Sarah Garwood, MD (Guest):   Hi. I'm Dr. Sarah Garwood, a St. Louis Children’s Hospital Mom Doc and a Washington University adolescent medicine physician at St. Louis Children’s Hospital. I'm very excited to talk about this topic today.

Melanie Cole, MS (Host):   Hey this is Mom Docs, the podcast from St. Louis Children’s Hospital. Today we’re talking about safe social media. It’s such an important topic for parents now and all the time really. Dr. Garwood, I'm so happy to have you with us. Before we get into this, what’s happening with our kids in the digital world? Do you feel this is making them smarter? More worldly? Is it positive or do you feel that it’s a little bit of both, negative and positive?

Dr. Garwood:   I think there are definitely positives and negatives to social media use. We know that to teens who may be seeking connections with other teens who have similar interest to them, social media can be a great platform to do that. It also can help teens who maybe feel a little bit socially anxious to build connections with other people or strengthen connections with some of their in real life relationships with social media platforms. Social media, as has been well described, can also have some downsides for kids. There have been some recent studies even linking increases in depression and anxiety to excessive social media use. So we definitely have to be careful about how we use those types of media and how we supervise those as parents.

Host:   So then let’s talk about the age because it’s certainly changing over the years. I didn’t want to let my kids even have a phone until they were 13, but that’s harder now. So what age should they be introduced to electronic devices whether they are iPads or tablets or phones where they can have access to social media?

Dr. Garwood:   I think it’s a great question. Our kids definitely live in a digital media landscape different than the one we grew up in as parents. Phones, iPads are really introduced and part of a child’s world from even preschool age. I think the key with any of the electronic devices and media is really supervision and boundaries and kind of a gradual introduction to some of those social media in particular applications. There are some published guidelines about appropriate platforms for younger kids, but really for young kids—especially the under 12/under 13 year old age group—we really want to try to keep kids to a minimum of two hours or less of screen time every day. So if they are allowed to use some of those age appropriate apps, we still want to be careful that they're not spending excessive amounts of time using those apps. We want to make sure that we are supervising and making sure privacy setting are correct and things like that. It’s always a good idea to follow the age limits of the social media applications. So several of them have a minimum age of 13 for example. I think as parents we should definitely follow those same guidelines. So we shouldn’t be kind of fudging on a birthdate or something like that to allow a child younger than 13 to participate in the social media apps.

It’s also a good idea to have some general familiarity with what different social media apps do and what they are and their purposes. There are a lot of different apps out there. Some of them are more teen and preteen appropriate than others. There are some good guides available through Common Sense Media, the American Academy of Pediatrics, and other sources about what different apps do, what their function is, what some of the risks of the apps themselves are. So as a parent you need to have kind of a general idea of what’s going on on the apps that kids are asking to download.

Host:   One of the interesting things I've found—and this is also interesting for the American Academy of Pediatrics—is that screen time has changed over the years. So now some of these guidelines are being looked at because kids have to do school online and they have to sometime even facetime with their teaches. You know a lot of it is online now. So how do we balance that with screen time and what we would consider screen time just a few years ago?

Dr. Garwood:   Right. That’s a great question. I think that’s a challenge for parents. We do know that kids use devices and screens to do a lot of important work. As you mentioned, even collaborating with other students for schoolwork projects and things like that. So that doesn’t necessarily need to count in our total screen time. We want to really look at time that’s used for entertainment and social media time separate from what’s used for school time. So we do need to take that into consideration. I think having reasonable boundaries for that extra time on screens is important. Also just encouraging kids to take a break or a timeout from being on screens is important so that they learn to help self-monitor a bit and to watch the clock on how much time they're spending on media apps. Having an open conversation with kids about things to be aware of. Things to be on the lookout for as far as privacy or even some of the content that may appear on apps is important so that when kids come across content that you would not feel is appropriate for them they would be able to feel comfortable talking with you about it so that you can discuss what they saw and why that’s either not appropriate or unrealistic or sometimes even a risk to the kid in some apps where strangers can--

Host:   Well so that’s a great point that you bring up. What if they are talking to someone that they don’t know? I've found my kids doing this a couple of times. Even when my son was little he was literally trying to give the number from his PlayStation from someone on his headset. I put a stop to it right away, but what do we do if we find them talking to someone they don’t know and they keep telling us, “Oh, well we’ve gotten to know each other now.”

