Presentation Transcript

1. How the Media Affects Children

   Ashley Bechtol, MD PGY1 Advocacy Presentation: May 2nd, 2013
2. Disclosures No financial gain or investments No current research
3. Objectives Discuss the types of media commonly used by children. Review AAP guidelines. Discuss media effects on our pediatric population. Provide resources for pediatricians and their target population. Approaches to discuss safe media use with children and parents.
4. Types of Media Print media: newspapers, magazines, pamphlets Broadcast media: television, film, wire services aka “up-to-the-minute news” and the radio Outdoor media: billboards, signs, buses, shops. Digital media: internet and mobile communication.
5. AAP Recommendations Discourage media use by children < 2 years old Discuss setting media limits at well/health maintenance visits. Parents are to limit media use to 1-2 hours per day for children older than 2 years. Encourage parents to use healthy and safe media by being aware of what their children are watching.
6. Frequency of viewing TV viewing > 4 hrs/day is associated with poorer social and school achievement scores and problem behaviors. This is the reported numbers of hours per day watching TV by children and adolescents in the US!
7. Attention > 2 hours of television and video game time associated with increased risk of attention problems in children and adolescents. Violent and nonviolent entertainment television viewing associated with attention problems at 5 years. Entertainment TV viewing (not educational) at age 1-3 years modestly associated with risk of attention problems 5 years later.
8. Violence More than 60% of programs included violence in 1997. Children’s programs contained some of the highest levels of violence; an average preschooler watching 2 hours of cartoons/day is estimated to see 10,000 violent incidents/year. Cartoons often show 25-50 violent acts/hour.
9. Violence Worrisome because they are developmentally incapable of distinguishing fantasy from reality. Violence exposure increases anxiety, desensitization and aggressive thoughts and behaviors.
10. Associations A study using MRI scans determined that the areas of the brain activated by media violence includes: Amygdala – “fight or flight” survival response. Premotor areas of the frontal cortex – prepares the body for action. Posterior cingulate – encoding long-term rapid access memories.
11. Associations between activities and health outcomes Schmidt M E , and Rich M Pediatrics in Review 2006;27:289-298
12. Language Infant television and video exposure associated with reduced parent-child verbal interaction (median exposure was 2 hours/day). Language development negatively associated with television viewing.
13. Academics TV viewing > 1 hour in adolescents associated with increased risk of future attention and academic difficulties including poor homework completion, negative attitudes toward school, poor grades and failure. TV viewing in childhood and adolescence associated with poor educational achievement at age 26.
14. Educational media In 2006, there was no evidence that baby videos or any screen media have any positive effects on infants and toddlers. A study in 2010 specifically analyzed baby media and found that only the performance of the parent-teaching group was above chance. Children with extensive exposure to popular infant videos either with a parent or alone did not learn any more new words than children with no exposure to the video at all. The absence of learning from the video was not due to lack of attention as many parents commented that “she [the child] was glued to the screen today” or “it’s crack for babies!”
15. What about those Baby Einstein videos? DeLoache J S et al. