Ment ental al Hea ealth lth Series eries Attachment and - - PowerPoint PPT Presentation

Attachment and Technology: A Paradigm Shift?

• Dr. Hazen Gandy

child & youth

Ment ental al Hea ealth lth Series eries

February 16th, 2017

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Declaration

• f conflict

Speaker has nothing to disclose with regard to commercial support. Speaker does not plan to discuss unlabeled/ investigational uses of commercial product.

Cro-Magnon Family

Modern Family (without technology)

Attachment – what is it?

• A relationship
• A Process
• The pursuit of proximity, contact and

closeness with others so as to be loved, known and understood by others.

Attachment – how does it happen?

Serve and Return:

• Greeting/Welcoming
• Eye contact
• Smiling
• Emotional attunement
• Acknowledgment
• Validation
• Social and emotional reciprocity
• Physical contact

Attachment – what does it do for us?

• Allows us to feel safe with others
• Allows us to develop intimacy with others
• Allows us to develop interdependence with
• thers
• Allows us to develop a sense of agency and

competency

• Allows us to experience solitude positively
• Motivates us to support and protect others to

whom we are attached

Attachment – what does it do for us?

• Allows us to work together
• Allows us to cooperate
• Allows us to collaborate
• Allows us to socialize

Through strong attachments, these qualities profoundly improve our chances of survival and the opportunity to successfully reproduce.

The Ultimate Modern day Collaboration

Modern Family with Technology

The positives of modern civilization

• We live longer, many of us have all our basic

needs met

• We have a world of knowledge at our fingertips
• We can communicate with someone across the

world

• We have incredible technology that one

generation would have been considered magical

• Today’s “Digital Natives” will continue to innovate

in ways we cannot predict

The positives of modern technology

• Telehealth technologies allow remote communities to

benefit from the expertise of a medical professional at a fraction of the traditional cost of transportation, lodging

• Newer generations of ‘empathy’ video games can

simulate experiences that will help us be more empathetic

• Communication technologies allow those who

previously could not connect, the ability to now connect, e.g. neurodevelopmental populations (e.g. ASD) or marginalized/oppressed populations

• And so on…

Despite the positives of modern civilization…

• Depression/Anxiety

– Suicide up 300% in female teens since 1960’s (StatsCan, 2010) – Increased demands for mental health services

• Increased narcissism / lack of empathy

– Generations born since the 1980’s show increased narcissism, lack of empathy, self-focused “Me Generation”

(Twenge, 2011)

What might be going wrong? Let’s look at our history on this planet…

In the Past…

• We lived closely with

nature

• We walked everywhere
• We interacted with

people face-to-face

• We had a wide circle of

family and friends

• In the evening, families

would spent time together

Deep connections to people, in particular family

Nature

As a result, child/youth are hard-wired to require…

Other meaningful things such as community, culture, spirituality, etc...

How things have changed…

• In cities, indoors
• Driving everywhere
• In front of a screen rather in front of fellow

human beings

• With smaller families and narrower circles
• f (true) friends, i.e. the village is no more
• Parents busy working, with two income

earners required to support a family

• Even in the evening, families often doing

separate activities

• Disconnected from families, friends, nature

and more connected to technology

Deep connections to people, in particular family Nature

As a result (of modern society), many children/youth are disconnected and over-connected to things that do not provide happiness…

Other meaningful things such as community, culture, spirituality, etc...

Peers Technology Pleasing the self through materialism, consumerism… Pinker, Village Effect; Turkel, Connected but Alone; Berscheid, 2003

• Q. Can things such as video games, TV,

materialism meet our needs?

• A. Things cannot meet our deepest

emotional needs…

• Technology, video games, consumerism, nice

clothes, holidays and hedonism may keep us distracted and entertained

• However, they do not

– … meet our hard-wired need for human connection – …help us develop an ability to be with ourselves – … help our brains make oxytocin

The problem with video games

• Q. What’s the big deal about video

games?

VIDEO CLIP: MODERN VIDEO GAME

Gameplay videos of many violent games are available from Youtube.com

Available at your local drug store!

