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Office Hours: Kids, Screens, and AI...Who's in Charge? · MIT - Conversations with MIT Health

• 0:02
  Emily Wade (Host): Does this advice sound familiar to you?
• 0:05
  Limit your screen time.
• 0:07
  Go offline.
• 0:09
  Touch grass.
• 0:11
  Yeah, let's face it, this is hard advice for adults, but it's even harder for kids.
• 0:18
  It seems like screens are embedded in an adolescent's life between streaming,
• 0:24
  between your downtime, and having your phone permanently, like, pointed toward
• 0:31
  YouTube or TikTok, and, lest we forget, the school issues, those Chromebooks.
• 0:38
  And, also on top of everything else, AI is lurking in the background, omnipresent AI.
• 0:48
  On this episode of Office Hours, we're going to do things a little differently.
• 0:54
  Today, I'm joined by Dr.
• 0:56
  Ed Levy, one of our beloved pediatric primary care providers, and we are going
• 1:03
  to talk through the questions he gets every day from parents about screens and
• 1:09
  phones and AI, especially around now, around the beginning of the school year.
• 1:14
  So, welcome to the podcast, Ed.
• 1:18
  Edward Levy, MD: Oh, Emily, thanks for having me, and for giving me an
• 1:21
  opportunity to talk about one of my simultaneously most favorite things
• 1:26
  to talk about and least favorite things to deal with as a parent.
• 1:30
  So,
• 1:32
  this is great.
• 1:33
  Host: Well, I'm really excited to have this conversation,
• 1:37
  because I am a blank slate.
• 1:40
  I know nothing.
• 1:41
  I am an indulgent aunt to four nieces and one nephew.
• 1:48
  And I'm endlessly, endlessly impressed that parents have to deal with not only
• 1:55
  managing their own screen time and all of these things for themselves, but
• 1:59
  also kids on top of everything else.
• 2:02
  So, very excited to have this conversation.
• 2:05
  Also, my husband's a high school teacher, and this stuff is
• 2:09
  the bane of his existence too.
• 2:10
  So, hopefully, I'll learn some really handy tidbits I can send back to him.
• 2:17
  To get started, yu'are always getting these questions about screens.
• 2:23
  When parents are talking to you about screens, what are they most worried about?
• 2:28
  And also, at the same time, what are the things you're most worried about?
• 2:34
  Edward Levy, MD: A lot of the things I think beneath what parents are
• 2:38
  worried about is a loss of connection, to their kid, both if the kid is
• 2:45
  always, like, on the screen or a loss of connection if the screen is
• 2:51
  managed and the tension that induces.
• 2:55
  The loss of development of other key parts of a kid's life, their schoolwork,
• 3:03
  their relationships, their physical ability, even, like, their sleep.
• 3:10
  So, it's kind of insidious the way it can creep into everything healthy
• 3:17
  that you want to see from a kid.
• 3:18
  But I think the deepest thing is the way it affects the relationship
• 3:23
  between parents and kids.
• 3:26
  Host: So, how do you go about suggesting a way in for a parent who's kind of
• 3:34
  overwhelmed and concerned about where to start with something like this?
• 3:40
  Edward Levy, MD: What I start with is that this is a very hard thing to manage.
• 3:44
  It's not simple that it hits on a problem of parents really feeling very alone,
• 3:53
  and not having a lot of other people.
• 3:57
  They don't necessarily have an aunt like you, Emily, who's going to play
• 4:00
  with their kids while they make dinner or do an important project for work.
• 4:06
  Oftentimes people are very mobile in the society.
• 4:09
  They're not around extended family.
• 4:11
  They're intense about work and don't have necessarily a lot
• 4:15
  of time to build relationships.
• 4:17
  So, they have to do everything, and that makes it hard.
• 4:23
  And then, you know, all these tech companies have armies of engineers
• 4:28
  and lobbyists who are creating a perfect storm of engineered
• 4:35
  happiness for kids to be on screens.
• 4:39
  So, the first thing is it's really hard to manage this.
• 4:46
  It's a hard problem.
