 Good evening, everybody. I want to welcome you this evening to the latest installment of our let's talk program. My name is Dan. I am the director of development and programming for the bed for playhouse. I want to welcome you all to tonight's program. For those of you who may still need the refresher. After a year plus of quarantining. In the webinar format that we're in, you can ask a question of our panelists tonight. By using the Q and a feature, which should be at the bottom of your screen. If you are on your laptop or a desktop computer. And if you're using a. Hand held device and iPad or your phone, I believe it's at the top of the screen. And so please feel free at any point during the presentation to post a question. And we will try to get to as many of them as we can before the end of the program tonight. Please try to refrain from using the chat feature. It just gets a little bit confusing in terms of us following where everybody's posting questions. So we ask that you kindly use the q amp a feature. If you are enjoy these types of talks, please check out our website, which is bedforplayhouse.org we have a lot of great programming, including this type of programming. Coming up, you can get previews for some of the streaming films that we do some of the other conversational programs that we have. And we are hoping that we will be open again. You know, theaters in New York have been given the okay to reopen. And we are looking to be reopened by May. We'll be ready to be welcoming everybody back with all the proper safety protocols necessary in place. So, without any further ado, I would like to introduce our presenters for the evening. Please welcome. Dr. Ethan Rothstein and Dr. Daniel glass. Thank you gentlemen. Nice to see you. Thank you. Hi Dan, thanks so much for the introduction. Thanks for everyone for joining us this evening. It's nice that we don't have to leave our homes in this rainy weather to all talk about this important topic. I'm going to share my screen quickly here. And what you'll see here is a PowerPoint that will help guide our conversation today. To be honest, Dan and I have given a couple iterations of this presentation. And we first developed this even before COVID, obviously a lot has changed since then. But I think that's a whole nother layer of this conversation and our talk today that really can't be ignored. You know, this slide is really to show us how rapidly things are changing. You know, yes, it's sort of joke that is today's ABCs. What I love is a lot of this stuff is already outdated on here, right? Instant messengers are on there. That's a shout out to the, to some older apps and things like that. You'll notice that technology video games, it's an ever developing process and it's hard to keep up with, especially as you have children talking to other kids and finding out new things and those things just evolve kind of without even our knowledge. So, admittedly, this was, these numbers are pre COVID numbers here, but some just general guidelines just to put some benchmarks in the ground here in terms of what the World Health Organization recommends in terms of screen time. So, you know, under two years old, really not much two to four years old or talking an hour or less. Okay, now five to 17 that's a big range. Now, screen time is tough because it's phone time. It's video games and consoles. It could be TV so that's that's a lot of things are in that now. You can see some averages on the left side where younger kids and again this was pre COVID or spending almost five hours on a screen. So, if you think about that as the baseline and now we've added on top that potentially a zoom meeting like this, other zoom formats not to mention remote school, even if it's hybrid, you know, seven hours of school plus the typical seven hours of screen time. That's most waking hours on a screen and that's a little scary. But so one thing, you know, we're going to cover a lot today. And, but one thing I want you to hear is that it's less about the number of hours on the screen and more about what it's taking away from. So what are we what are we missing out on when we're in front of the screen. I think that's a much better way to frame it then all screens are bad screens should not happen so are we missing social cues what things are not available to us over a screen. Whether it's non verbal behavior whether it's inflection in a text. We've gotten better about those things we can add emojis to our text right to just say hi I was really joking that was sarcastic right, but that nuances and always there. So academically, what are what are whether it's us or our children being pulled away from in terms of their academics. Are they spending time playing video games and on screens rather than doing homework, rather than studying for tests, or now with remote schooling, even rather than listening to instruction to click click click kind of behind the behind the scenes as I call it the tab behind the screen. Lots of kids have figured out ways to do that and are in our quick to do it. And it's, of course, the huge distraction. One question I get asked a lot. And this is a little bit of a philosophical question but there's also a real biological question here and physiological question is, is video gaming and addiction. There's a lot of ways if you look at the things that define an addiction like withdrawal tolerance, what it's like to go off of the game time spent on the game searching for games money spent on the game maybe breaking rules to play the game. A lot of those things if you took out game and put drug in there that would start to look a lot like an addiction so certainly you can see the parallels forming there. One of the linking factors there is our dopamine system, which is one of the