Screenshot from Call of Duty

Violence negatively affects children’s brains

• Media violence has negative effects on behaviour,

mood, relationships, physical health, sleep

• Worse effects with more engaging media

– Nature documentary < procedural police show < first person shooter

• Mechanisms of media violence

– Desensitizes us to violence and cruelty and have less empathy – Leads us to view the world as a scary place – Increased aggression

MediaSmartsca; American Academy of Paediatrics, Media Policy Statement

An Interesting Corollary

Crime is down…

2008

• Expected crime wave following financial

collapse did not occur-violent crime decreased while videogame sales increased 2009-2013

• Charges laid for robbery, motor vehicle theft,

aggravated assault and break and enters for those 18-24 years dropped 23-31%

• Charges for homicide dropped 29%
• Lowest rate since 1969

Ken Pease, 2015

Is crime down due to technology and/or security?

• Is crime rate down due to technology?

– Preoccupation with technology reduces the

• pportunity for violent crime and acquisitive

crime thus reducing them in the aggregate. – “Cyberspace becomes more interesting than meat space.”

• Is crime down due to increased security?

– Its harder to steal a car, shoplift these days due to ignition kill switches, increased surveillance technology, etc..

Ken Pease, 2015

Other observations

Margaret Wente –the Globe and Mail August 20, 2016

• Gender gap in universities is widening
• “Young men are dropping out of the workforce-not

interested in finding jobs. …living with parents or

• relatives. They spend 75% of their (new found)

leisure time playing video games. They are actually content compared to their working peers-they’re addicted to video games not because they are out of work but because playing video games is more fun working” - Erik Hurst University of Chicago

Before technology, how did we spend our time? Nature…

Nature is essential for health

• Despite modern society, most of our existence has always been closely

connected with nature

• Modern ‘westernization’ has doubled our life expectancy, but has created

emergence of new, serious diseases, e.g. depression / suicide

• Studies show that nature helps physical and emotional health

– Improves depression, anxiety (Berman, 2012), attention deficits (Taylor and Kuo, 2009) – Reduces aggression (Kuo et al., 2001) – Reduces myopia – Reduces cardiovascular problems (Beyer, 2014) – Wilderness course (2-weeks) has psychological/lifestyle benefits (Greenway, 1995)

• As a public health intervention, increasing exposure to nature is

perhaps one of the most cost-effective interventions (Maller et al., 2006)

Fractals

We are not getting enough nature

• “Nature deficit disorder”, (Richard Louv, Last Child

in the Woods, 2005)

• Today, human beings, especially children spend

less time outdoors  behavioural, emotional,

• ther problems
• “Time in nature is not leisure time; it’s an essential investment in our children’s health.”
• “Ecotherapy” (aka. “green therapy”, “earth-

centered therapy”)

– Nature based ways of physical and psychological healing (Clinebell, 1996)

Technology is really irresistible to our primitive brains

We know that our kids require face-to-face time and serve and return interactions…

But tech is irresistible, and can make us ignore our kids…

From http://www.babble.com/kid/parents-on-phones- ignoring-their-kidsis-your-picture-on-this-list/yeah-uh-huh- 2/

… Ignore our driving…

… Ignore each other…

This is what we are seeing…

• “Baby/Toddler Apps”
• >50% parents let their babies use

smartphone or tablet

– 1/7 allowing for 4+ hrs/day

Survey Data

• U.S. children/teens (age 8-18) spend more time in

front of an electronic screen than with family/friends

• Most have no household rules on their use

– 7 hr/day

• Television, cell phones, hand-held games, Internet games,

Facebook and video games

– 11 hr/day

• 30% of kids are multi-tasking 11-hrs of content into their 7

hrs/day

– 2-hrs/day

• Violent video games

Generation M2: Media in the Lives of 8- to 18-year olds, Kaiser Family Foundation

• 54% of kids preferred to spend time with the TV

compared to parents

AC Nielsen report

TeleNav survey of 541 US mobile phone users in July 2011.

• Q. Back in the 1990’s, when

children/youth were admitted to hospital (i.e. 6E), what was their number one question?

• Q. Back in the 1990’s, when

children/youth were admitted to 6E, what is their number one question?

• A. Youth: “When are visiting hours?

When do I get to see my parents?”

• Q. Nowadays, when children/youth

are admitted to hospital (i.e. 6E), what is their number one question?

• Q. Nowadays, when children/youth are

admitted to hospital (i.e. 6E), what is their number one question?

• A. When can I have my cell phone back?

