1. The Job of a Pediatrician

In my opinion, the job of a pediatrician can be divided into roughly two parts. One part of the job is in diagnosing and treating sick children, as a matter of course. The second part, however, is seeking out a suitable environment that can promote healthy growth and development for children and then providing this information to parents rearing children.

The first role is practiced at hospitals and clinics, while the second role can be carried out in various ways, such as giving medical check-ups and consultations at health-care centers, writing books on childcare, giving lectures, providing information through the media, as well as through websites, which is a recent trend. Furthermore, academic research on seeking out a better environment to assist the development of children can also be included in the second role.

With that in mind, as a pediatrician how shall I consider the results of the survey?

2. The Facts Revealed by the Survey

Although detailed data are provided in the survey report, I think the most important thing it shows is the fact that, since early childhood, children are building a close and friendly relationship with smartphones, something which has rapidly disseminated among adults in the past few years, in addition to TV which used to be the conventional popular media. About 30% of the children covered by the survey aged two or three years either look at or use a smartphone at least once or twice a week. However, this may not be surprising, given that 60% of the mothers covered by the survey own and use a smartphone. Unlike a TV, a smartphone is not something placed somewhere in the house, but something that is always "carried around" with the parents. Consequently, it is a matter of course that children become interested as they are always together. In other words, just like TV, the smartphone is now taken for granted as part of the rearing environment for young children in Japan.

I classify the prototype behavior patterns of young children into three types. One is "attachment behavior," which is the child's emotion in wanting to stay attached to their parents. The second is "imitation behavior," children's imitation of people's behavior surrounding them. The third is "curiosity" directed towards new and unfamiliar things and people. On reflection, a smartphone has all the features that stimulate the above three behavior patterns of young children.

The parent, with whom a young child wants to stay all the time, is using something unfamiliar and therefore interesting to the child. Any child would want to touch it. As my former supervisor Professor Noboru Kobayashi always says, "Young children are information seekers." Smartphones provide much more abundant information in terms of quality and quantity than conventional baby toys such as a rattle. Therefore, it is a natural outcome that young children are fascinated by smartphones.

3. How to Interpret and Respond to the Survey Results

Now, the question starts here. How should we, as pediatricians, respond to the close and friendly relationship of young children with smartphones revealed by this survey?

One thing is clear-that it is the first time in human history to have such an interactive object in the living environment of young children. Since human beings have a high ability to adapt to a new environment, which has allowed us to evolve to a much greater extent than other animals, we can easily imagine our quick adaptation to the new media environment such as smartphones. Nevertheless, it is not as if we are fully aware of all the effects beyond our imagination. It is still an uncharted area. Some pediatricians predict there will be "adverse effects" on the development of young children arising from smartphones and insist that children should refrain from using them.

However, if you ask if they have substantial evidence to back such opinions, the answer is probably "no."

The result that impressed me the most in this survey report was the opinions of parents about the advantages and disadvantages of media use. The above criticisms of pediatricians were based on their prediction that the use of media such as smartphones will reduce the degree of interaction between children and parents. In fact, the survey results show that 50-60% of the parents under the survey have the same feeling, which also indicates that the majority of the parents do not expose their children to the media without any consideration. What surprised me even more is that 15-25% of the parents cited as one of the advantages of using media is that "it will boost communication between children and parents." Such an opinion is never heard from people who issue warnings to keep children away from the media.

Considering the recent trend of the Read Aloud movement becoming popular, reading picture books aloud to children is obviously an effective way to interact with children. Young parents today have grown up in an environment surrounded by various types of media. Young parents who used to play video games in their early childhood may feel comfortable with smartphones and other new media, in the same way as parents of older generations who grew up reading comic books and novels would feel about picture books. This is why young parents do not only look at the disadvantages of media but also at the possibility of good effects as well. Then, who is making a more accurate decision, pediatricians who are professionals or the parents? We can make judgments on known facts, but as I have explained, we cannot say which is correct since it is a matter stepping into an uncharted area.

4. What We Should Do

There is only one conclusion to be reached from the above discussions: that is, we should continue to carefully monitor the effects (both good and bad) on the change in the rearing environment which the use of media is having on the growth and development of young children. This is a phenomenon we are experiencing for the first time in human history.

I believe the role of pediatricians is to carry out that mission by utilizing all our expertise.