Conversations with Clinicians: Najat Fadlallah, MD

Najat Fadlallah, MD
Visiting Scholar, Boston Children’s Hospital
Fellow, Developmental-Behavioral Pediatrics, Tufts Medical Center

What does a “day in the life” typically look like for you?

As a second-year fellow in Developmental Behavioral Pediatrics at Tufts Medical Center, most of my days are spent seeing kids and families for evaluations or follow-up visits and then putting everything together in detailed reports, which I actually really enjoy writing. What I love most, though, is that no two patients are ever the same. Even when kids share a diagnosis, their strengths, challenges, and developmental paths can look completely different, and that keeps me learning all the time. Not every day is strictly clinical: some days I’m focused on research projects, working through assignments for the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program and my MPA in Disability and Health Policy, or diving into more training in parent behavior management. It’s definitely a busy mix, but it’s the kind of busy that keeps me excited to come back the next day. 

What led you to the work you do?

I’ve always been passionate about child development and mental health. Even during residency, I always gravitated toward patients on the spectrum or with developmental differences, confirming that Developmental Behavioral Pediatrics was the right fit. Over time, I’ve become especially interested in how technology and screens are shaping childhood, since today’s kids are the first to grow up fully immersed in digital environments. Families often ask how much they should limit or allow screens, whether it’s watching shows, playing games, or using tablets for learning, but the truth is there aren’t clear answers yet. At the same time, they are surrounded by conflicting messages and disinformation, such as the blanket assumption that screens directly cause speech delays or autism, without much nuance or evidence to guide them.

As clinicians, we’re expected to provide concrete recommendations, but much of what we offer still comes down to old recommendations, gut instinct, and sometimes even our own personal experiences as family members. It can feel uncomfortable to sit in that gray area, but it’s also what makes this work so engaging. Every conversation with a family becomes an opportunity to weigh what we do know, acknowledge what we don’t, and help parents make decisions that feel realistic for their lives. This uncertainty, and the urgent need for better answers, is exactly what inspired me to embark on research in digital wellness, with the goal of making some contributions to building an evidence base that can truly guide families and clinicians in the years ahead.

What would you say are the greatest opportunities you see for kids growing up in a digitally saturated world?

I don’t think we pause often enough to notice just how much technology has transformed our own daily lives, let alone pausing to think about the environments kids are growing up in today. Not long ago, keeping in touch with someone abroad meant relying on infrequent international phone calls. Now, it’s as simple as a quick video chat. Even everyday tasks, like cooking a new recipe, are easier thanks to instant access to instructions and tutorials online. These changes made life more convenient, and they also opened up new opportunities, especially for kids growing up in digitally rich environments, to learn, explore, and stay connected in ways that simply weren’t possible just a generation ago.

Digitally saturated environments offer a range of benefits that go beyond convenience. Learning is perhaps the first idea that comes to mind. Children today can access information, tutorials, and educational resources at the click of a button, transforming both formal education and self-directed learning. For children with learning disabilities for example, technology can be especially empowering: families can more easily find online resources, specialized instructors, and tools that support individualized learning, helping children access opportunities that may not exist locally. Even beyond academics, children can learn new hobbies or skills through online platforms, in ways that are much more accessible compared to just one generation ago when learning a new skill or hobby meant finding a local group or instructor to offer that service.

What are the greatest challenges you see for kids growing up in a digitally saturated world?

What worries me most about kids growing up in today’s digital world is how early and constant exposure to screens shapes their developing brains and skills. Take infants and toddlers, for example. When they’re immersed in digital entertainment, they don’t always get the chance to build the kind of sustained attention that a book naturally requires. A book asks the child to sit with the same page and use their imagination and effort to stay engaged. A screen, on the other hand, does all the work, it flashes, moves, and makes noise to hold attention for them. That kind of stimulation can make it harder for kids to practice focusing on their own.