theories for why video games are so rewarding. They are invented and they are designed to be rewarded at just the right time. This little dopamine squirt, as they call it right so this, it's this pleasure chemical in the brain that would is a lot is the same chemical that would be for some drugs it was the same chemical that would be for sugar. And, in essence, in this way the video games are hijacking our brains chemical system, and our brains are getting used to this high level of dopamine. If we think about in the wild back in the, you know, long ago, our brains were not being flooded with dopamine it was a rare occurrence. Now it's, we, we, there's an expectation that's formed when you're playing video games that I should be getting this dopamine, this pleasure infusion, every few minutes. And that's what it starts to pull for so now your baseline is an oh something fun exciting and thrilling and pleasurable happens one today or every couple days. It's now I want it every few minutes. And in that way, video games become a super normal stimulus and what I mean by that is they're taking a physiological system that's sort of hardwired in us and, and essentially hijacking it. I think the easiest way the easiest analog here is junk food junk food is super normal stimulus and Oreo is a super normal stimulus. And what I mean by that is 100,000 years ago, something high in sugar and fat was a desirable thing to eat. We are hardwired to seek that out for survival to gain those calories to live off of to burn that energy to burn that fuel. Now, a lot of us have access to more calories than we need. And, and, but the draw to the sugar and fat is still there because it used to be really adaptive. So now we go to the pantry or the kitchen and, oh, you know, the Oreo sort of hijacked that system and that's why we reach for them rather than the carrot sticks. And in just the same way, that's what's happening with video games. Video games are hijacking that system. So again, if we think about not just that video games are bad, but where are they pulling us away from. And now what's the uphill battle we have to combat that super normal stimulus that is flooding our brain with dopamine. What can we do that? What is the alternative? Frankly, how do we get someone off of a video game if it's that rewarding. Dan will talk more about that in the second half, but I want you to think about that in terms of not only what's happening in the brain. But also in terms of how do we change and shape that behavior. If that's something that that we need to do in our home. I tried to get some numbers of what screen time looks like during COVID. This is for adults actually so and this doesn't even appear to be work time. This is just tablets and TVs and and phones and you can see how pre COVID. We're at eight hours or nine hours creeping up to 10 hours. Once COVID hits, you know, we jump three, three and a half hours on average per day. Think about that. More than half the day spent on the screen and that I don't see here included in oh I was on zoom for for work or something like that. Now this was actually from an eye safe source, which I thought was interesting, because that's a whole nother aspect of the screen time debate and how much we're on a screen. What often pulls forward is this reflexive response in the brain. So if I can just jump ahead here so our brain develops back to front. Okay, so this this the top picture here is a side view of the brain the bottom picture on the left there is a top view. So it's back to front. So the stuff in the back is what we share with with reptiles. You see the back area there and so that's, you know, breathing, eating reproduction, those sorts of things. And as we get more as we move forward in the brain, it gets more and more advanced until we get to the prefrontal cortex, a tippy front of our brain, just a little bit of brain matter but that's what separates us from apes and monkeys. That's what allows us to use executive functioning skills that's what allows us to plan, organize, use tool tools right poetry all those amazing things that make us human. But the problem is a lot of those video games are checking into this reaction time they're just reacting rather than reflecting so less of that. How do I really think through this problem and more of just a response. What's happening in the brain is it's a user when we're born we have billions of neurons and basically from that point on we are losing neurons user lose it. So in order for brain development to happen the simulation needs to happen varied is better we're forming more pathways I think about it like pathways in the woods that you know that first time you go through it it's really slow there's things to get out of the way. You go through it again it's a little bit faster and again again again you do that pathway every day and all of a sudden there's a path that's forming and it's easy and it's fast and you could run down that path. That's a well formed brain pathway that's that's forming because of practice, but the ones we don't use we start to lose. So again thinking especially about early development thing about academic development thing about language development. What is what are the screens getting in the way of in terms of varying our development screens encourages to multitask in short we all think we're really good at multitasking and we're really not. That is the bottom line take home message from the multitasking research here. And, you know, part of that is I see this Google effect, you know, we can Google anything we can Wikipedia get that first paragraph we've got the mile wide of knowledge getting that knowledge is never a problem right now. It's one it's one Google question away, but it's an inch deep right rarely do people