Episode 49: What does media do to the child brain? With pediatric neurologist Dr Jane Tavyev

Have you ever wondered what media does to the child brain?  We all know that we don't want to overdue screens with our kids---but we live in a time when screens are unavoidable! What should parents do?  In this weeks episode of Ask Dr Jessica, our guest is pediatric neurologist, Dr Jane Tavyev.   

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children.  Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. 

Do you have a future topic you'd like Dr Jessica Hochman to discuss?  Email your suggestion to: askdrjessicamd@gmail.com. 

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The information presented in Ask Dr Jessica is for general educational purposes only.  She does not diagnose medical conditions or formulate treatment plans for specific individuals.  If you have a concern about your child's health, be sure to call your child's health care provider.

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner.

Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.

Follow her on Instagram: @AskDrJessica
Subscribe to her YouTube channel! Ask Dr Jessica
Subscribe to this podcast: Ask Dr Jessica
Subscribe to her mailing list: www.askdrjessicamd.com

The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Transcript

Unknown: 0:00

Hello everybody welcome back to the Ask Dr. Jessica podcast. I'm your host and paediatrician Dr. Jessica Hochman. This week. My guest is a paediatric neurologist, Dr. Jane Tabia. A paediatric neurologist is a doctor who specialises in treating children and also the nervous system, including the brain. In this episode, Dr. Tabia, and I discuss media and the effects it can have on children as they develop. Thank you so much for listening. Dr. Tavi, and I were good friends, and we spend a lot of time getting our kids together. And we try really hard to have them engage in activities that don't involve media. And Dr. Tabia has been a great influence on me explaining why she thinks that media is not the best for children. This comes up so much in my practice, parents wanted advice. They want actual advice on what I recommend for kids and media. So I thought we would bring our conversation to the podcast. So let's start off. Dr. Tavi, tell me your general thoughts about children in media? Well, there's so much. So many studies coming out about what it's doing to our children, I mean, starting with what's happening to the teenagers who are doing social media, that it's raising rates of anxiety and depression and things like that, and then on down to young kids, mostly elementary school age that are starting to get addicted to video games, and what's that what that's doing to their attention span and things like that? There, there really are a lot of concerns. So the studies in the younger kids are showing that there's language delay social delay in the under two year old group. And so there have been raised some concerns about the link of screentime to autism, or at least development of some autistic like symptoms in in that age group. So there's just so much so many problematic things with with the media use that it's nice to try to stay away as much as possible. Basically, what happens is that kids are born with an overabundance of neurons, and those neurons are growing more and more and more, through really through age six, they're growing more and more and more. And then by age 15, they've done a lot of pruning, which is cutting away the ones that are not needed. So if you can think about this from an evolutionary perspective, basically, as humans, we have the same genetic information that we've always had for 1000s of years from caveman times. But we are designed so beautifully in this way that wherever this little baby is dropped. It's sort of if it's sort of designed to get cues from its environment and figure out what's needed. So you need different skills, if you're being raised on an African savanna in 500 BC, versus your being raised in the technology age, in the United States, in 2022. You need, you really need different things. And so the baby brain is really just trying to figure out what do I need, and the way it's learning that is what is in its environment. So whatever it's exposed to is literally, those brain connections are literally growing. So the auditory cortex is part of the brain that's responsible for language and social development. And the visual cortex is looking at screens, and they're kind of in opposition to each other. You want them to be sort of balanced, you want your visual skills and your auditory skills to be pretty evenly matched. But the research has shown, you know, quite unequivocally, although it's hard to demonstrate, because it's, it's more on autopsy and functional MRI and things like that. It's not something that is like commercially available, where you couldn't have this tested in your child, but that in children with autism, the visual cortex connections, the connections that go from the brain into the visual cortex, layer of the brain, from deep into the brain out out there are much stronger, and many, many, many more of them. So I I hypothesise and others have postulated an and it's hard to prove this, but that, I mean, it makes sense that screentime that exposure to screentime, we know is increasing those visual connections, because the brain is