Another piece that really concerns me is how often screens are used to soothe very young children. When a toddler cries or gets upset, instead of sitting with that discomfort and slowly learning to calm down, they’re handed a device. Over time, this can send a powerful message: “I can’t handle my emotions on my own, I need a screen to feel better.” I often wonder what the long-term consequences of these “pacifier screens” will be, especially since research is starting to link early screen-soothing to difficulties with self-regulation later on.

For teenagers, my concern shifts to the impact of social media on mental health. Teens are at such a formative stage, and the “reference points” they build, the mental averages they use to measure their own lives, are increasingly shaped by what they see online. Before social media, kids mostly compared themselves to family, friends, or people in their local community. Now, their benchmarks include global influencers, celebrities, and carefully curated peers. While that can sometimes inspire motivation in areas like academics or career goals, it can be damaging when it comes to body image or lifestyle comparisons. My hope is that as we learn more about these effects, we can guide kids toward healthier digital habits so they can enjoy the great benefits of their digital environments while avoiding the harmful effects.

How would you change or redesign technology and or media to be healthier for kids across the developmental span?

If I could redesign technology, one of the first things I’d want to do is make screens a little bit boring. I know that sounds counterintuitive, especially since so much research and investment goes into making digital platforms as engaging, stimulating, and hard to put down as possible. I think boredom is an incredibly powerful and underrated state, and it’s one kids today rarely experience in the same way previous generations did.

Boredom creates space. It gives children the chance to pause, reflect, and stretch their imaginations. When they don’t have instant entertainment at their fingertips, they’re more likely to invent games, dive into creative projects, or simply sit with their thoughts. Even the discomfort of boredom has value, because it teaches kids to tolerate that restlessness and figure out how to move through it. It’s in those quiet, unfilled moments that problem-solving, deep thinking, and self-discovery often happen.

So if technology could be redesigned to allow for boredom, whether by slowing down the pace of stimulation, breaking up endless content loops, or encouraging pauses instead of infinite scrolling, it might give kids back some of that valuable space.

What guidance or advice do you have for parents and other caregivers regarding helping kids develop and maintain healthy behaviors around digital media and technology?

When I think about developing healthy digital habits for kids, I start with a set of guiding principles that families can adapt to their own needs. For younger children, one of the most important rules is to avoid using screens as pacifiers. It’s understandably tempting when a child is upset or restless, but soothing with a device can take away opportunities for them to learn patience and self-regulation. Instead, screens can be introduced in ways that are more intentional and interactive. For example, if a toddler is watching a show or a funny video, sitting down with them, reacting to the content together, and turning it into a shared experience makes a big difference. This shifts screen time from being passive to being social.

Another principle I’d emphasize is to focus less on counting minutes and more on the quality of screen use as well as the balance with screen-free activities. One problem is that we often refer to “screen time” as an umbrella term, but not all screen time is the same. Three hours of online gaming with friends, laughing, strategizing, and catching up, offers a very different experience compared to an hour of solitary scrolling on social media, which is also different from watching tutorials to learn a new skill, like playing an instrument or trying a new craft. All of these different activities are grouped together in one bucket referred to as “average daily screentime” which parents are now convinced they need to fight and limit. However, when families evaluate screen use through that lens, meaning what value it’s adding or what skills or connections it’s fostering, it becomes easier to set boundaries that support kids’ growth rather than simply limiting their time.

In short, developing healthy habits around digital media isn’t about strict one-size-fits-all rules, but about creating realistic structures and recommendations in this day and age that encourage active, social, and purposeful engagement while still leaving plenty of room for offline play, creativity, rest, and even boredom!

Is there anything else you’d like to share?

There’s still a lot of uncertainty about what it means to grow up in a digital world, especially since technology is moving faster than research. That’s exactly what makes this so interesting to me. In the clinic, I try to use every encounter as a chance to reflect and learn how best to support families around digital wellness. I’m especially interested in what this means for children with developmental differences or delays, since technology can be both a powerful tool and a unique challenge for them.

Here at the Lab, we welcome different viewpoints and perspectives. However, the opinions and ideas expressed here do not necessarily represent the views, research, or recommendations of the Digital Wellness Lab, Boston Children’s Hospital, or affiliates.