The 5 Cs include:

• Child – Know your child and your child's temperament and the media your child is drawn to; and for what purposes your child uses online platforms. As all children are different, they experience different risks and benefits from online media.
• Content – Content quality shapes whether kids have a positive or negative relationship with online media.
• Calm – Children are learning strategies to help self-regulate their emotions and sleep well at night. Online media should not be a main go-to strategy for managing big feelings, distracting, or entertaining your child.
• Crowding out – Too much online media usage comes at a cost. Encourage families to focus on what they’d like to build back in, such as fun activities that allow children to unplug, learn, move their bodies, get outside, and connect with loved ones.
• Communication – Building digital media literacy is critical and early conversation about media usage can help facilitate that. Open-minded conversations allow parents and caregivers opportunities to intervene if they notice concerning patterns or behaviors.

Currently, on the Center of Excellence’s website, families can access a user guide for parents as well as the series of five age-based two-page handouts. There are also user guides for pediatricians who can distribute the age-based handouts at Well-Check visits.

In the coming months, the Center of Excellence plans to build out the content from the 5 Cs into easily accessible tips by age range (e.g., tips on Crowding out for school-aged children) that can be shared with families on social media and on posters that can be displayed in doctor’s offices, schools, and other settings as part of its 2024 Back to School media campaign.

Strategies for Parents and Caregivers

The Task Force convened groups of parents and youth from across the country to discuss a structured set of topics related to online health and safety, including their own experience with navigating social media, strategies for mitigating harms on social media, and how best to access support and resources. Using the information gleaned from these conversations, as well as previous work of the Center, the following five strategies provide practical tools for parents and caregivers implement the 5 C’s Framework:

1. Build a family media plan. Families can build a media plan using a tool designed to manage expectations and create an agreement across all members of a family or household about media use. For families with younger children, parents may need to provide more guidance on the rules, and as youth cross into adolescence, the plan should be revisited so that older youth can participate collaboratively with their parents in setting expectations that are workable for all members of the household.
2. Balance time with and without devices. Families can intentionally create screen-free times such as during an evening meal and during bedtime hours. Parents are often in the role of planning activities. Rather than just focusing on reducing screen time, help your family think about what they want to get back—such as family quality time, more sleep, time at the movies, playing with pets or time outdoors. This can include neighborhood walks, board games, or listening to music together. Starting when children are young, families can build a shared expectation for family time that is centered on participating in an activity together.
3. Talk about social media: Parents of youth of all ages should maintain open and non-judgmental communication about media use. Starting with younger children, parents can position themselves as individuals who can help navigate social media by problem-solving and separating real from edited content. As youth grow older, they seek more autonomy—and with the increasing influence of their peers— so staying connected with open communication is key. Working with the Center of Excellence, the Task Force developed developmentally appropriate conversation starters described more fully in the section below.
4. Set a good example: Parents are role models for their children. How parents use social media, the time they spend on social media, and their emotional reactions to social media use creates a framework of reference for children. Be mindful of what your children see you doing and consider describing why or what you are using social media for.
5. Optimize your family’s online experience. It is important to choose platforms and content that are developmentally appropriate for your child. Identifying quality online content to engage with together is important. It is critical to set ground rules around whom children can engage with online, while also ensuring that the strongest privacy settings are enabled. Privacy-preserving age-appropriate parental controls are important tools parents can use to help support safe online experiences for children. Be aware of warning signs of problematic online use including withdrawing from activities they previously enjoyed or changes in their routine including eating patterns and sleep habits.

Building Healthy Relationships and Conversation Starters for Families

In collaboration with the Center of Excellence, the Task Force developed a series of tools to help parents and caregivers engage in conversations with their children related to digital technology and media use (full text in Appendix E).

Building Healthy Relationships with Media: Essential Skills for Children 10 and Younger

Building Healthy Relationships with Media: Essential Skills for Children 10 and Younger presents practical strategies for families to build balance, critical thinking, and safety skills for toddlers through elementary school-aged children. It includes activity cards designed to be accessible and enjoyable for child- and family-serving providers and organizations to help promote dialogue between parents and caregivers and their children about online health and safety. Topic areas and activities addressed include:

• Make it a Low-Drama Part of the Family Conversation – Practical tips for parents and caregivers who often find discussion with children about screen time to be fraught with struggle.
   
• Normalize Having Boundaries – Ways to prevent technology from crowding out healthy behaviors such as sleep and quality time with family, by providing developmentally appropriate language to help limit device and online platform use.
   
• Pick Good Content – Ensuring children are engaging with age-appropriate content with appropriate parental monitoring of media use, given the plethora of content available online.
   
• Teach Non-Screen Ways to Manage Emotions and Boredom – Devices are often used to manage stress or boredom, and finding appropriate alternatives is important to help limit online media use.
   
• Build Digital Smarts and Kindness – When children see something upsetting online, empowering them to pause, think about it, block it, and report it. Kids should know that kindness and respect should be the expectation online, and rudeness or violence should not.
   
• Teach Safety Skills – When kids are young, we talk to them about street safety, swimming safety, and other rules that come with exploring the world. This tool describes safety rules for the digital world.
   
• “Sharenting:” Thinking Before You Share – Tools for parents to appropriately share content on social media that includes their children (e.g., pictures). Discussing this with children teaches them about consent and privacy, which may help them be a more responsible social media user as a teen and into adulthood.

Conversation Starters for Families of Tweens and Teens

Conversation Starters for Families of Tweens and Teens is intended for parents and caregivers of tweens and adolescents (ages 10–18). It includes conversation starters and follow-up prompts for a variety of scenarios that parents and caregivers may have with their child about cell phones, screens, social media, and other online platforms. Similar to the handout for younger children, these conversation starters and prompts were designed to be easily accessible for parents and caregivers. Topic areas that the conversation starters address include sample conversation starters with follow-up prompts:

• Setting initial boundaries around technology and digital media use – “I’d like us to talk about our family’s approach for setting some boundaries around technology and media use. I was thinking that this is something we could work on together as I’d like to include your input in these decisions.”
   
• Initial check-ins after setting guidelines and boundaries – “It’s been about a month since we set our guidelines around technology and digital media. I wanted to check in on how things are going.”
   
• Social media-specific check-ins – “I know that social media is important to you. I wanted to check in about it; how do you think things are going with your social media use?”
   
• Checking in on unwanted contact – “One aspect of social media use that is really important is protecting our privacy. Have you looked at the privacy settings on all your accounts? How are things going with those settings?”
   
• Checking in on unwanted content – “As you probably know, your social media platforms track your search and viewing patterns. They try to get to know you, and an algorithm (a set of rules that rank content across the platform) decides what to put in your feed. How is the algorithm working for you at this point? Is there content you don’t want to see? Can we look at ways to reset your algorithm?” 
   
• Struggles with meeting family expectations around digital media use – “I feel like it’s a good time for us to check in on how our family media expectations are going. How are we all doing with using our devices? I’ve noticed a few times that I’ve needed to remind you about our agreement to not have devices at the dinner table so we can spend time together (or other area that is a struggle). What ideas do you have to make that rule work better for you? What would work about that plan and what wouldn’t?” 
   
• Media and technology interfering with sleep – “Sleep is really important for everyone. I know you aren’t able to show up to [x] activity/have the energy to do all the things you want to do/etc. when you don’t get enough sleep. Let’s talk about some ideas for how to help you get better sleep.”
   
• Overheard conversation about social media – “When I was driving you and your friends today, I heard you talk about something you saw on social media last week. I’m interested in what’s going on for you, so I’d like to hear a little more from you about what happened.”
   
• Prompts to encourage reflection around relationships with media – “What does it feel like when you’ve lost track of time in your phone, versus [other favorite activities like a book, doing artwork, playing basketball]?”
   
• Reflecting on other peoples’ tech use – “When you’re hanging out with friends, and they are all on their phones and not paying attention to each other, how does that feel?”
   
• Parents talking about their own media use – “I sometimes have a hard time not checking my phone or feeling the need to respond to texts or emails. I’m working on how to be better about my own boundaries. Let’s help each other find a good balance.”

The conversation starters and scenarios were developed based on recurring themes identified from:

1. the Center of Excellence “Questions and Answer” portal,
2. presentations and convenings of parents, and
3. pediatric clinical experience.

The educational messaging and activities take into account the developmental stage of the child and are framed to alleviate feelings of guilt or shame parents often report around their children’s use of screens. The activities and prompts also draw from literature reviews on social media and youth mental health and motivational interviewing techniques. For example, these resources encourage parents and caregivers to have open and collaborative communication about their child’s online use and family expectations because children are more likely to follow rules when they have the opportunity to provide input and discuss their concerns about online safety. And close relationships between parents and their children are associated with fewer online risk-taking behaviors in children.

Compendium of Best Practices Resources for Parents and Caregivers

Finally, in addition to the learnings from the conversations with parents, youth and other stakeholders, the Task Force collected an extensive array of federal and non-federal best-practice resources to promote the online health and safety of children and adolescents.

This compilation resulted in the identification of over 30 resources covering various age ranges of children and youth, target audiences, and categories. These resources have been organized into an annotated compendium into the following six categories:

1. General Information about Youth & Social Media Platforms
2. Tools to Support Parents
3. Digital Citizenship
4. Bullying and Cyberbullying
5. Child Sexual Exploitation and Abuse
6. Teen Dating Violence and Other Forms of Gender-Based Violence

The Center of Excellence team evaluated each of the resources using a standardized approach to determine whether the resource meets the criteria for recommendation and to help determine relevant placement and integration into Center products. This vetting process reviews various features of each resource. Emphasis is placed on determining whether the resource employs an evidence-based, strength-focused, and child-centric methodology that is also pragmatic.

These and other materials developed by the Center of Excellence are housed and managed on the Center of Excellence on Social Media and Youth Mental Health American Academy of Pediatrics website.

Next: Industry’s Role in Promoting Kids’ Online Health, Safety, and Privacy: Recommended Practices for Industry