Pediatricians are always asking the parents of their younger patients about developmental milestones. In our heads, we have five to 10 “skills” that each age range should be able to accomplish to reassure us that brain development is keeping up with physical development.

At 15 months, a child should begin to show some “pretend play.” The standard question to assess this is: “Does she pretend to talk on the phone?” Most parents will say yes, often adding that the child will use anything as a phone: banana, TV remote or even his own hand.

Recently, one mother said to me: “Yes! She does that, and she also pretends to text!” The mother also showed me how her child will use one hand as a smartphone and the other to tap on it. It hit me then that soon we may change our usual question to ask about texting and swiping rather than talking on the phone.

Our use of media, the internet and various screens is ever-changing and ever-increasing. In keeping with its commitment to be a current, progressive organization, the American Academy of Pediatrics recently issued new recommendations for kids and media. Below are the highlights of these guidelines:

— Previously, the Academy said “no media before age 2.” This has changed to “no media before age 15 months.” After 15 months of age, appropriate educational media, such as “Sesame Street,” are OK.

Research suggests there is some educational value to certain shows beginning around age 18 months. Experts recommend that parents “co-view” these shows with their toddler to be certain she understands what she is seeing and to allow for verbal reinforcement of educational messages.

Children ages 2-5 should have no more than one hour of media per day.

— Video-chatting or Facetiming with loved ones does not count as media time. Even the youngest children have been shown to benefit and respond to video-chatting with relatives, especially during long absences.

A parent should be available to a child after video-chatting in case questions arise or the child appears confused. Why she can see Daddy but not touch him is a concept parents may need to explain over and over at first.

— After age 5 any set time limits can be taken away, and emphasis should change to making sure that media time never takes the place of time for play, sleep, study or interacting with others in person.

— Switching from violent to nonviolent media has been shown to correlate with improved behavior, especially in boys. There is now plenty of research to back up this long-suspected idea of parents, teachers and health care providers.

— Televisions, mobile devices and computers in a bedroom have been shown to correlate with decreased sleep and poor sleep quality. Don’t fall for “But Mom, I need my phone in my room because I use it for an alarm.” Buy an alarm clock, and plug the phone in to charge overnight somewhere besides the bedroom.

— “Well-designed television programs, such as ‘Sesame Street,’ can improve cognitive, literacy, and social outcomes for children 3 to 5 years of age.” This statement from the Academy’s media policy serves as a reminder that we need public broadcasting to ensure the availability of programs that remain true to this goal and do not deviate in order to sell toys or snacks.

— About one-quarter of teens describe themselves as “constantly connected to the internet.” Experts recommend that parents demand media-free zones, such as the dinner table, the car and the bedroom. Your child should not be constantly connected.

— Social media, such as Facebook, Snapchat and Instagram, have benefits such as improved connection, inclusion and social interaction. However, they can also be a forum for cyberbullying, exclusion and sexting. For that reason, it is recommended that parents teach kids about online citizenship and safety before allowing them access to social media. And some type of monitoring, while respecting their privacy, is indicated.

We can’t run from technology; it is here to stay. It has changed the way our children interact with the world, and therefore it must affect the way we parent.

  • For many more suggestions and ideas on this topic, check out this online publication from the American Academy of Pediatrics:
  • Dr. Pia Fenimore, of Lancaster Pediatric Associates, answers questions about children's health. You can submit questions at
child on mobile phones