saying, Okay, this is important in the world into which my little body was dropped. And so I have to build these connections, and it's doing that at the expense of the auditory cortex. So you think, well, if they're watching a movie, there's language in the movie also, but it's not it doesn't work that way. The auditory cortex is really a social is social, auditory use. So it's really responding to the human voice and social interaction and nonverbal cues, and the visual cortex even if there's audio on the video that they're watching. They're not really absorb, absorbing that audio as meaningful language they're absorbing it more as like a signal that's matched to the video. It's sort of like an accompaniment. It's not, it's not the back and forth of language that belongs in the auditory cortex. So when I take us history, and I don't mean to belabour the point, but when I take a history from kids who have autism, there are many who watched many, many hours of screen time or did at a very young age. And it's not to say that it caused it because those kids were probably prone to it. Genetically genetically predisposed. But it didn't help them to develop the skills that were a weakness. Okay, so you're saying to improve from symptoms of autism, there is nothing that replaces actual social interaction and discussion. Right, and those kids are more likely to be addicted to it. Okay. Now, realistically, and practically speaking, media is so pervasive, we're all looking at our phones screens are everywhere. I mean, I hear what you're saying that screens are not ideal for kids. But how do we like how do we realistically as parents find the balance? Because I think it's impossible to avoid them entirely? Or maybe, maybe I'm wrong. But what do you recommend as, like realistic advice for parents? Where screens are so dominant in our world? Well, I guess I I'll, I'll have to say I'm, I'm more of an optimist. And a realist, can I say that on this topic? So I don't think I don't think it's impossible to avoid. But I do know that that's a very common, that's a very common feeling. And people feel how, how can I possibly avoid them because they are everywhere. I think that one thing that's really important for parents to know is if their children are not exposed to them, then first of all, they're not going to ask for them. I think the hardest things that in our family about screens is the argument for increased screen time, and the whining and tantruming. To get more and to sort of exceed the limits. So I know that a lot of people talk about limits, setting limits, setting a timeline, a timer, and things like that, I find particularly in a child who's addicted to the screens, and particularly, maybe in a child who has autism, or in a childhood that you're very worried about that this screen time is really excessive, or that they're showing signs of addiction. I personally and professionally think it's easier not to have it, because you're looking at who's more motivated, right. So the child is motivated to get the screen that they're addicted to. So they're gonna keep whining and pushing and demanding of you, you've maybe you have these intentions that you're not going to give in, but then maybe you've come from a long day at work, or maybe you've been, you know, Holding, holding out for many hours that day. But then finally, you're just tired of fighting with them. And it's time to make dinner, and you're just exhausted. And so you just give in. So this is this is kind of classic, behavioural operant conditioning, basically. So you don't realise that this is happening. But this is kind of in the background. So you, you realise that you think you have a reason for giving in. And I'm just giving in just this one time, because I have a really good excuse, because I had a really hard day at work, or I've really been holding out all day. And now I have to make dinner. And in your mind, there's a very clear explanation that has a logical reason, the child doesn't see that logic, they're just seeing when they're little, they're just seeing input and output. So they're seeing if I cry or fuss or tantrum for five minutes, maybe I won't get it. But if I tantrum for two hours, or I raise the tone of my voice to the point that the neighbours here or something, some other element of the tantrum, then uh huh, then I get it. That's when she gives in. So they're looking at input output like a computer. And it's just a very binary kind of process that they're looking for. They'll break they'll break you down. It sounds like in my house, whenever we have dessert, the kids just remember that there's desert there. So like, for example, after Halloween, and there's a lot of candy around. They ask them they ask them they ask for more more candy because they know is in the house. But you're right. The second it's out of the house, they stop asking, right? You're saying with media similarly, just don't bring it into the house in the first place? Yeah, don't exactly if it's not an option at that moment. And if you set an external thing that's out of your power, like you make it, you make it something that can't be overcome, meaning if it's locked up, or you put the you could put the iPad in the car and lock it or something like that. You know, it's not you can ask me but I can't give it it's somewhere else. I have no control over the situation. And so they don't, they