​Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered podcast. I'm Dr Neha Pathak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine. Let me set the scene for you. Your child is watching endless videos, gaming, or using social media, and you feel like it's time to turn it off because they have homework to do, it's time to eat dinner, or time to go to bed, or you want them to actually socialize with someone.

But you hesitate because you know a negotiation is coming, and after the negotiation, everyone is going to leave frustrated, and that frustration is likely going to escalate into an argument. And you ask yourself if you're being too strict or not strict enough. Should you have just never allowed any of these screens into your home in the first place?

And then you wonder if you're being a hypocrite because the entire world seems to run on screens. Your job, their schooling, entertainment, and most of our communication and socialization. Setting limits around screen time can feel so complicated and completely overwhelming. In this episode, we'll help you move beyond simple rules about screen time and consider how different kinds of digital media may affect a child's attention, sleep, creativity, learning, mood, and relationships.

We'll explore how to set boundaries without framing screens as a forbidden reward, and why it's never too late to reset your family's habits. Whether you have a toddler reaching for your phone, a middle schooler caught in the YouTube Shorts loop, or a teen asking for social media, you're not alone.

This conversation offers practical guidance to help you lead with intention and clarity.

First, let me introduce my guest, Dr Jane Tavyev Asher. Dr Tavyev Asher is a board-certified child neurologist who served as director of the Division of Child Neurology at Cedars-Sinai Medical Center in Los Angeles since 2010. In addition to child neurology, she's also trained in neurodevelopmental disabilities and has a focus in lifestyle medicine, particularly for the treatment of migraine, tics, and ADHD-type symptoms.

Welcome to the WebMD Health Discovered podcast.

Jane Tavyev Asher, MD: Thank you very much. Nice to be here.

Pathak: Well, I am very excited to jump into our conversation for today, not the least of which because I have a first grader, a seventh grader, and a sophomore in high school. So we run the gamut in our home and are constantly trying to navigate what is the right screen time for each of these different age groups. So we're hoping that you can help us understand.

Before we jump into that, I'd love to ask about your own personal health discovery or aha moment in your research. What brought you to this work?

Tavyev Asher: Well, the screen time has been increasing, of course, over the decades, but it was really the COVID pandemic that made things really stand out. We saw just how much more screen time the kids were using, and it was something that the developmental pediatrics field had an opinion on for decades prior to using more screen time.

Meaning that there were AAP guidelines on screen time in the preceding decades, but the Developmental Pediatrics Association, which is—which was part of my training, they were saying for decades that there should be absolutely zero screen time under the age of three years of age until the child was able to discuss in sentences what they were watching on TV.

Now, if you think about this decades ago, this was the time before the iPad, before YouTube videos. This was just children watching plain old television, and this is how we were discussing it. And of course, since the time of my training, I've seen things in the last couple of decades really accelerate with what we're doing with screen time.

And so I see—because I trained long ago, at this point, I can see what it was back then and what we're, what we're doing now, and what effect it's having to the children that are coming with more diagnoses for us.

Pathak: So when we say screen time, we're talking about a lot of different things. So can you kind of think about or help us think about what constitutes screen time? When we're talking about it, what exactly do we mean, and can you break down the different types and, can you kind of put it on a spectrum of least risky to most?

Tavyev Asher: Absolutely. That's a great question, and that's what everyone is asking about now because there are so many more different types of screen time, right? So, like I just mentioned, just a couple of decades ago, screen time was literally only TV. That was the only form of screen time, if you're old enough to remember that.

But now there are iPads, there are iPhones, there are video games, there is the screen that's used for school, whether it's learning or using it to create things, different elements that are involved in the school use of the screen. So it is important to know the differences.

I would say that we still feel like TV watching, if it's done as a movie that the family can watch together, that is the least problematic form. Now, there are still old forms of TV shows or TV videos that we don't love. That would be things like Baby Einstein, which had promoted itself for a time, saying that it was going to enhance learning, but we know that it did have, in some kids, some deleterious effects on their language development.

Then what we preferred always in the developmental pediatrics world was something like Mr. Rogers, where instead of having rapidly changing images, it's people who are alive on the screen, so like either Mr. Rogers or the very old Sesame Street, where people are interacting at a slow pace and communicating to the children what, what they're talking about and getting the messages across.

