Before discussing the impact, Dr. Greenhaw explains that social media consists of internet-based platforms and applications that enable users to create personal profiles, post content, and interact with user-generated content, as well as to form and maintain online social networks and communities.

 Dr. Greenhaw emphasizes the importance of parental involvement.

“The platforms most used by children and adolescents in the United States are TikTok, YouTube, Instagram, and Snapchat, with Twitch, Discord, Pinterest, Reddit, and WhatsApp also playing significant roles in specific subgroups,” said Dr. Greenhaw.

 According to the American Academy of Child and Adolescent Psychiatry, children ages 8 to 18 in the United States spent an average of 7.5 hours a day using screens in 2025.

Artificial Intelligence (AI) and Roblox

Two areas not always categorized as social media include AI chatbots and Roblox.

Roblox: While primarily a video game, it features elements of social media, such as personal profiles, avatars and the ability to chat with strangers during gameplay.

The platform is incredibly popular and includes many red flags for potential harm, including its engagement-prolonging design, behavioral reinforcers and major concerns for privacy.

“It carries many of the same risks as social media,” said Dr. Greenhaw.

Artificial Intelligence: Web-based tools like ChatGPT, Claude and Gemini are creating "parasocial" interactions, where children and teenagers may begin to view AI chatbots as friends or confidantes.

“Given the difficulty of traditional measures to monitor children’s use of this technology, open communication is key for detecting problematic or potentially harmful use,” said Dr. Greenhaw.

Generally, parents want to be informed about their children’s internet use. Creating an open space for frequent communication increases awareness of how children are spending their time online. If a parent is not first aware, they cannot intervene.

"Social media use may lead to worsening mental health outcomes if it includes exposure to cyberbullying, harmful content, algorithmic feeds or engagement-prolonging design," said Dr. Greenhaw.

 For Younger Children

• Emotional Regulation: Children can develop a stunted ability to manage their emotions if they rely too heavily on digital platforms for stimulation or distraction.

 For Adolescents

• Mental Health: Teens with higher baseline depressive symptoms may increase social media use over time, which can lead to negative social comparisons.
• Body Image: Appearance-focused platforms like Instagram and TikTok have a significant impact on how adolescents view their bodies.

 Healthy Digital Habits

• Create a Family Media Plan: Establish screen-free times for the entire family and set clear boundaries.
• Select High-Quality Content: Prioritize content that models social-emotional skills or tailored learning goals, such as math or reading.
• Set Intentional Limits: Be deliberate about when your child receives their first personal device.
• Protect Sleep: Ensure devices are put away well before bedtime to prevent interference with rest.

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For Lisa Elliott, Ph.D., back to school means a full schedule of therapy sessions that all have a common topic – bullying. Dr. Elliott has been a psychologist at Cook Children’s for 28 years and says bullying now starts as early as Kindergarten.

“We see it moving down in years considerably,” Dr. Elliott said. “Parents need to understand, given our culture, that most children will engage in bully behavior because it is being modeled for them through programs on TV, news media and reports, online exposure and adult actors, sports figures and political figures.”

The pandemic has only made the bullying issue even worse.

“COVID, isolation and increased use of social media have definitely impacted bullying – the number of bully incidents have significantly increased, and the severity has also,” Dr. Elliott said.

Since children spend a large amount of their time at school, teachers have the opportunity to demonstrate inclusion and empathy toward others.

“The reality is that teachers are critical role players, and their kindness matters,” Dr. Elliott said.

Types of Bullying

Four types of bullying exist – physical, verbal, social and cyberbullying.

Physical bullying accounts for less than 1/3 of bullying incidents and more boys engage in this type. 

Verbal bullying is the most common form affecting an individual’s self-esteem and feelings for years, leaving scars that last a lifetime. This includes spreading mean rumors, making accusations that are not true, gossip, lies, spreading embarrassing private truths, name-calling, taunting, belittling and cruel criticism.

Girls have the highest engagement in social bullying – a difficult-to-detect form of bullying including ignoring, isolating, excluding or shunning. It is the most potent kind, especially in the middle school and high school years.

As soon as children have cell phones, cyberbullying comes into play.

“Cyberbullying is 24/7 and has a rapid transmission. It reaches the world in an instant,” Dr. Elliott said.

Five years ago, cyberbullying in schools was addressed with the enforcement of David’s Law in Texas which requires schools to notify the parent of an alleged victim of bullying within three business days of a report, rather than waiting for the findings of an investigation. The school also must adopt policies allowing students to anonymously report incidents of bullying and may expel or place a student in a disciplinary alternative education program.