don't feel the need to ask you anymore, so it makes it easier on you to hold your ground. Okay. Okay, so I get this point, you know, avoid buying your kids phones, getting them iPads. But what about things that are in the house? Like TV? I mean, practically speaking, I think most people have TVs in their homes. Is there any advice for parents on what types of TV shows children should be watching TV is TV is preferable to iPad and video games, because what we're looking at in terms of early brain development is how quickly the images are changing. So back to the visual cortex, basically, it was it sort of developed to look for movement. And it was it comes from our hunter gatherer ancestors. So it's looking for, you know, fixating on something that's moving like a gazelle in the savanna and hunting that Gazelle and eating it for dinner. So you're staying very, very, still very focused. And then you see the movement and your eyes want to track it, and you get this dopamine rush, okay, which is a rush of excitement. And you want to track that animals for the hunt. So what's happening with these rapidly changing images is that it's constants of tracking, see, having stillness, and then seeing the movement of the gazelle. The iPad is basically going Gazelle gazella, gazella, gazella, gazelle, because I'll develop and so it's really just releasing too much dopamine into the brain. And it's and that's what's addictive to the child. So that dopamine rush is like any other drug. It's like doing cocaine, it's like having nicotine. It's like a shopping addiction. It's anything, anything that gives pleasure jump, bungee jumping, anything that gives people pleasure, it's the same rush of that feeling. But it's just constant, it's too much. When that dopamine is released, the brain feels the rush eminent down regulates the dopamine receptors in the brain. So then the next time, you actually need more dopamine to hit the same number of receptors, which work in the lock and key kind of phenomenon. So you're looking for how many lock and key matches did you make, and that's what creates that that pleasurable sensation. So the next time you need more, so it wasn't enough. So then that's how they get addicted, because maybe 10 minutes of watching iPad videos, you know, was gave them pleasure next time, it's going to be 20 minutes Next time, it's going to be 30 minutes. And they like that feeling of pleasure that they got last time and they don't they of course they don't understand what's happening. They're just seeking that pleasure. So so limiting what what was. The question was whether about TV, and so that's why TV is better, because the images are changing more slowly than they would on a video game on or on an iPad. You know, video game developers, they'll admit this, you can look this up on the internet, they hire addiction neuroscientists to help develop the video games. So these are people who are actually have PhDs advanced degrees in how does the brain get addicted, and every single video game company hires these people. And your video games are now connected to the internet. So there's no free standing stations, like when we were growing up, it was Atari, no one knew how long he played your Atari for. Now the information is going through the internet, going back to the video game company, and they collect all this data and they analyse it and they see, okay, 40% of our people are spending 70% of their time on this screen. What is it about this screen that gets people that draws people in? And then this screen, you know, only five people 5% of the people are interested, everyone just passes through it. So they try to figure out is it the colours? Is it the movement? Is it the characters? What is it and then they tried to just bring more of that into the rest of their video game to literally with a goal of making it more addictive to your brain biochemically. So TV is not TV is not doing that. So well net maybe Netflix is I'm not sure Netflix might be budget TV generally is not they Netflix is developing content based on what people are watching. They get that data also. But anyway, TV is moving much more slowly. Although some of its moving a little faster. Like if when we were growing up. I watched reruns of Leave It to Beaver, which was so much slower than anything that's on today. But the slower if you can watch Mr. Rogers, something like that, I would say unlimited of that type of slow movement, depending on the age. But if you're really looking for something to watch, go for the slow things to kind of raise your children in a low dopamine state. So the shows that came from the 1950s 1960s much slower pace, those are preferable when they're younger, the old cartoons even? Exactly yes, because those were all hand drawn. So they would all the scenes on the cartoons, they would draw them by hand and it was like a flipbook essentially is how the cartoon worked. But it was limited by the number of pages that that they could hire someone to draw with a slight difference in the rabbit moves his ear up and down your nose, and now it's all computer generated. So the number of hours Scenes is unlimited because the computer can do a lot more. So it's really more sort of pages. And that flipbook would be the metaphor. And the idea is that slower paced TV show would be less addictive to the child. Right? It would, it would release less dopamine. So