Now, what has changed since then is the rapidly changing images. So anything that's on the iPad or a YouTube video, those are very different. Those have things that are... First of all, you're, you're scrolling perhaps with your finger, so just one movement with the finger to move things along, or things are flipping automatically for you with no end, meaning that the old television episodes, they lasted maybe half an hour, at most one hour, and then they, they would have an end time.

So you knew this is the episode, it ended, it's time to move on and do something else. But the YouTube videos just keep cycling through. There's no end. They can take you endlessly through an algorithm in what you might be interested in. The same thing happens with scrolling on social media, for example.

There's no end to that. And then there are also video games that have troublesome features, which is either they have no end or they have violence that is becoming part of the children's world, where they're not seeing it as strange or dangerous or anything like that.

They're just becoming overly comfortable with that level of violence, which we don't want either. And then, of course, there's the last category, which is I think the trickiest to understand or to discuss, which is when screens are used in schools for learning. So obviously, that is something that we can look at in different ways.

There are elements of it that can help the teachers and that can help certain students who have perhaps certain le- learning challenges or need it for an IEP or something like that. And then there's a component of it that can hinder learning, and we've seen the results of this in testing.

So certain, certain programs that we thought accelerated children's learning of math concepts, for example, made them score lower on examinations of mathematics.

Or if they are, for example, trying to write the definition of a word and they just go into a dictionary online and just copy and paste it into their answer sheet, they have not gone through the process of learning that definition. We know that writing things by hand helps us to learn things. We know that different ch- different parts of the brain, and we can go into this into a little bit more detail that high school piece especially.

But just to kind of give you an overall summary that we're looking at things that are definitely harmful pretty much in all contexts at those ages and things that have a little bit more nuance.

Pathak: Let's start again, for no particular reason, but let's start with my young child, my youngest child. So that'll give us kind of a lifespan approach to this.

Help us kind of think through what screen time on that spectrum of deleterious to nuanced for that sort of age group and younger.

Tavyev Asher: Perfect. Yes. That's a great question, and I will break it down. So we are looking at dopamine, we are looking at neural connections, and then we are looking at creativity, basically. So those are kind of the three categories that we'll look at in an overview.

So the dopamine aspect of it, of course, we know that anything that brings excitement or novelty gives our brains a rush of dopamine. And the way that the dopamine receptors work, I always like to say that it's like a game of musical chairs, where you get this dopamine rush and the dopamine molecules are looking for the dopamine receptors.

And so if the receptors get flooded with dopamine, then the receptors say, "Oh my gosh, there's so much dopamine." We, the locks and the keys, too many locks and keys fit together. We have to down-regulate the dopamine receptors. So let's regulate that down, take away some of the receptors. And so the body feels like it needs more of a dopamine release to kind of make more of those lock-and-key connections between the dopamine and the dopamine receptors.

So the cravings just increase, and you need more of a rush. Now, you have to understand that all of these companies, anyone who is making, whether it's video games or YouTube content or all of these companies, they hire people who have PhDs in addiction neuroscience, okay? These people are hired by the processed food companies, and they are also a big component of the screen time companies.

And so they are very familiar with the dopamine response, and they—when they're creating something, they are measuring what creates more dopamine. And so that is something that no one can consciously really regulate themselves by because the dopamine creates such a great feeling. So the dopamine is created by novelty, by speed, by brightness, by sounds.

Those are kind of the different categories that are going to create that. What is that doing for us? Again, when you move away from that screen and you go, or really for the child's developing brain, what happens when they move away from that high-dopamine experience and they go to a low-dopamine experience like doing a worksheet or reading a book on paper?

It's not going to give them that same dopamine rush. And so things that we know that are actually beneficial to them, like sitting and doing their schoolwork, sitting and reading a book, those are very beneficial activities. But because they don't create that dopamine rush and they're so used to frequently throughout the day getting these dopamine rushes, it's hard for them to sit down and do that activity.

And that is going to affect the long-term trajectory of their learning.

Now, let's also look at the kind of creativity and neural pathway piece. So again, when it's a passive activity, they're not playing a role in that. So we have this goal of fostering a situation where our children can turn out as creative individuals that can use their skills to create in their life's trajectory.

So that is our hope for them. We hope that they will have some kind of career in the future in something that they are interested in. But if they are receiving visual images constantly, there is absolutely no creativity. That is completely passive interaction. And when we kind of combine that with the neural pathways, we know that particularly in the under-three crowd, we do a form of developmental testing where we do language testing, fine motor testing, gross motor testing to get their level, their developmental quotient.

