Pediatricians Zap Media

By: Lawrie Mifflin

Children under 2 years old should not watch television, older children should not have television sets in their bedrooms and pediatricians should have parents fill out a "media history," along with a medical history, on office visits, according to recommendations by the American Academy of Pediatrics.

Saying that television viewing can affect the mental, social and physical health of young people, the academy for the first time has laid out a plan for how pediatricians and parents can deal with television.

"As pediatricians, we are taking all the research concerns into account, and trying to raise the bar a bit, as suggestions for optimal parenting," said Dr. Marjorie Hogan, the lead author of the report, which appears in the August issue of Pediatrics magazine.

No reliable research has been done on how television viewing affects children younger than 2, Dr. Hogan said. But the academy based its recommendations for such children on knowledge of what babies need for proper brain development - notably, close-up interaction with older people - and the commonsense notion that, if they are watching television, babies are not getting those other essential stimuli.

Violence in movies and television has been linked to violent behavior in young people in studies by the American Medical Association, the American Psychological Association, the American Academy of Child and Adolescent Psychiatry and the National Institute of Mental Health.

So while the academy may appear to be venturing into sociological territory with little direct connection to medical health issues, the study's authors say that the influence of mass media is a major public health concern.

"For example, media violence," cited Dr. Miriam Baron, head of the academy's committee on public education, which wrote the policy. "A bullet in the body is a physical health issue. Children who spend a lot of time in front of the TV set tend to gain weight; obesity is a physical health issue."

The academy is distributing to its members a sample "media history" checklist for their young patients. It includes questions about movies, video and computer games, music videos and the Internet, as well as about the radio and books.

Also available to the 55,000 members are brochures explaining the positive and negative influences that media can have on children, with suggestions about how to guide families toward positive uses, including critical discussion on what they watch. To encourage such talk, the academy suggests that televisions and computers not be kept in children's bedrooms but in common rooms, where parents can monitor and participate in children's use of them.

The policy's main purpose, the authors said, is to encourage pediatricians and their patients to learn about and discuss the issues.

Many parents interviewed Tuesday said that television's influence was a proper concern for pediatricians but that it was unrealistic to set arbitrary limits and unnecessary for doctors to intervene unless a child already had social or emotional problems that might be related to media exposure.

"I understand the theory, but practically I think it's not very doable," said Lari Mills of Nashville, Tennessee, who has an 8-month-old baby as well as a 7-year-old and a 9-year-old. "The little one is often around the TV when the older ones are watching, but he's not really watching it."

In Chicago, Valerie Barney said her 2-year-old son watches "Barney" and "Teletubbies" on PBS, and she sees no harm in it as long as an adult is watching with him. "He interacts very well with the TV," she said. "He sees someone fall down, he falls down."

"Teletubbies," a British import on PBS featuring a group of cooing, brightly-colored creatures who babble baby talk, is the only show on American television specifically made for children under the age of 3. It was developed by an educational television producer and a speech pathologist; nonetheless, many pediatricians see little merit in it for very young viewers.

"We don't put it on in order to attract a younger and younger audience," said John Wilson, senior vice president for programming for PBS. "But we know from research that there is an audience of children under 2 watching television, for better or for worse, and at least we have something on the air that is developmentally appropriate for them."

Himself the parent of small children, Mr. Wilson said many families where both parents work might be helped by "taking this information to whoever is watching their child during the day, and letting them know they should find something else to do besides watch TV."

Brown Johnson, senior vice president for Nick Jr., the preschool programming segments of the children's network Nickelodeon, said she favored any policy that encouraged parents to spend time with children.

"Television or videos will be used in some form, to give parents a break to make dinner or whatever, so I'm not sure it's realistic to say no television ever," she said. "But if the AAP has to make this kind of a declaration to have people really sit up and listen, that's fine."

The academy spent more than two years developing the latest policy statement, which was approved by its board of directors in May, but it has been involved in research and communications about media influences on children for much longer. In 1990, it issued a recommendation that older children not watch more than one to two hours of "quality" television per day.

In 1997, it began a "Media Matters" campaign to educate pediatricians and the public about how media can influence children, positively as well as negatively.

For example, studies have shown that programs about the effects of substance abuse or tobacco can influence adolescent behavior for the better.

"The evidence is clear that media use can have an effect on children's overall health - physical, mental, emotional," said Vicky Rideout of the Kaiser Family Foundation in California, which has done studies on these subjects. "To my knowledge this is the first time such a clear blueprint has been laid out for a pro-active role on the part of individual doctors."

Robert Lichter, president of the Center for Media and Public Affairs, a nonprofit research group in Washington, said the delineating of specific recommendations for pediatricians to give parents was a new step for the pediatric group, despite its decade-old interest in the subject.

"This is part of a drive by health professionals to view certain social problems as public health problems," he said.

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