start digging down on it. So it's this idea that we have all this knowledge a little tiny bit of knowledge about a whole bunch of different things. And also with this concept is the idea of we're not allowing for downtime or boredom. I'm guilty of it too. I'm in a line for two minutes. Boom. Smartphone comes out right we all we have gotten intolerant or less tolerant of being quiet with our thoughts and our kids are the same way. There is that low hanging fruit of super stimulus video games, and they don't have to be bored and quiet with their thoughts. But if we think back how much creativity and problem solving comes out of boredom. It's a lot when we're sort of forced to engage that. And this last point, we think about social development. It's ever changing in my goodness. You know, middle school and high school or a lot different worlds and social media that's just that that's just the truth and it used to be Facebook then Instagram now take talk. And again the idea it's hard to keep up with so what's sort of hit new and fresh. But from a social perspective, what is that doing to sort of alter our thinking and our reality truly. So these up here, half jokingly and these are these are terms that are kicked around but just for a little levity but there's also some serious pieces here and I think we could see how we especially from a social media point of view how it could increase anxiety or something but no phobia like am I going to lose cell phone coverage phobos the fear of being on like whoops I left my zoom camera on we've heard horror stories of that happening so you know maybe you've heard about FOMO but now phobos. That was just not a thing before, you know what 13 months ago. I don't think anyone really would have had that that that wasn't a widespread fear that you can't you might have left your camera or mic on. So I've touched on these a few times you know a lot of these risks are again less about. Oh my goodness video games are horrible. And really what are they getting in the way of is it interacting with parents, friends, siblings is it's you know that the effects on health and vision are a little bit more real in that way that blue light aspect. And mood effects though, you know, yes, there's probably a correlation. I see it as a well what aren't we doing because we're playing video games are we sedentary on the couch all day well my goodness that's going to affect your mood. Staying up late and losing sleep over and study time obviously that's going to interfere with your daily functioning that attention and focus that craving of dopamine all the time can lead you to go. Oh man this lecture is boring. I want the video games, bring me the dopamine, and you can imagine all the behavioral issues that might come out of any one of these facts here. Video games and violence is of course a hot topic. A lot of the video games, you know, objectively are very realistic very gory. Is this evidence. Is it causal. Is it a high risk group. You know, my, my, my feeling is that while some kids can handle that some kids can't to put it bluntly so I'm thinking about, you know which kids can really kind of leave that on the screen and walk away from it and doesn't spill over into their daily lives. There are a hundred parts about technology and screen that you know that while it's reactive that rabid problem processing some games pull for problem solving skills, not all games are created equal just like not all TV shows are created equal. Obviously watching Sesame Street has better outcomes and a lot of the other junk that's on TV for kids. So there's been research that shows that so again it's what is what is the interaction like with that game. It's purely passive. There's educational programs out there, you can be interacting with people all over the world. And in this age where we are physically distinct we have to be socially distant and I could talk about this last topic for all day long. But you know the philosophical question of is our our video games a social activity. The only source of socializing is that okay. And that that's a hard question. And a lot of parents are grappling with it right now because a lot of kids, other social options are really restricted. So again, think about the alternatives of, hey, don't just play video games with your with your buddy, go out and meet them. That's not as easy right now. So the alternatives aren't there. So again, think about the alternatives. What are we missing out on how can we make sure that's happening. Research is very young. There's not a lot of research that connects to the brain. A lot of it, if anything, it's the brain pathways aren't as well formed, but a lot of it's done with college students because there's sort of a convenient sample but I really would love to see research at a younger age group for that developing brain. So I wanted to write so this is what school is like now you know where it's all screens all tablets. You know I've certainly had my kids pushing on my laptop thinking it's a touchscreen that kind of thing. So you know it's different expectations right now, but I'll turn it over to Dan, he's going to talk about some of the nitty gritty aspects of what it's like to have a child on video games and frankly try to get them off. And now this is a presentation that was originally designed for a longer format so what I'm going to do is go through these tips, relatively quickly, and during the Q&A session if there's anything that you would like me to sort of circle back on and cover in more detail you could ask and at that point we can go into some of that. So there's two big content areas that are pretty useful to know one about one is how to transition at the end of screen time and move on to something else. And then there's the bigger