Hello, my name is Doctor Sarah Walker, and I'm honored to serve as the 2025 president of the El Paso County Medical Society.

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Presented by the El Paso County Medical Society and hosted by Kathrin Berg.

Have you ever heard anybody say, well, that's not how we did it when we were young?

Or do you find yourself saying that to people who are younger than you?

Childhood.

Play looks a lot different today than it did years ago.

Today we're going to discuss about how screen time and reduced outdoor activity is reshaping cognitive and developmental health in children.

This program is underwritten by University Medical Center El Paso and UMC Health Care partners.

And we also want to take the El Paso County Medical Society for bringing the show to you.

Since 1997, I'm Kathrin Berg, and this is the El Paso physician.

Neither the El Paso County Medical Society, its members nor PBS El Paso shall be responsible for the views, opinions or facts expressed by the panelists on this television program.

Please consult your doctor.

Thanks again for joining us.

Today's childhood does look a lot different than it did when we were growing up.

I'm 59 years old.

I often like to tell people how old I am because it's a lot of perspective that we bring to the table, and we're going to talk about how screen time has really changed, how children act, how their parents act, and sometimes how their grandparents act.

And there's a lot of mirroring and mimicking going on there.

Today we have three pediatricians with us.

We have Doctor Alison Days, who again, pediatrician, and she's with UMC healthcare Partners and Healthy Days Pediatrics.

We also have Doctor Ruben dependent if we want to do it the Italian way or the Spanish way.

Right.

We have doctor, Ruben Roncallo or Roncalo That's cool.

He's a pediatrician also with UMC Healthcare Partners and Border Pediatrics.

And we have doctor Janelle Lynch, who's a pediatrician with UMC El Paso Clinic.

So now that I kind of have described where you all are from, Doctor Days, I'm going to start with you because you do a lot of things with the El Paso County Medical Society.

I'd like you to talk a little bit about that because it's a big deal.

And if people don't know how hard you work, they should know.

And then I'd like you to bring it to your role here today on the program.

Okay.

Well, in terms of the El Paso County Medical Society, in the past, I was, president, current.

That was several years ago during the pandemic.

Yeah.

And that's fun.

That was not a lot of cheese.

Was a lot of work.

Currently, I've taken more of a backseat position to some of the newer, people on the executive board, but I still help out with several of the executive committees, including their educational committee, which helps with this program.

And the magazine, the El Paso County Physician magazine.

So I would like for you to talk a little bit about the El Paso County Medical Society, El Paso Physician Magazine, because people who are not familiar with that and only watch the show, what is the platform for that?

That why does that exist?

Maybe that's.

And so the magazine is actually much older than the TV show.

And started as a way to involve local doctors in both submitting, items that they were working on.

So submitting research, submitting case reports and allowing it to come out to the rest of the community so we could all sort of know what each other we're working on.

So that's where I started.

Kind of a peer to peer.

Peer to peer.

Exactly.

Yeah.

And over time, especially over the last six years, and even more specifically last two years, we've been working on trying to bring it into the 21st century in terms of things like, getting it more online, getting it into a way that we can look it up and, restore it.

Like if you're doing research, you can look up a specific topic that was, quoted or, there was an article in the El Paso Physician magazine which you didn't used to be able to do.

You could read the whole, magazine online, but it was a PDF format.

Now we're trying to make it so that it's actually a research format.

And, in the way of the Library of Congress, you know, with labels like that.

So we're taking on our new medical students, new college students who know more about the online platform.

Speaking of screen time.

But, you know, having that be available now, they just know stuff.

You give them a screen and they can they can fix it, which is lovely.

Doctor Ruben Roncallo Let's talk about you.

So you've been in El Paso.

How long?

And what is it that you do all day?

To help people at home understand your perspective coming to this program?

Okay.

I've been in El Paso since 1993.

Probably is 33 years ago.

Okay, so I was born in Colombia, and then, I produced my is a medical school in Colombia.

And I went to come to come to the United State, to do my pediatrics fellow.

So I came to, Texas Tech after I passed my boards.

So I was an Texas Tech and I my function in Texas Tech first was, chief resident for two years, and then I was in charge of pediatric clinic at 16, director of the pediatric clinics.

So I stayed with Texas Tech for 4 or 5 years, and then I decide, sorry, I decide to go, private practice.

So I've been in private practice in 2001.

So I learned a lot and then Texas Tech, and that helped me to function as a pediatrician in this community.

So I one of the things that I learned was I get a I get a lot of things from Texas Tech.

I'm from El Paso.

While I was working in and, my clinic, I decided to open a free clinic in Canutillo So we opened a free clinic.

It Canutillo for about five years.

So we not only attending pediatric population, but we were attending adult population 133 00:06:57,784 --> 00:07:00,987 I decided we decided to close because the the doctor that was, helping me was Jose... It was a gynecologist So it was a beautiful person dedicated to help the paso.

So we stayed there.

Then I was working for almost 20 years with, Washington to be charged all the illegal immigrants.

So I was the doctor in the shelters, and then I decided to just go with UMC right now I'm working for, UMC, my clinic, UMC, healthcare partner, Border Pediatrics, and it's been amazing.

The way that I'm working and, and UMC, because I'm able to help people.

Now, when I saw the topic, when I was reading the topic that I, that I was assigned.

So it's so good because now I am the director of the juvenile detention center.

So I know what's going on when you don't pay attention to certain conditions that kids develop when they are young.

So it's so good that.

And thank you for inviting me today.

My pleasure.

And I'm glad that you mentioned the juvenile detention center.

We're looking at aged men's too.

And also what is available to certain populations.

