Opening Remarks

David Stewart, PhD

Executive Director of Meetings & Courses, WSBS Professor, Cold Spring Harbor Laboratory

Good evening, I think we should get started. So, welcome to Cold Spring Harbor Laboratory. My name is David Stewart, I'm responsible for the meetings and courses here at Cold Spring Harbor. The Laboratory, for those of you who haven't been here before, was founded in 1819 and it's been a powerhouse for research in genetics and molecular biology for more than 125 years. Our research now spans fundamental cancer research, plant genetics, genomics and informatics, and a significant amount of our scientists now work broadly in neuroscience. In parallel with the scientific research that goes on here at Cold Spring Harbor, we host many scientific conferences and courses on areas spanning the life sciences, ranging from topics such as genome editing or CRISPR, Alzheimer's disease, to disorders of early childhood development. Some of the most significant discoveries in biology have first been discussed here, and in fact back in 1986, in this, the newly-built great auditorium in which we're now sitting, the auditorium witnessed the first discussion of the human genome project, which of course has had a major impact in scientific research over subsequent years, and increasingly in the practice of medicine.

Neuroscientist and Nobel laureate Eric Candell has called Cold Spring Harbor a magical academic home away from home. And this is very much how I hope you will all feel after three intensive days of talks and discussions. In putting this Congress together, I want to emphasize that the driving force for putting the program together has been thanks to the inspiring vision of Children and Screens and the Institute of Digital Media and Child Development. Initial plans for this Congress grew out of discussions between Children and Screens and Cold Spring Harbor earlier this year and following the very successful first Congress organized by the foundation at the National Academy of Sciences, which no doubt, many of you attended. So I am very happy to see all this work coming to fruition in the form of this second Children and Screens Congress on Digital Media and Developing Minds.

So to kick the proceedings off, I'd like to invite one of the organizers on the Congress committee, Dr. Dimitri Christakis from the Seattle Children's Research Institute, to introduce our first speaker. Thank you.

Dr. Dimitri Christakis, MD, MPH

George Adkins Professor of Pediatrics, Adjunct Professor of Psychiatry, and Adjunct Professor of Health Services, University of Washington School of Medicine;
Director of the Center for Child Health, Behavior and Development, Seattle Children’s Research Institute;
Attending Pediatrician, Seattle Children’s Hospital; Editor-in-Chief, JAMA Pediatrics; Advisory Board Member, Children and Screens

Thank you very much, it's really a privilege to be here. I have the honor of saying a few words to introduce our first speaker, whom I think you all know. So I only have I think an hour and 20 minutes to do this introduction, so I'm going to say more than a few words. I'm going to say three. The first word that comes to mind when I think of Pam is 'visionary.' And like many of you, I've been a media researcher for some time, when I first met her. So about six years ago, Pam called me out of the blue. I had no idea who she was and she self-identified as a pediatrician and as a parent and she had some concerns about children and media that grew out of her own parenting experiences. I hope I'm not speaking out of school. Pam has shared these with us. I think they were a real motivator for what she came to do. One of the first things that Pam said to me was that being the quick study that she was and looking at what was happening, trying to figure out what the state of science around children and media was, she said, 'You know, there's a lot of different disciplines studying this, and you all really don't talk with each other very well. You're all kind of in the same sandbox, but like toddlers, you're engaging in parallel play.' So you kind of know who else is in the sandbox and most of the time, you have never met them. Sometimes you cite them, but you certainly don't play together. You certainly don't collaborate very much.

I don't think it comes as a shock to anyone in this room, but the amazing thing about Pam was that she took it upon herself to take on this challenge. So I think of getting 20 different disciplines to work together, and I want to take a nap. And Pam looked at that, and started the Institute for Children and Screens, which is what has brought us all together.

Hewing that from nothing is a pretty daunting task, which brings me to the second word that I think of when I think of Pam, and that word is 'relentless.' I think it really has made this vision of hers happen. Her relentlessness is, I think, in many ways made possible by the language she speaks. Some of you may know Pam's language, so for Pam, no means maybe, maybe means yes, and yes means how soon? I think this has really been what has made this happen. It's what made the first Congress happen three years ago, it's what made this one happen, it's what is going to make the next one happen because she's already talking about it.

The third word, because I think few means three, and that's all I said I would say, is 'connector.' And the phenomenon of connector I think has existed probably as long as humans have walked the earth. Malcolm Gladwell, I think, at least he is credited with giving that application to it, as a person who transcends many different social and professional networks and ties people together, brings them together in the right way, in the right time, in the right place. You're probably familiar with the six degrees of Kevin Bacon phenomenon, and that's a pretty difficult parlor game to play, but it's pretty easy to play the game with Pam. All of us here are one degree from Pam, and in theory that makes us two degrees from each other. I have one of the great privileges of serving on the board of advisors for Children and Screens and having come to the last Congress and to this one is having the extraordinary opportunity to have Pam connect me with all of the people she has connected me with. I know I speak for many of you, too, because there are many people in this room who I don't know, whose work I have known but who I only know as individuals through Pam.