issue of how to set guidelines for that screen time so that you know that the child knows what the expectations are, and that that's communicated pretty consistently. So, next please. Let's talk first about managing the transitions from screen time. This is when it's time to move from one thing which involves electronics to something else which doesn't. Okay, just a few things to keep in mind here. Number one, being close by in physical proximity when screen time is over is going to be effective in a way that shouting across the house or asking a child to make sure you're off by five o'clock and then not checking out on him. Number two is it's just too tough for the reasons that Ethan described to expect a child to always disengage from a screen themselves, especially if they're on the younger side where if they have ADHD or executive functioning issues or work avoidance or anxiety or things like that. So get up walk across the house and make sure you're there. At the end of the presentation, if we have time, I'll tell you a little bit about some methods of directly controlling children's electronics usage and a lot of parents ask about that. Things where they could like remotely shut off the Wi-Fi or shut off a child's electronics when the parents not actually there. And I would say it solves the immediate problems the child's not on the game anymore but it actually causes a lot more problems than it solves so that's not something that I would recommend except in the most extreme circumstances. Next please. So another thing to help with managing transitions is to know a little bit about what games the child was playing and knowing when they're going to be done. It's a good idea in general to sort of understand what your kid is doing on screens but this also has the benefit of helping to manage the transition better. A lot of parents say, okay, it's time to get off of the device and the child says a couple more minutes and then the parent doesn't know what to do. Right. So, you know, it's important to recognize that some games you can save anywhere and stop immediately whereas some games you can't save your progress except in certain times of the game or in certain points. Oftentimes kids are playing multiplayer games meaning that they have friends on the other end of the internet or they have maybe random strangers that they're playing with and they don't want to leave the game in the middle of the round. So if you know what they're playing you can know how long each round lasts and then you can plan ahead and set the end time of the transition to when the round is going to be over. For example, if you know that your child is playing a game in which the rounds last eight minutes then, you know, plan ahead if you have to leave the house at five o'clock p.m. You'll want to make sure that your child is finishing up maybe 10 minutes to five so that if they're in the middle of a round when you come to get them, then you've got a little bit of a cushion and you can say, all right, so finish that round and then it's time to go after that. Next please, especially for for younger children and this is a useful one emphasize that you're transitioning to the next thing. So, instead of saying, Okay, time to stop, you can say, All right, it's dinner time and then you can have some ice cream or whatever the sort of thing is right just emphasizing the appeal of the next activity. Next, I'd like to give a reminder or warning ahead of time, especially for younger kids again, and sometimes multiple reminders can be useful giving a five minute warning a three minute warning a one minute warning. Sometimes it's necessary for children who are fairly young or who have ADHD or executive functioning or emotional regulation difficulties sometimes. And then if you don't give them another couple of warnings, the, the exhortation to stop comes out of the blue and really, really upsets them. Next please. A method that I like is the countdown method and I want to be clear that this is not the same thing as threatening like you've got 10 seconds to get off and this is a common parent trick. This is a little bit different than that this is an opportunity for them to earn some sort of reward or some sort of praise. Right. So, you tell them when it's time for them to get off. All right, so you've got 30 seconds or you can you can say 20 if it's a bit of an older kid but you know whatever you've got you've got 30 seconds. And if you get off then you can earn the reward and the reward is sometimes, you know, extra screen time the next day or it could be whatever other sorts of tokens you have. You know if you have a token economy or you know if it's candy or whatever sort of thing you have right and then you start counting 2928 and their expectation is that they're going to either you know close the close the game window or turn off the tablet or whatever by the time you reach zero and if they do, then you can praise them and say great job you earn the thing and if they don't then you just encourage them to try again next time. Next please. You can say, good job, or you can say, that's all right you can tomorrow you'll have another chance. Next. All right, so another one is to make sure that you've talked a little bit about the expectations before the child gets on the screen, not after they've got the controller in their hand or the iPad in their hand, but beforehand and say all right so if you're going in remember that you know where we have to stop by 450 and and sometimes for for especially difficult to direct children. It's even useful to have a practice and say okay so showing what's going to happen. So I'm going to I'm going to give the countdown and you're going to earn the reward and then practice handing me the remote very good job. Okay, now