So I'm very glad that you mentioned that.

Thank you for that.

Doctor Lynch, how about you?

How long have you been in El Paso?

Specialty.

All that good stuff.

I've been here in El Paso since 2013.

I also completed my pediatric residency here at Texas Tech.

Great.

And so then, since then, I joined UMC, and I've been working for their, their neighborhood clinics, and it was, I mean, a big reason that I chose them two was to be able to work with underserved populations.

Kind of their dedication to doing that.

I worked at a variety of their clinics.

I was for five years.

I was working in Fabens in their clinic with their clinic in Fabens.

And then now I'm working here in the the West clinic.

So I see patients from newborns through adolescence.

I'm a general pediatrician.

Okay.

So this helps me a lot to with the area of how we're going to do our questions.

And doctor Days.

I'm going to I'm going to start with you because again pediatrics is everyone from zero to usually 18.

But I know my kids saw their pediatrician till they're like in their 20s because college and everything gets kind of crazy.

So we used to talk about traditional injuries.

You'd go outside and your bicycle and I have scars on my knee.

Still, when I was riding a bike and a skateboards and my broken tooth because I crash on the way to the pool.

What kind of injuries are you seeing now that are being replaced by old school play?

And I don't even know if you would even call that.

And I guess to the trend that you saw, and I don't even know what year it was, and everybody started getting phones.

I'm thinking my my children, a 29 and 23 and my daughter, I'm a working mom, had to write me a dissertation has why she was allowed to get a phone in the fifth grade.

Well, that's something that I remember.

I can tell you.

Just as a side note to that, my one of my nephews was born in 2020, no, 2000 okay, the year 2000.

And when he graduated from high school, the statistic was that that was the first generation that had never been without a cell phone.

2020 that makes sense.

He graduated 2000 was when he was born, and he graduated from high school in 2018.

So I'm going to say somewhere around there those teen years was when they started doing that.

The interesting thing is that and I did actually look this up just to see if I was wrong.

Right.

We are seeing a lot of new injuries and new health conditions as a result of people using screens.

More often, but we're not necessarily seeing less of the other things.

So I can tell you, in the summertime we still see just as much football injuries, concussions, people falling off their bikes.

But now it's dirt bikes more than regular bikes.

Or it's, you know, it's BMX, you know, crazy bikes kind of things like that.

It's scooters.

It's but there's all kinds of stuff out there that still happens.

So we still see a lot.

We still see younger kids who are just running too fast and trip over something and fall.

So those injuries are still there.

The question really is how has screen time affected those type of injuries?

And there is some research to show that, yes, that possibly because people are using screens later at night, they're getting less sleep.

The teens.

And so they're actually more prone to injuries in their sport or in their, kids are using screens at younger ages.

So whereas they might be running around in their local, you know, backyard or something and trip and fall, now they're running, holding a phone and they trip and fall, you know, so you're seeing new, not new injuries in themselves, but new, ways they get those injuries.

Right.

So things like that can happen.

We also see things like, changes in bone structure that we're starting to see now.

And I've even talk about chiropractors that have said they've seen this in orthopedic doctors, okay.

They're actually seeing reshaping of the neck bones because kids are like this all the time.

And I can literally tell you, my younger daughter, who's 16, I am constantly telling her to do this.

If she's looking at her phone right, right.

Even the adults.

And we have to watch it too.

And, you know, looking.

So we're seeing more back aches and more neck aches and more headaches that are from neck problems or how you're holding your head.

We see more hands aching.

And there is something now called, like the texting some, you know, from people doing this all the time.

You thought it was all it's basically now it's basically like what used to be called a trigger thumb is that you?

The chatting texting thumb, you know, from a but it's basically the same type of strain on the finger from using it constantly.

So those are the things I've started to see.

And then of course there's things like visual differences.

So maybe kids are, you know, if they're starting like this from a very young age with that screen, it used to be that we wouldn't see a lot of visual changes until they hit middle school or high school because they were staring more at books, or they were staring maybe at the early part of computers for school, but now they're starting so much younger before their eyes are even.

Well formed, that we're seeing a lot more vision problems earlier on.

So interesting things are coming.

Okay, so as I'm listening to you describe all these and they're coming, parents are coming to children coming.

You're noticing things.

What are the treatments and or simple advice that you're giving to parents regarding their children?

Like what are some of the most common things that you're saying to parents?

Because you can't not you can't take a look problems.

But we're trying to be realistic wise now.

Yeah.

No, it's really part of life now.

The AARP recently changed their recommendations because it used to be hourly.

You know, they used to say, hey, you shouldn't watch more than or let your kid watch more than two hours of screen time.

And then they realized, number one, that was unrealistic because screen time was also now part of school.

I mean, I can tell you again, my younger daughter, we kept her from Instagram for the longest time, and then in high school they told them, you have to have Instagram because that's how we send out information from the school now.

And so we had to do it right, so they can't limit it to that extent anymore.

But now they've modified it to say look at things that look at your child, look at what type of person they are.

Are they, do they have an addictive personality?

Are they going to be on all the time?

Okay, you might need to limit that kid more or put in more.

You know, blocks on their phone like, you know, restrictions on their phone for that or wait until they're much older to allow them to use those social media things.

Or they'll say, you know, hey, make it all up all the time.

We say, no matter if they're two years old or 18, try to watch stuff with the kid.

So don't use it as a babysitter, you know, don't be like, hey, here's which we see all the time.

And again, I have I have parents sometimes who say, I'm such a bad mom.

I give it to them.

I said, you're not a bad mom, I get it, you're running around crazy.

