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American College of Pediatricians - January 2009
ABSTRACT: The media, especially the visual media, and most particularly television, play a significant role in the lives of children and adolescents in the United States. Media is a powerful tool that can be used to exert positive, as well as, negative influences. Studies show that audiences tend to absorb information from television even though they forget the source, and whether the events were real or simulated. 1 Young children are especially vulnerable; since they are less able to discriminate what is on the screen from what is real.
Children view an average of 3 to 6 hours of television and other visual media on a daily basis. 1 Of concern, nearly two thirds of all TV programs contain violent scenes, including so-called children’s programs. 2 And it is well documented that children imitate behavior seen on television, including such media violence. 2
Excessive viewing of television, movies, computer, and video games also results in increased tobacco and alcohol use. 1,3 A recent study documented that when parents restrict viewing of R-rated movies, children have a reduced risk of trying smoking in the future. 4 In addition, the negative associations between excessive media exposure and academic performance, body concept, and nutrition have been well documented. 5 Children with a television in their bedroom are known to score 7 to 8 points lower on standardized tests for mathematics and reading than those without a television in their bedroom. 5
Another development over the past 25 years has been the increased access children have to the internet and video games. Children using the internet and video games add, at the minimum, one-hour more daily to the time spent in media use. This time must be taken from other activities of the day, interfering for many children and adolescents with adequate quantity (duration) and quality (nighttime waking, nightmares, irregular bedtimes) of sleep. In addition to the well-known problems associated with inadequate sleep, poor quantity or quality of sleep is associated with impaired immune function, and impaired regulation of metabolism. 6 Sleep deprivation has also been reported to be associated with obesity, diabetes, school failure, and behavior problems including hyperactivity. 6
The human brain undergoes significant growth and development during the first 3 years after birth. Longitudinal studies have shown that early television exposure (pre-school children who watch more than 2 hours of television a day), is associated with attention problems at age seven. 7
Another problem is the sexual messages in film, television, and music, which are explicit, often inaccurate, and misleading, and yet frequently accepted as truth by young people. Both programming and advertising are highly sexualized in their content. Teens rank the media as the second leading source of information about sexual behavior. (The first being school sex education). 8 A recent survey of adolescents documented that; exposure to talk about sex was associated with risks similar to being exposed to actual sexual behavior. 9 The media is believed to be an influencing factor in the earlier onset of sexual activity in children. 10
A related serious challenge facing children, adolescents, and their parents is cybersex. Cybersex or Internet sex is a virtual sex encounter between persons remotely connected via a computer network. It is a form of role-playing; the participants pretend they are having sexual relations. These computer sites are available to all who wish access, including children. The Internet also plays a growing role in sex crimes committed against children. These crimes range from sexual exploitation, such as child pornography, to actual assault against a victim identified through the Internet. 11
It is also important to mention the impact not only of media content but also of sponsors, i.e., advertisers. Advertising is a powerful force in American culture. The preeminent advertising medium is television. The principal goal of most children’s television is to sell products to children and their families. The television commercial is likely the single most influential source of information to which the young are exposed. The average American child will have viewed approximately 500,000 television commercials by the end of high school. Numerous studies have documented that the young child is often unable to understand the intent of advertising and usually accepts the advertising claim as true. 12 One could argue that responsibility is shared by sponsors, which explicitly or indirectly endorse certain programming decisions.
Among products seen on television, food is the most widely advertised. In children’s shows, 50% of advertisement time is devoted to foodstuffs. Most of these ads are for products that nutritionists argue should be consumed occasionally and/or in small portions. Only 15% of food ads targeting children include reference to an active lifestyle. Public service announcements (PSA) on fitness and nutrition are very few. TV stations donate an average of only 17 seconds per hour to PSAs; moreover, 46% of all PSAs air after midnight. Children under 8 years see one PSA on fitness and nutrition for every 26-food advertisements. 13,14 In addition, the sedentary hours spent viewing media take away from outdoor activities that might promote a healthy lifestyle and counter the rising incidence of obesity. Young children (mean age of 8) have been shown to select food products that they have seen advertised over those that were not. 15
Finally, we would like to emphasize the positive and critical role of media education. Media education is defined as the study and analysis of mass media. A media-educated public is better able to understand the message and its purpose. A media-educated person understands that all media messages are constructed, that media messages shape our understanding of the culture, and that mass media has powerful economic implications. It is essential that all parents become media literate. Parents should be aware of program ratings and monitor programs that their children watch. 16 Software that allows the adult to block undesirable programs is a helpful tool. The mass media must be held accountable to the principles of the Children’s Television Act. Enforcement of the Children’s Television Act of 1990 and 1996 will help ensure that children’s programs are truly designed for them. Media education of children has been accomplished as early as elementary school. It has been incorporated into school curricula in Canada, Australia, and Brazil. As a result of this intervention, children have demonstrated the ability to evaluate programs and advertising more critically. 17
In summary, the media have a substantial influence on today’s children and adolescents. At the current time, disappointingly, parents cannot confidently look to the media for a consistent menu of high quality programming. Pediatricians and parents must do their part, ideally working with the media, to secure opportunities for educating children that facilitates the best outcomes and the best for children. We urge them to do so.
