By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

A digital ecosystem is defined as a compilation of digital media, including television, social media, video games, the Internet and interactive assistants. Interactive assistants are AI-powered software or systems that help people complete tasks, provide information, or automate actions. This can include Siri, Google Assistant and Microsoft Copilot. 

The American Academy of Pediatrics (AAP) is releasing a policy statement in the February 2026 issue of its professional journal, Pediatrics. The policy statement provides evidence for the impact of the digital ecosystem on childhood development.  

Past research has focused on the time spent on the digital ecosystem and how that translates to health, including mental health and brain development.  Time spent is still an important consideration in evaluating the impact of screen time.  However, the most recent evidence outlined in the policy statement includes the design of the digital media and the type of engagement involved from the child and caregiver. 

The evidence from the studies has shown consistent links between digital media and childhood development. Studies have focused on child learning, social relationships, and emotion regulation. Many of the digital ecosystems are engagement-based designed and are intentionally constructed around commercialization and incentives for businesses.  These models encourage prolonged and frequent use and can lead to an amplification of negative content with a negative impact on children’s health. 

An example of these negative effects can be found in The Lancet study published in January of 2026, looking at infant screen time and the development of anxiety as a teenager. The study followed babies born between 2009 and 2010. The authors followed 168 infants into their teenage years. The researchers reported a significantly higher decline in visual-cognitive control between the ages of 4.5-7.5 years with increased screen time and a higher level of anxiety reported at age 13 years with more screen time. The researchers believe the extended screen time changes the development of pathways in the brain and leads to the increase in adolescent anxiety. 

The AAP policy statement is encouraging a different conceptual framework that promotes health where the design of the digital ecosystem meets family needs and helps children thrive both in the present and future.  This framework would follow a socioecological model involving children’s characteristics, their caregivers, the digital ecosystem, and societal structure/systems. 

The APP recommends digital ecosystems be child-centered, designed to support language, cognition, social, and emotional development. This design would be drastically different and much less harmful to children than digital-engagement designed programs. The APP Policy Statement outlines specific examples of the harms found with engagement designs.  The publication is free to download at https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-075320/206129/Digital-Ecosystems-Children-and-Adolescents-Policy?autologincheck=redirected

One of the recommendations is for pediatric healthcare providers to use the 5 C’s approach to understanding family goals around digital media. The 5 C’s include the Child strengths, the Content they are interacting with, the media being used to Calm the child, what else is the digital media Crowding out from other activies and how is the family Communicating about digital media. 

The APP statement provides recommendations for children, teens, and families relating to best practices with the digital ecosystem.  The APP Center for Excellence on Social Media and Youth Mental Health has useful tools to get started at https://www.aap.org/en/patient-care/media-and-children/center-of-excellence-on-social-media-and-youth-mental-health/?srsltid=AfmBOoq-skEIhkg_YoZotvGyvq8ss6KZNd5oMtizh63II4SF99MK4So4) One important aspect is for families to make a Family Media Plan.  The APP gives advice on how to find high-quality digital content that is child-centered.  Higher-quality digital content should promote critical thinking and be tailored to learning in areas such as math and reading.  

The APP provides guidance on purchasing a smartphone for a child or teen and the use of tablets.  Additional guidance discusses families creating screen-free time for the entire family and establishing phone-free zones during mealtimes, bedtime, and while doing homework.  The APP recommends setting some time boundaries and limiting the number of hours even with appropriate and high-quality digital sources.  Some recommendations can include less than 1 hour a day for toddlers and preschoolers and 1-2 hours a day for school-aged children that is entertainment and not school-related.  

Consider replacing screen time with other healthy activities such as reading, sleep, play and physical activity.  Find ways to incorporate other activities such as sports, music, art, outdoor movement, or even community volunteering. The APP statement includes a pie chart of play as an example of a healthy balance.  This chart has the majority of time concentrated on sleep and school and then equal portions of family/friend time, homework, mealtime, reading, movement, and digital play.  

Consult your healthcare provider and the AAP website for more recommendations. 

Let’s promote a positive digital ecosystem to protect the health of our children.