Signs and Symptoms of Being Bullied:

• Does not want to go to school/skips school/gets into trouble at school
• Grades suffer
• Stops talking about peers and school activities
• Loses interest in activities
• Physical manifestations (sleep disturbances, withdrawal and wanting to be alone, complaints of pain or illnesses, appears tearful, displays victim body language such as keeping head down, hunching shoulders and avoiding eye contact)
• Emotional manifestations (appears sad, angry or irritable, withdraws and acts timid, becomes overly moody or anxious, exhibits aggressive behavior)
•  Social/behavioral manifestations (withdraws socially, changes friends, engages in self-mutilation, threatens violence to self and others, talks of running away or suicide, suddenly stops using the computer or other mobile devices)

Signs and Symptoms of Being the Bully:

• Suddenly stops using the computer/device or turns off the screen when someone comes near
• Appears secretive about what they are doing on the computer/device
• Appears nervous when using a computer/device
• Spends an excessive amount of time on the computer/device

“If your child is bullying others, react calmly and don’t blame yourself because there are so many influences in a child’s life. I commend parents who recognize their child could be a bully,” Dr. Elliott said.

Equip Your Child with a Foolproof Tool

When talking to children about peers, the growth mindset of appreciating and valuing differences of opinion should be addressed. Tell your child how to help a classmate who is being bullied such as spending time with them and encouraging them at school and outside of school, helping them get away from the negative situation and telling an adult. 

After researching various strategies to deal with bullies, Dr. Elliott created a response tool that has proven to stop the bully from coming back for more harassment.

“If you show pain, hurt, fear or anger it feeds the bully,” Dr. Elliott said. "Ignoring the bully still gives them the idea they are successful in hurting the victim which fuels the fire and motivates them to keep bullying. The fewer words you say, the better – use words such as ‘OK’ and ‘whatever’ before walking away.”

This strategy acknowledges the bully while at the same time showing him that the tactics are not effective.

“I’ve never had a child or teenager tell me that it doesn’t work,” Dr. Elliott said.

Proactive Tips for Every Parent

Modeling empathy needs to be at the forefront when raising children. Focusing on others’ needs and feelings will contribute to a child’s overall happiness.

• Openly talk about bullying all the time
• Ask questions like “Has bullying ever happened to you? How did it make you feel?”
• Role play and ask “How do you think this would make you feel?”
• Teach empathy and kindness – have child open doors for people, get involved in a service project

“Kids are naturally born with kindness and empathy,” Dr. Elliott said. "What changes over time is what gets modeled for them and what they see.”

No matter who you are, chances are you’ve struggled with body image at some point in life. For children, thoughts of inadequacy can begin early, especially if they have a parent or caregiver who speaks negatively about themselves. On this episode of Raising Joy, Cook Children’s psychiatrist Akemi Watkins, M.D., joins us to talk about fostering a healthy mindset about body image, for both children and ourselves.

She also tackles tough questions like what to do if a family member feels it’s OK to comment on the body size of others – and how we can help kids and teens navigate the filtered world of social media. We also delve into the real dangers of children seeking validation outside of themselves, especially online. If you’re a parent or someone who cares about a child in your life, this episode is for you.

Raising Joy is part of Cook Children’s Health Care System’s Joy Campaign, a communications initiative aimed at preventing youth suicides. For more information about the Joy Campaign, visit cookchildrens.org/joy.

New episodes of the Raising Joy podcast will be available each Tuesday. It is currently available on all major streaming platforms including Apple, Spotify, Google Podcasts and YouTube.

On episode 9 of the Raising Joy podcast, hosts Wini King and Kristen Pyrc, M.D., speak with Lisa Elliott, Ph.D., a licensed neuropsychologist and manager of Cook Children’s Behavioral Health Clinic in Denton.

In this episode, Dr. Elliott discusses bullying and a research-based technique that kids and teens can use to stop harassment, as ignoring bullies rarely stops unwanted behavior.

Dr. Elliott also spotlights social media, video game addiction and what changes she has noticed in most children during the COVID-19 pandemic. In discussing these topics, she notes ways in which parents can serve as a model for behavior and help their children develop resiliency.

“Our kids are watching us navigate difficulties and ethical dilemmas,” she says. “If we approach things with honesty, fairness, respect and kindness, they’re more likely to do that, too. We are all better in power and strength if we work together.”

Raising Joy is part of Cook Children’s Health Care System’s JOY Campaign, a communications initiative aimed at preventing youth suicides. For more information about the JOY Campaign, visit cookchildrens.org/joy.

New episodes of the Raising Joy podcast will be available each Tuesday. It is currently available on all major streaming platforms including Apple, Spotify, Google Podcasts and YouTube.

When we hear the word ‘addiction,’ we often think of drugs and alcohol, but in the 21^st century, addiction has taken on a new meaning. Lisa Elliott, Ph.D., psychologist and clinic manager of the Behavioral Health Clinic at Cook Children’s in Denton, says children are becoming addicted to their phones and gaming systems, driving parents to seek help through licensed therapists.

“We have the research that shows there is a chemical addiction as well as a behavioral addiction,” Dr. Elliott said.