And, you know, we used to give something else to kids food, or we used to plop them in the walker or whatever, and now we give them a screen and it's the same behavior.

The thing is, you just want to watch that.

I mean, if you do it for a couple minutes while you run into the bathroom because you have to do and you haven't had a chance to yourself all day, it's perfectly fine if you leave that kid with that phone in a walker for eight hours, that's really not appropriate, right?

So looking at some of those things and modifying behaviors that you know are going to happen anyway.

So just talking to them about, hey, if you're giving your child, your two year old a screen and an iPad and they're watching TV, look at it with them and use it as a learning interactive tool, hey, what's that child doing the same way you would a book, right?

Right.

There you go.

So you have to do it.

And if you have a 15 year old who's watching shows, maybe they shouldn't.

Maybe you can't keep them away from it because your TV doesn't block that.

Or they have an older sibling and they go on the siblings profile.

And I do my to bring up contacts throughout this hour.

And we could talk that out there, but then you sit with them as well.

So, hey, sit with your 14 year old and watch, interview of the vampire or whatever personal experience with that one.

But yeah, that's the old movies.

Yeah.

So you watch these kind of things with them and you talk about, hey, what are they bringing up?

You know, what kind of issues are coming up in the program and have a discussion and a way of, of of entering that conversation with your child, right?

Yeah.

Right.

So, Doctor Lynch, I'm going to turn things over to you for a moment.

The sun exposure and I know there's such a controversy on that because it's sun sunscreen and this and that and other, but there's good old fashioned vitamin D, and we happen to live in the Sun City, thank goodness.

So it's different here.

But you noticing and are there are any detriments to it.

Are you noticing kids just not getting out as much as they used to, used to vitamin D deficiencies, etc., etc.?

How is that kind of factor into everything?

But I do see vitamin D deficiency, in my practice, and definitely and we do believe that it's tied to kids getting out less, less.

Less often than they used to set of this whole lifestyle lifestyle changes.

So before when, you know, kids used to be outside more and now, like we said, they're inside more, you know on the phones playing video games or on the tablet instead of going outside.

So I believe the so and I do see kids in my practice that are, that are deficient in vitamin D, and I believe it's about the estimate is around 15% of younger kids and 30% of older kids that are deficient in vitamin D. So it's something like, what are we going to do for us?

So why is it so good for us?

So the major thing that we're worried about is bones help.

Having kids need needed kids need or anybody needs enough vitamin D to have strong, healthy bones.

So we're so that's a big concern if they're, you know, very deficient in vitamin D, it can even cause an increased risk for broken bones, things like that.

If they're not they don't have enough enough vitamin D. There is also for immune function.

And then as well as some research showing an increased risk for depression if they have low levels of vitamin D. So I mean so it's an important and important.

But I love this program for so many reasons that we have kind of some questions that we have.

But then you all will go into different topics.

And I do want to talk about depression because I feel like that is such.

Yes.

Not that it has not always been there, it has always been there.

But either it's coming to the forefront more or there are more, you know, doomscrolling, etc.

so I do want to talk about content, like any time we can throw in some content.

Again, the way I look at it is doom scrolling.

I know it's called so many different things.

Talk about depression and just mental health.

So in the area of screen, we have unfortunately seen an increase in in depression anxiety.

And as we've seen an increase in screen time and unfortunately and even higher, especially for adolescent girls, there's a lot a lot of and some of that is believed to be tied to social media.

You know, they're comparing themselves to the, you know, and unfortunately, cyberbullying, things like that, that are happening.

So does tie in to knowing knowing your child.

So perhaps if your child already has social anxiety, they might have, you know, have even more negative effects to to being on social media or more screen time than maybe your other child that doesn't have that and that, that issue.

But unfortunately, because, you know, not only are they they're exposed to the, the social media, the things maybe they're not realizing that that might not even be true.

And the things that they're comparing themselves to that they see, people have unfortunately, in cyberbullying, like I had said, that that does happen.

And then and just the what happens when they're inside doing, you know, on the screen instead of outside exercising or face to face interaction with friends?

They used to be happening more than maybe it's been replaced with online interactions and then even exercise too.

I mean, exercise can be a great way to decrease risk of depression.

And, you know, get those endorphins going.

But instead of, you know, that they maybe replace time that they would have been exercising with with being on the in, you know, inside on the screens.

So we have to really be be aware of what, what we're replacing, you know, what what are they not doing because they're right on the screen too.

So you're mentioning some of the the treatment so to speak, or some of the advice.

And just again, the whole world of being realistic and I want to ask about the juvenile detention center as well, being realistic, you have the parents of the child or just a child in front of you, and you're giving them, exactly what you're saying to me.

Hey, try to do more face to face time with your friends, this and that and other.

Do you find that to be welcoming advice?

Do you find that to be.

Oh, she's a doctor.

I'm just going to blow her up and I and I want you to be brutally honest, because I think that's what affects you, because people who are watching and listening to this are like, that's exactly my kid.

That's my grandchild.

And just just withdrawn that home, I guess, while I try to, to be realistic, I mean, probably you're not, you know, that screens are everywhere.

They're apart, they're in schools.

They're, you know, they're not going to you can't avoid, you know.

Yeah.

Of screens.

So really and to understand when you know with parents like sure.

Of course are you know sometimes maybe they do for a short period of time that, you know, or so they have another sibling they need to attend to or something.

You know, we're not saying that you're a bad parent if your your kid has some screen time, but being aware or making sure that they are getting, you know, the other things, it's not taking over their life.

You know, it's not.

They are getting some face to face time with you, like a good way is or making sure that they're not you're not having screens at mealtimes, so you're having face to face interaction with them.