• 4:48
  There's a lot of data both ways.
• 4:50
  You know, there's fear-mongering.
• 4:52
  There's kind of a lot of passivity.
• 4:56
  Other parents, even family members, may not support you in what you're
• 5:00
  trying to do and undermine it.
• 5:02
  So, I start by saying that if people are wrestling with this,
• 5:06
  they're probably pretty normal, and that it's a tough thing to do.
• 5:14
  Host: I relate to that.
• 5:16
  I relate to that on my own personal level.
• 5:18
  So, I can't imagine having to manage it for someone else.
• 5:24
  So if you're kind of considering, you're trying to start limiting
• 5:33
  screen time and screen use, does the kind of screen matter?
• 5:42
  Is it something where it's like—are we worried about phones?
• 5:46
  Are we worried about the internet?
• 5:48
  Are we worried about—God, the phrase internet sounds so antiquated now.
• 5:55
  It's like the World Wide Web.
• 5:58
  Are we worried about kind of like input?
• 6:00
  Like, like things like social media?
• 6:03
  Where are the spots that it's, like, this is less of a big
• 6:08
  deal, this is more of a big deal.
• 6:10
  Does that make sense?
• 6:11
  Edward Levy, MD: The American Academy of Pediatrics, the healthychildren.org
• 6:15
  has some nice guidance that I would direct people to.
• 6:19
  And I think I want to talk about like the five Cs, which I think is a really
• 6:27
  good way to think about it.
• 6:29
  And I like where they come out with that rather than with, like, strict
• 6:32
  time guidelines, although, you know, we can talk about time guidelines, too.
• 6:36
  So, the first is, and probably know your own child.
• 6:40
  You know, you have the best sense because different kids can handle different
• 6:47
  levels of responsibility and independence.
• 6:50
  There are some kids who have some vulnerabilities that are very prone
• 6:54
  to using the screens to distract from emotional situations or skill barriers
• 7:03
  that they need help moving through.
• 7:05
  So, it depends on the child.
• 7:07
  The second C that I like to focus on is it's not so much what's in
• 7:12
  the screens as what it crowds out.
• 7:14
  We used to, after a long trial and error in my own family,
• 7:20
  develop like a bucket system.
• 7:21
  And so, the screens, there are certain buckets you need to fill every
• 7:25
  day to be a healthy, whole person.
• 7:28
  Your sleep, your nutrition, your movement, your social connection,
• 7:33
  your schoolwork, maybe something like creative or community building.
• 7:40
  And so, the question is not so much something bad is coming from the screen.
• 7:45
  It's what is it crowding out?
• 7:47
  And I think everybody has had the experience, like, of adults of
• 7:51
  going to a restaurant and seeing people out on their phones together.
• 7:55
  And everybody has a sense, "That's weird.
• 7:57
  That doesn't seem right," you know?
• 8:00
  And so, it's not so much the content coming in, although sometimes
• 8:04
  the content is problematic.
• 8:07
  It's more what else isn't happening, what's being crowded out.
• 8:10
  The third C is calmness.
• 8:13
  You know, is a child calm on the screen, and are they calm coming off it?
• 8:18
  Because if there's too much agitation from the involvement or coming off
• 8:22
  it is too hard, those need to be tagged as problems to work through.
• 8:28
  The content does matter.
• 8:31
  You know, there's certain content, you know, like Daniel Tiger or Sesame Street
• 8:36
  for younger kids, that there is healthy content, so you can't make a blanket
• 8:42
  statement about the digital ecosystem.
• 8:46
  \ And the last one is connection, is, you know, where I started is, are
• 8:51
  parents and kids connecting or is the digital entertainment or enterprise
• 8:58
  interfering with that connection?
• 9:00
  So, I think that's a really helpful place to start.
• 9:04
  And it's all those things together.
• 9:07
  But the biggest question is, you know, what is it crowding out?
• 9:11
  What is it taking away from?
• 9:15
  , Host: I like that, five Cs.
• 9:18
  I guess one question I have, especially, you know, I think,
• 9:24
  you touched on you know your child best.