“I think the thing that makes it even more dangerous for me is this is happening with young children, very young children, as much as it is with teens and young adults.”

In 2019, the World Health Organization (WHO), voted to include ‘gaming disorder’ as an official condition in the International Classification of Diseases, akin to anxiety, depression, etc. This paved the way for psychologists such as Dr. Elliott to bill insurance providers, making access to care more affordable for many families with health insurance. However, aside from video gaming, adolescents and teens are also glued to their electronic devices. She says remote learning due to the global pandemic has also played a major role in this addiction.

Cheryl, a North Texas mother, says her 12-year-old daughter is obsessed with YouTube. The family is now seeking guidance from a Cook Children’s family therapist.

Cheryl and her husband didn’t allow their daughter to have a cellphone until they believed she needed it for safety purposes. She wasn’t allowed to have any social media accounts, but her parents did allow her to watch TikTok videos.

“She has a cellphone and iPad, but we made sure everything had parental controls and restrictions,” Cheryl said.

When they later deleted the TikTok account out of concern for privacy issues, they allowed her to watch YouTube videos.

“She watches kids playing innocent pranks on each other, and she gets invested in that. She consistently talks about who is dating who and is always looking forward to the next update like she knows the people in the videos,” Cheryl explained.

Cheryl added that her daughter knew exactly when the episodes were coming out and had a fear of missing out on what was next in the lives of her favorite YouTubers.

When the Cheryl and her husband realized their daughter was going behind their back to find ways to watch YouTube, after she’d been instructed otherwise, they decided to reach out for help.

“For me, it was really about correcting that behavior because right now she has this temptation in front of her and she's making bad choices,” Cheryl explained.

Why are young people becoming obsessed with a reality outside of their own? Dr. Elliott believes the global pandemic has a lot to do with this rising trend.

“I think it's pervasive, so it's not just from an academic setting, but it's also how kids are filling their downtime. It's how they're maintaining social relationships, whether they're healthy or not,” Dr. Elliott said.

Cheryl and her husband couldn’t agree more. They don’t have any issues with their daughter’s choice of content. The issue is her actions and what these minor actions could lead to in the future when bigger temptation is put in front of her.

Cheryl’s daughter sees Stephanie Golden, LPC, a therapist at Cook Children’s Alliance. Golden has been working as a mental health professional for 20+ years but says phone and social media addiction is something she has seen more in the last three to four years in her practice. While phone addiction isn’t healthy, Golden believes it is treatable.

“It’s certainly a widespread problem, but I believe one that can be improved upon with boundaries,” Golden said.

Boundaries are exactly what Cheryl believes would be beneficial for her daughter when it comes to her desire to watch YouTube videos.

In a 2019 study released by the Child Mind Institute, 1% to 10% of children and adolescents have excessive and impairing online behavior. This behavior impacts a child’s ability to focus, the hours of sleep they get at night, and their social behavior with others when they aren’t behind a screen.

Cheryl says having a daughter that’s addicted to YouTube and going behind her parent’s back to find ways to watch it is hard because there aren’t resources for this problem specifically.

“It was really hard to figure out what to do and how to handle this,” Cheryl said. “We tried every single thing we could, from taking away her devices and even sitting down with her and asking her what she needed and how we could help.”

Cheryl and her husband struggled even more because they felt their daughter’s actions were ‘minor’ and ‘innocent’ because she wasn’t struggling with substance addiction. However, Dr. Elliot says addiction is handled the same whether it’s social media or something severe like drug use and gambling. She also notes until more research is done, therapists have to continue to rely on coping mechanisms and techniques they’ve used for adults who’ve struggled with addiction for many years. However, she says that it is scary because she doesn’t want to see adolescents fall into deeper temptation in the future.

“My concern is, if children are creating this addictive response, which we know happens, what kind of addictions does this lead into later?” Dr. Elliott asked. “So I'm concerned about the potential risk they might have for other addictions down the road.”

Cheryl and her husband also struggled with the guilt of putting their daughter in therapy because they didn’t want to take a seat of a child who might’ve needed the resources more.

“She isn’t suicidal and she isn’t depressed,” Cheryl said. “But I had to remind myself that we are putting her into counseling so she can learn skills and those skills can be applied to other areas of her life as well.”

Golden agrees with that sentiment and says in situations like this, she also gives guidance to families/parents.

“Set boundaries around cell phone usage and be consistent with the rules,” Golden said. “Following suggestions from experts can help protect a child’s mental health.”

Dr. Elliott adds another reason boundaries are important is that peer pressure and the need to fit in as at an all-time high. The Child Mind Institute reports 81% of teens say social media makes them feel more connected to their friends.

Cheryl agrees her daughter fits into that category.

“When we ask her why she wants it so bad or feels the need to sneak around to get what she wants, she tells us all of her friends in class are on YouTube all the time on their devices,” she said.