Dr. Garwood:   Those are tough things. I think being concerned about that is appropriate. I think we want to guide our kids that they should have privacy settings on their apps that prevent strangers from contacting them. We want to have frequent check-ins with our kids asking them about who you're interacting with in these apps, kind of frequently pruning, deleting, or blocking people that you don’t know well that really aren’t your friends. Trying to keep that personally identifiable information always out of the app space. So you don’t want kids to be sharing things like, as you said, a phone number or an address. Even for adolescents encouraging them not to post their location is a good safety measure as well.

Host: So then what about cyberbullying? Such a huge problem these days. How do we know? I mean if we are following our children on Facebook or Instagram. Then there's things like Snapchat and other things like that. So how do we know if they're being cyberbullied?  

Dr. Garwood:   I think the best guard against that is trying to have a good close relationship with your child where they can talk with you about things that are going on, frequently checking in with them. As I said, monitoring their accounts is important. But as you mentioned, there are some accounts that can have posts that can disappear or be secret. So we may not always catch that. We also need to have good preventative guidelines for them just about appropriate interactions online. So when they're experiencing something that is harmful or bullying, they can recognize that pretty quickly and hopefully put a stop to that themselves by exiting that conversation or blocking that person in some cases. Remembering that we want to be guiding our kids on their own approach. So telling them that they really need to think carefully before they post anything. That anything that they post can be cut, altered, pasted, sent around to anybody else. That they want to try to avoid online drama. Not to contribute to those kinds of situations. That kindness is really important. That we expect them to be kind online just like we expect them to be kind in person. We want to set good models and examples of that with our own behavior as well of course.

Host:   So important all of those points. So give us some best practices for our kids and social media. Whether it’s computer in a common room so the parents have a little bit of an eye on it, knowing their passwords or friending them on these social media accounts. Give us some of the best practices you think are so important for us.

Dr. Garwood:   I think one of the most important best practices is limiting the amount of total time that kids spend on social media. So several studies have linked amount of time spent on social media, bedtime use of social media as contributing to depression and anxiety and poor sleep, even ADHD symptoms in kids. I know in my own practice this is something I see pretty frequently that I am concerned about, which is the poor sleep quality that can be associated with late social media use, social media use in your bedroom, or really just too many hours on the device. So having appropriate boundaries on amount of time. Again, I would still go with the American Academy of Pediatrics of two hours or less being pretty appropriate for recreational type of use of screens.

I think second is making sure you have conversations with them about privacy settings as we’ve mentioned before. About never meeting strangers offline, about not sharing personally identifiable information, and really getting to know the parental control features of your family phone plans. You can help set some of those up yourself. Reviewing with them what their privacy settings are on any app that they have is really important. Following them is important and kind of monitoring their content, maybe sitting with them and looking through their sites around once a week or so. The password issue I kind of have mixed feelings on because our kids are pretty smart and they're pretty quickly going to be able to change those passwords or find a workaround or something like that. So I don’t feel as strongly about asking them for their passwords because I feel like it’s probably more important that we try to have that open conversation with them and that we try to have that open conversation with them. And we try to provide coaching and guidance for them as a support rather than trying to have access to their passwords.

Host:   What a great point. So before we wrap up, give parents your best advice—because this is really something that we’re all going through together—about communication, trust, do we start from that place of trust, social media and our kids, and what you see as a pediatrician happening with our kids today.

Dr. Garwood:   It’s important for parents to remember that we’re all in this together. All parents are struggling with answers to these questions. The most important thing is to continue communication with your child, continue to work at understanding their world, and continue to provide parenting in the digital space and in social media just like you provide parenting in the real world. It’s really important for our kids to be able to learn from us and have us guide them because this is an important part of their lives and their relationships. The more we can communicate and talk with them about what’s going on in their lives the better off they’ll be and the more we’ll be able to protect them from some of the potential harms.

Host:   Thank you so much Dr. Garwood. Really great information and so important for parents to hear. That concludes another episode of Mom Docs with St. Louis Children’s Hospital. For more advice and articles on teens and social media, please check out the Mom Docs website at childrensmd.org. You can get more information or get connected with one of our providers. Please also remember to subscribe, rate, and review this podcast and all the other St. Louis Children’s Hospital Mom Docs podcast. Share this show with your friends and family, the ones with kids because we all need to hear this great information together. I'm Melanie Cole.