it's that rapid movement that's basically making them feel like if, if you're thinking of their brain in hunter gatherer society, that they're hunting one animal, imagine if at that time, they were supposed to be hunting 1000s of animals that were just all around them, and they didn't even know what to shoot, which is sort of like a video game, I guess. But, but that would be overwhelming, that would give them an overwhelming sense. And so this is the same kind of concept. Okay, leave it leave it lower dopamine state. I mean, I think with my kids, we watched some Daniel Tiger, that was a pretty slow moving show, trying to think of other examples that are more that are, you know, on more today's TV networks. I, you know, I think that many parents will see that, and this doesn't apply across the board, but many of the boys are going to get more addicted to these things than the girls. So parents have, you know, the, what I hear from my patients is that if they're if they have a son and a daughter, they feel more worried about their son getting addicted to video games than their daughter. Because the the, in some people, there are these just brain differences, where it just makes it more common. So I think you have to sort of see how your own child is responding. Even even what the data is showing that in, for example, social media is really affecting the girls more than it's affecting the boys. So again, these are generalisations. They don't apply to everybody, but it's sort of how our literature is defining it these days. So I'm using it as a as a guideline to help families understand what they should do. Yes, no, I, one thing that I noticed with my kids is that when they watch TV, they're very well behaved. So I do selfishly enjoy it, because they're busy, they're not fighting. They're not tantruming when they're watching TV, and I can get things done. But I definitely noticed that as soon as the media device is turned off, especially if they've been watching it for a long period of time, they act a lot worse, but more likely to fight, they're more likely to behave poorly. Is there any reason why that happens? As a neurologist? Can you explain why that happens? Is this normal? Well, I think it's it. I don't think there's like a clear explanation. I've never come across anything in the literature, per se about that. But I would say that they're in this heightened dopamine state of pleasure, and you've just taken the pleasure away, so it kind of makes them a little more cranky. With withdrawal. Yeah, it's a withdrawal. Yeah. It's like that. Scary. So it really is like a drug for kids. It really is like a drug. And the thing about it is that the, the younger the brain is the more it's developing and changing. So I always use the analogy of smoking cigarettes. You know, most people I would say, don't don't really know people who smoke cigarettes so much anymore. There's been so much data about it that the younger generation is not smoking the classic nicotine cigarettes, but if you know someone in your, in your circle that smokes cigarettes, I can, I'll be willing to bet you five cents, that they started smoking before they the age of 12. Okay, that's because if they started smoking, when they were 30 years old, or something like that, and then they realise the health risks, and their doctor suggested that they quit or something like that, they had much less trouble quitting someone who starts any habit at a young age, whether it's you can use this to your advantage as a good habit, or view it as a threat with a bad habit, it's going to sort of evolve with their brain, meaning that as the brain is changing so rapidly in this age, growing the brain cells pruning away the ones that are not used, it's literally creating the neural network that relies on this thing that they've become addicted to. Now, I didn't want to scare you with that you could use it to get them addicted to exercise to healthy foods, you could take it to your advantage to I was just gonna say as someone who spends time with your children and witnesses it you definitely have shown me that good behaviours can result from from, you know, reinforcing it as a parent Jane's kids eat vegetables, they eat really healthy, they hike, they don't complain when they hike. So and they don't ask for TV or they don't ask for media. So I think what I like about you is that the advice that you give you actually follow in your own personal life. I definitely have a sense that if I am giving people a shred of advice, I'd better be sticking to it to the nth degree. You know, I don't I don't want to come across as a hypocrite. So if I'm telling you about it, I'm I'm certainly doing it. So what are you going to do when your kids are older? And they asked for phones, all their friends are on telephone on on cell phones? What age do you think is acceptable for a child to have a cell phone? Right? It's a it's actually a question that we're struggling with in my house. And it's one that like I said, anything i Any advice, I'm telling you, I want to make sure I'm following it myself. So I'm going to hedge on this one, because we haven't gotten to that point yet. But I will say that my husband is definitely trying to push a campaign there's there's various names for them, like wait until eighth and things like that, where a parents are banding together to wait until eighth grade, at least