• 9:29
  Are there points where it's like, you know, a kid little older, they
• 9:38
  have some developmental changes.
• 9:40
  And then, all of a sudden the things they were okay with maybe out of
• 9:44
  the blue, they're starting to act out or they're kind of pushing back
• 9:48
  or trying to kind of push back on you trying to impose those limits.
• 9:58
  How much of that should a parent kind of be worried about, and
• 10:03
  how much of that is just sort of like normal developmental aging?
• 10:08
  Edward Levy, MD: I think that's classic normal development because, you know,
• 10:13
  very often one of the experiences people have, they see like a growth
• 10:18
  chart and they see this smooth line, but that's not how development works.
• 10:24
  You know, all of a sudden new brain centers switch on or new
• 10:27
  realizations or new experiences can really change in a very short time,
• 10:34
  people's sense of where things are.
• 10:39
  So, that kind of all of a sudden things are okay, that's a
• 10:44
  classic experience of parenting.
• 10:46
  It's something that was working before, you know, things are calm,
• 10:50
  all of a sudden, it stops working and you have to reinvent yourself and
• 10:54
  your relationship, and that's why I think parenting is a super hard job.
• 10:59
  And it's meaningful to try and support that.
• 11:03
  Host: Absolutely.
• 11:04
  So, you know, at the same time, you know, we have a kid who's maybe kind
• 11:10
  of like developing those feelings of wanting to kind of resist having
• 11:17
  controls placed on them, especially around things like screens, it's around
• 11:21
  the same time that it's like, "Hey, kid, it would be handy if you had a
• 11:26
  phone or a tablet or, you know, the school's going to give you a Chromebook."
• 11:34
  So, you know, you have these external forces that are also, you
• 11:40
  know, operating on the situation.
• 11:45
  What are the points where it's like it makes sense to consider giving your
• 11:52
  kid a smartphone or, you know, kind of expanding past a computer or an iPad?
• 12:00
  When are those kind of points that a parent should be kind of
• 12:06
  considering that it's like, "This is my moment for the phone" of it all?
• 12:15
  Edward Levy, MD: There are some like phone readiness questions, but
• 12:19
  I don't think like they're really that strong what's out there.
• 12:23
  And so, people are kind of left to their devices.
• 12:26
  I see people doing all kinds of things, you know, and
• 12:29
  there isn't like the pathway.
• 12:31
  So, I think it's important to be thoughtful.
• 12:35
  Some people are using call-enabled smartwatches that are less intrusive.
• 12:41
  You know, they don't have big screens, but they allow communication.
• 12:46
  Some people just use tags.
• 12:49
  You know, you can use a flip phone.
• 12:53
  Some of the devices have these lockdown settings.
• 12:58
  For example, there's a very little-known setting on the Apple phone, the
• 13:02
  assistive access, that kind of can really limit what people can do.
• 13:09
  I know people who just use landlines for kids to talk to their
• 13:13
  friends, you know, at certain ages.
• 13:16
  There are lockdown apps like the Life360 platform or Qustodio.
• 13:24
  So, you can find, you know, paid services like that.
• 13:26
  It's worth giving it some thought about which device you're going
• 13:31
  to get and how it's going to be locked down and how you're going
• 13:34
  to connect to your kid about it.
• 13:36
  But I would say there are assertions kids make about their privacy, about the right
• 13:45
  to equity with their friends, about the necessity and harmlessness of devices that
• 13:55
  sound good but don't really bear merit.
• 13:57
  And so,
• 14:00
  I really like the concept of parental presence.
• 14:04
  And parental presence, which is talked about, Haim Omer, a psychologist,
• 14:12
  is making kids clear that you are their parent forever, you're
• 14:18
  deeply invested in how well they do, in how well their life goes.
• 14:23
  And you, to some extent, know better than they do.
• 14:27
  And you're going to accept that they're unhappy because you think that's
• 14:33
  what's necessary for their development.
• 14:37
  And it's not an equal power relationship.
• 14:40
  But I think this gets back to this is hard stuff to do.
