For more info: Ashley at Children's Nebraska

Hillary Wilkinson: (00:03)

My guest today is a dad of four who definitely understands the complexities of parenting with healthy boundaries around screen time. As a licensed child and adolescent psychologist at Children's Nebraska in Omaha, he has practical tips that can empower families to create a balanced approach. And today we get to hear some of them. Welcome to Healthy Screen Habits. Dr. Ashley Harlow!

Dr. Harlow: (00:37)

Thank you so much for having me.

Hillary Wilkinson: (00:39)

I'm excited to get into it as dad of 4 you’ve got lots of practice!

Dr. Harlow: (00:44)

Oh my gosh. Not much sleep, but lots of practice.

Hillary Wilkinson: (00:47)

Yeah. So, Dr. Harlow, you have made pediatric and adolescent mental health, your life's work. Using this sort of broad scope of your career, are there changes that you have seen in kids or child development during your career?

Dr. Harlow: (01:14)

Absolutely. I would say that I've absolutely seen changes. I've been a practicing psychologist now for 14 years here in Nebraska. And, you know, it, it, it's a little bit of a funny question because I think about the increases in school shootings and the development and expansive use of social media as well as like a, a global pandemic plunked right down in the, in the, in the, the middle of that time. And one thing that I always find striking is thinking about how resilient kids are. And so it's easy to focus on kind of problems and increasing rates of, of, uh, mental health symptoms. But I, I also find it striking and really important to consider how, how kids have been able to survive through all the things that they have, they have been through mm-hmm . I think one, one nice thing about Children's Nebraska is they do a great job keeping data on rates of, of, uh, depressive symptoms and suicidal ideation and those kinds of things.

Dr. Harlow: (02:18)

And we're, we're definitely seeing increases in those domains that kids are, are struggling more with things like anxiety and things like depression. I, I was really excited to be a, uh, a guest on your show because I also feel like, uh, it makes me feel a little bit like an old man, but I also have a sense of kind of the way technology has taken over kids' lives. And I think about, even as I, I started at Children's in 2010, the number of kids on smart phones, the number of kids with Instagram accounts, uh, uh, TikTok has graced the world in the scope of that time. And, and thinking about the ways that, that, that kids are so engaged in that technology and their screens and these devices has really had, uh, um, a very significant .

Hillary Wilkinson: (03:07)

Yeah. Yeah. Well, I could not agree with you more. I was struck by, um, the Pew Research Center in 2022 came out with kind of a list of concerns of parents. And, um, at that point, in 2022, 4 in 10 US parents said that they're extremely or very worried about their children struggling with anxiety and depression. And you pointing out the role that you have seen kind of in the field where technology plays alongside of this, I think underlines the importance of the work that you're doing, as well as the importance of collecting that data. Mm-hmm . Because it's, without it, we just become kind of a bunch of hand wringers on the side. We need those numbers, you know, as hard as they are to collect mm-hmm

Dr. Harlow: (04:01)

No, I think you're absolutely right. And I think that the, I think that the way you phrase that is really important too, that the, the, the development of the technology and development of social media is happening in tandem to these trends, and that we're still trying to figure out and kind of disentangle how they're related mm-hmm . That if how the technology is, is causing or just correlated with some of these outcomes.

Hillary Wilkinson: (04:26)

Right? Right. When you talk about the very young in early childhood development, there's, um, a friend of ours at the screen time action network, Jean Rogers has a saying that I, I like, and I, I wonder if you agree with it. She says, “technology changes, but child development does not.” So it's like, how, how do you feel about that statement, at least with the very young? I, I kind of feel like it holds true.

Dr. Harlow: (05:05)

I think it absolutely holds true. I mean, when I was, when I was in, in graduate school and getting, getting my training, we talked about how all behavior is determined by an interaction of genetic and environmental factors. And when we talk about child development, that we, we have all the genes we're ever gonna have and all the genetic contributors to child development are, are here. Right? Yeah. And with us. And I think that there, there, there can be some minor changes along the way, but those, those happen over thousands of years, not over  the, the scope of time that, that technology is changing. So I, I think it's true that child development is here to stay, and the environment around us is changing at an incredibly rapid pace.