You know, if it's if you can't do mealtimes, at least you know, another time in the day that you're, that you are putting down the screens, that they are getting a break, instead of it being sort of like a, you know, a constant thing, you know, trying to make sure that they are getting some, some physical exercise.

So even if they are spending some time on the screens, you know, we would say like we're at least an hour a day.

I mean, if you could do more, that's great.

But something where they're moving, they're exercising, they're, you know, having and then as well as those face to face interactions, but also the exercise.

Yeah.

I mean it's something that it's different that we haven't talked about.

But sleep also because a lot of the time on the screens is taken away from sleep.

So that can have a lot of even in, you know, in terms of them feeling more depressed or things like that because they're, they're tired if they're not getting enough sleep because they're, they're on the screen.

So sort of, you know, they they might they're going to have screen time, but then making sure that it's not like if they're getting these other things that they need also, at the same time, even as an old person.

Right?

I mean, I've had to wean myself off of nighttime screen time, because I will I'll go down a rabbit hole.

I'll see.

It's algorithms are a blessing and a curse.

You know, you find something that interests you and you go to and it's another click, another click, another click.

So it's, to your point, it's it's whatever your addictive behavior can be.

Dr.

Roncallo and Calo Okay, so grandpa in Italy is 'Calo' right?

'Callo' here for all everybody on the board.

I love it.

And I love the way that you explained that earlier, too.

So, I'd like to go back to what you had said earlier about working with the juvenile detention department.

Only our our the children can't call them kids.

The kids are the kids, and they're allowed to have their screens all day.

Or is there limit to time screens?

How do you see that different from the population that is not in that situation?

Okay, first of all I need to mention that what is the reason there is so many kids now going to juvenile detention center?

Okay, that's a great story because there's multiple factors.

And one of the most common that we see constantly is family dysfunction.

Right.

The father start early doing whatever they go on and drugs get in trouble go to jail.

Mother's doing the same thing involving drugs.

So who takes care of those kids?

Grandma.

Grandma is not capable to handle the whole thing.

So those kids, beside that, they don't have some kind of guidance where they have all the problems that never been diagnosed because, grandma, didn't have the chance to take the child adequate to the pediatrician and be screened.

One of the problems I found there is something that we see frequently so simple attention deficit disorder.

Yes.

Right.

So attention deficit disorder.

They don't pay attention.

And we know what is attention deficit disorder.

One of the main thing in attention is impulsivity disorganization.

So many thing that they involved in in that regard that because nobody pay attention that they shouldn't this disorder, this kid is more prone to be involved in drugs.

So you start drugs early.

I have kids and then juvenile detention center at the age of 11, and they were already doing really bad thing.

They're already killing people.

They already stolen cars.

They they do awful things over there.

And I and I think even though myself that I see then that they develop anxiety, depression when they are there, even though I do screen because they're harder for me.

I had the opportunity to do a screen, find out what's going on.

And also we have a Texas Tech psychiatric department.

Get involved and they have the evaluation.

So we go to well, I do the screen, I find out what's going on.

And I, I refer it to a psychiatric, doctor at Texas Tech.

So we being able to do that.

But even though this case and we put in a medication and they behaved, they get clean for about a month or a year and they go out, they go to the same environment.

So the whole time that we were there teaching guidance, it's like we losing the time.

Do you think some of it sticks?

I think later on, yeah.

Yeah that's all I, I've been working with the juvenile and they doing a beautiful work because they teach them welding They teach them electricity.

There is a program there called Challenge It's a lot of discipline.

And you see that they, different case when they are there and they try and they function, we guide them.

But the thing is, the problem is not there.

The problem is society that we need to have a different kind.

The situation in how we confront this problem with society We know the social economic issue is, important in those and especially here in El Paso, I noticed that there is a lot of incidents of single mothers.

So those single mother, my God, when they go to my office and they tell me what they do, they have to work, and they had to come.

They had to wash, or they had to clean.

They had to cook, and they had to teach the kids.

You know, it's overwhelming.

And you think the kids will will get it.

I don't think so is to do anything that the kids what Dr.

Day was saying, they had to do all the things that they need to give me the iPad, the telephone for them to finish the work that they had to do.

So I've been I've been involved in El Paso, managing a lot of behavioral issues, and I see most of the autistic kids in El Paso, and I see, well, autistic is something el behavioral is something.

So one of them is genetics.

But the majority is acquired because of the their environment.

Yeah.

So here's a question.

And there may not be any answer to this.

Outside the outreach outside, the home, the children's detention center and the families, I know that there are programs and you guys are fantastic about creating these programs.

And again, just with brutal honesty, how many families are able to or do participate in the retraining if possible?

Again, there are circumstances where they can't be retrained, but are there is a reception of help being received by the parents and by the grandparents and the people who are taking care of the children outside in their home environment?

Do you see that being addressed is a very hard question.

Why?

It is because most of those parents are in jail.

Most of the mother I using drugs and the mother and the grandparent, they don't have enough education to understand the whole thing that we're trying to do, even though they even in the juvenile detention they they trained in and they passed the test to be to have the high school.

And we say, you know, you ready?

You can work any, any place that you want to.

But it's tough because they go into the same thing.

So that question, it's hard to answer, but there may not like I said, there may not even be an answer to it.

Yeah.

Just kind of curious how that how we as a pediatrician trying to help our grandparents, help that society in El Paso.

But there is something else that we don't see in our clinic, because those kids, they don't go to pediatricians.

Yeah.

So here's a question.

I'm going to kind of throw it out.

