Maggie McKay (Host): Social media can be a double edged sword. It can be helpful in some instances, but harmful in others, especially when it comes to our kids. Today, Dr. April Touré, Director of Child and Adolescent Psychiatry Consult Service at Maimonides Medical Center, will tell us how to support kids in the era of social media. This is Maimo MedTalk. I'm Maggie McKay. Thank you so much for being here today, Dr. Touré. As a parent, I know I can't get enough information on how to deal with social media issues and my son, so I can't wait to hear what you have to say.

April Toure, MD: Thank you so much for having me.

Host: Absolutely. To begin, when children encounter upsetting information online and elsewhere, how do we talk with them about it?

April Toure, MD: That's a very good question, and a very timely question, because anyone who's paying attention right now knows that there's lots of opportunities to encounter upsetting information online. So, I think first it's really important for parents to keep open lines of communication with their children, to be curious about where they're getting their information and what they're encountering online, whether it's through TV or through their phone or through different applications that they're using, and to try to keep open non-judgmental conversations about what they're viewing and how it's impacting them.

Host: Keyword non-judgmental, because I know myself, when my son was younger, I'd be like, what? You're looking at what? So you're so right. You have to just be okay, uh huh. And take in all the information and go from there. So with all the sensitive topics out there daily, how should we guide them? What tools can we suggest to keep them from feeling scared or hopeless?

April Toure, MD: I think that there's two approaches to take. So one is like, how do I proactively make decisions or talk to my child about their social media and online use to best set them up and protect themselves? And then I think there's also the reactive part of like what do I do once they've already encountered information that may be upsetting or have an interaction online that may be upsetting.

So proactively I think it's really important for parents to educate themselves. As someone who grew up using social media; I can tell you that it has changed a lot, even over my lifetime, and we have to continuously educate ourselves about different applications and have a sense of what kids are using online.

And so there are some resources that can be very helpful for that. For example, I really like this website called Common Sense Media. That's commonsensemedia.org, where you can look up different social media platforms and really educate yourself about the different security settings and monitoring settings that you may want to set up proactively with your child in order to help manage what kind of content they're coming into contact with.

And then on the proactive side, I think it's important to when there's upsetting things that come up, whether it's in the news or elsewhere; I do think it's important to talk to your children about what's going on so you can have the best sense of both how they're impacted but also the understanding that they have and the information that they have to make sure that they're understanding things accurately.

And letting that kind of foster further communications about how to best support them. For example, if they're encountering information on the news that's really upsetting, that may give you an opportunity to talk about what their worries are, and how to best address those worries. If they're having negative interactions online, for example, getting an upsetting message from someone, or virtual bullying; that can give you an opportunity to talk about how to best support them when it comes to those kind of interactions as well.

Host: And what age do you feel is appropriate to give your kids their own, say, cell phone or tablet?

April Toure, MD: It's such a hard question to answer. And what I can tell you is that there are several organizations that have put out some general guidelines about social media and phone and device use for children, right? So there's the American Academy of Pediatricians. There's the American Academy of Child and Adolescent Psychiatrists and others who have put out some general guidelines. And what I can say is that there's a lot of evidence that before the age of two, kids should really have almost no access to screens or only use it to communicate with others.

And then from there on, using screens and tablets and devices, to access primarily educational material. But what I also know, practically speaking and pragmatically speaking, is that, cell phone access and personal laptop access is almost ubiquitous by the time kids are in middle school, and definitely by the time they finish high school, but it's a very personal decision.

So what I like to tell parents is that you want to think about, when you think your child is ready, meaning that they understand some of the dangers of having access online, for example, not sharing their personal information with strangers on the internet, when to get an adult involved about things that they're encountering and interactions they're having online, and that ultimately it is your choice about when you want to give it to them and when you think they're ready and not the choice of society or other parents.

And so, it's kind of hard to say. A lot of people do have devices by the time they're 12 or so, and I don't think that there's any hard and fast rule, but you really just want to be mindful about having some conversations ahead of time, even before introducing something like a cell phone, to help set up expectations about how they can use it as safely as possible, and what some of the limits or boundaries may be around that device use.

Host: So you bring up a good point. What do you tell parents to say to their children who say, I'm the only one in the whole class who doesn't have one. My son, we went through this for at least three years and I said, and you will be the only one for a couple more years cause you're not getting one until you're 12.