Dr. Elliott urges all parents to keep a very close eye on children’s social media and device use. She says not only can addiction to devices impact schoolwork, it can affect social relationships with others. When a child’s brain is still developing, she says children need healthy and appropriate social interactions to learn empathy, how to relate and communicate, as opposed to learning unhealthy social skills through a device/gaming system.

Cheryl understands the importance of limited screen time and says adolescents don’t fully understand phone etiquette, and how to properly interact with their peers and it is important to set an example and put boundaries into place at an early age.

As Chery’s daughter continues to see Golden, and the family works through this issue, Golden says it’s important to “face the issue with compassion, understanding and firm kindness.” She goes on to add “We don’t always like to have rules, but it’s often healthy and good for us when we follow them.”

Find more technology guidelines from Dr. Elliott shares with her patients from the American Association of Pediatrics below.

• Birth to Pre-School Years
  • There should be no technology from birth to 3 years.
  • Any screen time at this age impairs social communication, development, and attachment to family members.
  • This age should be devoted to social development, sensory-motor skills, and reading skills.
  • Limited exposure may be introduced at 4 years with only high-quality programming.
  • American Academy of Pediatrics (AAP) cautions that all technology programs should be watched with their children.
  • Parents have to lead by example: Do not check messages at the dinner table, do not become absorbed by devices, look at people when they are talking – children notice and mimic everything!
  • Never undervalue unstructured “free play.”
  • Parents should not give their children a tech device as a reward for good behavior. Children must learn to self-soothe.
  • Appropriate activities for 4 year olds
    • Periodically use eReader for storytime.
    • Allow limited access to electronic toys that educate and teach numbers, letters, and vowel sounds.
    • Utilize mobile apps/tech devices for sorting shapes and finding objects.
  • It is critical children engage in physical play, have social engagements and read books!

• Grade School Age Years
  • Create a balance between technology, along with social and physical play.
  • AAP recommends no more than two hours of screen time per day with close parental supervision! And that should be less during the younger grade school ages.
  • It is critical to watch alongside your kids to point out messages that are not congruent to your values.
  • Parents need to designate media-free spaces, including bedrooms, meal times, and playtimes.
  • Screen time should be quality; age-appropriate, share your values, and engage your child’s imagination.
  • Never make screens a reward or consequence.
  • Encourage other activities such as free play outside, playing sports, creating hobbies, arts and crafts, and social activities.
  • Appropriate activities for grade school
    • The goal is to teach responsible use.
    • Use internet under supervision only.
    • Create tech-free talk each day.
    • Institute strict time limit restrictions and rules for use.
    • Monitor computer homework; eliminate all technology when screen time rules are broken.
    • Children need to stay involved with school activities and friends.
    • Model appropriate technology behavior

• Preteen and Teen Years
  • It is critical parents model appropriate technology behavior – they have to practice what they preach.
  • Parents need to establish the rule that their children will agree to “friending” them on social media platforms.
  • Parents should have access to passwords.
  • Maintain open dialogue about what is and is not appropriate sharing on social media platforms.
  • Parents and their tween/teens should develop a social media contract that includes expectations, violations as well as discipline for violations. Try out this great free tool from @AmerAcadPeds: http://www.healthychildren.org/MediaUsePlan
  • Bedrooms should be tech-free, all devices should be removed from bedrooms at night.
  • Snapchat is the most difficult platform to monitor – may be wise not to allow this platform.
  • It is imperative to teach your children about the potential consequences of their postings on social media platforms.

In today’s society, social media is a major part of life for all age groups. While some use the platforms to keep up with family and friends, others use the sites for networking and job hunting. For those 18 and younger, social media has changed the way young people communicate with each other, often leading to inappropriate use, and bullying among other things.

As part of Cook Children’s Joy Campaign, which aims to reduce the number of children and teens attempting suicide, we’re looking at the role social media plays in the mental well-being of young people.

Kristen Pyrc, M.D., medical director of Psychiatry Outpatient Services and the Partial Hospitalization Program at Cook Children’s, says the number of her patients dealing with anxiety and depression has significantly increased over the past year. She’s concerned that social media is playing a role, especially during the pandemic when young people are online more than ever.

“I have seen an increase in depression symptoms in teenagers who had not had them before,” Dr.Pyrc said. “So maybe I regularly see them for something like ADHD, and now they are showing symptoms of depression on top of that.”

Dr. Pyrc said she often hears complaints from parents that their children are ‘tied’ to their phones. She believes a major problem with that is a lack of exposure to seeing friends in person, and the opportunity for kids to feel left out when they see peers online having fun without them.

“I think online culture can worsen students’ feelings of loneliness and rejection because they see their friends doing things together without them in real time,” she explained. “Also we tend to post things that highlight what’s going well in our lives, but may not tell the full story of the times that we feel sad or inadequate. When teens are feeling down, seeing everyone else having fun without them can make them feel worse.”

Katie Greer, an internet safety expert, has spent the past 15+ years educating students, parents, law enforcement, and large companies across the country about the importance of online safety.

