Chad Perlyn, MD (Host): Welcome to another episode of the For Peds Sake podcast, a Nicklaus Children's podcast that is all about putting children at the heart of healthcare. I'm Chad Perlyn, a pediatric plastic surgeon here at Nicklaus Children's and host of the podcast. And I am very excited and a bit nervous to have the amazing Dr. Marisa Azaret on the show today. Dr. Azaret is the Director of Psychology here at Nicklaus Children's, but she's also my co-host on the Spanish edition of this podcast. So, not only do we get to have her as a co-host, but today she gets to be a guest. So, welcome my friend.

Marisa Azaret, PsyD: Thank you. It's a true honor to be here with you, Chad. We never thought about this, maybe two months ago when we began podcast. So, here we are, both of us together. So, it's quite a pleasure to be with you.

Host: It's really fun. All joking aside, we're going to talk about something really important today, and it's the launch of a new campaign by the hospital called Safe and Sound, which is about empowering families, empowering children with the tools to navigate the digital world we are all living in. Tell us about this program. I know you're involved, and I know it's of great meaning to you and to our community as we roll it out.

Marisa Azaret, PsyD: And you said it, it's of great meaning for me because I believe so much in education and prevention. And I guess the bottom line, Chad, is that we cannot wait. Our children cannot wait. Adolescence goes very fast, so we don't have years to wait for research results or whether our politicians are going to create new laws, we need to move now. Are we going to be able to change whatever we need to change in the future? But the goal is with this campaign, let's get together. Let's create a community of teachers, parents, kids, pediatricians, policymakers, everyone involved, and let's learn, let's share that knowledge, and let's educate our kids in terms of dealing with the digital era that is here to stay.

Host: Yeah, I love the fact that Nicklaus Children's, and you and your Department of Psychology are helping lead this. I think as we actually speak right now, in the U.S. government, in the Capitol, there is active discussion going on about digital safety for our kids with the leaders of the major social media company. So, what amazing timing as, as you and I are having this conversation that it's happening at the federal level, literally as we speak. How does this program work? What can families expect out of this program?

Marisa Azaret, PsyD: It's a liaison of community partners, and it goes from tools to begin a conversation with your teenager or young child to videos for the younger one? It's what you mentioned at the beginning of this podcast is empowering families. It's giving them tools. It's giving them information. It's giving them a platform where they can chat and they can discuss ideas and they can be part of the solution.

Host: You know, one of the things that I think so many families struggle with, we in our own family, I have two teenage boys, as you know, is should our kids have social media to begin with? And when? I know my older one uses it to see what's happening. Social media, it's often a tool for his social calendar. We haven't gone there, but the time feels like it's coming at some point. It feels appropriate. Is it? Should we? What's your advice to families?

Marisa Azaret, PsyD: And that's a very good question. And many parents ask that question, because they feel ill-equipped to deal with those questions and those issues. When we look at social media, we cannot say, "This is black and this is white." There is a lot of gray in social media. And three hours on the computer, on the phone for one kid, for one child, may be very different from another child.

So in a way, it's how responsible is that child? What is the level of communication with the parents? What is he doing in social media? Is he getting together with friends, study group? It's so heterogeneous, that group, the group of adolescents, that we need to be mindful of where they are at, what they need, the level of responsibility, the maturity, and have that conversation and then let the parents make that decision, if they have enough information that they feel comfortable to make such decision along with the child. Does that make sense?

Host: It does. It makes a lot of sense. And as you were talking, I was also thinking, you know, it doesn't have to be black and white or set in stone. There are world events that often happen far outside of any of our control. And I think it's appropriate at times to tell your children when they can press the gas on social media and when there's a time to back off, depending on you as a parent and the influences that you want your children exposed to. So, I like what you said a lot. I think it was very intuitive.

You know, one of my other concerns, we talk about social media being social, of course, using it as a calendar, but this notion that we put things out in the world, and we want people to see them. And some of those people are our friends or people we know. And others are strangers, especially if our children use hashtags or encourage other people to look at their social media. And there is a staggering number, so much research now, the number of children that have had interactions, even more than just a like with strangers online. Talk to us about that. How do we protect our kids in that situation?