Recommendations
1. Discourage TV viewing for all children under the age of two. 18
2. Limit all media exposure (television, movies, computer/video games, and music) to 2 hours per day for children over two years. (The American College of Pediatricians encourages parents to specifically limit television viewing to one hour or less per day.) 18
3. Encourage alternate forms of entertainment especially those involving physical activity and/or the participation of all family members. 18
4 Parents should screen the media viewing of their children and adolescents.
5. Pediatricians and parents should become media literate: Learn to understand the message, recognize the motive, and identify the action encouraged.
6 Pediatricians should routinely provide anticipatory guidance that addresses media exposure as a part of the health maintenance visit.
7. Pediatricians and parents should discuss the profound influence the mass media has on a child’s well being and actively work together towards improving the overall quality of media content.
8. The media industry should consider the substantial influence that programming and advertising have on children and adolescents. We call upon the media industry and their sponsors to act responsibly. This would include limiting the portrayal of unhealthy behaviors including violence, smoking, overeating, eating high sugar/high fat foods, sexual behavior between unmarried individuals, and sexual innuendoes or frank references. Instead, increase portrayals of healthy behavior to include families engaging in physical activities together, healthy eating, and respectful dialogue between individuals.
Originally posted as Children, Adolescents, and the Media on October 24, 2005.
Updated January 30, 2009
The American College of Pediatricians is a national medical association of licensed physicians and healthcare professionals who specialize in the care of infants, children, and adolescents. The mission of the College is to enable all children to reach their optimal, physical and emotional health and well-being. More information is available at www.BestforChildren.org.
A printable Adobe Acrobat (pdf) copy of this position is available by clicking here.
REFERENCES
1. American Academy of Pediatrics, Committee on Public Education, Children, Adolescents, and Television, Pediatrics, Vol. 107, No. 2, February 2001, pp. 423-425
2. American Academy of Pediatrics, Committee on Public Education, Media Violence, Pediatrics, Vol. 108, No. 5, November 2001, pp. 1222-1226
3. Gidwani PP, et al, Television Viewing and Initiation of Smoking Among Youth, Pediatrics, Vol. 110 No. 3 September 2002, pp. 505-508
4. Sargent JD, et al, Effect of Parental R-Rated Movie Restriction on Adolescent Smoking Initiation: A Prospective Study, Pediatrics, Vol. 114, No. 1, July 2004, pp. 149-155
5. Orzekowski D et al, TV in the Bedroom May Hurt School Achievement, Arch Ped Adol Med, Vol.159, July 2005
6. Zimmerman, FJ, Children’s Media Use and Sleep Problems: Issues and Unanswered Questions, Research Brief, Kaiser Family Foundation, June 2008, pp. 1-8, www.kff.org
7. Christakis DA, et al, Early Television Exposure and Subsequent Attentional Problems in
Children, Pediatrics, Vol. 113, No. 4, April 2004, pp. 708-713
8. American Academy of Pediatrics, Committee on Public Education, Sexuality, Contraception, and the Media, Pediatrics, Vol. 107, No. 1, January 2001, pp. 191-194
9. Collins RL, et al, Watching Sex on Television Predicts Adolescent Initiation of Sexual Behavior, Pediatrics, Vol. 114, No. 3, September 2004, pp. e280-e289
10. Escobar-Chaves SL, et al, Impact of the Media on Adolescent Sexual Attitudes and Behaviors, Suppl. to Pediatrics, Vol. 116, No. 1, July 2005, pp. 297-331
11. Wolak, J, et al, Internet Sex Crimes Against Minors: The Response of Law Enforcement, Crimes Against Children Research Center, University of New Hampshire, National Center for Missing and Exploited Children, November 2003
12. American Academy of Pediatrics, Committee on Communications, Children, Adolescents, and Advertising, Pediatrics, Vol. 95, No. 2, February 1995, pp. 295-297
13. Executive Summary, Food for Thought: Television Food Advertising to Children in the United States, Kaiser Family Foundation, March 2007, pp. 1-4, www.kff.org
14. Graham, R, Kingsley, SW, News Release, 24 Jan 2008, Study Finds Television Stations Donate an Average of 17 Seconds an Hour to Public Service Advertising, Kaiser Family Foundation, www.kff.org
15. Chernin, A, The Effects of Food Marketing on Children’s Preferences: Testing the Moderating Roles of Age and Gender, Ann Amer Acad Polit Soc Sci, vol. 615, pp.102-118
16. Cheng TL, et al, Children’s Violent Television Viewing: Are Parents Monitoring? Pediatrics, Vol. 114, No. 1, July 2004, pp. 94-99
17. American Academy of Pediatrics, Committee on Public Education, Media Education, Pediatrics, Vol. 104, No. 2, August 1999, pp. 341-343
18. Gentile DA, et al, Well-Child Visits in the Video Age: Pediatricians and the American Academy of Pediatrics’ Guidelines for Children’s Media Use, Pediatrics, Vol. 114, No. 5, November 2004, pp. 1235-1241
OTHER RECOMMENDED READING
American Medical Association, Physician Guide to Media Violence, 1996
Neil Postman, Amusing Ourselves to Death, Penguin Books USA Inc., 1985
Neil Postman and Steve Powers, How to Watch TV News, Penguin Books USA Inc., 1992
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