April Toure, MD: I think that that is an absolute fair approach. I think that it is okay to validate your child's frustration without agreeing with what they're asking for, right. Yeah, I get that that must be incredibly frustrating to feel like everyone else has access to something that you don't.

Tell me a little bit more about why this is so important to you. Are you open to hearing from me why I don't think now is a good time and when I think you'll be ready? And then maybe try to think about if there are things that are important to them. For example, a lot of their friends are using their phones or social media to communicate.

Okay. It sounds like you really want to be connected with your friends. Can we think of some other ways to get that same need met without depending on the device to do it? And so basically trying to explore if there are some alternative ways that you can support the things that are important to them, even if you're not quite ready at that point to give them the device that they're asking for.

Host: And Dr. Touré, what is reasonable when it comes to allowing them to have like TikTok, Instagram, all those accounts?

April Toure, MD: Let me say this. There is increasing evidence that is coming out specifically about social media and its impact on children. A lot of the evidence is probably right now, more so heavily focused on the impact of female identifying youth and young adults; but really it can be across the board, and so I say that to say that we do know that there are some potential downsides of having access to social media.

For example, exposure to cyberbullying or the tendency for people to post only the best things that are going on in their lives. So it can lead to a lot of feelings of inadequacy or insecurity and all of those things. And exposure to content that is just not age appropriate. And sometimes those things are very easy to access on platforms like Twitter or TikTok.

So what I advise parents to do is to, again, it goes back to that education piece. If you are deciding to give your child access to social media or access to a device where they have the potential to download those things; do your research. Look into the different social media apps because each one actually has different types of safeguards that allow some degree of parental oversight or certain things that features that are not accessible for a person who registers for a device who's underage. And there may be other ways too, for you to monitor, for example, when they have access to those apps; there are ways to set up their phone so that they turn off at a certain time.

So you know that they can't have access to certain apps on their phone, after a certain time of the evening. So you'll know that they're not up all night on their phone, talking to their friends. And so that's going to be very platform dependent, though. And so, again, that's why I really like the website Common Sense Media, because it's has a lot of approachable content to kind of walk parents through that.

Host: Right, they are great. Our school actually played a movie from them all about social media and that was invaluable. Just to wrap it up, kids are so savvy with technology today. So how can we monitor as parents, all the accounts they have and, you know, we're not even aware of some of the accounts they have maybe, especially in their teen years in high school, forget about it.

April Toure, MD: Yeah, I think that part is incredibly humbling. You do the best that you can to monitor, but also I think that it is important to have a certain amount of realistic acceptance that you're not likely to be able to completely monitor their every move on this internet space. They have access to things at school, like even if you don't allow access at home or through their friends and things like that. And so that's why I think it is important to do what you can to set up some safeguards on the front end as far as what you're allowing access to or how you're monitoring it.

But I also do think that another very important part of the conversation is to just like we would prepare them for other aspects in life, how to ride a bike and teaching them to wear their helmet and to look both ways before crossing the street. You know, you teach them those safety behaviors. And so I do think it is important to not only just talk about not having access to devices and to apps, but also proactively have conversations about how to use social media safely. Thinking before you post something, or thinking about how you're using it or what you're posting online may impact you in the future.

Or those very important safety precautions, like, what information is okay for us to share online with someone versus when is it not okay? If someone is talking to me in this way, sending me messages of this nature, asking certain information of me, when should I let an adult know? And I think keeping those lines of communication open can really be important so that even if they are using media in a way before you want them to, in a way that you don't want them to, you still have access to checking in about what's going on in their virtual world.

Host: Right, well, thank you so much for all your advice and sharing your expertise. This has been really informative and helpful. We appreciate it.

April Toure, MD: No problem. It's my pleasure and thank you for having me.

Host: Absolutely. Again, that's Dr. April Toure. Thank you so much for joining me today on Maimo MedTalk. I'm your host, Maggie McKay. Call 718-283-7800 to make an appointment. For general information, visit Maimo.org. That's M-A-I-M-O.org. If you found this Maimo MedTalk podcast helpful, please share it on your social media channels. To listen to additional episodes of Maimo MedTalk, please visit Maimo.org, M-A-I-M-O.org.