And we know that fine motor testing in that age group very highly correlates with essentially their future IQ. So that is the test of cognition in that age group. And how does that—how is that quality developed? That is developed in what we think is—it's so simple. It looks so simple, but it's really just playing with toys.

So stacking blocks, looking at things from different dimensions. I'll bring up a concept that is just so basic to us, we can't even think about it. But if you think about a four-month-old, let's say, looking at a chair, when we see a chair, we know exactly what that chair looks like on the backside of the chair.

And you and I would never come to each other and, as a conversation, say, "See that chair over there? I know what it looks like on the other side of that chair." That's not—We take that so for granted, it's just not even something we would think about or certainly talk about. But to a four-month-old, they're looking at the front of the chair.

They haven't seen thousands of chairs in their life. They're looking at the chair, they wanna see what looks—what does the back of this chair look like? What does the back of that chair look like? And they kind of create in their mind now these neural pathways that are giving them a cognitive sense of the world and what things look like when they can't see it, and what things are out there in the world.

And so that is shaped step by step through play, through three-dimensional play. And when a child, especially in that under-five-year-old crowd, when they are looking at iPads in the two-dimensional sense, iPad or iPhone in a two-dimensional sense, and they're just seeing the world two-dimensionally, and that is taking up the majority of their time, then those are the neural pathways that they are developing.

So they are literally growing neural pathways that are meant to interpret, understand, or want to follow the two-dimensional world. And then they are not that interested in the three-dimensional world. We don't want that.

We want a brain that's looking at the three-dimensional world in a creative way and developing pathways for future creativity.

Pathak: That makes a lot of sense. And then I wanna bring in, I think what the fears that a lot of parents have is that you've done something and it's just not reversible. Like, you've just screwed up your kids and that's it. And so we have this amazing terminology around neuroplasticity. Can you talk a little bit around folks who feel like, "Oh my gosh, I made so many mistakes when my children were younger"?

What are some of the pathways towards really engaging in that neuroplasticity to not reverse, but to shift and change and allow your child to go on a different path?

Tavyev Asher: I would say, I wanna say very emphatically that parents should never feel like they made so many mistakes and they have permanently changed so many things, okay? Never feel that way. Everything can change at any time that you decide to change things. The only thing is, if you've gone many years a certain way and then you suddenly try to shift, it's just harder to do that.

It's going to take more effort. It's going to take more, a different level of habit formation. So it's, it's more work. But don't ever think in your trajectory of parenthood that something is permanent and things cannot change. We can change things any time along the way. Even adults can change habits, can change trajectories, can change their style of thinking, can change all kinds of things, and we see it happening all the time when there's enough will for that.

Children are easier to change things on because their brain is growing. I think the concept of neuroplasticity, we're using it to give comfort to adults who are trying to change their brain. In children, yes, of course, it's neuroplasticity, but it's original neuroplasticity.

Pathak: That's great. I love that. And I love starting there sometimes just because I think sometimes when we have these conversations, people's minds just automatically go to, "Well, I didn't do that," or, "I didn't do this." So I think this is a great sort of level setting for everyone to know that there is no judgment here, there's no perfect answer, and that there is just a lot of opportunity to be very intentional and to shift and change things, even if this maybe wasn't your baseline before. So then I'd love to shift us to that older child. So talk to us a little bit about that age group.

Tavyev Asher: I think that the biggest mistake that I think is the easiest to correct is, or the most important to correct, let's say, is that we know that the children love the screen time, but we have to understand that that's a dopamine-based love.

So we don't wanna view that as a reward. We don't want to discipline like, "You will earn the screen time," or, "This is a reward, and I'm taking the reward away from you." That's really, that's really affecting the psychology of how hard this is, how hard or how easy this is to do in our homes. What we want to do is we want to explain to them.

And middle school is a perfect time where they're really starting to understand what their future goals are going to be, and they're starting to set up things that they would like to achieve, both scholastically or in life. They're just starting to think about these things. So you want to say things like, you're sitting in the classroom, and whether it's hard for you or easier for you to pay attention and learn the things that are being taught to you, which are a very important piece of your trajectory in life, you have to understand that the screen time is having a very negative effect on your brain's ability to focus in the classroom.