• 14:43
  You know, if you kind of have your sword and shield up all day at work
• 14:49
  and commuting and getting stuff done, there's a desire to have softness
• 14:54
  in one's family relationships.
• 14:56
  But at certain points in development, you know, there's very much and.
• 15:02
  You know, kids are wonderful and fulfilling, and sometimes it's hard,
• 15:10
  and sometimes, you get disconnected.
• 15:14
  So, there isn't, like, one clear pathway, but I would encourage people to push back
• 15:23
  against a kid saying, "I have, you know, unmitigated right to privacy and control.
• 15:31
  And what I do is, like, harmless and not your concern, and
• 15:35
  everybody else is doing it."
• 15:39
  So, I want parents to feel empowered to say, "Wait a second."
• 15:44
  And I want to go back to that word and, because the digital ecosystem is a
• 15:51
  source of information and entertainment and connection and participation.
• 15:58
  And it's also a source of misinformation and loss of skills,
• 16:06
  both in self-regulation and in connecting to other people.
• 16:10
  Obviously, there's this irony that we're putting out information on this digital
• 16:13
  platform that's going to be consumed on a digital platform, so we can't get
• 16:18
  too negative about digital platforms.
• 16:21
  So, both, both things are true.
• 16:24
  It's part of our life and it needs to be monitored, regulated, just the
• 16:30
  way, you know, you wouldn't let a kid have unlimited number of cookies,
• 16:35
  you know, over the course of the day.
• 16:37
  Host: You had mentioned de-skilling, which
• 16:44
  I hear that coming up more and more, especially around AI, the bane of my
• 16:50
  high school teacher husband's existence.
• 16:53
  And we work at MIT, so we talk about AI.
• 16:56
  We're in the AI landscape, and we can't hate on it entirely.
• 17:04
  But we do have this situation where it is becoming easy and beguiling for kids to
• 17:16
  use it as a shortcut at school, but also as a place to develop relationships with,
• 17:26
  you know, sentient, non-sentient, you know, entities, for lack of a better term.
• 17:37
  How much of that is kind of bleeding into the concerns that you're getting
• 17:44
  with the parents that you're talking to?
• 17:46
  And
• 17:49
  it's so new, and it's overwhelming.
• 17:53
  How do you recommend that they kind of encounter and engage with this?
• 17:58
  Edward Levy, MD: There's a really nice.
• 18:03
  Actually, September's Journal of Pediatrics just talking about this AI
• 18:07
  and the development of teen identity.
• 18:09
  And, you know, an important point they make is that only relationships
• 18:20
  can transmit cultural values,
• 18:25
  you know, that what oftentimes AI will just reflect back
• 18:31
  what it's being presented.
• 18:34
  You know, because it wants engagement and approval, you know,
• 18:39
  the whole sycophancy problem.
• 18:42
  But it can be a useful tool.
• 18:45
  So, it's important to connect around it to say, "Look, here's what it can do
• 18:52
  for you and what it can't do for you."
• 18:54
  But the de-skilling is really a concern and the replacement of virtual
• 19:01
  relationships with real relationships.
• 19:04
  But again, we have to acknowledge that making real relationships is hard.
• 19:09
  You know, people can give you negative feedback.
• 19:12
  They can be exclusive.
• 19:16
  They can be derogatory.
• 19:19
  They cannot be a fit, and you can just find a nice echo and mirror with the AI.
• 19:26
  So,
• 19:29
  it's problematic.
• 19:32
  And parents, you know, need to find ways to connect around it.
• 19:37
  Host: And it's also especially hard because, you know, as you said, and I
• 19:42
  certainly know this about the parents that are in my life, you know, we're
• 19:47
  in a place where increasingly a lot of the parents that we interact with,
• 19:53
  they're busy, they have hard jobs.
• 19:56
  They're, you know, often not by family members that can help and stuff.
• 20:02
  And so, you know, sometimes it's, I'm sure, even beguiling for a parent to,
• 20:08
  you know, write to a chatbot to say, "Hey, I'm having some trouble here.
• 20:13
  Do you have some recommendations?"
