-By Dr. Jonathan Wood

What can we do?

On average, children and adolescents spend more than 6 hours a day with media - more time than in formal classroom instruction. In addition, parental monitoring of media use is extremely difficult and US youth have unprecedented access to it:
two-thirds have a television set in their bedrooms
half have a VCR or DVD player
half have a video game console
almost one-third have Internet access or a computer.

It is now clear that media has an influence on a variety of health issues, such as sex, drugs, aggressive behavior, obesity, eating disorders, and suicide. While the 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, including the following:

Violence Research on media violence and its relationship to real-life aggression is substantial and convincing. Young persons 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% of real-life violence. Office counseling about media violence and guns could reduce violence exposure for an estimated 800 000 children per year.

Sex Several longitudinal studies have linked exposure to sex in the media to earlier onset of sexual intercourse, and 8 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 airing unprecedented amounts of sexual situations and innuendoes in their prime-time programs.

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 a year is spent in the United States on advertising cigarettes ($13 billion), alcohol ($5 billion), and prescription drugs ($4 billion).

Obesity Media use is implicated in the current epidemic of obesity worldwide, but it is unclear how. Children and adolescents view an estimated 7500 food advertisements per year, most of which are for junk food or fast food. Contributing factors to obesity may include that watching television changes eating habits and media use 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 also 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 10 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 the TV ratings are not understood by most parents. The Internet cannot be regulated. More graphic violence on TV shows and 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 have to change the way their children access the media:
o 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
o limiting entertainment screen time to less than 2 hours per day, and
o co-viewing with their children and adolescents.
o PG-13 and R-rated movies need to be avoided – the content is clearly inappropriate for young children.
Clinicians need to ask 2 simple questions at routine visits.
Is there a TV set or Internet connection in the bedroom?
How many hours per day does the child or adolescent spend with a screen?

The media is a powerful teacher of children and adolescents – the only question is what are they learning and how can it be modified? When children and adolescents spend more time with media than they do in school or in any activity except for sleeping, much closer attention must be paid to the influence media has on them.

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