So I think those three words for me are what really come to mind when I think of Pam, and with that I would like to bring a visionary, relentless, connector to speak to us and open the Congress. Pam?

Pamela Hurst-Della Pietra, DO

Founder and President, Children and Screens: Institute of Digital Media and Child Development;
Clinical Assistant Professor, Health Care Policy and Management, School of Health Technology and Management, Stony Brook University

Good evening, and welcome to the Second Digital Media and Developing Minds National Congress. On behalf of Children and Screens, co-host Cold Spring Harbor Laboratory, and our entire Congress committee, thank you for joining us. I look forward to learning from all of you.

It's been three years since our first National Congress. This anniversary calls not only for celebration, but also for reflection on the past and preparation for the future. So for the next few minutes, I'd like to consider where we've come from, where we are, and where we're going.

So why are we here? The issues that concern us are so global and so ubiquitous that it's tempting to answer this in terms of vast abstractions. But for me, one need look no further than everyday interactions we've all observed between children and media. We've all seen a compliment online make our teen's day, while a critical posting or exclusion brings self-doubt and tears. We've seen children physically together, but worlds apart, as they wordlessly type into their devices. We've checked in on a school night, hoping to find our teen asleep, but instead finding the blue glow of a phone under her blanket. And we've observed 3-and-4-year-olds asking Alexa if they can have candy for dinner.

As parents and adults, we can discuss and share these stories. But as researchers, clinicians, and educators, we must do more. We must ask what our science tells us about this. There are real children, real families, and communities behind the data. Their well-being depends on the science, depends on us, and depends on you. That is our collective origin story.

That is why we are here, we have come to answer the three fundamental questions with which I opened the first National Congress three years ago in 2015, that remain just as relevant today. First, how are digital media enhancing or impairing children's ability to live happy, healthy, and productive lives? Second, how are years of electronically-mediated interactions shaping children's physical, cognitive, psychological, social, emotional, and behavioral development? And third, what should we do about it?

So where do we stand now? What progress have we made to refine, amplify, and expand upon the insights and objectives we identified in the first Congress? In 2017, Pediatrics: The Journal of the American Academy of Pediatrics, published the special supplement, Children, Adolescents, and Screens: What We Know, and What We Need to Learn. Its 22 articles reflected the work of over 100 named authors from many academic disciplines. Children and Screens initiated, organized, and funded that project, and gratefully acknowledges all those that collaborated on it. You can find copies outside at our bookstore. Also last year, the National Institute on Drug Abuse sponsored a workshop on social media, mobile technology, and youth risk behaviors. It explored the relationship among media exposure, data analytics, and the promotion of healthier choices and better outcomes.

Early this year, media exposure and early childhood development workshop at Eunice Kennedy Shriver National Institute of Child Development continued the process of shaping future research. In addition to NICHD and Children and Screens sponsors, including NIH Office of Behavioral and Social Sciences Research, The National Science Foundation, The Society for Research in Child Development, and the American Psychological Association. Just this month, the proceedings of the National Academy of Sciences published a number of papers drawn directly from the first National Congress of which NAS was a co-sponsor, as you've heard. In his introductory essay, the University of Michigan's David Meyer eloquently described the state of the art in our field. He wrote, 'The rigorous study of digital media and child development has had relatively little time to progress. Much of the new methodology needed for advancing this field still has to be fully conceived and implemented, hence empirical findings, conceptual hypotheses, and theoretical formalisms in this domain are still relatively rudimentary to date.' I don't consider this to be a criticism. I consider it to be a call to action.

The 2016 policy statements from the American Academy of Pediatrics supply guidance to parents and practitioners. With these, the AAP reminded us of our collective responsibility to pediatricians and other clinicians. We must empower them to identify not only media-related opportunities and risks for children in general, but also each child's particular needs. That will be our contribution to the age of precision medicine.

The World Health Organization recently took another step forward. The WHO included gaming disorder as a diagnostic category in the 11th revision of its International Classification of Diseases. The WHO based this decision on its "reviews of available evidence" and a consensus of experts from different disciplines and geographical regions. The extent of that consensus will become clearer when the American Psychiatric Association makes its own final determination about internet gaming disorder. The most recent addition of the APA's Diagnostic and Statistical Manual of Mental Disorders, DSM-5, defines internet gaming disorder but includes it only as a "condition for further study." That is, the APA has not determined whether or not internet gaming disorder is a unique mental disorder, but it has identified criteria for further study.