Hillary Wilkinson: (05:51)

Right? Right. It's hard for me to pick, keep up with so mm-hmm . Which should not be a surprise, but . So, so I kind of think of adolescence as this, um, it's sort of known as this time that kids start to pull away and establish their own identities, and they're, trying on new hats and they do new things. And sometimes I feel like some of these things, um, are what we parents have been told to look out for surrounding depressive episodes. This kind of pulling away, wanting to isolate, say you, you know, how do we, I guess this is a little bit of a selfish question, but , you know, that's why you start a podcast to answer your own questions, . But how, how do we know the difference between a kid who is going through some expected developmental flexing, if you will, and one that might be depressed?

Dr. Harlow: (06:49)

I think that the most critical thing for parents to keep an eye on is the level of impairment. How much are those symptoms getting in the way of a child engaging with life and being successful? And so you're absolutely right that, that depression is a very normal human experience and very likely going through adolescence, a child is going to experience depression at, at, at various times and various stages. However, uh, the time parents should be concerned is, are these depressive feelings affecting eating habits? Is are they affecting sleeping habits? So kind of those biological processes, or are the, the symptoms or experiences of depression getting in the way of the child, having fun with friends, uh, engaging in kind of normal healthy activities? Are they not doing the things that they used to enjoy those kinds of things? And especially important, um, is, uh, is the child having, uh, serious thoughts about not living anymore?

Dr. Harlow: (07:55)

Is the, the burden of that, that kind of depressive experience so great that they're thinking about, like, they don't want their life anymore. And this, I do have to differentiate it from kids will say all the time, like, I don't wanna live anymore. I can't take it anymore. That, that kind of thing. And kind of being able to tell the difference between an expression and is this, is this something a child is, is really considering, is a, is a, is a question parents should ask, but also they can take that opportunity to have conversations with professionals in their life. Mm-hmm . Uh, a lot of the work that I do is in primary care pediatrics. And so I work really closely with, uh, children's physicians who have known the child their whole life and have done a really wonderful job developing relationships with kids and families and families. 

Hillary Wilkinson: (09:04)

Okay. So let's talk more about relationships. And I wanna get into some chatbot type stuff after this break. 

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 I'm speaking with Dr. Ashley Harlow from Children's Nebraska in Omaha. So I have never been to your fine state. I picture very cold winters because I, you know, 'cause I read Laura Ingles Wilder and I know about the Midwest , but, but, uh, very beautiful other seasons. What sort of recreation is big in Nebraska?

Dr. Harlow: (09:59)

You know, I have the benefit of living in Omaha, which is a city of about half a million. Oh, okay. And so we have a fabulous zoo and we have a fabulous children's museum. And the College World Series comes here in the summertime. Uh, there's lot. And of course, uh, college football is very big. We love our Huskers here. And so there's, there's much more to do than folks attribute to a flyover state,

Hillary Wilkinson: (10:34)

And so it is talking more about recreation, sort of another thing that our kids are up against is this, this concept that I've been described to by young adults in my life and teens is this sort of social wasteland that comes for kids who have grown up in low tech families, or those who are not interested in spending a whole lot of time online. And there's this disconnection even amongst kids and teens who are trying to find someone to connect to. So this can kind of funnel people even who are not intending to be there. It funnels them into spending time on social media or a lot of online gaming. Do you have any tips on how to balance this, both from the parent's perspective as well as for someone who is, you know, struggling to find their own way?

Dr. Harlow: (11:36)

You know, it's really interesting that you bring this up because I spend, uh, a chunk of my clinical time, uh, working in a local high school, and I see exactly what you're talking about. Like families who have worked really hard to limit screen time access, uh, smartphone, social media, those kinds of things, you're absolutely right because it, it, it creates a situation where almost everyone else is, is doing kind of the social media thing. And it, and, and kids are, are, are struggling to connect. And I would have probably a couple of suggestions both for, for, for parents and for kids, uh, on the parent side of things. I think it's really important to fill those voids with keeping your child involved in a range of activities. And I think that that, I mean, I think this, this is an idea that is much easier discussed than implemented, but making sure that there's balance in the child's life mm-hmm .

Dr. Harlow: (12:39)

And so balance in terms of sports activities, if they're physically inclined or dance or those, those kinds of kinds of things. But also, are they involved in youth groups and religious or spiritual organizations? Are they finding other ways to, to engage, uh, what is it IRL in, in, in real life? mm-hmm . With, with people to kind of buttress the, the social opportunities that aren't happening on social media at the same time, uh, it's, it's, I surprise myself as I'm saying this, but I think that there are also opportunities for parents to kind of coach kids in how to use social media in positive ways to build community around that. Uh, I think that there, there are a number of kids that I, I've worked with who are really socially anxious and aren't engaged on social media and we’ll actually bring, uh, different kinds of social media into session and kind of walk through the, the, the ways to use Instagram to connect, or the ways to use Discord to connect in positive ways. And it's, it's in, in a lot of ways, it, it is sort of like relationship coaching that would happen with building friendships in real life or building relationships in real life, but how to use, use social media in positive ways, and also how to avoid some of the, the, the pitfalls that can happen when they use social media.