“I have seen social media used to bring out the best in humanity, but I have also seen it rip families apart in a matter of minutes,” she said.

Greer, who began her work as the director of Internet Safety with the Massachusetts Attorney General’s Office, believes social media has evolved in ways no one was ready for. Not so long ago, bullying was something that happened mostly at school. Now, young people are bullied online, in front of countless people. Even worse, a bully’s comments can be liked and shared by others.

“Kids were already spending a lot of time on their phones and online, then came a global pandemic. Now, they’re attending school online and relying on things like gaming online and social media platforms to connect,” Greer said. “There’s a lot more opportunity for cyberbullying and while it can start with one person, it can be a matter of seconds for others to jump in with a like or a comment and gang up on the victim.”

Situations like this increase a child’s chances of dealing with anxiety, depression, and self-harm.

“We know that developmentally, children’s brains aren’t fully formed,” she said. “When we put something in front of them as complex as social media, it’s almost as if we are asking for trouble.”

Greer also warns parents about the newfound TikTok culture.

“TikTok is a platform that has created unrealistic expectations about everyday life,” she explained.

She said children and teens see their peers or influencers having “perfect” lives and begin to feel as if they’re inadequate, or aren’t enough or worth it.

“Children have a desire to fit in and they want to have as much or more than their friends,” Greer said. “When children see their friends flaunt material things, or lavish experiences, that can make them spiral.”

Another issue putting kids’ mental health in danger is ‘sexting’ or the exchange of nude photos and videos, which has become quite prevalent.

“I recently was made aware of an incident where a girl sent a guy nude photos and he leaked them. Once they were leaked, so many people saw them, the young girl was humiliated,” Greer recalled. “The family reported that this led to the young girl untimely killing herself out of embarrassment and humiliation that her photos were leaked.”

Greer said, in cases like these, it is vital to remember that not only does suicide hurt a family, it also tears apart the people who loved and supported the victim.

Cook Children’s launched the Joy Campaign, which this story is a part of, to bring awareness to the increase in suicides and suicide attempts being seen at the medical center. In 2020, seven Cook Children’s patients died of suicide, making suicide the leading cause of traumatic death for the first time ever. The hospital has also seen record numbers of patients being admitted for suicide attempts month after month, most recently in March when 43 children and teens were treated for injuries. While the increase in suicide attempts cannot directly be tied to the pandemic, Dr. Pyrc said children need certain things to properly function in day-to-day life.

“Kids need in-person interactions. They need sunshine and exercise and all things encompassing,” Dr. Pyrc said. “Whenever your world is mostly virtual, it can hurt both your physical health and mental health.”

What does Greer suggest parents do? Stay alert and ask questions.

“A simple, “How was your day?” or “How are your friends doing?” can go a long way in opening the lines of communication,” she said.

She emphasizes knowing what your child is looking at online and know who they are talking to. If you are concerned about your child’s safety, there are measures you can take.

“While I am typically against this and wouldn’t always recommend it, there are ways parents can use apps that will mirror their children’s phone,” Greer said. “I do believe this could hurt the trust between a parent and a child, and isn’t the best way to go about typical monitoring, and I only recommend phone mirroring for dire situations.”

Before leaving any session, Greer reminds everyone she speaks with about the importance of a trusted adult.

“I tell parents and all adults it is important that children have a trusted adult they know they can come to at all times. Parents have to be okay with the fact that the adult may be someone other than them, it is all about a child feeling safe and opening up,” she said. “I also remind every child that I come in contact with that having an adult you trust is one of the most important things you can do to protect yourself and even help a friend.”

Both Greer and Dr. Pyrc see the issue and know there is a lot of work to be done to ensure we are helping our children with their new reality. Both professionals share their tips to help parents and families better support their children.

1. Take your child’s phone before they go to sleep at night. Disrupted sleep has a negative impact on adolescents.
2. Have an open dialogue with your child without judgment and give them the ability to freely express themselves to you. Given the amount of time kids are online, these conversations should happen every day.
3. Ask about their social media. Talk to your child about what they’re seeing, how it impacts them/makes them feel, and know who they’re communicating with.
4. Ensure your child can identify a trusted adult and make sure they understand that an adult can be their go-to person at all times.
5. Talk to your child about good social media etiquette. Remind them if they see something, say something and describe how that can help save someone’s life.
6. If you believe your child is in danger, there are apps available that can monitor their phone so you can see everything they see and get them the help they need immediately.
7. Reach out for help. Do not wait until your child is in a dire situation to reach out for help and get them the resources that could save their life.

Monitor your child’s social media, and make sure you have their usernames/passwords in case of an emergency situation.

Important to note:

Instagram has an anonymous reporting tool that allows users to report when they believe something could be wrong with a friend. The site sends the person resources depending on what was reported on their behalf. These resources could be vital in saving someone’s life by simply reporting.