Marisa Azaret, PsyD: Yeah. And that is why it's so important. I think, Chad, the most important tool that we parents have is communication. It's the same way as you would talk your adolescent or pre-adolescent when he's going into a game. And you say, "Okay, if you need to go to the restroom, you go with a peer. You don't go alone. You don't stay alone with an adult." And I want parents to always remember that that is the most important tool that we have as parents, is communication. And that communication begins early on in life. It's not like, you turn 15, "Let's sit down and have a serious talk." It doesn't happen like that.

Host: No, you're right. And I know we're focused on the safe and sound program that we're rolling up. But for those listeners, if you haven't heard Dr. Azaret's co-director of the department who helps her lead it, Dr. Sara Rivero-Conil, talked a little bit about this on her episode. And she had a brilliant expression, which I want to share with our listeners today, which was mindful mentoring. So when you are talking about these things with their children, knowing you are mentoring them and having the mindfulness, the awareness that they're watching you as well, and how you interact with social media is a model for them too. So, that's a great episode for folks to listen to if they haven't had a chance. Talk to us a little bit more how parents can get more information, more resources out of the Safe and Sound. I know you're going to be putting out a lot of content. What should families expect?

Marisa Azaret, PsyD: Yeah, what we are doing, it depends on the age of the child that they are addressing. Like I mentioned before, we have videos, we have answering questions like when to give your child a smartphone, what are the red flags that you might see in your child that worries you and it means that you need to take action.

 What we want to do in particular, Chad, is changes are difficult. This is a big change in our society. Parents honestly are burnt out. They are exhausted. We're coming out of a pandemic and we saw a tsunami. of mental health issues, not only with kids, but with the parents too. So, I don't want to scare parents either. I want to give them the sense that if you're frozen, if you don't know, if you're frustrated, great, you know that you are at that space. So, let's move forward. That is a signal to you as a parent that you need to learn, that you need to empower your family.

I think that many parents, they are afraid of this digital era because it's new, because it's something that they find that they don't have control. And what I mentioned before to one of my colleagues is, once the parent gets familiar with one platform, you know, Instagram, immediately, they notice that the children are jumping into another way of communicating. So, that is so frustrating and it brings a great deal of anxiety to the parents. So again, they will have tools in this website, they will have videos. They will have an ability to connect to organizations. Let me give you an example, like Common Sense Media, which is a national organization and they have a lot of data, a lot of way of beginning that conversation with your kids.

Host: And last question, how can families access this information? What's the plan to share these tools and resources through this program with our community?

Marisa Azaret, PsyD: Through the website here in our hospital, and I believe that now, today, you know, they can Google safeandsound.org. And then, it will take them to that. I have three advices that I want the parents to hear. Because you know that I'm very pro education and prevention and things like that.

First, as a parent, look in the mirror and ask yourself, how do I describe my relationship with social media and the phone? Be honest. Because what the kids are telling us is that my parents are too busy surfing the net, or posting pictures, or answering emails. So, that's the number one. And the number two is sit down with your child. Learn about what he's doing. Most kids would be happy, I honestly believe, to teach you about new things on the internet. Three, maintain that communication. Not when they are 15, but when they are little. If you create that bridge of communication, as they get older, it's so much easier to maintain it versus, it gets to 15, you have to do it.

And in terms of social media, and limiting, and creating a schedule, we need to use the combination. You know, it's okay to say, "Okay, at 9:00, 10:00, you go to bed. But let's talk about what you would like during the day. Can we negotiate something? Tell me what you like about the social media, and tell me what you don't like." Because kids don't like a lot, the bullying component, always comparing themselves to others. So, let's have that conversation. And I can assure you that it will help not only the kids, but the family dynamics.

Host: Amazing advice and said in such a real and useful way. And it made me so happy hearing you talk, because I remember when we first started planning this podcast as the two co-hosts, that's exactly what we had talked about doing, was delivering real information that our families can use. So, thank you so much for being the show, for being a guest and my co-host, of course. You are an amazing resource to this community, as is your entire department and all of our mental health experts here at Nicklaus Children's.

Marisa Azaret, PsyD: Thank you very much. And I hope the next one is going to be in Spanish with you.

Host: Well, you'll do better in English than I would in Spanish, for sure.

Marisa Azaret, PsyD: You're invited. You know that.

Host: Thank you. So, this concludes this episode of For Peds Sake podcast. And I will share that I normally sign off by telling our listeners about all the social media channels where we can be followed on. But given the light of this podcast today, instead I'm going to say, let's all go home and just spend time with our kids tonight. Thanks so much for listening and see you at the next episode.