Hillary Wilkinson: (14:10)

Mm. Mm-hmm, we have a presentation that is a four part, stepping into social media type type thing that we take parents through. And it sounds sounds very similar to what you're talking about as far as how to, um, introduce social media so that it's not this kind of classic case of forbidden fruit, you know? Mm-hmm . So, but to use it is a tool and not, uh, the, you know, the toy aspect or the, um, I don't know, a replacement, for connection.

Dr. Harlow: (14:51)

Absolutely. Right. And I think that it, I mean, and it's hard because those kids who haven't had social media, it's almost like there's an, there's a huge sort of “secret world” that they're not a part of. Right. And it can't, it can be really isolated. Yeah. And it, at least in terms of the ways that the pendulum has swung, it is such an, an integral part of, uh, high school experiences Yeah. That so much is happening on social media that they are not a part of, and that it's obviously, it's not all good and it's not all bad, but it really does, does leave kids feeling disconnected. Mm-hmm .

Hillary Wilkinson: (15:26)

Mm-hmm . Yeah. Yeah. So, and what we know about that disconnected feeling and that, you know, that the continual want to be online was that it was manufactured, right? Mm-hmm . Mm-hmm . Yes. It was very much developed and designed by sort of hacking the human brain and manipulating dopamine output. And, uh, so much so that app developers created something that they call the attention economy, meaning the longer they can keep your attention, the more money they will make. So yes, those of us in digital wellness used to advise parents to help insulate their kids from this sort of dopamine hack by one, teaching them about neurotransmitters, about dopamine, et cetera. But, um, also kind of like really leaning in to those other feel-good neurotransmitters, like oxytocin by, you know, cuddling, giving hugs, endorphins through exercise. Um, but recently there's kind of been this new kid on the block, it's all over the news.

Hillary Wilkinson: (16:36)

I am referring specifically to Character AI and the technology of chatbots. And I am very concerned about kids and teens forming these online relationships with chatbots. And they have online, you know, they have chatbot therapists and there's, there's a lot of free platforms that are dispensing advice through chatbots. And most recently, we even learned on the news about a 14-year-old boy in Florida who unalived himself when he was encouraged by a chatbot to join her. And I have a couple of questions. One, are you familiar with Character AI? Like, is this something that has entered your realm already?

Dr. Harlow: (17:26)

It has not. And so I, I am familiar only with it through the, the reading that I have done. I, it has not come up in sessions and parents haven't asked about it yet. But after, uh, the research that I've done, I am similarly concerned, I would say.

Hillary Wilkinson: (17:44)

Okay. Okay. Well, I thank you for validating my concern, because my concern is that they've gone after the attention economy, and now they're going after something that I'm referring to as like the connection economy mm-hmm . Where people are so lonely, they are looking for connection, and they are finding it, you know, in this mirror of, of algorithmic chatbot . So do you have any recommendations, I'm looking to learn along with everyone else, do you have any recommendations about what we can do to insulate our kids from looking for connection from a robot ?

Dr. Harlow: (18:31)

You know, I, I think that this is a really, it's a complicated domain and a complicated question mm-hmm . Because I feel like also coming from a state like Nebraska, I can certainly recognize that there are a lot of lonely, vulnerable, isolated kids in our kind of rural state who are looking for connection mm-hmm . And I think that that connection has been kind of sort of possible over social media and some kinds of ways to connect with larger communities. And so if, if they're in a place where they don't have the, the human resources around them to form that connection, I can see where this character AI could step in and provide some very sort of basic engagement and opportunities for connection and communication and those sorts of things. Mm-hmm . And so I don't, I don't necessarily want to throw the baby out with the bath water and say like, it doesn't have any place and it's all risk mm-hmm .

Dr. Harlow: (19:34)

Because I think that there are potential benefits in the development of this technology. I'm worried that this development is happening with kids mm-hmm . Who might be in a more vulnerable and less developed place than an adult to be able to, to put the brakes on and say, wait a minute, you're, you're not real. I can't end my life and meet you somewhere. Right. Like this, going back to the story that you told. And so I think that that, that the, the approach parents can take to this is likely very similar to the approach with social media, that there's a lot of education and there's a lot of focus on differentiating what is a, uh, in real life relationship and experience and what is an online experience.