And, I’m pretty sure my freshly minted 10 year old will soon be asking about his own Twitter, Instagram or YouTube account soon. I realize this is a tricky situation. Especially since I’m the medical advisor for Digital Health at Cook Children’s and I’m active on social media.

Trust me I see the irony … or maybe the hypocrisy.

But Right now I’m planning to hold off AS.LONG.AS.I.CAN.

Why?

Because I’m a parent. I worry about my kids like everyone else and I want them to be safe and protected

I’m also a pediatrician and I talk to too many kids in my office who are dealing with the negative fall-out of social media. I also see way too many studies addressing how social media has caused harm.

Social media can lead to:

• A fear of missing out. I wasn’t cool in high school (this may shock you and if it doesn’t just stay quiet) but I really didn’t know what I was missing out on. Everyone partied on the weekend but didn’t say much to me about it on Monday. If there had been pictures and posts from the weekends, I would’ve understood how left out I probably was.
• Inappropriate expectations of appearance. We don’t look like the celebrities we follow on social media and we probably never will. Sometimes though it’s important to remember the celebrities don’t look like the celebrities when they are on social media either. They are photoshopped and edited many times. But still, our kids are left to compare themselves to people who taking professional photos or using editing software to make everything look perfect. It’s their job after all. Unfortunately, that doesn’t keep many of us from feeling jealous or feeling like we’ve fallen short when we don’t.
• Bullying. Anonymous or even semi-anonymous (or “behind the screen”) empowered bullying can cause isolation and fear. And it doesn’t stop when you go home from school like it did when I was a kid/teen.
• A lack of ability to process our feelings. The constant ding of dopamine we get from the amount of likes on our posts enables us to continue posting to get our fix rather than process and dive into our sadness.
• Oversharing and shame. Teenagers and preteens don’t understand the significance of oversharing and what can happen later when those details (or pictures) get shared to a wider audience.

So what should we do as parents?

Here’s what I recommend:

• Keep your child off social media as long as possible. I know. I hear it too with my three kids. But the longer you can keep them away from it, the more time you have to talk to your kids about this issue and let them mature to handle what will inevitably come their way.
• When they get on, you get copies of their passwords and connect with their accounts. You can have privacy when you are out from under my roof. Oh man, I’m starting to sound more and more like my dad. But until then, sorry kids, I’m doing everything in my power to protect you.
• You reserve the right to delete the account and take their phone at any time. I paid for it and I can take it away.

I hope this helps. Just know I’m dealing with it too and would love to hear your thoughts. Again for irony … on social media.

A recent poll by Common Sense Media shows how much teens rely n their media devices. About 50 percent of teens say they are addicted to their devices. 

But what are the consequences to this addiction?

While social media itself is not inherently dangerous, the content that teens are exposed to on social media can be harmful.

It may be all fun and games at first, sharing funny videos or posting pictures from vacation. But social media exists in an arena where comparison, bullying and inappropriate content can occur. While teens may not be using social media for these reasons, they are still in danger of exposure to potentially hurtful content, especially cyberbullying.

JAMA Pediatrics (The Journal of the American Medical Association) conducted 10 studies that explored the link between social media victimization and depression. Alarmingly, every single study showed a significant correlation.

Twenty-three percent of teens report that they have been targeted by cyberbullying. There’s something about the privacy of a keyboard and a screen that gives teenagers a false bravery and security, convincing them that they can post and share whatever they want, without consequences.

“Cyberbullying can be more extreme than other forms of bullying because it leaves the victim feeling as if they have no escape. Since it occurs on their personal electronic devices, they can be sent and received quickly with a feeling of permanence,” said Lisa Elliott, a licensed psychologist and clinic manager of Cook Children’s Behavioral Health in Denton

The National Institute of Mental Health estimated that 2.2 million adolescents have had at least one major depressive episode in the past year due to social media. Even worse, victims of cyberbullying are more than twice as likely to attempt suicide. It’s heartbreaking to think that because of a cowardly comment typed from behind the security of a screen, a teenager decides that life just isn’t worth it.

Even if teens are not experiencing cyberbullying, some are finding their self-worth on social media. Teens invest emotion into the number of likes and comments on a post. The Common Sense Media poll found that 72 percent of teens feel the need to respond to text messages, social media messages and other notifications.

The more likes, the more validated they feel. The less likes, the more self-conscious and lonely they feel. It’s as if there’s some unspoken ranking based on the number of likes an Instagram post can get. Sorry, teens, but validation is not found in the double-tapping of a screen.

Social media is also the perfect platform for teens to experience what they call “FOMO” (fear of missing out). They compare themselves to their “friends” on social media, and are constantly exposed to things that make them yearn to be included. If your teen is commenting #FOMO on everything on their news feed, then they feel extremely dissatisfied with their life compared to somebody else’s because of the false reality social media has the power to project.