to give their children a phone. I think if there are even just a few other kids that don't have them, I do think it's hard to be the only one that doesn't have one. But if you can get a small little group of like, it can just be 10 or 15. Kids, that also don't have one, I think that can be comforting. I know that there are different communities around the country where they're, they're really interested in this research, and particularly around the Silicon Valley, we've had visitors from Marin County, we've had visitors in our home from San Jose. And both of those places. People, the parents are not giving their kids cell phones, to a large, a large percentage of the class does not have cell phones, until, you know, later in high school. And so. So that's easier, it's easier in those communities to do that. If you are in a community where most kids have them, I would suggest being the champion, being the pioneer and trying to convince other families to go along with you. I think a lot of parents just want their kids to fit in. And so they want, they want to do that they feel the peer pressure themselves. But if you can create a different type of peer pressure that's really more based on the literature and is really doing something positive. Let's let's all feel the peer pressure to do something positive for our kids. So let's try to hold out. I know that there are phones that look like iPhones but don't have a connection to the internet. I think it's it's a very hard question. Because how, how do we give this to our kids when we know it's so addictive? And yet, and we know that they're more predisposed to addiction because of their age and their stage of brain development. And so we're we're handing them something that's highly addictive, and then just telling them don't get addicted to it? I mean, I don't know. It seems so unfair. It seems like a really unfair thing to do. So. I'm sure I'll come up with with more specific strategies when my kids get to that age right now, I could just speak in my general hopes for that time. No, I agree with that. I see, you know, my daughter who's about to start middle school, she doesn't have a cell phone, but a lot of her friends already do. And they want to talk to her. And we don't have a house phone. Because now every you know, I think this is pretty common. Now we have our cell phones only and so I'm getting a lot of text from her friends to my phone. And that's getting a little irritating because I don't want her friends. You know, I don't want to give her my phone. That's that's not her phone. It's my phone. And so I can see how parents eventually give in and you know, and and get phones, we're going to really try to wait till eighth as you recommend it. And maybe you know, my wishful thinking is even beyond. But to me, it's, it's your right, it's your handing them something that you know, they're gonna get addicted to. So one piece of advice, I think is really important, when you just mentioned is not having the internet connected. There are some really scary statistics about how many kids have been exposed to pornography at a very young age and all sorts of content on the internet that I think is potentially really harmful for kids. Yes, definitely. You know, there are there are more phones coming out phones that look like iPhones, phones that are wristwatches that don't connect to the internet, but can do texting and do phone calls and things like that. And you can monitor which phone numbers are, are listed there and how many people and so forth, you can monitor what the texts are that come through. So I think that if we as parents, you know, we live in a free market economy. So we as parents want something, we drive the market to create that so. So if our voices are heard, someone will want to sell us that product and they'll come up with it. Alright, that's good, actionable advice to get a a non internet connected cell phone that can text and make phone calls without having the ability to have Google. Yes, there are a few commercially available and you can track your your kids with them. Some of them still just have a GPS so you can use it to see where your kids are. I don't know how I don't know how I feel about that. But maybe that's maybe that's a good thing. What I see is that parents literally are afraid of taking it away. They're afraid of making their children miserable, or the tantrum or the discomfort or the Yeah, yeah. The big thing I hear from parents is that it's now their new social outlet that they meet their friends on the video games, and that's their time to see their friends. And that I understand, I'm sympathetic to that. But I do really believe that there's nothing better than seeing a friend in person, right? I mean, I just think there's that cannot replace. Yes, absolutely. And, and that makes me that makes me sad, honestly, to hear that when I hear that, that that's the social outlet that children playing a video game together in different homes, is considered the social outlet. So I would think, I would think, quality over quantity, that's, that's my personal philosophy, I would say, if you're able to invite the friend over to, to play in some way that doesn't involve screens, isn't that so much better, and they can connect better have an opportunity to have conflict and resolve it an opportunity to understand someone's emotions. I mean, this is you, you