you can have, you can have this. You can have this controller back in and so forth. Okay, so next please. Okay, so after all of this, be prepared for an outburst right be prepared for the possibility that even with all of these things, the kids going to be angry, right, and you know that that comes to tips for managing outburst which is just a useful thing to understand, understand that you know it's a possibility know your child know that this could happen validate I know how much it stinks to have to get off something I know, of course it does. Maintain those consistent limits if you said that you have to be off by 450, then you know it's okay to have the wiggle room that you yourself decided upon. So in your own head you know okay could be 450 could be 458 something like that. But don't don't give in to to the child's demands if it was not something that you and the child already decided upon. Right. And setting consequences for aggressive or destructive behavior is important, but make sure you do it in advance knowing what would happen and it's your child should know what the expectations are if they throw or break something right, as opposed to giving a reactive punishment in the moment and you know sort of acting out of anger. Next please. Right. You know this is a cartoon obviously which gives me a moment to pause and answer a great question that was asked about how to get a child off of a multiplayer game that has that doesn't have fixed rounds, right and so this could be an open ended thing. But that's again where it comes down to having to make an agreement with the child beforehand. And, and I think this sort of gets into the next bit of the lecture because it's about the about setting those expectations together, but this is going to be one that you know it has to be set in advance where it's, it's, you know, if there is no particular set point then the kids going to have to to be able to acknowledge that and say at some point. You're going to have to tell them you know at some point we're going to have to leave and it's going to be at you know five o'clock we have to go and you're not going to like that and so let's let's practice it you know and make sure that the kid is okay. Getting off the, the screen before they're able to, you know, before they're allowed to start. Let's talk a little bit more about some of that. And the next bit of the lecture. So this comes, this comes to setting guidelines, right. There are three different approaches in order of preference, where the most preferable thing is a collaborative approach where you work with the child ahead of time to sort of set the guidelines together. And this is I think where this, this question comes in that was just asked about, you know, multiplayer games. If that is not effective then there's always the behavioral reinforcement plan and then finally, having direct control such as making, you know, taking away the, the electronics or using some software, right is the least, the least effective and most likely to cause problems. Next please. So the collaborative approach looks like this, you, you talk with the child ahead of time and you say, you know, so look, you know, you know that I know that it's hard for you to get off games, you know, it's something you enjoy, you get it. So how much, how much screen time do you think that you should be able to get, you know, per day. Start with that, start with that question. I am surprised every child that I've ever asked that question of has given a reasonable answer to me as a therapist. Now, how much they actually want in the moment is different but they have a reasonable expectation in mind meaning they know what is, is acceptable for a young person. Right. And that's a starting place. Their, their answer might not be what you want but it's usually reasonable. Most kids don't say I want eight hours a day. Most kids would take that if you gave it to him 100%. But that's not what they think is reasonable. It's the same thing if I asked you, you know, how many calories do you want to eat over the weekend. Right. So understanding that the child has a, you know, potentially reasonable starting gambit, right, and, and then start to start to work with them and you say, you know, I think, you know, four hours might be a little much on a weekday. But, you know, what about to write and have that conversation and, and then ask your child, how, how can we, how can we end when it's time to end. What can we do because I know you don't want to I know if you're playing with friends it's going to be tough. And yet most children will agree that they're not, you know, they shouldn't play multiplayer games with friends, you know, 24 hours a day in theory, right. So ask their ideas for how, how to set those limits right and sometimes they'll have some good ideas. Of course, you know, it's good to be able to negotiate with them but the parents have the final say, right, and again, the conversation of course can't happen while they're playing this has to be, you know, at a time where there's no screens around maybe you guys are driving maybe you're taking a walk maybe it's over dinner, having this kind of conversation. Next please. Putting a behavioral reinforcement plan is a good next step if you find that the collaborative approaches in and of themselves are not sufficient like let's say the child agrees, you know, here's how it should go. You know thanks for talking about it with your mom or whatever and then in the moment is completely resistant to the plans that you and he or she made. Okay, then putting a behavioral reinforcement plan is is very useful. I'm realizing that there are different ways to reward behavior. And I recognize that some parents conflate this concept with the idea of a bribe which is a different