So what is the solution? If you ask a teen to quit social media, you may run the risk of sending them into a state of shock and withdrawal. It is also not fair to say that every teen on social media is depressed. So how do we address the ones that are suffering from the harmful effects of social media?

Elliott said to check what your teens are following. If their news feed is filled with braggadocios posts and bullying, then they need to reassess their “friends.” Social media should be a safe place to socialize.

Therefore, encourage your kids to be a light on social media – talk to them about how real life exists beyond a handheld gadget or a lit up laptop screen. Ultimately, challenge them to use their social media for positive interactions. If they wouldn’t say that comment out loud, in person, don’t say it. If they wouldn’t want their dad to see that photo, don’t post it. If they see something inappropriate on their news feed, report the content and remove the friend (they sound like trouble, anyways).

“Educate your children that everything they put out into the cyber world is there forever and how important it is to have a positive online reputation,” said Dr. Elliott.

Social media is not going to go away. However, there are ways to overpower the harmful effects it can have on our teenagers. Pay attention to their demeanor. If they’re in a bad mood, ask them how many Instagram likes they got that day.

Written by Elizabeth Sparks

Games and apps that are locally loaded and need no connectivity to the Internet to work are not categorized as "dangerous" as long as the content is appropriate for the age level of the child. However, most "free" apps require some level of connectivity for ad delivery. These ads are often unregulated or under-regulated and could contain links to material that is inappropriate for young children.

2. Social Interaction

Xbox, Playstation, and Wii (to name the popular consoles) all have the ability to connect a player with other, anonymous users. There are also games and other apps on Andriod, iOS devices, and PC that also allow social interaction with the gaming community. Kids can be subjected to ridicule, bullying, and age inappropriate conversations. Of course, sites and apps designed specifically for social interaction can be a worry if the content is not filtered and users can remain anonymous.

3. Information Sharing

A good deal of social media sites and apps give out a plethora of information about the user. This data can range from age to birth date and general regional area to specific city or even the exact address. A lot of times the information given is based on the users input and privacy settings; however, sometimes it can be unknown to the user. Take GPS location services as an example. If the young user may not be aware the app is pinpointing their current location to within 30 feet. Or, if they do, they may not realize the dangers associated with this type of situation.

4. False Accounts and Anonymity

Most social media sites and apps - even the most well known - allow for fake accounts to be created. Beyond fake accounts, a lot of apps out there promote anonymity among the users. Apps like "Omegle" and "Chat with Strangers" were built around the premise of anonymity. The problem comes when the child is encouraged to give out their personal information during a chat session. Children can be gullible and may more readily fall for scams being perpetrated by an adult. Even seemingly useless information can be used to create a bigger picture.

5. Lack of Filtering

Some sites and apps are policed for inappropriate content while others are not. However, even on sites that are supposed to be policed and filtered for inappropriate content, some things still get through. Take YouTube as an example. It is very difficult to police millions of videos and code that can successfully filter videos by content are not very useful (i.e. skin tone recognition) and produce too many false positive alerts. Because of this, YouTube relies on the community of users to police the content and alert YouTube if inappropriate material is found. Does this work? Not well. When's the last time you spent hours looking at random videos for inappropriate content? Beyond YouTube, sites and apps usually filter content based on age restrictions. My kids use age appropriate sites for educational entertainment that does filter content. If you attempt to type foul language, the words will be replaced with asterisks. You will also be warned and, if the behavior continues, your account will be terminated. The big problem comes when children lie about their age and sign up for apps designed to be used by adults. In those cases, there are not content filters.

6. Intent of the App

Any app can be used in a benign or harmful way; however, many apps out there are specifically intended to be used for meeting up with people to either date or downright have a sexual encounter. Regardless of what my child may tell me regarding their use of an app specifically designed to facilitate a sexual encounter with an adult, I would never allow continued use of the app. The bottom line is apps intended to be used by consenting adults should not be used by anyone under age - period. Even if the child's intention is to use such an app outside of the apps expected use, other users on the app will not know this. Things can go horribly awry.

7. Maturity level

Continuing with the intent of the app and the age and maturity of the user, children may be signing up on these sites out of curiosity or the lure of monetary gain. Sites and apps designed to be "Sugar Daddy" dating apps can be alluring. "Meet a millionaire" who will bestow expensive gifts upon you! These sites are very dangerous. The judgment of a child is not mature ... because they are still a child. Reactionary decisions can lead to catastrophic results. A young girl may be upset because her parents refused to upgrade her iPhone to the latest version and her friend tells her about some "sugar daddy" dating app where she can meet a man that will buy her whatever she wants. Immaturity can be a hindrance to thinking things through and recognizing the potential dangers.

I love to watch them play and have fun, but I’m not watching them every single second. I’m usually reading something on my laptop and I glance up here and there to see what they’re up to. More often than not, they’re pausing to get the rules straight before they conquer that which would destroy us all. However, I have found myself jumping from my seat and running to the back patio door to tell them to stop! Why? Because I notice them doing something with their sticks that has a high potential to hurt one or both of them.

