婴儿需要人类的互动才能健康成长

主持人安珀·史密斯: 锡拉丘兹上州医科大学, New York, 邀请您成为“知情患者”, 我们的播客邀请了来自纽约中部唯一的学术医疗中心的专家. 我是主持人，安柏·史密斯.

Both the American Academy of Pediatrics and the World Health Organization recommend that infants avoid screen-media exposure. 然而，许多18个月大的婴儿经常接触到这种物质.

A team of physical therapists and nurses looked into this issue in a paper that was published in the Journal of Pediatric Nursing. 今天和我一起讨论这个问题的是. 丹尼尔Hoose. She's a doctor of physical therapy and a pediatric clinical specialist and part of the voluntary clinical faculty in Upstate's department of physical therapy education.

欢迎来到“见多识广的病人”节目. Hoose.

丹妮尔·胡斯，DPT: 谢谢你们邀请我.

主持人安珀·史密斯: 让我们从屏幕媒体曝光的定义开始. 我们说的是电视屏幕、手机还是电脑? 这是什么??

丹妮尔·胡斯，DPT: 是啊，我们说的就是这个. 屏幕媒体包括任何有屏幕可以显示视听内容的东西. 电视、电脑屏幕、平板电脑、手机，所有这些都包括屏幕媒体.

主持人安珀·史密斯: 那么婴儿多早开始接触或看这些设备呢?

丹妮尔·胡斯，DPT: 根据我们的文献综述, 我们发现，大多数婴儿从一开始就经常接触到这种物质, 所以我们看到他们只暴露在一个小时内, 长达五个小时, per day.

And we find that this is because many parents believe that educational television shows or smartphone apps or games are helping their infants learn and develop. 但真正的, 没有证据表明，在无人监督的情况下使用屏幕媒体对孩子的发展有任何好处.

主持人安珀·史密斯: 所以这不仅仅是被动的——当你在家吃饭的时候电视开着. 这是有目的的.

丹妮尔·胡斯，DPT: Correct. Yes.

主持人安珀·史密斯: Well, why does the American Academy of Pediatrics (AAP) and the World Health Organization recommend avoiding screen-media exposure, then?

丹妮尔·胡斯，DPT: They're recommending it because we know that infants are not able to translate what they learn from a two-dimensional device to their three-dimensional world, 这在生命的头两年继续发展.

所以对于婴儿来说, infants, toddlers, 2岁以下的孩子, 让他们学习, 他们需要真正动手探索他们的自然环境. 他们需要与照顾者或家庭成员互动, 他们需要以非结构化和创造性的方式玩耍的机会.

So time spent using screen media is time taken away from these important real-life interactions and opportunities for learning.

主持人安珀·史密斯: 所以你让我想起了我们听说的苹果公司制造的新眼镜. 这将使2D/3D世界更加模糊.

丹妮尔·胡斯，DPT: 当然是. 我很好奇这会带来什么结果.

主持人安珀·史密斯: 这太疯狂了. So does screen-media exposure affect the baby's ability to learn faces or recognize faces and social skills like that?

丹妮尔·胡斯，DPT: Yeah, 我们发现了这一点, 尤其是在语言方面, 我们真的需要通过与他人互动的积极方式来学习语言. 我们必须和我们的孩子说话，让他们发展语言. And the (medical) literature is actually supportive that children who started watching television during their first year of life and who watched more than two hours per day are six times more likely to have language delays than those who do not.

And we think it's because screen-media use is taking away those opportunities for children to actively interact with adults.

主持人安珀·史密斯: 那么，屏幕媒体也有例外吗? 因为我在想和祖父母进行视频通话, say, 谁不住在同一个社区. 屏幕是否有一些积极的用途，让婴儿从远处认识面孔?

丹妮尔·胡斯，DPT: 是的，确实有. 美国儿科学会最近修改了他们的建议，加入了FaceTiming, 或者视频聊天, 作为这一弱势群体可接受的屏幕媒体使用方式. 所以，一旦你的孩子长大了，能够理解FaceTime，并对它感兴趣, 视频聊天适合与那些远方的亲戚建立关系.

所以你可以用视频聊天来指出和标记你和孩子在屏幕上看到的东西. 你可以模拟如何回应屏幕上的人, and you can play some interactive games like peekaboo or singing songs or making funny noises to facilitate some of that back-and-forth socializing.

主持人安珀·史密斯: Now, 因为你参与的研究, 你在乔治亚州调查了近200名有18个月及以下婴儿的母亲, 宾夕法尼亚州和纽约州.

这些调查都是些什么问题啊?

丹妮尔·胡斯，DPT: 所以我们问了妈妈们10个简单的问题, and it included statements that they had to rate on a scale from one to five on whether they agreed or disagreed with those statements related to screen time, 比如他们是否相信屏幕时间对孩子有益, if the pediatrician's office talked to them about screen time and how many minutes per day their child was watching screen time on average.

主持人安珀·史密斯: 那么研究发现了什么呢?

丹妮尔·胡斯，DPT: 所以我们发现79%的婴儿超过了每天零分钟看屏幕的建议时间. 我们发现，29%的父母每天让孩子接触的时间超过30分钟, and 61% of moms did not recall receiving any recommendations from their pediatrician regarding screen-time exposure.