are given we as parents are given the responsibility of really developing our children's brains for the future. So the brain's you know, there's neuroplasticity, so even when you're an adult, you know, if even if you had, you know, hopefully not, heaven forbid, terrible parents or something horrible happened, you can undo that. So nothing is a nothing is a permanent script. But it's, it's harder to undo things. And it takes more work as an adult, and we are charged obviously, with doing the best that we can as parents, that's our responsibility. And if we can sort of view that responsibility, as an as an honour and as a privilege, it might make it easier to do the hard choices. So it, it's a hard choice from the eye of a child maybe or doesn't seem like a good choice from the eye of a child. But if you can step back and see it from the big picture of your responsibility for this little person's path into adulthood, that may inspire you and may make it seem easier. But the way that I am able to make choices that might be hard, even if my kids don't like them in the moment is I, I think about it, as you know, what, what do kids really want, if you really gave your children everything that they wanted, they would probably sit in a pile of mud, eating ice cream, pop ice cream and popsicles all day long, from, you know, early in the morning until midnight, or something. So the choices that a child would make for their own, I'm doing air quotes, happiness, really, generally speaking, are choices of pleasure that have no foresight into the future. So I'm not generally thinking of my children's pleasure, that's my parenting style, I'm thinking that the choices that I make are going to give them pleasure when they reach adulthood. And when they are, they have developed certain competencies for adulthood that that will give them a happy adult life. But children's pleasures is very fickle, cheap to buy, but doesn't have long lasting benefits. I also really believe there's a pandemic of loneliness going on. And I think I genuinely feel like it is from, I think a lot of it is coming from media, I think a lot of people are spending their time on social media, using media as opposed to getting together in real life with good friends. And that's, and I think that's one of the reasons why we're seeing people, you know, more anxious and ever more lonely than ever. And so I agree, I want to give my kids those skills, to see their friends in person and to work on conflict in person and to you know, there's nothing better than being face to face. As much as I like seeing you here. I do look forward to seeing you. Also not on, not on here. Absolutely. I agree with that. And that's, I think what you just said is a nice thing to think about when parents are caught are conflicted with this idea that, you know, their children's social outlet is playing video games with other kids. Well, you know, what, what are you giving up in terms of what they could be? What skills they could be learning, what are you giving up by having them develop their friendships in that way? I also have really good memories of being a kid playing outdoors with my neighbours and running around. So you, you know, media also takes away when you see your friends socially on media, you're not exercising with them, right? You're not playing around, you're not playing outside, you're not playing catch, you're not playing hide and seek basketball, whatever the game maybe. And that just makes sense that that's not as healthy for kids. Right. I mean, that's, that's felt to be a huge piece of the obesity epidemic. So if I think we're speaking about the effects of screentime, in almost an esoteric way, I mean, it's sort of abstract this dopamine concept, and what's it really doing to the brain? And it may seem sort of out there, and is that really happening? But what people can see, you know, and feel is, is their child's weight. And if they're going into the obesity category, and there's a lot of screentime, you can, you can really link those two together quite easily. Like, let's say tonight for the parent that goes home and they want they want to take your advice to heart and their kid ask them tonight to watch TV. What should they do? So they offer them a book, should they say? Well, I think I think one other think that's a great question. One other way to start is to just at least have one day for your family that's technology free, but also helps to sort of reduce the addictive properties because it kind of provides a natural reset for the brain. So if it's too much to do a whole 24 hours, you can start with this for hours on Saturday morning or Sunday morning, whatever it is, this is our family time. And so we don't mommy and daddy, the parents, whoever, whoever the caregivers are going to put down our screens as well. And we will all just hang out together, spend time together. And none of us will be connected on the screens will be connected to each other instead, and then see what that does to your family and see how that expands. That's great advice. I'm gonna try it tonight. Thanks for coming on. Great to see you. Thank you. Great to see you. Thank you for listening to this week's episode of Ask Dr. Jessica. If you are enjoying this podcast, I would be so grateful if you would take a moment to help spread the word either by leaving a five star review or sharing it with a friend