concept right bribing is giving someone something in order to change their behavior, but you give them the thing first and you hope they're going to be nice for you in in behavioral reinforcement or reward that's something that you give only if they've done the thing that you asked for and this is how any sort of major behavioral change happens, you know that this long lasting in in adults that that we really like so for example we go to work and do our jobs most of us due to some sort of reward whether we're getting paid for it or whether we're doing volunteer work, we're getting some sort of reward out of it this is a very basic thing and so it's nothing. There's nothing, you know, shameful about using a reward plan if the child doesn't find the the act of making their parents happy to be rewarded enough. Okay, so sometimes you could you can set extra screen time you could say, Okay, so you can get your extra 15 minutes if you if you get off piece of lead today. Some sometimes you know using games or the microtransaction money such as the Robux or the V bucks and Fortnight or whatever whatever the child asks for anyway, you know, instead of having to have fights about whether to give the money for the downloadable content they're asking for, make them earn it by by getting off the screen, you know, piece of lead. Next please. So, the, the other part of it is that rewards shouldn't just be monetary like, you know, toys and games and things like that, asked their child's idea for some different things that they might want and you'll be surprised at what child, what and what children might find interesting like, you know, making ice cream, you know, with the ice cream maker might be really really special to a young kid. Right. Or, you know, going on a walk with dad or you know, me and mom go and go to the movies together, you know, whatever have a movie night at home. That's, you know, really special and you set aside time and you make popcorn and you know these are all different things that could be really rewarding for a child. If you're having trouble doing this on your own and a lot of parents do not because there's anything, you know, deficient about their parenting skills sometimes kids just don't respond the same way to a parent that they do to a different professional that having having that professional there, but the behavioral therapist can help you set the plan and help get the child on board and help work with this sort of thing. Okay. And then the least preferred method is the direct control one and sometimes there's no other option this is especially with older kids who are extremely, you know, sort of resistant. It might happen but usually it's with younger kids that there's some level of effectiveness to this. Once kids get to be old enough, it's really, really, really upsetting to have something taken away from them taken out of their hands. Right. And whenever I hear about a parent child really getting in a fight over, you know, video games right or something like that or getting off of YouTube something like that. The parents will say I asked him to get off and there's a big fight and then you know if you ask the kid about it's like well, my mom grabbed that in my hand and that's when I got angry. Right. So, you know, taking the hardware away, or using software to control it, not, not my favorite thing to recommend but in conjunction with other methods such as, you know, collaborative parenting, then it could be all right. Right. There's timers, there's remote shut off things then they can be handy sometimes if you need that extra help you have to know your child and know is taking the hardware away going to be effective at controlling this behavior or is it going to breed resentment which is often what it does. Next please. Okay, next. These are just some examples. We want to distribute these, you know, if you did want some, some different software ideas for controls but again this is not what I would jump to. Next please. Remember that the direct controls are supplemental and should never be a replacement for the collaborative authoritative parenting strategy that we've talked about. Next. And then just some final tips using the blue light filter before bed. So, if the child is going to use electronics before bed they should have a blue light filter on, and this is not the same thing as we did in the screen. This is about the wavelength of the light and by default phones and laptop screens have a lot of blue wavelength light which wakes the brain up. Make sure you have that blue light filter on your phone turned on most of them are a default option right now they just turn on at certain times of night on phones and tablets. If you select that, you can get a program called flux for free on on a PC or Mac. And, you know, it just you can set it to turn off the blue wavelength it looks a little bit more red but it sort of helps the brain shut down and then ideally having no screens an hour before bed although you know I know most of us do a little bit of screen time in bed you know before you before you turn off the light and you know it's just a little bit harder to go to sleep if the brains been excited in that way. I also suggest that the gaming devices at possible be in the common area, rather than in the bedroom. So, you know, the, these are just some miscellaneous tips about, you know, don't think about that you have to monitor their, what they're doing but more be a mentor sort of no show interest in what they're playing play with them sometimes. You know help them understand what's going on and, you know, it's often better to, you know, if they're playing a violent video game instead of saying turn that off I don't want you playing that it can be better to sort of talk with them and make, see