Jonathan P. Wood, MD
Eastern Maine Medical Center
On average, children and adolescents spend more than six hours a day with television, movies, video games, computers and other electronic media — a staggering statistic since it is more time than is spent in formal classroom instruction. In addition, parental monitoring of media use is extremely difficult and youth across the United States have unprecedented access to it.
The following numbers may surprise many parents:
Two-thirds of kids today have a television set in their bedrooms.
Half of kids today have a VCR or DVD player in their rooms.
Half of kids have a video game console in their rooms.
Nearly one-third of children have Internet access or a computer in their rooms.
It is now clear that the media has an influence on a variety of health issues, including sexual activity, drug use, aggressive behavior, obesity, eating disorders and suicide. While the television and other electronic media are not the leading cause of any pediatric health problem in the United States, they do make a substantial contribution to many health problems.
Violence – Research on media violence and its relationship to real-life aggression is substantial and convincing. Young people learn their attitudes about violence at a very young age and, once learned, those attitudes are difficult to modify. Conservative estimates are that media violence may be associated with 10 percent of real-life violence. Office counseling about media violence and guns could reduce exposure to violence for an estimated 800,000 children per year.
Sex – Several studies have linked exposure to sexual behavior in the media to earlier onset of sexual intercourse, and eight studies have documented that giving adolescents access to condoms does not lead to earlier sexual activity. The media represent an important access point for birth control information for youth; however, the major networks continue to balk at airing contraception advertisements at the same time they are broadcasting unprecedented amounts of sexual situations and innuendoes in their prime-time programs.
Alcohol, tobacco and drugs – Witnessing smoking scenes in movies may be the leading factor associated with smoking initiation among youth. In addition, young persons can be heavily influenced by alcohol and cigarette advertising. More than $20 billion dollars a year is spent in the United States on advertising cigarettes, alcohol and prescription drugs.
Obesity – Media use is implicated in the current epidemic of obesity worldwide, but it is unclear how. Children and adolescents view an estimated 7,500 food advertisements per year, most of which are for junk food or fast food. Watching television changes eating habits and media use in general displaces more active physical pursuits.
Eating disorders – The media are a major contributor to the formation of an adolescent’s body self-image. In Fiji, a naturalistic study of teenaged girls found that the prevalence of eating disorders increased dramatically after the introduction of American TV programs.
At the same time, clinicians need to recognize the extraordinary positive power of the media. Antiviolence attitudes, empathy, cooperation, tolerance toward individuals of other races and ethnicities, respect for older people – the media can be powerfully pro-social.
Media can be used constructively in the classroom in ways that are better than traditional textbooks. For instance, middle school students are often assigned to read Romeo and Juliet as their first exposure to Shakespeare. Might it not be more effective, given that Shakespeare wrote his plays to be observed and not to be read, to watch one of the at least ten different versions available on DVD? Reading Civil War history using a textbook pales in comparison to watching a TV documentary bring history to life. What could be a more entertaining way to teach high school physics than using episodes of Mythbusters? In addition, no drug or sex education program is complete without a media component.
A kinder, gentler, more responsive public media would be nice, but is unlikely. Hollywood has been resistant to any outside criticism, the Motion Picture Association of America ratings have remained closed to scrutiny for decades, and television ratings are not understood by most parents. The Internet cannot be regulated. More graphic violence on TV shows and in movies, more sexual suggestiveness in primetime shows, and more edgy advertising can be expected in the future. Easier access to media will occur as cell phones are used to download TV shows and movies, and soon a personal Internet device about the size of a paperback book will allow instant online access anytime and anywhere. Conclusion? The solution to children’s exposure to inappropriate media cannot rely on its producers.
So what can we do? How can parents, teachers, pediatricians work together to minimize the negative effects of media and at the same time celebrate the positive aspects? Broad-based education of parents, teachers, and clinicians through PTA meetings, teacher in-service training, and conferences is necessary. Education of students about the media should be mandatory in schools.
Parents can change the way their children access the media by not permitting TV sets or Internet connections in the child’s bedroom. Research has clearly shown that media effects are magnified significantly when there is a TV set in the child’s or adolescent’s bedroom.
Parents should limit entertainment screen time to less than 2 hours each day and co-view with children and adolescents when possible. PG-13 and R-rated movies should be avoided – the content is clearly inappropriate for young children.
Clinicians need to ask two simple questions at routine visits.
1. Is there a TV set or Internet connection in the child’s bedroom?
2. How many hours per day does the child or adolescent spend in front of a screen?
The media is a powerful teacher of children and adolescents – the only questions are what are they learning and how can it be modified? When children and adolescents spend more time with electronic media than they do in school or in any activity except for sleeping, much closer attention must be paid to the influence it has on them.
Adapted from:Strasburger, VC
“Media and Children: What Needs to Happen Now?”
JAMA, 301(21): 2265 (2009)