I.e. cellphones have become our teens’ single most important attachment…

Ways in which technology is bad

Why devices are bad for infants / toddlers

• Speech/language pathologists in First Words programs 

increased numbers of children with speech/language delays due to overuse of technology

• Digital devices are sedentary  impair physical development

including impaired motor skills and hand-eye coordination

• Digital devices do not have ‘serve and return’  between

parent/child necessary for language development

• Digital devices cause child to connect with a device to meet

their needs rather than human

• Devices are particularly bad if we use them to soothe a child

 child learns that you use technology to self-regulate

Why devices are bad for children

• Children are “hurt” by being ignored when a parent uses a

device (Turkle, 2010)

• And when our kids want our attention, we get more frustrated

at them

• Parents using devices are more likely to respond to their

children in a harsh or negative manner (Radesky, 2014)

• Screen time is...

– Not restorative (unlike time in nature) – Nor does it meet our core needs – Nor does it promote creativity

Lack of face-to-face contact  Loss of empathy

• Plugged in kids have…

– Less face-to-face communication with a live human being – Less opportunities to learn how to make eye contact, read facial expressions, interpret body language and tone of voice – Less opportunities to learn empathy

• Studies confirm…

– Many adolescents and teens today are having difficulty identifying emotions in people – Generations since the 70’s are more and more narcissistic and less empathic (Twenge, 2013) – UK Association of Teachers and Lecturers reports rising numbers of children who can swipe a screen, but unable to perform use building blocks, or socialize with others

Why technology is bad for parents

• Parents using devices more likely to respond

to their children in a harsh or negative manner

(Radesky, J. Paediatrics, 2014)

• Children emotionally hurt when ignored by

parents distracted by a device particularly at

1) at meals, 2) at pickup after school, 3) extracurricular activities, sports events (Turkle,

2013)

“Screen sucking”

• Screens are a “time suck”

– Wasting time from spending cumulatively thousands of hours in front of screen learning few (if any) useful skills for life – Loss of child’s time from participating in other beneficial activities, such as being outdoors, getting exercise, reading a book,

• r doing schoolwork
• Dr. Hallowell, ADHD expert

How modern technology weakens parent-child relationships

• Q. In the old days, who did children ask if they

didn’t know an answer?

• A. Adults, such as parents

• Q. Nowadays, if your teenager doesn’t know

something, what do they do?

• A. Google – in other words, parents have been

replaced by Google

• Q. A child is playing ball with a parent.

Who is going to be more competent at it?

• Q. A child is playing ball with a parent.

Who is going to be more competent at it?

• A. The Parent

In traditional societies, the young learn from and thus respect their elders…

Margaret Mead, 1956

• Q. But in today’s technology obsessed

world, who do our children turn to when they have a tech question?

• A. Their peers

• A. Our children know more about the

technology than we do, which makes them think they are superior…

Boy, my dad is terrible! I hope my son appreciates all this effort I’m making

Why are Screens so Darned Addictive?

What Fuels the Addiction in Children and Adolescents?

• Developing, immature frontal lobe and executive

functioning

• Cultural shifts –
• Peer orientation and invalidation of adults
• Techies, adolescents and marginalized depicted as heroes
• Celebrity culture
• Possibility of instantaneous success
• Easy access to entertainment
• Software designed to addict – “Hooked” – Nir Eyal
• Hardware designed to be personal and “all or

nothing”

Screens give us “easy dopamine”

“Easy dopamine”, i.e. provides lots of dopamine, adrenaline with little effort When your brain gets used to “easy dopamine”, its harder to do things that provide less dopamine, that are ‘boring’ like:

• Going for a walk
• Homework
• Face to face contact
• Driving
• Looking at your child…

Screens are overstimulating

• Although it gives our brains a

rush of adrenaline / dopamine, it is actually not calming nor refreshing, and can trigger fight/flight responses

• Especially in those with brain

conditions, e.g. seizure disorders, sensory processing issues, autism, issues that affect filtering such as psychosis, or anxiety

• Multi-tasking just makes this

worse…

With excess screen use…

• With excess screen use over time, the body is under

chronic alarm, i.e. stress

– Blood flow shifts from frontal (developed brain) to the more primitive parts of the brain

• Thus, one can see problems with regulation, attention,

creativity, social behaviour

– Body makes cortisol, a stress hormone

• High cortisol impairs memory (from hippocampus), disturbs

sleep, disturbs concentration, causes weight gain

• Electronic Screen Syndrome (ESS)

– Signs of an overloaded brain can mimic any psychiatric disorder

• E.g. inattention
• E.g. mood/anxiety problems
• Dr. Victoria Dunckley

Quotes from Sherry Turkle

• “Because you can text

while doing something else, texting does not seem to take time but to give you time. This is more than welcome; it is magical.”