• 20:15
  And so, you know, I think it's probably a little hard to, as a parent, feel
• 20:21
  like you have to be the person who's like the sheriff of AI to your kids,
• 20:26
  but it's also an appealing thing that you may want to turn to for yourself.
• 20:31
  Edward Levy, MD: No, absolutely.
• 20:33
  It can be a useful tool, and it can be what feels like a very
• 20:39
  safe way of managing, challenges.
• 20:45
  The sheriff metaphor, you know, the question we might look like how
• 20:51
  you mentor your kids around AI use.
• 20:56
  Because if you look back to the early recommendations, co-viewing
• 21:01
  and co-experiencing AI, the AAP recommendations highlight that the
• 21:05
  tablet is a problem because it's such, an individual experience,
• 21:12
  and kind of only one person.
• 21:14
  So, co-viewing, co-experiencing, processing together
• 21:23
  is the ideal.
• 21:27
  It's hard, but, you know, it helps to kind of experience things together.
• 21:35
  But that's a big energy flip, right, for a parent, and we just have to name that.
• 21:40
  Because the reality is, when the kid's on a screen, you know, it frees you up.
• 21:48
  But on the other hand, if you have to monitor it, then it ties
• 21:53
  you down to doing it with them.
• 21:55
  And so, there has to be a mix of like co-viewing.
• 21:59
  But doing settings so you can look at chat histories is important
• 22:06
  Host: Now, for a parent whose kid is, you know,
• 22:12
  about to, say, graduate high school and, you know, going off to college or
• 22:19
  something like that, where you're at the kind of like toward the end of the
• 22:24
  journey, where should a parent start to sort of feel like, "Okay, I need
• 22:31
  to start kind of like stepping back a little bit," and and how to kind of
• 22:39
  disengage with that without feeling like you've completely, you know, lost touch?
• 22:46
  How could a parent sort of like make those first steps?
• 22:53
  Edward Levy, MD: So, let me see if I get your question right.
• 22:55
  How can a parent, if they're kind of mentoring and monitoring, how they can
• 23:03
  prepare the kid to thrive when they can't be in that position anymore?
• 23:09
  Host: Yes.
• 23:10
  Yes.
• 23:11
  Edward Levy, MD: So ultimately, you know, the hope is that by 18
• 23:18
  you've transmitted a lot of values.
• 23:21
  You know, by all these things you've done before, by, you know, getting them
• 23:29
  healthy food, by making sure the family goes outside, by all the parenting
• 23:35
  you've done, you know, prepares you that they have instilled your values.
• 23:42
  Because tno matter how much they fight you, there are pieces of you inside them.
• 23:46
  You have transmitted who you are, and they, by evolutionary and
• 23:53
  biological means, are somewhat obliged to either say yay or nay to the
• 23:59
  values that they've gotten from you.
• 24:01
  And hopefully, they'll say more yay than nay.
• 24:04
  But again, it's going to depend somewhat on the kid and their own trajectory.
• 24:09
  Host: So, there is, and we're adding to it, an overwhelming amount of
• 24:15
  advice about kids and technology.
• 24:18
  It's, you know, it's one of the many topics that has kind of created
• 24:23
  almost an infodemic, if you will.
• 24:27
  Where are good places where parents can go?
• 24:31
  I mean, obviously pediatrician is a very good place to go, but where are some good
• 24:37
  places that parents can go to kind of like get information, especially when they're
• 24:43
  feeling kind of like overwhelmed, like this is almost like an insurmountable
• 24:52
  task that needs to be resolved?
• 24:55
  Edward Levy, MD: You know, I totally agree with you, and I'm really glad,
• 24:56
  Emily, that you bring up that issue with the info epidemic because, you
• 25:01
  know, looking at the literature, it's not a very clean or clear literature
• 25:06
  that you definitely have the answer.
• 25:08
  If people want to familiarize with themselves, two of the big names
• 25:13
  in terms of raising the alarm about social media are Jonathan Haidt,
• 25:18
  H-A-I-D-T, the NYU psychologist, and Jean Twenge, T-W-E-N-G-E, who
• 25:27
  have kind of focused on the harms.