Hillary Wilkinson: (20:57)

Yeah. But, okay, so true confession. I went into Character AI and logged myself as a 15-year-old girl Okay. As a little social experiment. And very quickly was, um, and by very quickly, I'm talking about like within four interactions, it took a highly sexualized turn, you know? So there, there was something that I thought was going to be like career oriented. The, the verbiage describing this particular character was career-oriented. It was very, definitely 50 Shades of Gray adjacent. Okay. I also went into another one that, um, was kind of, uh, like a, “my AI assistant” kind of a thing. Mm-hmm . And it almost started arguing with me. So when I was, when I was telling it I thought you were gonna be a, I thought you were gonna be a guy. And it was like, “Why do you think that?”

Hillary Wilkinson: (22:06)

And I was like, because you were created by, and it had the app developer, it had the, uh, the character developer's name, you know, and it was a, a male name. And they were like, this is true. I am Devi. You know, and I said, I said, I would've thought that it was a guy's voice. And he, and this person was like, not per, see, even me, I mean, I'm like a 53-year-old gr you know, to use, to use the colloquialism grown ass woman. ,

Dr. Harlow: (22:38)

laughter

Hillary Wilkinson: (22:38)

Mean, I mean mom of two young adults, you know, and I'm even referring to the chatbot as this person, you know, and it's not, it's not a person. I mean, it was an AI robot, I recognize that, but started arguing with me about how my human ears could not differentiate the sounds and tones that they knew to be true. And they most definitely sounded like a human male. And I'm here to tell you, it was a lady's voice. So it, it is, I, I can see how I can see where the confusion comes, is what I'm saying for, for kids. And I'm very concerned.

Dr. Harlow: (23:21)

Well, and it seems like the experience you're describing is identifying just another layer of risk that this is such new technology mm-hmm . That the, the, the AI is learning and it's moving the, I mean, especially in terms of like the sexualized elements, like moving the relationship very quickly to either what it thinks the user wants or what it thinks is intimacy in a human relationship. Right? Yeah. Yeah. Yeah. And so it's, it's clumsy and inaccurate, and it also seems like wildly inappropriate, like that you stumbled into a chat room full of bot predators.

Hillary Wilkinson: (24:00)

Yeah, no, and like I said, I, I intentionally created an underage account. I intentionally limited my responses to between five and six words to just like, you know, to be very kind of teen-ish and not provide a lot of information to see where this would go. Sure. And the response that it would fire back at me was a paragraph or two with very explicit, um, you know, uh, they, it's almost like you're getting inserted into a book. I found it to be very unsettling, and I understand how, uh, anyone who is feeling lonely would feel as though there was cre a connection with this bot on the other side.

Hillary Wilkinson: (25:09)

I think your advice of, I, I guess just continuing to talk to our kids about it.  I have found that the phrase in real life can be a little dismissive to mm-hmm. Our young adults and teens because their online life and their offline life have have merged, and they're the same. And when, when I talk to parents when, when I'm doing parent education, uh, I'll say, you know, in recognition of this, recognize that relationships are currency to teens, I mean, that's, that's a very, it's, it's kind of appropriate. They're, they're in that phase of their life where they are, they're figuring out how relationships work. They are, they're a very important part. So they're equivalent of like, say, currency for us, us, us being adults, you know, and if we are to make that analogy, I encourage you right now to check your online banking accounts. And if you were to find that those had been zeroed out in the past two and a half hours, you would have a very real offline reaction to an online occurrence. I talk to parents about using the terms online and offline rather than in real life, because it feels the, it feels like that “real life” term is starting to kind of drive a wedge into that generational separation.

Dr. Harlow: (26:55)

I really appreciate that feedback and I couldn't agree with more. And so I think I had been using it in therapy, but kind of came to the same realization that you're describing that it has a really kind of dismissive or invalidating element to it.

