Pediatricians and family physicians have a rich body of evidence testifying to the influence that smartphones and social media can have on children’s health, says Pasadena pediatrician Lindy McGee, MD, chair of the Texas Medical Association’s Committee on Child and Adolescent Health.
“We see problems stemming from social media frequently,” she said. For instance, one adolescent patient recently came in with disordered eating after watching videos on social media that recommended eliminating all carbohydrate consumption.
“It goes from as serious as that to something [like] pre-teens who come in thinking that they have to buy expensive skin care products and sometimes getting dermatitis because they’re using so many because their TikTok algorithm is showing them [those products],” she said.
Fortunately, many resources related to social media and smartphones are available for physicians and parents, Dr. McGee says, prompting TMA’s House of Delegates in May to change existing policy and approve a joint report on social media and smartphone use.
In three parts, the policy change encourages:
- Families and physicians to refer to established guidelines from the American Psychological Association and the American Academy of Pediatrics (AAP) on promoting healthy technology use.
- The development of state legislation to set restrictions on data mining that involves minors.
- Continuing research and education regarding the growing impacts of social media, smartphone use, and overall technological advancements on mental health.
Staying current can be difficult because this topic changes rapidly, Dr. McGee says. For instance, in May, U.S. Surgeon General Vivek Murthy, MD, issued an advisory stating that “social media use by young people is nearly universal, with up to 95% of young people ages 13-17 reporting using a social media platform and more than a third saying they use social media ‘almost constantly.’”
In June, Dr. Murthy followed up the advisory with a recommendation that social media come with warning labels like those on tobacco and alcohol products.
“The mental health crisis among young people is an emergency — and social media has emerged as an important contributor,” Dr. Murthy wrote in an op-ed for The New York Times announcing his call for a warning label. As this is a new proposal, TMA does not currently have any policy related to Dr. Murthy’s warning labels, Dr. McGee says.
The TMA report approved in May calls on social media and tech companies to assess the impact of social media on children and adolescents, prioritize health and safety in their designs, share relevant health data with researchers, and respond quickly to suggestions and complaints from the public.
The report also spells out recent state regulations on social media and called for tighter restrictions on data mining of minors. However, most social media regulation is probably best handled at the federal level because creating a patchwork of state laws in regulating the internet often causes uncertainty, Dr. McGee says.
“The landscape is really confusing right now,” she said. “A lot of states are trying a lot of different things.”
In the meantime, TMA’s updated policy gives direction for physicians, and by extension parents, to have ongoing conversations with children about social media and smartphones, Dr. McGee says. These conversations should resemble the other ones they have about safety, she says. When it comes to crossing a street, for instance, parents must hold the hands of a toddler and talk constantly about staying out of the street, but parents modify that approach as the child grows older and more mature.
“It’s not a conversation you’re going to have once – it’s a conversation we have with them over and over,” she said. “Is this a calm street in the neighborhood, and is the child ready for this? That’s the same way we have to approach social media.”
The AAP’s “Five Cs” approach helps physicians and parents follow this process, Dr. McGee says. For instance, they should take a close look at the content children are consuming. Is it a helpful video on cooking or dancing? Or are they watching something with extreme violence and promoting unhealthy habits?
“All of that needs to be part a conversation that we have constantly with the children and adolescents in our lives,” she said.
Physicians also must be educated about the ever-expanding research about young people and social media, Dr. McGee says.
“Physicians need to be prepared to answer a lot of questions about social media and to use the Five Cs method and know how to ground parents on how to have these conversations,” she said.