• 25:31
  Boston's own, like Peter Gray at BC, who used to collaborate with
• 25:35
  Jonathan Haidt, you know, takes more position there is something to this,
• 25:42
  but the correlation you're saying is much stronger, i you're saying is
• 25:48
  much stronger than it actually is.
• 25:49
  We have to look at other things like play and academic expectation
• 25:54
  and other pieces of the culture that explains mental health.
• 25:58
  So, those are some of the names you can start to familiarize yourselves.
• 26:02
  There is an additional resource from the American Academy of Pediatrics.
• 26:05
  You can download the Family Media Plan.
• 26:09
  And then, there's another good nonprofit, Common Sense Media, that you can search
• 26:16
  that has a lot of guidance about a variety of different platforms and content and,
• 26:23
  you know, how to think about things.
• 26:26
  Host: Well, that sounds great, and we will make sure that those links are down
• 26:29
  below on this, in the description here.
• 26:36
  So, If we wanted our parents to kind of take away one thing from this
• 26:40
  conversation, especially the next time that, you know, they've tried to kind
• 26:47
  of gently moderate their kids' screen time or, you know, social media use,
• 26:56
  and they've gotten pushback, and they're just feeling discouraged and overwhelmed.
• 27:01
  And if we could give them one kind of piece of advice or word
• 27:09
  of optimism, what would that be?
• 27:12
  Edward Levy, MD: You know, I was thinking about that.
• 27:16
  Parents matter tremendously.
• 27:21
  And you do matter, you're not simply a chauffeur and a
• 27:26
  cook and a provider of Wi-Fi.
• 27:30
  But to feel that you matter takes some risk and some persistence
• 27:37
  and some time and energy.
• 27:38
  There's a lot of potential energy in being a parent and converting it to the
• 27:44
  kinetic energy of parenting is the trick.
• 27:49
  So, what do you need to do to support yourself?
• 27:51
  You know, how do you manage stress in your life, your exercise, your sleep?
• 27:59
  If you're a mom going through perimenopause, you know, is
• 28:03
  that being addressed?
• 28:05
  Who is on your team?
• 28:07
  In many ways, I'm really struck by how, you know, great people really
• 28:14
  their life is their work and their kids and don't necessarily feel
• 28:19
  supported by family friends, and other people in the community.
• 28:28
  So, have a support network.
• 28:32
  You know, make that something that you invest in.
• 28:37
  Host: I think that's a really great way to kind of wrap up this episode.
• 28:42
  And especially because I think especially if you are a part of the
• 28:48
  MIT community and the MIT health community, we have so many people who
• 28:54
  are ready and excited to be on your team.
• 28:58
  And so, make sure that, you know, we have care for every member of
• 29:05
  the family, and make sure that you are going to health.mit.edu
• 29:11
  and checking out everything that we have to offer and maybe even setting up, up an
• 29:19
  appointment for yourself or for your kid.,
• 29:24
  I believe, Ed, that you are accepting new patients, so…
• 29:28
  Edward Levy, MD: Yep, definitely.
• 29:29
  Definitely
• 29:31
  Host: Always great to become a part of the MIT health family.
• 29:38
  All right.
• 29:38
  Well, thank you so much for being on the show.
• 29:40
  Edward Levy, MD: Well, Emily, thank you.
• 29:42
  Thanks for your great questions and helping frame this and for being a
• 29:47
  dedicated aunt to your four and nieces.
• 29:51
  They're lucky to have that support.
• 29:57
  We'll talk another time.
• 29:59
  Host: Yep.
• 29:59
  Thank you.
• 30:00
  Thank you for educating me.
• 30:02
  I feel like I have some tools now, so maybe I'm not going to
• 30:06
  be quite so indulgent anymore.
• 30:09
  Well, this has been a great episode of Office Hours.
• 30:12
  And if you have a question for Office Hours, go to health.mit.edu/thrive
• 30:19
  and you can send in your question.
• 30:22
  Until next time, see you later.