And Doctor Lynch, I think I'll start with you, but cognitively.

So I think that, and have heard and, you know, research here and there, the way that kids learn today just cognitively versus and again, I'm 59 say someone who's in their 70s or 80s, you know, used to be go to the library.

There are books.

And then it was like, well, then you have, you know, what do you call those cheat sheets when you could read a book?

And it was anyway, it was just all kinds of ways that we cliff notes.

You know, I kind of lived off a cliff.

Notes.

Don't tell anybody.

But it's just one of those things.

So just cognitively and the whole sphere of learning.

Now, how has that changed?

And I don't even know how many years you want, I want to say since 2000, maybe we can look at since 2000.

How do you think that has changed since 2000?

And where are we going in the future?

I don't want to introduce AI, but I feel like it's everywhere and screen time is AI time so...thoughts?

Anyone can chime in on this one.

I mean, I think that we have seen it's it is difficult for kids to to pay attention longer or to read a whole book or two or that becomes more, you know, things that we maybe were more common before it.

Sort of the videos are getting shorter that they're watching sort of, and they just scroll, you know, scroll from this that they don't even.

I think there's a reason most people don't even watch a whole video or the longest is like, maybe, I don't know, 10s hey, you watch where you you go to something else.

You're just constantly kind of scrolling to different things.

So it becomes difficult or more challenging to, to, to focus more or to, you know, or something than the, you know, our learning that doesn't require sustained focus.

So, I mean, I think and then we've seen that, that in schools, and then so AI for sure, for sure, is coming and then whether that, you know, that's really going to change, I mean, I guess maybe whether it's necessary to have some of these skills that we thought we needed before, if I is now, going to be that easily accessible is information now, you know, I think about that too.

Yeah.

You know, I'm kind of going in my head again.

My son is 23, but when he was in junior high and he was taking world history, his teachers literally and homework was TikTok.

And you would look at these like five minute videos that I learned so much from, you know, this is how Columbus really discovered America.

But really, you know, and I and I remember thinking, wow, that is fascinating.

If I could have learned that in that amount of time when I was younger, how great that would be.

So I want to look at both the positives and then obviously the negatives.

But and maybe that's what I'm looking for here to what what have been the positives?

I mean, I guess and not social media, but that is on social media.

Like you said, they're getting homework on Instagram.

These TikTok videos, frankly, were brilliantly done by a school astic entity.

And just just again, the ways of learning.

AI can basically be the teacher now.

So I guess I guess or a positive is you can get feedback.

I mean, right away you could put, you know, you put that there and get it corrected.

I mean, I guess the negative is that they're right.

AI can write your paper just for you now I guess.

But but but yeah, you can.

I mean, any question you want answered, I mean, I guess that can be, you know, positive and negative, maybe that anything that we say, I think a positive.

And I was actually just mentioning this to my family the other day, I, you know, again, back in our day or any of our days.

Yeah, we would have to kind of some would ask us a question.

Yeah.

We outside of school hey you know, whatever.

This happened a long time ago.

Oh, let me see if that's true.

And we did go to my next video.

We have to go to library and get it and look it up on microfiche even or other, that kind of thing.

And so I microfiche look at you.

Right.

So I think the advantage now is that, yes, you can get information very quickly.

You get answered questions very quickly and you can get it from all over.

I mean, it allows you to reach to different countries and different people and different things.

The downside, I think, to that exact same situation is what you were saying is that, number one, I think these days with AI and even before I it's hard to help your children and even for us as adults, learn what things are actually correct, right?

Which things are worth believing in, which things are not.

And to stay away from the downside because you get at the same time be looking up one thing and other ones come in just automatically they're scrolling and all of a sudden they've got another thing that's on there that isn't what you were trying to look for, right?

And that is where it becomes extremely hard for parents these days, because again, you can put some restrictions on kids in terms of how often they're on YouTube or what things that go to YouTube.

But in reality, it's it's almost impossible for that to be helpful these days, because it's so easy for the AI bots or whatever you want to call them, to sneak underneath that and reach the kids anyway.

Something.

And then the kid will look up what they just saw and that just spirals.

Like you said, the doomscrolling is just everywhere now, so that's the downside to it.

But I do think there are some advantages, and I know that my kids have learned how to memorize things faster because they're not having to look, they're hearing it, or they're hearing music with it, or they're seeing someone dance to the rhythm of a history lesson.

And so all of that comes into play, and I think those are the good sides to, you know, sorry.

Yeah.

Doctor on Kyle.

So if we're looking at learning kind of the same concept and same question to you.

And again, I'm looking at you, even though everybody kind of has the same population, I'm looking at you as a population too, that learning continues and, and I'm going back.

You're the juvenile detention guy today just because you mentioned it.

You're not that guy, I get it, but because you mentioned that that's a unique population that is different from the other population.

Regular school days, after school days, homework.

How is screen time helping or is it a detriment at all when it comes to homework?

I guess that's a good question too, because homework is very different now than it was years ago.

Yeah, that is very important question.

And I always talk to the parents because, you know, when they come to your office, they always come with a concept that the teacher said, oh, your child has ADHD, he's attention deficit disorder.

He doesn't pay attention.

He's just jumping and this and that.

So and then when, when, when we screen those kids in reality is not ADHD It's something that we need to have some kind of, guidance at home study at home for example that the first thing that I do with the parents So do you have a special schedule with the kids starting when they wake up.

So you had to put it waked up at this time.

You take their breakfast, you're going to school, you come in from school.

So what do you do after school?

You do homework or you or you go, activity free activity.

One hour to hour.

What time you go to sleep?

Brain is conditioning all the time.

