some structure - for example, getting up, eating and going to bed around the same time every day. Consistency and structure are calming during times of stress. Kids, especially younger ones or those who are anxious, benefit from knowing what's going to happen and when.

The schedule can mimic a school or day camp schedule, changing activities at predictable intervals and alternating periods of study and play.

It may help to print out a schedule and go over it as a family each morning. Setting a timer will help kids know when activities are about to begin or end. Having regular reminders will help head off meltdowns when it's time to transition from one thing to the next.

Be creative about new activities - and exercise

Incorporate new activities into your routine, like doing a puzzle or having family game time in the evening. For example, my family is baking our way through a favorite dessert cookbook together with my daughter as sous chef.

Build in activities that help everyone get some exercise, safely, especially now that some restrictions are being relaxed. For example, going to the park without contact with other kids or things touched by other kids, like playground equipment. Take a daily family walk or bike ride or do yoga - great ways to let kids burn off energy and make sure everyone is staying active.

David Anderson, PhD, a clinical psychologist at the Child Mind Institute, recommends brainstorming ways to go "back to the 80s," before the time of screen prevalence. "I've been asking parents to think about their favorite activities at summer camp or at home before screens," he says. "They often then generate lists of arts and crafts activities, science projects, imaginary games, musical activities, board games, household projects, etc."

Manage your own anxiety

It's completely understandable to be anxious right now (how could we not be?) but how we manage that anxiety has a big impact on our kids. Keeping your worries in check will help your whole family navigate this uncertain situation as easily as possible.

"Watch out for catastrophic thinking," says Mark Reinecke, PhD, a clinical psychologist with the Child Mind Institute. For example, assuming every cough is a sign you've been infected, or reading news stories that dwell on worst-case scenarios. "Keep a sense of perspective, engage in solution-focused thinking and balance this with mindful acceptance."

For those moments when you do catch yourself feeling anxious, try to avoid talking about your concerns within earshot of children. If you're feeling overwhelmed, step away and take a break. That could look like taking a shower or going outside or into another room and taking a few deep breaths.

Limit consumption of news

Staying informed is important, but it's a good idea to limit consumption of news and social media that has the potential to feed your anxiety, and that of your kids. Turn the TV off and mute or unfollow friends or co-workers who are prone to sharing panic-inducing posts.

Take a social media hiatus or make a point of following accounts that share content that take your mind off the crisis, whether it's about nature, art, baking or crafts.

Stay in touch virtually

Keep your support network strong, even when you're only able to call or text friends and family. Socializing plays an important role in regulating your mood and helping you stay grounded. And the same is true for your children.

Let kids use social media (within reason) and Skype or FaceTime to stay connected to peers even if they aren't usually allowed to do so. Communication can help kids feel less alone and mitigate some of the stress that comes from being away from friends.

Technology can also help younger kids feel closer to relatives or friends they can't see at the moment. My parents video chat with their granddaughter every night and read her a (digital) bedtime story. It's not perfect, but it helps us all feel closer and less stressed.

Make plans

In the face of events that are scary and largely out of our control, it's important to be proactive about what you can control. Making plans helps you visualize the near future. How can your kids have virtual play dates? What can your family do that would be fun outside? What are favorite foods you can cook during this time? If your area is starting to reopen, you could come up with safe ideas for family activities, like getting take-out from your favorite restaurant or going on a socially distant bike ride with friends. Seeing you problem-solve in response to this crisis can be instructive and reassuring for kids.

Even better, assign kids tasks, like picking the restaurant you're going to order from, that will help them feel that they are part of the plan and making a valuable contribution to the family.

Keep kids in the loop - but keep it simple

"Talking to children in a clear, reasonable way about what's going on is the best way to help them understand," says Rachel Busman, PsyD, a clinical psychologist at the Child Mind Institute. "But remember kids don't need to know every little thing." Unless kids ask specifically, there's no reason to volunteer information that might worry them.

For example, our two-year-old daughter Alice is used to seeing her grandparents regularly, but right now we're keeping our distance to make sure everyone stays safe. When she asks about them we say: "We won't see Grandma and Grandpa this week but we will see them soon!" We don't say: "We're staying away from Grandma and Grandpa because we could get them sick." Older kids can handle - and expect - more detail, but you should still be thoughtful about what kinds of information you share with them.

Check in with little kids

Young children may be oblivious to the facts of the situation, but they may still feel unsettled by the changes in routine, or pick up on the fact that people around them are worried and upset. Plan to check in with younger children periodically and give them the chance to process any worries they may be having. Children who are tantruming more than usual, being defiant or acting out may actually be feeling anxious. Pick a calm, undistracted time and gently ask how they're feeling and make sure to respond to outbursts in a calm, consistent, comforting way.

Sometimes the path of least resistance is the right path

Remember to be reasonable and kind to yourself. We all want to be our best parenting selves as much as we can, but sometimes that best self is the one that says, "Go for it" when a kid asks for more time on the iPad. My daughter is watching Elmo's World - and possibly drawing on the wall - as I write this. That shrill red Muppet is the only reason I'm able to write at all.

"We should forgive ourselves the image of perfection that we normally aspire to as parents," says Dr. Anderson, a parent himself. This is not a normal time, and trying to hold ourselves to pre-COVID standards is likely to backfire. "We can give ourselves license to relax these boundaries a bit. We can explain to our kids that this is a unique situation and re-institute boundaries once more when life returns to normal." Whatever that normal may be.

Accept and ask for help

If you have a partner at home, agree that you'll trade off when it comes to childcare, especially if one or both of you are working from home and have younger children. That way everyone gets a break and some breathing room.

Everyone who can pitch in, should. Give kids age appropriate jobs. For example, teens might be able to help mind younger siblings when both parents have to work. Most children can set the table, help keep communal spaces clean, do dishes or take out the trash. Even toddlers can learn to pick up their own toys. Working as a team will help your whole family stay busy and make sure no one person (Mom) is overwhelmed.

"Be creative and be flexible," says Dr. Busman, "and try not to be hard on yourself. You have to find a balance that works for your family. The goal should be to stay sane and stay safe."
Did you know the Child Mind Institute is offering telehealth services? Learn more about Telehealth.
Click here for more resources related to the coronavirus crisis.

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Supporting Kids During the Coronavirus Crisis | Child Mind Institute

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As the coronavirus crisis continues, parents everywhere are struggling to keep children healthy and occupied. If you're anxious about how to protect and nurture your kids through this - often juggling work obligations at the same time - you're in good (virtual) company.

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childmind.org-The Power of Positive Attention

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Adolescents are notoriously sleep-deprived, because of a combination of biology, technology and the demands of school and extra-curricular activities. This guide outlines how lack of sleep can affect teenagers, and how parents can help them build more sleep into their lives.

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How Mindfulness Can Help During COVID-19