The DSM-5 language had its intended effect. It has inspired five years of further research. As a scientist, I appreciate that methodological, credible, persuasive studies take time, but as a parent and child health advocate five years strikes me as a very long time in the life of a child or a family in distress. On the public policy front, pending legislation justifies cautious optimism. The first National Congress called for a coherent, coordinated, and comprehensive program of multidisciplinary youth media effects research under the national institutes of health auspices. The recently introduced Children and Media Research Advancement Act, the CAMRA Act, answers that call.

Children and Screens has endorsed the CAMRA Act, but our enthusiasm is tempered by two concerns. First, some version or another of this bill has been introduced in Congress several times before, but never enacted into law. Congress and the White House may fail us again. Second, even if the CAMRA Act becomes law, it's mandate will provide more money than the bill provides. Additional money from businesses and philanthropy will be needed. Children and Screens is working to devise an appropriate collaborative funding model. I invite you to join in this effort. CAMRA co-sponsor, Senator Edward Markey, will be addressing us on video tomorrow.

With or without the CAMRA Act, the companies monetizing young audiences can be important funding sources for academic research. We must be vigilant, however, about our intellectual independence. Neither corporate donors, nor their captive non-profits, can be allowed to influence researcher's decisions about what questions to ask and how to pursue, interpret, and disseminate the answers. Be vigilant about discovering and disclosing the ultimate sources of your own research grants. Doing so will protect the credibility of your findings. There has been a lot of news about that recently.

The positive force of collaboration is not just influencing academia and capitol hill, socially conscious investors are displaying it too. Earlier this year, Jana Partners and the Cal State Teacher's Retirement System wrote to Apple's board of directors. They asked Apple to "offer products that offer parents more choices and tools to help them ensure that young consumers are using its products in an optimal manner." The tone of their letter is as interesting as its content. It is a firm but well-informed, restrained, specific and pragmatic call for dialogue. For example, Jana and Cal State Teachers argue that "it is both unreasonable and poor long-term business strategy to ask parents to fight this battle alone. Imagine the good will Apple can generate with parents by partnering with them in this effort, and the next generation of customers, by offering their parents more options to protect their health and wellbeing."

In its response, Apple defended its business practices, but acknowledged the need for additional child safety features. It released a number of them just six months later. Is this a sign of things to come? I am cautiously optimistic. As the shareholders wrote to Apple in June, mobile technology will continue to evolve and the research around developmentally optimal usage will continue to come into sharper focus, meaning this must be an ongoing effort. I look forward to seeing more potential technologists and child advocates working together to identify, articulate, pursue, and achieve shared goals for children's health and welfare.

So how do we proceed from here? First we must collaborate. We are engaged in a dazzlingly complex task. We are trying to understand what's happening at the point where three dynamic phenomena collide - rapidly-evolving media, children racing through developmental stages, and a fluid social and cultural context. No one academic or professional discipline, and certainly no one lab or university, has all the tools needed to do this. That is why multidisciplinary, multi-institutional research was an organizing principle at the first National Congress and why it is again at this one.

Next, we must innovate. While continuing to learn from elegantly designed, rigorously analyzed, and thoughtfully employed survey, diary, and interview-based studies, we now have the opportunity to complement existing tools and methodologies with new ones. We can more directly measure what children are doing, hearing, seeing, and feeling in real time, all the time, and through what physiological and neurological mechanisms. With our growing ability to create and manipulate such massive data sets, we may discover the cause and effect relationships, underlying mechanisms of action, differential risk and benefit susceptibilities, and personalized interventions toward which many in this room are working. Parents need more than general advice from us, they need empirically validated, actionable, and demonstrably effective guidelines for their children's media exposure.

Finally, we must communicate, even about controversial issues, in measured and respectful terms. There will always be those who embrace confrontational approaches. Some will be drawn to the simplicity of technophilia and technophobia. Others will employ such extremist views because they produce usefully provocative and distracting sound bites, tools for exploiting divisive problems rather than solving them, we cannot yield the field to them.

The first Digital Media and Developing Minds National Congress and ensuing events have shown that there is a better way. The disciplinary, institutional, and philosophical diversity of the second National Congress confirms it. So too does the breadth of our agenda. It continues many of the conversations that we began in 2015, but also includes many important topics that received little or no attention. We have assembled all the ingredients needed for four days of evidence-based collaborative, multidisciplinary problem solving, and for years more of productive research and influential discourse. All that remains is for you to ignite this engine of discovery. Please be generous with your expertise this week. Be open to insights from unexpected sources. Be imaginative about the potential of unlikely partnerships. Be curious, be engaged, find people who know and do things that you don't, who ask questions different from yours. Invite them to sit with you at lunch, something exciting is sure to happen. I hope you'll let me know when it does.

Thank you for being here, I look forward to spending this time with you.