You condition that brain, that brain is going to work better, more organized.

So what happen is the same thing on weekends.

So most of the kids come in Saturday and Sunday and they don't know what to do.

And they spend time doing things that they don't supposed to do.

So I think we should pediatrician guidance department and start telling them things that they should do to improve the cognitive and the, the the relation between what the school is, what its heart is.

So those kind of thing, we always need to pay attention.

And that's what I, I do because most of the parents think, oh, let's say that is a true eight years of the that's an old diagnosed.

That's another problem.

So I'm going to go down that road for a moment.

All three of you all.

How does one diagnose A.D.D.

HD.

Am I saying that right?

ADHD and then when do medications come in, when do behavioral differences come in?

And I know I'm opening it up, I and I and I respect it.

Everybody's got this.

So sorry I know millions of people had this kind of condition.

So attention deficit disorder simple.

It just deficits in the attention I see squirrels all the time.

So it's just like, we are here, like, looking at you, and my brain is thinking something else.

I'm with you, I understand that.

And then the other one is the with the hyperactivity ADHD So in that one, the kid, they don't it's not their fault is their brain is all the neural transmitters that are not working properly.

So and that I think is one that I wanted to mention few minutes ago, is sometime I tell the parents, okay, we have a screen We prove that is the ADHD with the history, and we tell the parent this and there's nothing that we can do.

We need to put this new child in medication or no, "you 're not going to do that with my child."

So that is completely wrong.

Even though we had to be really strong and trying to educate.

Why?

Because those are the kids that end juvenile detention center.

Yeah.

Good point.

Excellent point.

And that's so difficult to we may go back to that or not, but I do want to talk a little bit about, the whole counseling.

I know we've been on this, but I feel like this is such a great program.

A lot of times we're able to talk about prevention.

Maybe we can do that with some that are younger.

Again, a lot of the parents that we're talking about, our parents that maybe didn't grow up completely with screens.

But again, I have a 29 year old, 23 year old, 29 year is probably going to be a mom pretty soon.

A lot of her friends already are and have been, so they're already in that world of being children who have grown up on screens and now they're having children on screens.

So talking to the parents who are already having these issues, right.

There's like that one generational gap.

How do you all address that?

And again, I'm just I'm just throwing out there and Doctor Days because it's your turn to talk you.

It's like, what's it okay.

Well first of all, I think again we see it in our exam rooms, you know, where the parents will come in, and maybe they'll have a couple different kids and the the youngest one or even the all of the kids come in holding a screen, right?

Or if they're not coming in, holding their own screen while the parents are talking, they slide their phone over them because the kids are crying.

Right?

And so I think there's a couple issues there.

So one is that the parents, like you were talking about conditioning.

The parents are conditioning themselves to give that every single time the kid cries, right?

I can't listen to the child crying.

I can't I'm, I'm I'm too stressed to figure out why they're crying.

I'm just going to hand them something to occupy them.

Right.

So that's the first part of it.

And the second part is the kids themselves.

The longer they're and the younger they are when they start looking at that more, I think we see attention issues because they're used to those quick, quick, quick scrolling and those quick videos that are that I can't stand because they're so addictive.

It's just it's stuff, I mean.

Right.

And so it's much harder for them after that point to pay attention to thing for a normal amount of attention span that we would all know.

That doesn't mean they have ADHD.

It just means now something they don't like, things that aren't quick anymore.

Okay.

So they do that.

Kids with ADHD sometimes you'll ask the parents, okay, what are they?

What what are they like at home or what do they do that they can sustain attention to almost 100%?

The parent will be, well, they do fine if they're playing a video game or a video game.

Right?

Because the video game is active for them.

So they're they're watching it go by and it's active, active, active.

Whereas if you tell them sit and read a book, sit and play with blocks sitting outside, it's not active enough for them to help them calm down.

And so one of the thing you want to look at is, I talk to the parents a lot about, again, what what is your child like?

Things about calming them down.

So what can we do to calm them down?

That's not a screen.

So talking about that, you know, what can we do for that?

What can we do at night?

Because I have multiple level two teenagers who will come in and the parents will complain.

They're so tired in the morning I can't wake them up.

I'll ask the kids and they'll.

I'll say, what time do you go to sleep at night?

Two in the morning, three in the morning.

Why?

Because I'm on my phone and I turn to the parents.

They say, why does that child still have their phone at night?

It's you as the parent.

They're going to be addicted to it.

It's a very high rate.

They'll fight and and it's hard for even us.

When the phone goes off and it buzzes.

You want to look at it right away, right?

That's even all of this will do it.

Yeah.

Yeah, sure.

So the kids who have problems with that anyway and don't have a frontal lobe, that's fully developed, you know, will sit there and they'll hear the buzz and they'll have to answer it and they'll have to do it, and they'll have to do it again.

And I'm telling my own kids, it's not an emergency.

Mine might be an emergency because we're doctors and somebody might be calling.

Right.

Yours is never going to be an emergency at your age.

It's not, you know, you're sitting there, so give it a couple seconds, wait, and then go look at it.

Calm yourself down first as opposed to reactively answering.

And parents take the phone away before they go to sleep.

Bye.

And my family?

It was by 8 or 9 you lose your phone.

It was all digital, you know, and that's it.

And then the next day, if you do well, you get it back.

Yeah, kind of thing.

So I'm going to try to again we have varied ages in this room, but I'm trying to think too of just watching a newscast.

If you're watching today, today we're going to see you'll see my face.

You'll see.

But you're not going to see the ticker tape on top.

Who's winning the World Cup.

What's that score right now.

And then hold on.