Sherry Turkle

Quotes from Sherry Turkle

• “Connecting in sips may work for gathering discreet bits of

information, they may work for saying, "I'm thinking about you," or even for saying, "I love you," but they don't really work for learning about each other, for really coming to know and understand each other.

• And we use conversations with each other to learn how to

have conversations with ourselves.

• So a flight from conversation can really matter because it can

compromise our capacity for self-reflection.

• For kids growing up, that skill is the bedrock of development.”

Quotes from Sherry Turkle

• “You end up isolated if you don’t

cultivate the capacity for solitude; the ability to be separate; to gather yourself.

• Solitude is where you find yourself so you

can reach out to other people and form real attachments.”

Taking a Digital History

• How do you spend your day? Walk me through your day…
• What type of devices / electronics do you use? (e.g. TV,

tablet, cell phone, etc.)

• For each device, ask

– Where? Where do you use your device, e.g. bedroom? – When? How many hours a day do you spend on ___? – What?, i.e. What games / devices / etc. do you use?” – Why? i.e. What do you enjoy the most out of using ____?’ (in

• rder to assess for needs that might be replaced elsewhere)
• Negatives

– What’s the worst thing that has happened to you online? – Ever been bullied online? Ever done anything online that you’ve subsequently regretted? (e.g. posting, sexting, etc.)

Diagnosis of “Tech Addiction”

DSM-5

• DSM-5 does not recognize video gaming or technology addiction per se, although

it does propose diagnostic criteria for Internet Gaming Disorder: Internet Gaming Disorder

• Repetitive use of Internet-based games, often with other players, that leads to

significant issues with functioning. Five of the following criteria must be met within one year:

1. Preoccupation or obsession with Internet games. 2. Withdrawal symptoms when not playing Internet games. 3. A build-up of tolerance–more time needs to be spent playing the games. 4. The person has tried to stop or curb playing Internet games, but has failed to do so. 5. The person has had a loss of interest in other life activities, such as hobbies. 6. A person has had continued overuse of Internet games even with the knowledge of how much they impact a person’s life. 7. The person lied to others about his or her Internet game usage. 8. The person uses Internet games to relieve anxiety or guilt–it’s a way to escape. 9. The person has lost or put at risk and opportunity or relationship because of Internet games.

“Tech Addiction” based on DSM-5 principles

Technology “Addiction”

• Repetitive use of technology (e.g. video games, computers, cell phones, tablets,

etc), that leads to significant issues with functioning. Five of the following criteria must be met within one year:

1. Preoccupation or obsession with technology 2. Withdrawal symptoms when not using technology . 3. A build-up of tolerance–more time needs to be spent using technology . 4. The person has tried to stop or curb using technology, but has failed to do so. 5. The person has had a loss of interest in other life activities, such as hobbies. 6. A person has had continued overuse of technology even with the knowledge of how much they impact a person’s life. 7. The person lied to others about his or her technology use (e.g. online games). 8. The person uses technology to relieve anxiety or guilt (e.g. when upset, person uses technology to soothe). 9. The person has lost or put at risk and opportunity or relationship because of using technology.

Management/Interventions for the Technology Addicted Child

Treat any treatable DSM-5 conditions

• Interventions for any mental health conditions such as

ADHD, social anxiety, autism spectrum disorder (ASD)

– Untreated ADHD with inattention, high need for stimulation and lack of impulse control may make it harder for a child to detach from technology and thus, treating ADHD may help – Untreated social anxiety disorder, with an avoidance of live social contact may similarly make it hard for such a child to connect with people – A child with ASD who has no other social contacts or interests is possibly more likely to be overconnected with a device; hence, appropriate interventions with ASD may be able to help connect a child to healthier attachments

Education for Parents

• Take a look at your own technology use.
• Understand what children/youth need above all,

is healthy connections with parents

• Understand that technology is no replacement

for genuine human interaction

• Ensure you have a close relationship with your

child that is nurturing and caring

– Spend 1:1 time with your child – Be sure that you are the primary influence in your child's development rather than technology, to protect yourself and their children against negative influences from television, media, video games – Be close so that your child can turn to you to meet their core needs rather than technology