In and of itself a stick is not dangerous. A stick is a stick. You can poke in the mud with it, you can use it to imagine slaying dragons, or you could run with it out in front of you (the tip only inches above the ground, bobbing with every stride) and potentially impale yourself with said stick. Or, you could witness your 4-year-old swinging his stick wildly as the 8 year old, backing up to prevent being struck, stumbles over a toy wheelbarrow while the 4-year-old continues his assault. That’s what got my attention.

So, let’s talk about sticks … I mean apps. It’s the same conversation. Sticks come in all shapes and sizes. Some may be too big for my 4-year-old to handle; however, being a bit older, my 8-year-old may not have a problem with a slightly larger stick. Comparing this to apps on the tablets, my 4-year old does not understand some of the games my 8-year-old might play; but, he loves Reading Eggs®! But, since my 8-year-old is reading chapter books, Reading Eggs® (which helped him at one time) is now a “boring baby game.” For one, the stick is too small. For the other, the stick is just right.

As they grow older, they will want to delve into apps that challenge their maturity level and hold their attention. In the tween years, they will become more and more enthralled with social apps. On into the teen years, connecting with friends will more than likely become far more important than playing Cut the Rope® or Where’s My Water?®. It’s during these transitional periods that we’ll want to glance up from the kitchen table to take a quick peek into the virtual backyard. Knowing how to do this is half the battle.

Any app – even ones designed specifically for the facilitation of risky behavior – can be used in a way that is benign. All children are different and most are going to push the boundaries at some point or another. It’s our job as parents to guide them. In order to guide them, we need to be able to “glance up” to see what they are doing. Are they using social media apps? Are they playing games? What apps do they have loaded on the device? Are they chatting with strangers? What information are they giving out? I could keep adding questions. First, let’s talk about the most dangerous app of all.

Depending on their temperament, maturity level, risk taking, decision making skills, and overall attitude, the most dangerous app could be between your child’s ears. On the flip-side, it could also be the best security app available. Apps are not dangerous. Impaling yourself with apps is dangerous. Teaching your child good decision making skills and helping them to keep their compass as north as possible is the number one best way to prevent harm, period. In order to do that, you have to be able to “glance up” to ensure the compass needle is not falling.

There are two ways to secure a mobile device. One way is preventative security. Net Nanny® is a great app for enforcing parental controls for younger children. It prevents the errant Youtube video from introducing your child to inappropriate content as they follow the rabbit hole after searching for Spiderman. As they get older (and a bit wiser), preventative security measures lose their potency and can lead to a false sense of security for the parent. That’s why I recommend monitoring software.

There are several monitoring software packages available and, as with apps in the app stores, they are a moving target. iSpyoo® for iOS and Android (and other mobile phones) has received an “outstanding” editor’s rating on CNET.com. The review (which can be found on the CNET.com site and a search for iSpyoo) is for Android specifically; however, iSpyoo’s website boasts that “iSpyoo works on all mobile phones and networks from around the world.” Whichever monitoring software you choose, ensure it (1) cannot be detected by your child and (2) can send periodic alerts to your email address. A quick scan of the activity could either set your mind at ease or raise red flags. However, in order for this to work, you must maintain ownership of the device.

As a security professional with over 20 years of experience, I am 100 percent against giving smartphones, tablets, and other devices as gifts unless the rules are laid out appropriately. My rule is that, until you are on your own, you are borrowing MY device. I am the administrator and you are my child. That phone is on MY data plan and, while I did name it as your phone on the carrier’s website, I still pay the bills and I can cancel at any time. If you lay these rules out from the beginning, you could potentially run into far fewer problems down the road.

The bottom line is, yes, there are apps on the markets that give us concern. Some apps can be used for setting up a rendezvous with a stranger in a dark alley. If I were to tell you about specific apps today, I would miss the ones that will be coming out next week, month, or year. In all of my research and expertise, I still have not figured out how to definitively foretell the future. I can predict with a high degree of certainty, however, that there will be more apps coming. Keeping track of what your child does on their phones, tablets or computers will always be the best way to protect them. Just remember to bring your own stick to the game.

About the author

Jody S. Hawkins, Information Systems Security Officer, has been in technology for medical facilities since early 2000 and has been practicing for more than 20 years with his start in the United States Air Force. He is a part of Cook Children's Experts on Call Speakers Bureau. Hawkins specializes in privacy and technology safety and is a regular speaker at the National HIT/HIPAA Conference. He has been quoted and published in several national publications, including Health Information Management Magazine.

Hawkins' can speak on a variety of security topics facing our children & parents today, including:

• Social media
• Cyber bullying
• Sexting
• Safety online (Parents & Child)
• General home networking security
• Virtual Child (Parents)
• Internet Safety (Parents & Child)