You've got the the stock market and it's got all this.

And then there's this logo over here.

And then there's a temperature over here.

And then you've got this advertisement over here and something new comes along.

Oh wait a minute.

We're going to introduce somebody else.

And we're going to have two heads talking when we have to introduce three other heads talking.

And I often look at that as what is my attention going to.

You know, again I see squirrels a lot for me currently I'm a World Cup fanatic.

So the only thing I'm watching is the scores and who's playing and who's playing tomorrow.

Where are they playing?

And so that that's me.

That's my scroll.

And you guys can see 5 or 6 other things on that screen.

But we're all watching the same screen at the same time, in the same place, getting different information.

And I think about this often in classrooms now when we're talking about bringing that down to pediatrics, to schools to teach you, how has that affected?

And I was saying earlier, just cognitively, how is that affected what is coming in and what is, by perspective, being processed?

Because what's being processed is only stuff that you have perspective to and I want that, but I don't want this.

Do you.

Do you see that being.

And I'm going to put it in this format.

Do you see that being addressed now to where in the future Since we have this knowledge now, it takes a generation sometimes for us to get our butts kicked and figure out what's going on.

Do you see that in the future being something that we can cognitive of, we say, okay, let's bring it down.

Let's just have 1 or 2 subjects at a time and let's learn certain things without having all these things just crashing into us.

Yet I, I don't, I don't you don't know, I think I think we're gone.

I'm trying to be positive.

I'm trying to be honest.

Yeah, yeah.

So the way that I do my life.

Yeah, even the I think I have a part of the ADHD, but I know how to organize my cell and that's what I'm trying to do with the other kids That's the key word organization.

I love that you said this.

Okay.

So let's say my wife, we love this situation because before I leave home, everything is clean and organized.

Why?

I didn't do that?

Because I wanted to start organize myself now besides that I need to have somebody in my office to have everything organized for me.

When I go there, everything is there, right?

Because if not, it's going to be terrible the whole day, I get it, I do, I think the same way.

If my space isn't clean, I have a hard time getting on track.

When I say clean and ordered, put in stacks, etc.

so I function better.

So that's the reason I tell the parents to do this.

Close what I do and you will see the difference in the kid Something that I learned.

And I say I going to do and study about this when you have a baby and you don't to hear that you have a baby.

So when you start doing that, taking care of those baby.

So you should be on a schedule for all the feeding, right?

Two three hours constantly.

What time you going to give it a shower What what time they go to sleep What're you doing there?

You start conditioning baby's brain organizing.

So when I see those babies I see when they become three, four years and the mothers say it's time to sleep.

7 or 8:00, they go to sleep because they're trained, like you said.

Exactly.

Yeah, yeah.

So we need to train the parents.

We need to train the young mothers to do that.

And but the other ones do know feeding any time, the shower at any time, sleeping at nine and ten.

So what do you think is going to be with that brain.

So there is hope for us as what we're saying.

That's correct.

It's just about conditioning ourselves.

Exactly.

To create conditioning in our children.

That's how I think.

Okay.

I like that.

So where do like a ten minute mark.

And this is usually where I kind of stop questions from here.

And I want to just throw it to you three, knowing this topic and driving over here this afternoon or while you're having your coffee at 3:00 because it's part of your routine.

Did you have a piece of cake with that?

Because I do.

What is it that you wanted to have come across this evening while you're here?

And I'm just going to open that up to anyone who wants to take that first.

Well, I think I thought some of the parents can watch this program because this program has a lot of messages.

A one of the themes that I would like for them to do is to be sure that a child has a good medical care.

When I say that good medical care, if not when they are sick, is also the guidance that they going to receive when they come into our practice.

So we hope that they listen and they go and continue it, and they do it to take the kids in the time they're supposed to be saved by the pediatrician.

So and for those that don't know, how often is that?

Well, let's say this baby, usually we see the baby three days after birth or four days and then nine months and then and two months for this shot, for month for this shot and guidance, six months for the shot and guidance.

This is Doctor Nikki, two, four and six months, 912.

I've asked what is that?

Yes, those are the babies.

And, and, and we detect a lot of issues there and regarding cognitive it regarding behavior.

So we tell the parents that the earlier that we detect issues, the better the prognosis.

To know.

Very true.

I'll say I definitely agree with that.

And I think also just speaking of screens and the internet and all that, we also see a lot of parents who walk again, will skip a lot of time to come see us because they think by asking a question to Google, they get all the right answers.

Oh, doctor Google.

Yeah.

You know, sometimes they do, sometimes they don't.

But and I told I tell parents also I said it's not a bad thing.

Just like we do is not a bad thing to look something up online.

But it's sort of like what is it.

Trust but confirm.

So and I and I admire my patients who do that, who will look something up and then call us and say, it looks at me on Google and this is what it told me about sleep training or about nutrition in my child, or about this and that.

But I want to hear what your take is on it, and that is really what they should be doing with us as as pediatricians, as they can look up elsewhere, they can hear it from their internet, or they can see it on their Instagram, but confirm it with us and at least just see what our take is on that, on all sorts of things.

I mean, where we are primed to talk about things at these visits, like nutrition and screen time and development and schooling and sleep and, you know, elimination and all kinds of things like that.

And if they only come to us when they're sick, for one thing, they don't get all that other information that maybe will save them from having to come when the child is sick.

So that's one thing.

The second thing, just about screens in general, I really like like if people want to know about it, I really encourage them from when they're little to not just accept that they need to give their child a screen.

That there is such a thing called media literacy, both for parents and for kids, and to learn about what times are okay, what content is okay, when you should get help for someone who's on the screen too much, whether it's an older child or a younger child, and how it really can affect their behavior later on.