So rather than presenting it as, "This is a reward that I am withholding from you," no, you're saying, "I have information. I have information about what this does to you." And I think middle school is a perfect age to have the kids read a book called "The Amazing Generation." That is written by Jonathan Haidt, who wrote "The Anxious Generation."

That's a warning and instruction manual for us as parents to understand what the screen time is doing to the children's brains. But we wanna spin it in the right way to the children who are learning about it so that they are-- they're not viewing themselves as anxious. We don't wanna put that on them.

We wanna show them that they are amazing, and this is their potential trajectory that they can be launched on if they avoid these pitfalls. So, the YouTube Shorts, again, as you're telling me that story, I'm thinking, why, why are, why is the child, why is your child going on the YouTube Shorts? I know why.

I know the answer why. They want to 'cause they're finding it interesting. But why were they allowed to? Why did they have access to it? Why why is it such a hard conversation to steer them away? And the reason that I bring that up is, again, I'm always stepping back and looking at this from the parenting perspective, and it's just because I've been doing this for so long that Whenever people tell me what you just told me, I just wanna tell you, you're so not unique in this, in this story, okay?

The main thing to understand is we as a society are very frequently saying, "I just want my children to be happy." That is what a lot of parents are saying, "I just want my children to be happy." But if you can understand that childhood happiness is not rooted in the same things as adult happiness.

Childhood happiness is really dopamine-driven.

So, and there is, there is a component of being loved also that's part of that. But dopamine-driven, meaning that the child, a young child would probably be happiest sitting in a tub of mud, eating popsicles and probably watching YouTube Shorts all day and just not, not getting out at all for any reason.

But that's not what you want for your child. If you think intellectually, you want an adult who has achieved adult milestones and is able to build a life and create a life and create things in their life and get other, deeper senses of pleasure from that, that will give them a fulfilled adult life.

So your emotional experience of feeling like this will make them unhappy or this will do these things is not-- rooted in reality. And you should not fear that it will make them feel unloved. You should explain to them that, "I am not keeping you from the YouTube Shorts because of love."

Meaning, it is, it's in fact that, "I am keeping you from the YouTube Shorts because of my intense love for you." And you should continually explain to them, "It would be easier for my parenting if I could just sit you in front of the YouTube Shorts, and then I would be free almost as if I don't have children, just running around and doing whatever I wanted to do, and you would be on the computer just for hours and doing your thing, and that would be easier.

But it is because of my very deep love for you and my concern about your future and the extra intellectual perspective that I have as your parent to understand what is better for your future, that I am spending my energy, even with some difficulty, to help you to, to get on that path and to create that for your life."

Pathak: I would love your take on this, which is just that, we are now seeing a lot of negative impacts from social media on, particularly I have three daughters, on mental health.

And in the same way that I would not let you just drink a can of alcohol because everyone else in your friend group is going to a party and drinking alcohol or smoking cigarettes, that's as strongly as how I feel about social media. Now, sometimes I feel a little bad because I'm like, "Is that an exaggeration?"

But so I'd love your take on my sort of connection between these three addictive substances.

Tavyev Asher: Well, I think, I think specifically at that high school age, it's important to let them know what the risks are with each thing and what your thinking is for each thing, right? So you don't want to equate things that are not to be equated. You, you don't need to withhold the information from them.

This is the time to be completely honest, and this is the time that they can read that book, "The Anxious Generation," and literally read the stories of what social media is doing to the girl's brain and what it's doing to the boy's brain. And, it's doing different things to different brains.

But I guess what I'm trying to say is you want to, explain why you're keeping this from them because you really, really wanna make sure that it's not viewed as a as a prize that they're trying to reach and you're keeping them away from this special prize.

And by the way, another important thing to bring up is What we're doing as parents in the home has a huge role to play in this. Meaning that whatever we are able to do because of adulthood, that is, of course, that becomes aspirational, right?

So they see us driving, they often would like to drive because we're adults who drive, that, that's a positive trait that a child wants to see what adults are doing, like getting married, raising a family, all of that owning a home, having a job, all of those things. We want them to aspire to reach those adult goals or adult milestones.

So-- But what we don't want is to have things that we don't want them to do as being extremely aspirational, right? So again, that doesn't mean you can't use any social media at all because you're telling them that they can't use it at this age. But you do need to explain that it is addictive at certain ages until the, while the brain is still developing.