how much is really internalizing that violence are they saying look, this is, this is revolting to me too it's just a game I'm playing like this is terrible, or is the child saying this is really awesome you know this is great to kill people right make sure that you can get that kind of information from your child. Look for the positives in video games it really is just another medium, extremely addictive medium but in the end it's an entertainment medium like like books and television and those things were predicted to rot our brains when they first, you know, the press first came out people thought well now you know this is the end of Western civilization as we know it. Right. So, look for some of the ways that you can find those positives that Ethan mentioned. Offer alternative activities. What I recommend is making a list that you keep somewhere of all the unplugged activities that child can do they have trouble in the moment on board I can't think of what to do. Okay, make a make a list and be very specific about what the different things are you can go play play soccer outside and then and then go to the shelf and write a list of all the different kinds of games and activities you have don't just put play a board game that's the most boring sense for a child to read I'm not going to play a board game. No, you put play shoots and ladders play cootie play campaign of Dungeons and Dragons, make a clay monsters like go through the entire shelf and have a list there, so that you know you can present it to the child at any given point when they say they're bored, and they can really pick something from that list. So having a no phone zone and mealtimes or before bed is a really useful thing and then of course watch the behavior that you're modeling for the children. Okay. Next. All right, so, you know, I'm going to pass it back to Ethan for the wrap up, and then we will take some more questions. Yeah, so the major things I think about is what isn't happening right so oftentimes it's, it's getting in the way of something video games technology getting the way of school are getting in the way of bedtime are getting the way of social interactions. It's not going away, right, whether we want to or not, if anything technology is more infused now than it was in our lives 13 months ago so really the goal is moderation balance rather than pretending like we can live a completely device free life truly. So I want to make sure we have some time for your questions I'll stop the share here and take a look at the the q amp a. So, the person I wanted to, to bring up was a question about what are some appropriate consequences for destructive behavior when when getting off the screen I mentioned that in passing. And the question is okay so you, it's very useful to be able to agree on this with with a child. You know, here's what's going to happen if you know if you break something right and you know to have this conversation with your child if they're the type of kid that breaks things. I think this gets down to a more general question of you know, what are the sort of appropriate consequences in general, and the more desired consequences, and the, the best sort of consequences, if you have to give consequences are the ones that are what are the consequences that follow or natural consequences rather that follow naturally from the thing that the child has done if the child says I'm not taking a code today, the child's cold all day. That's a natural consequence, or if the child, you know, gets angry and, you know, throws their their iPad and it breaks, then they don't get another iPad for quite some time right so that's a natural consequence. Sometimes it's possible to to impose natural consequences for things. Let's say a child breaks something in their own in their room. Then, especially if you know some some piece of property that's theirs, then not getting that piece of property back not getting it repaired or having to deal with it broken is a natural consequence. So the next level would be a logical consequence that doesn't naturally occur from the thing that they did, but is logically related. And so, if a child is shows problems around getting off of their screen. A logical consequence consequence would be well tomorrow you don't you don't get your normal screen time right because you know that's a logical sort of that logically follows from what they did, you know the the the next level if there is no logical consequence you can sometimes have a an arbitrary consequence so you don't get to go to do this other thing right. So, you know, that's the, that's the order in which I would think about it is there a natural consequence no is there a logical consequence I could, I could do no, then you know, losing dessert or some other thing but the, the important part is that that the consequence be administered pretty quickly after right so let's say a kid throws a temper tantrum tonight especially a young kid, and you say, Okay, you don't get dessert tomorrow right or you got to go to bed early tomorrow. So if it's not more effective that would be in the younger kid or a kid with executive functions that consequence is too far away, and you know, won't really won't really have the impact that it should. Thanks. I see another question here about teenager, a teenager might be resistant to therapy but gaming has really affected them socially and academically. In a way that's a very common story or theme right now. So, the resistance to therapy piece is tricky, but what I would encourage you to do because it sounds as though you see the social and academic impact I'm wondering if your team does right so having that conversation about what, you know, are they motivated to change anything do they see the effects it's having or not do