So we get a lot of kids who come in later in the like.

They're they're having behavioral issues or they're having school issues, and some of it might be environmental and some of it might be like I said, they're not getting sleep because they're not getting their phone, but the parents don't even see that as a part of the puzzle.

They just say, oh, my kid is not doing well in school.

They must have ADHD in the midst of this.

And then you work them back through everything and you find out that really it's a sleep issue.

It's not an ADHD issue, it's not an academic issue.

And the sleep issue is because of the screen and the screens.

It becomes so once you work that.

So that's what we do too.

So I just encourage all parents to not just look at it blindly either, like say okay, throughout their life, your child is going to be exposed to a screen.

How do we want to do that?

What do we want them to look at?

And how can we sort of teach them through the years to use it like that?

Like I said, it's not going away, but realistic about the training.

I'm putting all of you on the spot, and I didn't ask you ahead of time and I should have.

Do you have a website or a phone number or something we can throw out for the, you know, for people that so if I would like to have some guidelines but a verified would you say trust that was missing for a trust fund.

Verify just to confirm whenever we go.

Yeah.

So the I really like I mean the AAP is a great place to start.

Okay.

They have a website for all sorts of things called HealthyChildren.org Okay.

And if you look up media or screen or something like that, they have a lot of -- They actually have a family media literacy guidebook that you can go on and put how old your kids are, what kind of screens you have, and it'll help you come up with a schedule for, how to how to use it at home.

And they also have, what they call the five C's.

So that's what we were talking about before that.

The who's your child?

What do they do to calm themselves?

Is it crowding out other things?

Like what kind of connections?

Okay.

Do they have an I forget the last one anyway.

So again you can look it up.

So again you of AP or healthy children family media literacy, common sense media that has come into some of our, this is companies look at these games and that are more than.

And did you say games that were on there.

Okay.

Nice.

Doctor Lynch, we haven't heard from you on this and yet kind of along with Doctor Day's, I'm saying I mean, I would say and to parents even or if you already have older kids that maybe you feel like they are on the screens a lot, or what do I do now?

I mean, it can be overwhelming, but I think, I mean, we've kind of said this a lot, but I think the most underrated thing is sleep.

I mean, I see that all the time too.

That and parents don't think it's a big deal.

But really, if your child is exhausted, I mean, they're not going to do well in school.

They're probably more irritable.

You're going to see behavior problems, all of this.

So if you know you're going to some small changes can really make, you know, a big difference, even if it feels overwhelming, like trying to get them that sleep.

Throw some exercise in there.

And I think, would you suggest taking the phones?

And I was not kidding.

So far in the bedroom and also because they're going to see what you're doing.

Yes.

If you're out there, they're much more likely to do it if they see you modeling it rather than you just telling them to do it.

So, you know, but some small changes can make, you know, can make a big difference.

And I would say definitely sleep and like you said, and some exercise and just, you know, I'm going to throw a sleep out there in our families sleep is like a bad word.

I, I am a horrible sleeper and I have been all my life, even before screens were even a thing.

My son very much unfortunately, is that guy as well.

How does one calm themselves down enough without screens?

Say the screens are gone.

No medications, but children.

I don't know if that is something that is innate.

Is it learned?

Like how do you get people to sleep if they're not in natural sleepers like they were nappers either?

And I'm sure there are some parents that come to you like my kids.

Just won't.

Now what are what are some quick things to throw out there?

Because we've got a little bit of time.

Well, again, with the screens if possible, no screens for an hour before bedtime.

So they do have some time to wind down.

When, if you can, a routine where the same time every day and even, you know, it's hard but to get close close to that on the weekends or not, you know, because if they're on the weekends, if they're staying up till 2 or 3, that's going to throw the whole the whole routine off.

So try to I mean, some things can be calming, you know, like routines.

I really like the idea that men's bathroom, shower, showers and I like the idea too.

And I'm just trying to think of how I was training my my little ones is organizing their day, but having them be part of that in their own bedroom, like, what am I going to wear tomorrow?

Would I do my change completely the next morning?

Because you know, you want to do socks last night, tomorrow you want grid socks.

But that whole idea of just putting together a routine make makeup that I away from the screen, making that part of it.

I really enjoy that.

That's good.

All right.

If you just tuned into this and are interested on, just cognitive behavior, on how to help change behavior and or adapt to the screen time of all times, that's what this show is about.

And if you want to watch this program again or any other program, the El Paso County Medical Society put together with the El Paso physician, you can do that in three different places.

The, program that you're watching right now is on PBS El Paso.

You can go to PBS El paso.org, and you can also go to the El Paso County Medical Society website.

And that is El Paso County Medical Society, the acronym EPCMS that's a .com.

And then if you are familiar with YouTube, which I think everybody is, you can go to youtube.com.

And the way that you search this is in the first two websites the El Paso Physician will pop up You won't have to look for it for YouTube, you have to write in the El Paso Physician And usually the last show that we're doing like this will be the last one that you will see in July that will pop up.

And if you're looking for a program that we did on knee surgery a couple of months back or on, pediatric trauma, head injuries, we did that a couple of months back, but you can just look those up.

So any program that is done by the El Paso Physician and by the El Paso County Medical Society, you can find in those three places again, PBSElpaso.org, EPCMS.com and then youtube.com.

We very much appreciate you being here.

Again, this is called Modern Childhood and the Developing Brain.

That's a title of this program, A Pediatric Perspective.

And this is the El Paso County Medical Society's El Paso physician.

I'm Kathrin Berg.

Good night.