我们也发现了这一点, 一个母亲受的教育越多, 他们就越不相信使用屏幕时间对婴儿有益.

主持人安珀·史密斯: 母亲受教育程度越高，她就越不可能认为有好处?

丹妮尔·胡斯，DPT: Correct.

主持人安珀·史密斯: 这些发现让你感到惊讶吗?

丹妮尔·胡斯，DPT: 是的，确实如此. 我真的认为儿科医生会更常规地教育父母, and it wasn't until I had a baby myself that I saw in my own (baby's) well visits that that piece of education really isn't being shared at well visits.

主持人安珀·史密斯: 你认为护士和理疗师的角色是什么?

丹妮尔·胡斯，DPT: 我们知道儿科医生有很多事情要做, 由于访井期间面对面的时间有限.

他们有很多话题要讲. 所以我们认为执业护士可以是一个医疗保健专业人员，可以分担这个负担, 他们可以在探井期间就这些指导方针向家属提供建议.

作为儿科物理治疗师，我们经常在孩子家里工作. And we see firsthand if there are screens being used in the background or for entertainment during our therapy sessions.

And so, we as therapists can use those opportunities to also educate parents on the guidelines and offer some alternatives to promote development.

主持人安珀·史密斯: 那么，对于婴儿接触屏幕媒体的问题，您有什么建议吗? 在家里开着电视的背景声可以吗?

丹妮尔·胡斯，DPT: So the problem with early exposure to background television is that quality of parent-child interaction and the distracting nature of the television from whatever activity is ongoing.

主持人安珀·史密斯: 如果你正在给宝宝喂奶或抱着熟睡的宝宝怎么办? 那么可以开着电视吗?

丹妮尔·胡斯，DPT: 实际上有一个术语来描述它. 我想媒体称之为“brexting”，是“边哺乳边发短信”的简称.再一次, the problem with using your phone or having that television in the background is that you're limiting your opportunities to connect with your baby. So often, 宝贝会向你伸出手, smile, 制造噪音, 如果你的注意力集中在手机或电视屏幕上, you miss out on those opportunities to respond back to your baby and create some of those positive social interactions that are so important for babies' development and to build secure connections.

主持人安珀·史密斯: 你提到的, I mean, 一些教育电视节目, “芝麻街”和其他节目, 它们也有一些积极的品质, 但是在什么年龄, 家长建议让孩子开始看这些节目?

丹妮尔·胡斯，DPT: “芝麻街”实际上是一个经过充分研究的节目, 对学龄前儿童也是如此, 3到5的范围, studies have found that when they've been limited to just one hour of exposure to that high-quality programming, 他们确实有一些好处，有更大的词汇量和更好的学前准备.

但是再一次, the American Academy of Pediatrics still recommends that you limit that screen use to just one hour because those real-life interactions should take priority over that passive screen viewing.

主持人安珀·史密斯: 在不同年龄的孩子身边管理屏幕时间有什么策略? Because I'm thinking the younger kids in the family inevitably are going to be exposed at earlier ages because of older siblings. 是这样吗??

丹妮尔·胡斯，DPT: 是啊，这是真的，对家庭来说很难管理. 所以如果你真的无法避免在家里看屏幕, the American Academy of Pediatrics recommends that parents try to offset that developmental risk by doing some co-viewing of high-quality educational programming. So that means sitting with the child and having conversations with them about what they're seeing on the screen and trying to have just more interactive engagement with the baby and what they're viewing, 所以比起被动观看，它更主动.

主持人安珀·史密斯: Now, 当婴儿在去商店的路上脾气暴躁时，手机作为一种分散注意力的工具是很诱人的. 还有什么替代方案? 那一定很诱人.

丹妮尔·胡斯，DPT: 哦,当然. 作为一个蹒跚学步的孩子的父母，我能理解. 有时候真的很难，压力也很大. 我总是试着提前计划, 所以吃零食, toys, 我试着让我的孩子在我购物和与他们互动时大声说话.

幼儿的注意力持续时间很短，所以使用重定向是一个强大的工具. 给他们选择:我们应该买青苹果还是红苹果? 或者说，“看那个!把他们的注意力从可能让他们心烦的事情上引开. 我也尽量避免会引发崩溃的情况, like staying away from that toy aisle at the grocery store and try to make sure the baby's well rested or fed before we go shopping.

主持人安珀·史密斯: Well, Dr. 豪斯，很感谢你抽出时间来接受采访. 非常感谢.

丹妮尔·胡斯，DPT: 谢谢你们邀请我.

主持人安珀·史密斯: 我的客人是博士. 丹尼尔Hoose. She's a pediatric clinical specialist and part of the voluntary clinical faculty in Upstate's department of physical therapy education.

“知情的病人”是一个关于健康的播客, 科学与医学, 由锡拉丘兹上州医科大学为您带来, New York, 由吉姆·豪制作.

在upstate找到我们之前的剧集.edu/informed.

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我是主持人安珀·史密斯，感谢大家的收听

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