Media are not all bad: Children can actually benefit a lot – from using the Internet to learn to play the ukulele to getting help on homework. They can quickly access information on any subject, in spite of our misgivings that they will never learn how to use a library. But kids also need to learn how to determine which information comes from credible sources, now called "media literacy."
Media literacy includes teaching people some principles. All media messages are invented; they shape our thinking; some people are affected differently than others; and mass media are used to influence our buying things. Since we can’t stop exposure to media, we need to be sure children are taught to limit their use; make positive media choices; find other forms of entertainment; be skeptical and critical of media; and develop an understanding of media’s political, social, economic, and emotional implications. While you and the parents of your patients can’t do all this yourselves, you can advise frustrated parents to advocate for media education in the schools as well as at home.
For younger children, problems with media come from lack of adult structuring. Asking about screen time and content, and advising on limiting screen time to less than 2 hours per day (and only after age 2 years), with none in the bedroom, are American Academy of Pediatrics recommendations (Pediatrics 2010;126:1012-17). I personally feel that setting rules for no media at all from Sunday night through Friday morning from the very beginning sets a precedent that can put off struggles for several years.
The problem can remain from media use by the parents, however, which attracts the child, is often inappropriate for them, and above all interferes with the adults giving their full attention to the children – with all its behavioral sequelae. Limiting media and turning them off before making a request of the child are now one of my basics in teaching effective parenting.
As children get older, mechanisms for blocking "mature" Internet content are widely available. But I have heard that such mechanisms interfere so much with ordinary use of the computer as to be largely impractical. Besides, any child over 10 is probably better at bypassing such barriers than most adults are at setting them up! Keeping the computer in a "public area" of the home and having parents wander by regularly works better. In terms of TV content, discussing what the child is viewing and how it makes them feel is one of the best ways of not only monitoring a school-age child’s experiences, but also getting to really know them.