Amber Saraceno keeps her kids, 4 and 7, busy.

That way, she says, they aren't always asking to watch tablets or TV.

The Lake of the Four Seasons mom plays Play-Doh with her children, does crafts with them, and participates in a Facebook group where people paint, hide and search for rocks around Northwest Indiana.

"A lot of parents don't want to do stuff with their kids, so they throw them an iPad or a cellphone," she said. "It's easier than dealing with kids sometimes."

In the days of smartphones, tablets, and streaming video, parents are left fighting a near-constant battle to keep their kids from staring at screens all day. A 2015 report by the market researcher Childwise found that kids age 6 to 15 consumed 6 ½ hours of screen time a day, more than double the amount in 1995. But Region parents and health professionals have recommendations for how you can limit that.

"Balance it out with other stuff that's productive," said Dr. Kaveh Rahmani, a family practitioner with UChicago Medicine Ingalls Memorial. "If you're going to let kids watch TV for two hours, make sure they go out and do exercise for an hour. Or do a puzzle or a mental activity for another hour or two."

According to age

Eric Heinert, a pediatrician with Community Healthcare System, follows the American Academy of Pediatrics' recommendations, which were updated in October 2016.

Kids younger than 18 months should have no screen time, he said, unless it is video chatting like Facetime that will actively engage the child with a person. From 18-24 months, children should have less than one hour of screen time and use only apps that allow the kids to learn colors, letters and numbers, with the parents participating and reinforcing the learning.

Past age 2, children should be limited to one to two hours a day of screen time as a secondary activity to exercise, playtime, social interactions with family and friends, and sleep.

"It is recommended to have designated media-free times together, such as family dinner, and media-free zones, such as bedrooms," Heinert said.

Children who spend too much looking at screens are at risk for delays in development of fine motor skills, visual skills, sensory processing, and general development, said Leah Jones, a pediatric occupational therapist with LaPorte Hospital.

"Kids develop through play, through hands-on activity," she said. "It's a bigger deal as kids get older and need fine motor skills for getting dressed and buttoning buttons. Those muscles develop at a young age through playing with different things."

Youngsters who spend too much time looking at screens can also have emotional problems, including a lack of ability in self-soothing, she said.

"I do see a lot of families with kids with behavioral issues, who use screen time as a calm-down method," she said. "When you're an adult, you can't always get out a screen to calm yourself. You need to develop healthy coping skills."

She recommends parents teach their kids self-regulation techniques such as deep breathing, removing themselves from a situation, and going into a "calm-down corner."

She also suggests that mothers and fathers not allow their children to have screens an hour before bedtime because the blue lights reduce melatonin, the hormone that tells the body to relax.

Monitoring usage

"Children under 2 years of age learn more from exploring the world around them and interacting with and playing with parents, siblings, other family members, and other children," said Dr. Camille Borders, a pediatrician at Community Healthnet and vice chair of the pediatrics division at Methodist Hospitals. "These interactions have a greater impact on language, motor, social, and emotional development."

She recommends that parents be involved with their children's screen time no matter their age. If the kids are older, mom and dad should monitor the content of the programming and ensure the children aren't involved in cyberbullying, sexting, or interaction with sex offenders.

Screen time can affect not only brain development but also physical shape, she noted. Being sedentary and snacking while consuming media puts the kids at risk for obesity.

"With almost all family members being engaged with media use throughout the day, parents should designate screen-free time for the family to spend together," Borders recommended. "Mealtime is a great time for families to come together and socially interact with each other, stay connected with what is going on in each other's day-to-day-life, and learn from each other."

A unique approach

Kristi Moke, of Crown Point, places no restrictions on the amount of screen time her kids — ages 14, 12, 8, and 3 — can consume. And it works.

"Because there are no arbitrary limits and I don't leverage it as a punishment or reward, my kids will readily choose other activities," she said. "They play outside a lot and have lots of interests."

She said not limiting her children's technology takes away that "forbidden-fruit dynamic" and acknowledges that not all screen time is mindless entertainment.

"You can watch movies and read and communicate and look things up," she said. "You don't just sit there and turn into a zombie. It's like calling a book 'paper time' or outside 'air time.' It's a rich resource for a lot of different things."

She said that since her kids don't worry about someone taking away their iPhone or iPad, they're free to put it down and do other things. Which they do.

"All of my kids are currently outside, by the way," she said during a recent phone interview. "They could be inside on a device, but they're all outside playing."

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Giles is the health reporter for The Times, covering the business of health care as well as consumer and public health. He previously wrote about health for the Lawrence (Kansas) Journal-World. He is a graduate of Northern Illinois University.