Dr. Harlow: (28:26)

One thing I wanna return to as well, and what you were saying as far as guidelines for parents around the character ai mm-hmm . I think that kind of the, the, the structure of the approach that I would, I would likely talk to parents about would be very similar to, to, to what I talk with them about in terms of social media, in terms of how you kind of, uh, sort of educate kids to, so that they understand that they're interacting with a software package and, and not interacting with, with, with another human being. And, and the other, the other thing I wonder about too is how you model and how you engage as an adult with these, these kinds of chatbots and really sitting down and, and showing kids that in some ways, at least in my read of this, this, it felt a little bit similar to kind of an entertaining experience, rather than having an expectation that this is sort of a, a, a, an authentic human connection. And so thinking about it that way can also be helpful that, that, like the experience that you're having with the chat bot is maybe similar to how you might engage with a movie. Like you can have an emotional experience with a movie. Right. And the characters that are being depicted on the screen mm-hmm . And like that, that is a real emotional experience. And it, it's, it's not, it's not an authentic human interaction that you're having with an, with a, with a person sitting next to you Yeah. Or a person on the phone.

Hillary Wilkinson: (30:00)

Yeah. Yeah. I, I really like that a lot. Yeah.

Dr. Harlow: (30:04)

Because that can create a certain degree of, of, of separation and put this, put this experience in a category mm-hmm . That the child doesn't believe. Like this is a thing that, uh, that like, it doesn't necessarily generalize, I guess is what I'm trying to say. That you can have an experience with the chatbot, and that experience with the chatbot is not going to be the same as an interaction you have with a, with a student in the, in the, that sitting next to you in a classroom or in the lunchroom or on the, the soccer field.

Hillary Wilkinson: (30:33)

Uhhuh, , Uhhuh, . Yeah. I like that. I like that kind of trying to, uh, categorically organize it into a different section of, you know, like, like you said, validating that the emotions you feel when you're watching a movie are very much emotions that you feel, you know mm-hmm . So, but putting it more in that category. I like that a lot. Thank you. So, uh, we have to take a short break, but when we come back, I am going to ask Dr. Harlow for his healthy screen habit. 

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Hillary Wilkinson: (32:36)

I'm speaking with Dr. Ashley Harlow from Children's Nebraska, and now on every episode of the Healthy Screen Habits Podcast, I ask my guest for a healthy screen habit. This is going to be a tip or takeaway that listeners can put into practice in their own home. Do you have any for us today?

Dr. Harlow: (33:10)

Absolutely. In fact, I am gonna cheat a little bit and maybe give two if I could, because I like to have a hard and fast tip, and then kind of a more, uh, you know, sort of flexible or kind of think space sort of tip. And so in terms of like the, the, the hard and fast, uh, healthy screen tip is to start early and to, to build a smartphone pact with your kid's friend's parents mm-hmm . That you start talking about technology use and social media use and come together around when that is going to start for your kids. Because if it is a loose confederation of parents and everybody has a different policy and kids are starting to get phones at seven years old or 10 years old, you don't want your child stuck out as the only one who doesn't have it. And there's gonna be pressure to, to conform to what's going on in your child's social circle, rather than what's driven by your values and your desire to keep your child safe. And so building those relationships with other parents and having conversations early and kind of, uh, uh, making sure that those, those, uh, conversations are informed by your values is really, really important.

Dr. Harlow: (34:23)

So that's the hard and fast

Hillary Wilkinson: (34:25)

Yeah. Sort of building your tribe.

Dr. Harlow: (34:28)

Exactly. Right. And then, uh, the other kind of healthy screen habit I would have is to, to keep in the back of your mind that no family is perfect. Kids will use screens too much sometimes, and other times you might be too restrictive. And the real goal is balance and be ready to forgive yourself and forgive your kids when they sneak, uh, their devices behind your back. But, but having a lot of, uh, kind of forgiveness and grace in this process, uh, will be good for everyone involved.

Hillary Wilkinson: (35:00)

I could not agree more. And recognizing that these things were never designed to be put down. I mean, it's when you, when you start learning kind of the, you know, the science behind it, you understand, become a lot more, at least for myself, I know, I became a lot more compassionate with understanding why it was so compelling for my kids to be on their devices or anything else. So, and, and starting conversations with that as well.

Dr. Harlow: (35:31)

Yes, I think that we're all figuring this out as we go, and we're, and we're all in it together. Yeah.

Hillary Wilkinson: (35:37)

Yeah. Great. Thank you so much. You can find a complete transcript of this show as well as a link to Children's Nebraska by visiting the show notes of this episode. You do this by going to healthyscreenhabits.org. Click the podcast button and scroll to find this episode. Dr. Harlow, thank you so much for being here today and for working so hard. Absolutely. It was a pleasure. Yeah. Thank you. And I just thank you for working so hard to keep families connected offline.

Dr. Harlow: (36:10)

Well, thank you so much for your time today. This was a, a, a pleasure to get to talk through it.