Piyush Gupta1, Dheeraj Shah2, Nidhi Bedi3, Preeti Galagali4, Samir Dalwai5, Sanwar Agrawal6, Jijo Joseph John7, Vidushi Mahajan8, Pinky Meena1, Hema G Mittal9, S Narmada10, Chabungbam Smilie11, Padmasani Venkat Ramanan12, Yolanda N Evans13, Sanjeev Goel14, Rajesh Mehta15, Sudhir Mishra16, Harish Pemde17, G V Basavaraja18, Bakul J Parekh18, Michael Rich19. 1. Department of Pediatrics, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi. 2. Department of Pediatrics, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi. Correspondence to: Dr Dheeraj Shah, Director-Professor, Department of Pediatrics, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi 110 095. shahdheeraj@hotmail.com. 3. SGT Medical College Hospital and Research Institute, Gurugram, Haryana. 4. Bengaluru Adolescent Care and Counselling Centre, Bengaluru. 5. New Horizons Child Development Centre, Mumbai, Maharashtra. 6. Ekta Institute of Child Health, Raipur. 7. Believers Church Medical College Hospital, Thiruvalla, Kerala. 8. Government Medical College Chandigarh. 9. ABVIMS and Dr RML Hospital, New Delhi. 10. Nalam Medical Centre and Hospital, Sathuvachari, Vellore. 11. Regional Institute of Medical Sciences, Imphal, Manipur. 12. Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu. 13. University of Washington Seattle Campus: University of Washington, USA. 14. Computer and Medical Informatics Chapter of IAP, Vadodara. 15. World Health Organization Regional Office for South-East Asia, Delhi. 16. Tata Main Hospital, Jamshedpur. 17. Lady Hardinge Medical College, New Delhi. 18. Indian Academy of Pediatrics, Mumbai, Maharashtra. 19. Harvard Medical School, Boston, Massachusetts, USA.
Abstract
JUSTIFICATION: Screen-based media have become an important part of human lifestyle. In view of their easy availability and increasing use in Indian children, and their excessive use being linked to physical, developmental and emotional problems, there is a need to develop guidelines related to ensure digital wellness and regulate screen time in infants, children, and adolescents. OBJECTIVES: To review the evidence related to effects of screen-based media and excessive screen time on children's health; and to formulate recommendations for limiting screen time and ensuring digital wellness in Indian infants, children and adolescents. PROCESS: An Expert Committee constituted by the Indian Academy of Pediatrics (IAP), consisting of various stakeholders in private and public sector, reviewed the literature and existing guidelines. A detailed review document was circulated to the members, and the National consultative meet was held online on 26th March 2021 for a day-long deliberation on framing the guidelines. The consensus review and recommendations formulated by the Group were circulated to the participants and the guidelines were finalized. CONCLUSIONS: Very early exposure to screen-based media and excessive screen time (>1-2h/d) seems to be widely prevalent in Indian children. The Group recommends that children below 2 years age should not be exposed to any type of screen, whereas exposure should be limited to a maximum of one hour of supervised screen time per day for children 24-59 months age, and less than two hours per day for children 5-10 years age. Screen time must not replace other activities such as outdoor physical activities, sleep, family and peer interaction, studies and skill development, which are necessary for overall health and development of the children and adolescents. Families should ensure a warm, nurturing, supportive, fun filled and secure environment at home, and monitor their children's screen use to ensure that the content being watched is educational, age-appropriate and non-violent. Families, schools and pediatricians should be educated regarding the importance of recording screen exposure and digital wellness as a part of routine child health assessment, and detect any signs of cyberbullying or media addiction; and tackle it timely with expert consultation if needed.
JUSTIFICATION: Screen-based media have become an important part of human lifestyle. In view of their easy availability and increasing use in Indian children, and their excessive use being linked to physical, developmental and emotional problems, there is a need to develop guidelines related to ensure digital wellness and regulate screen time in infants, children, and adolescents. OBJECTIVES: To review the evidence related to effects of screen-based media and excessive screen time on children's health; and to formulate recommendations for limiting screen time and ensuring digital wellness in Indian infants, children and adolescents. PROCESS: An Expert Committee constituted by the Indian Academy of Pediatrics (IAP), consisting of various stakeholders in private and public sector, reviewed the literature and existing guidelines. A detailed review document was circulated to the members, and the National consultative meet was held online on 26th March 2021 for a day-long deliberation on framing the guidelines. The consensus review and recommendations formulated by the Group were circulated to the participants and the guidelines were finalized. CONCLUSIONS: Very early exposure to screen-based media and excessive screen time (>1-2h/d) seems to be widely prevalent in Indian children. The Group recommends that children below 2 years age should not be exposed to any type of screen, whereas exposure should be limited to a maximum of one hour of supervised screen time per day for children 24-59 months age, and less than two hours per day for children 5-10 years age. Screen time must not replace other activities such as outdoor physical activities, sleep, family and peer interaction, studies and skill development, which are necessary for overall health and development of the children and adolescents. Families should ensure a warm, nurturing, supportive, fun filled and secure environment at home, and monitor their children's screen use to ensure that the content being watched is educational, age-appropriate and non-violent. Families, schools and pediatricians should be educated regarding the importance of recording screen exposure and digital wellness as a part of routine child health assessment, and detect any signs of cyberbullying or media addiction; and tackle it timely with expert consultation if needed.