And you also don't want to do it in an addictive way. So you don't want to be wasting your time scrolling either, right? If you have, let's say, a business and you post things to kind of, get people's attention and bring them to your business, that's separate. So you're saying, "I'm on this because I, I'm trying to attract clients," or whatever it is.

But you don't want to be scrolling excessively. So I think that--that's probably the hardest part about this. But you, you also wanna be realistic about what the different-- what the harm-benefit ratio is with all of the different things, and just why you feel that way with all the different things.

And then you're also explaining, "I see that saying no to some of these things is harder for you than saying no to other these things. And so while you are in the stage where your brain is still developing, and I am your parent, I am willing to be here as your helper to keep you away from the things that you shouldn't have in your life, so that we can both give your brain the time that it needs to develop into the brain that we would love to watch it become."

Pathak: We started the conversation with really that there are clear places where screen time is negative, and then there's some places where it's nuanced. Are there areas where we have some evidence of benefit? And what are those areas for certain types of screen time, if any?

Tavyev Asher: Well, I mean, a family watching a movie together, and especially there are many movies that have really nice stories behind them that teach important lessons. Things that have, like, these nice kind of moral stories behind them where they're teaching things that you would like your children to learn through stories, and then you're watching it together and you can talk about it.

I would say that that's a positive shared family experience where you're being entertained together, and you can cuddle on the couch together and, and see a story that way. There are some things in an educational perspective that can be helpful, especially to certain types of learners, and that's, that's another nuanced piece.

But there's nothing that you can say kind of from a blanket perspective.

This has been such a helpful conversation. We have gotten so much clarity around some of the pitfalls of screen time and some of the myths that we tell ourselves so that we can sometimes rationalize some of the decisions we make around not wanting to argue with our children and those types of things.

Pathak: So I wanna thank you so much, and I wanna cede the last few minutes to you. Any final thoughts, any practical tips for families listening around screen time and their children?

Tavyev Asher: Well, I think we could probably just pull up those, those kind of key points one more time, which is one is it's never too late. So I don't want a single parent to ever think that it's ever too late to get started on any path. Everything can change like that. You can change your style, and things will change suddenly.

You can explain things to your children in a different way, and, and they will change. Your relationship with them will completely change. Do not ever think that anything is permanent is number one. Number two is do not fear your emotions, and do not be led by them. Take enough time to learn the intellectual piece of this, and let your emotions get rooted more tightly into the intellect.

Don't be swayed so much by the emotional piece of this. And number three is understand the hardwired emotional aspect of this that your children are coming from, especially at the later ages, and help them to navigate through that and understand that, that their emotions are telling them incorrectly that if this doesn't go this way, that this is the end.

And then number four is remember that creativity in your children is your ultimate goal. And remember how to redefine the concept of, "I just want my children to be happy." You don't want them just dopaminergically happy. You really, like, create a broader vision of deep joy and happiness in life that you are envisioning for them, and that involves creativity, that involves motivation, that involves attention.

And make sure that you're, you're focusing on helping them to create those things on their trajectory.

Pathak: So, so important. Such important points, and I want to thank you so much for your time.

Tavyev Asher: Thank you so much. It was a pleasure to be here.

Pathak: Thank you so much for being with us today. We've talked with Dr Jane Tavyev Asher about screen time. My key takeaways from this discussion are first, not all screen time is the same. A family movie with a clear ending and an opportunity to spend time and talk together is very different from the solo experience of rapidly changing, endlessly scrolling videos, social media feeds, or games designed to keep children addicted.

Pay attention to how much time your child spends on screens, the type of content, how it's used, and what it may be replacing in their day-to-day life.

Second, setting boundaries from a place of love and values is different than coming from a place of punishment. Instead of treating screen access as a reward to earn or take away, help children understand why certain platforms and habits may not be good for their developing brains, their attention, creativity, and well-being.

The idea of setting consistent limits can feel difficult in the moment, but they're an expression of care and love, not a lack of trust, and they compound over time.

Finally, it's never too late to make a change. Children's brains are adaptable and still developing. Families can and will shift their habits.

Begin with one intentional change and replace it with a shared activity. This will allow you to focus on building the capacity for improved attention and deeper connection that you want with your child and habits that you want your child to carry into adulthood. To find out more information about Dr Tavyev Asher, make sure to check out our show notes. Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you'd like to send me an email about topics you're interested in or questions for future guests, please send me a note at [email protected].

This is Dr Neha Pathak for the WebMD Health Discovered podcast.