they feel like no this is my social outlet and doing just fine in school or is it. Yeah, I have, I don't have a great social outlets right now, and my grades are struggling but still video games are an option. You can get them to articulate that, and not a judgmental way, but in a way of, hey, what do you think is going on, let's try to do this together. That's much more of that collate collaborative approach that Dan talked about in terms of joining with your team which can be really hard, but teams love the battle. They love the resistance so if you come on too strong, they'll pull away but if you can if they feel like you're joining them and you understand like, hey, there's a lot of this going on. It seems to be affecting these areas. What can we do about it and again the answer may not be no more video games the answer may be, how do we prioritize social interact you know social gatherings or I shouldn't say that but how do we prioritize socializing maybe offline socializing how do I prioritize academics and school to those things need to come first. Fine you can play video games if x, y and z criteria are met. That's that's the way I think about it. In terms of getting, you know, joining with your team to build that motivation, rather than just feeling like you're forcing your agenda on teams adolescents. I absolutely hate that and and what there's going to be reaction to it. The addiction question has has come up again. I think you'll get different answers depending on who you talk to, but the more video games the longer they've been around. I feel personally my personal my individual as a individual professional that there's more and more evidence that these do fit an addiction model. It's really hard to look at the criteria for addiction and go, oh there's no way video games meet those criteria. So in that checklist way meets it on a brain based way I feel like it meets it from a dopamine level. But again, a lot of this is new. So the follow up question to that was how do professionals become educated about this. To be honest, right now the direct answer to that question is continuing education. There are workshops that are coming out about this, what it looks like to moderate video game playing do we have to have to go with an abstinence model. I've heard of an inpatient program out in Oregon, I believe I think don't call me on that, but it's a video game addiction clinic truly which obviously is sort of the, the big time intervention but the fact that that exists, certainly a lot of people would describe it as an addiction. So, what do we do about it there's you know there's lots of those steps in between nothing and an inpatient stay at a clinic where somebody sleeping there and it's it's full detox and everything. But the idea is, again, think the dance point of what, what are we shifting to what are the alternatives, but also thinking about how rewarding and stimulating video games are, if you need a, an alternative it needs to be pretty awesome, especially to start it needs to be pretty good right it can't be the born board game it needs to be something compelling. We're shifting to this now. And that I mean that's the only way to start changing that cycle because right now it in the sort of addiction cycle is all the rewards are coming from video games and they're there for the taking so in that way. I knew that gamer isn't crazy. They are responding to their own brain chemistry if that makes sense. So, that's how I would view I don't I don't know if Dan you had anything specific to add to that. No, I was actually going to look up right now the a little bit about the, what the latest is on that so the DSM five which is the most recent mental health manual that psychiatrists and psychologists use have internet and gaming disorder. I want to get the name right. It doesn't matter having a, I think it's called internet gaming disorder. I don't know why they specify internet doesn't have to be internet but you know as a potential for inclusion in future versions of this manual basically the idea that you know this there's more evidence that is needed here. But it, it's probably going to be more formally introduced in some way in future versus that manual. I think the best way to think about addiction the way I think about it. One of the main behaviors is to think about any sort of behavior that has that kind of dopamine rush can can be addictive in that same way and so you know it doesn't necessarily. It's not necessarily the case that we have to have a particular separate diagnostic label for each addiction, but nobody asked me I don't write the DSM but the way I would think about it is anything whether it's sexual behavior or whether it's, you know, stealing or any of these other sorts of things and gaming just falls into it can become addictive under the right circumstances. That's about the questions we have I don't know if anybody wants to try to add one more but I'm mindful of the time as well. Thanks to everyone who joined this evening I hope you got something out of it. Thank you guys really appreciate it. Of course, and we should just say to everybody who's who's listening that we did record tonight and we're going to forward everybody a link to the recording so if you want to go back and there are certain parts you want to rewatch, because they were helpful will do that and we'll see Dr glass will also perhaps give us some links to some resources that will share with you so that you can investigate some of these things further if you're so inclined. And we really appreciate you two gentlemen taking the time for us tonight. Thanks very much everybody for tuning in on this rainy night. And I hope gentlemen we can do it again sometime. So, thanks so much for having us. Thank you very much everybody.