American Academy of Pediatrics (2013)

• Have a family plan with reasonable but

firm rules

• Limit total screen time to < 1-2 hrs/day
• Keep screens out of the bedroom
• Monitor what media children are using
• Enjoy with children and discuss
• Enforce mealtimes & bedtime “curfew”

Resources

• Consider

1) Dr. Dunckley’s “Reset Your Child’s Brain”, which has a four- week ‘electronic detox’ protocol for parents 2) Going to http://www.drdunckley.com and signing up for the “Save Your Child’s Brain” mini course – 4 newsletters that summarize the electronic detox protocol

Principles

• Be a role model for others on

healthy technology use

• Don't use technology to meet a

child’s needs that should be met by a human being

– E.g. don’t give a toddler a device to soothe, but instead, pick up the child and co-regulate yourself

• If a child is complaining of

boredom…

– Involve them with chores, or – Let them be bored so that they can then experience creativity

• Limit electronic toys
• Use natural toys, e.g. wood

Principles

• As a parent, be a role model for your kids
• Have rules/limits about technology

– E.g. no video games / consoles in bedrooms

• Have tech-free times so that family can connect

– E.g. All family members (including parents) should put devices into a basket when they come in through the door, and only retrieve them at a pre-designated time, e.g. after dinner

• Limit technology during times when people

should be connecting

– E.g. dinnertime (i.e. ideally no TV), in the car

Principles

• Find alternatives to screen

time

– Encourage non-electronic activities such as reading,

sports, crafts, nature, etc.

• Create rather than consume

– Encourage technology to create (e.g. writing a story, making a movie, etc.) – Discourage technology that is just about ‘consuming’, e.g. playing a violent video game, binge watching TV…

Recommendations

• If there is screen

time, ensure this is balanced by non- screen time

– For every 1-hour of screen time, 1-hr of restorative nature time is needed (Louv, 2005) – For adults, every 90-

• min. of technology,

give 10-min. rest (Rosen, 2014) – For children, every 1-

• min. of technology

needs 5-minutes doing non-tech (Rosen, 2014)

Recommendations for age 0-2

• No technology

– No TV – No handheld devices – No video games

• No non-violent
• No violent games
• This includes background

exposure

– Background TV shown harmful for language development

Canadian Paediatric Society (CPS) Technology Guidelines

Recommendations for age 2-4

• Less than 1-hr a day
• f screen time
• Less is better!

Canadian Paediatric Society Guidelines

Recommendations for age 3-5

• Some technology

– Some non-violent TV

• 1-hr daily max

– No handheld devices, e.g. no smart phones, no iPads – No video games

• No evidence that video games (even educational

video games) improve child development

• “Positive studies” show improvements in isolated

measures such as eye-hand coordination but not in development overall

– Less is better!

Recommendations for age 6-9

• Some technology

– Weekdays:

• No gadgets at all
• No screen time
• No video games
• No screen time in bedroom
• * Exception is computer use for schoolwork

– Weekends

• Up to 2-hrs screen time (i.e. non-violent TV) under

parental supervision

• No screen time in bedroom at all
• Dr. Kimberly Young

Recommendations for aged 9-12

• Up to 2-hrs screen time / day
• No use outside of parental supervision, and no

access to online games such as multiplayer games

• Permitted technology: Internet under

supervision.

• Dr. Kimberly Young

Recommendations for aged 12-18

• Age 12-18
• Child must have responsibilities such as

school, and home chores

• Child must have healthy activities such as

friends, peers

• Dr. Kimberly Young

Parent Handout: Unplug and Connect

Available from

• www.cheo.on.ca
• www.eMentalHealth.ca

Aussi disponible en français  Contact us if you’d like to rebrand for our agency, or turn it into a policy statement

Summary

Attachment and Connection to our Children/Youth

• Strong attachments (i.e. connections, relationships) of

children to nurturing adults is one of the strongest foundations for mental health (i.e. resiliency factor)

• Unfortunately, many factors such as modern society

and technology have the potential to disconnect us from one another

• Fortunately, there are many things that we can do as

individuals to reconnect

• Advocacy will likely also be required so that there can

be changes in policy and industry, so that the technologies can be used to strengthen our connections, not weaken them

How society is making us…

Adapted from Neufeld, 2005

Peers

Parents / Nurturing Adults

Child

Technology and things

Peers

Technology and things

How it should be…

Adapted from Neufeld, 2005

Peers

Parents / Nurturing Adults

Child

Technology and things

Peers

Technology and things

Questions?

Technology Use from Tech CEO’s

Silicon Valley execs send their kids to a school with no computers

• Many top executives from Google,

Apple, Yahoo, Hewlett-Packard, send their kids to the Waldorf

School of the Peninsula

• No computers in the

classrooms

• Younger pupils educated with

pencils, pen and paper, painting and knitting

• Students get frustrated that their

parents /relatives that can’t put down their devices

• There is one Waldorf school in

Ottawa… – Trille des Bois

http://www.nytimes.com/2011/10/23/techno logy/at-waldorf-school-in-silicon-valley- technology-can-wait.html?pagewanted=all

Computers in classrooms cannot replace good (human) teachers

• “Students who use

computers very frequently at school do a lot worse in most learning outcomes.”

Organization for Economic Co-operation and Development (OECD) Report on Computers and Learning, 2015

http://www.theglobeandmail.com/news/national/education/computers-in-classroom- have-mixed-impact-on-learning-oecd-report/article26373533/

Steve Jobs, Apple CEO, was a low tech parent!

• Steve Jobs did not allow

his youngest children (aged 12, 15) to have iPads when it came out in 2010

• Reporter: “Your kids

must love the iPad…”

• Steve Jobs: “They

haven’t used it… We limit how much technology

• ur kids use at home… At

the dinner table, we talk about books and history.”

http://www.nytimes.com/2014/09/11/fashio n/steve-jobs-apple-was-a-low-tech- parent.html?_r=1

What we might do as a professional group…?

– Update Policy Statements on ‘How to Safely Use Technology without Becoming Overattached to Technology’ – Target different levels

• Government/policy leaders

– Proper regulation of technology likely needs to happen – Right for more parental leave to form strong child/parent attachments

• The Technology Industry

– Child safe controls should be built into our technology, e.g. technology to keep teens from sexting – Apps for infants should be banned – Onus on technology companies to prove a feature is safe before they become released to the masses, just like drugs are

What we might do as a professionals?

– Workplaces

• Thanks to technology, there are now 24/7 demands on employee’s

time

• Set limits on workplaces demands on employee time during evening

hours that should really be spent as family time

– Educators

• Many countries have replaced a human teacher with devices as the

primary mode of instruction, e.g. iPads in kindergartens

• However, recent OECD studies show technology in moderation

– Parents

• Teach parents about what they can do in their homes to ensure

healthy attachments with their children

To End on a Hopeful Note

Awareness is growing of the problem of

• verconnection to technology

• “Take one hour a

day and turn that thing off. Take your eyes off that screen and look into the eyes of the person you love. Have a conversation, a real conversation.”

• - Eric Schmidt, Google

Chairman, 2012

• “"The great challenge

facing us today is to learn once again how to talk to one another, not simply how to generate and consume information.

• “Put down the

devices, learn to talk again…”

• - Pope Francis, 2015

References

• Freeman J (2012). The health of Canada’s young

people: a mental health focus : summary, Health

• Canada. Retrieved Mar 18, 2015 from

http://www.jcsh-cces.ca/upload/hbsc-mental- mentale-eng.pdf.

• Jones et al. (2015). Relationships between Negative

Spiritual Beliefs and Health Outcomes for Individuals with Heterogenous Medical Conditions, 17(2): 135- 152.

Guidelines

• American Academy of Paediatrics has screen / media

guidelines that will be updated by 2016

• Canadian Paediatric Society (CPS) has screen / media

guidelines, last updated in 2011

• MediaSmarts.ca, Canada’s Centre for Digital/Media

Literacy, has a good summary of evidence and is targetted towards educators, parents as well as professionals

References

• McKnight Z: The real reason crime is falling so fast,

Maclean’s, July 31, 2015

• Radesky, J. (2014). Patterns of Mobile Device Use by

Caregivers and Children During Meals in Fast Food Restaurants, Pediatrics, 133(4), e843-849.

• Turkle, S. (2012). Alone together: Why we expect

more from technology and less from each other. New York, NY: Basic Books.

Book Readings: How Society Disconnects Us

Books: Advice on how to (Re)Connect

Detox protocol for tech addicted youth Attachment-informed parent strategies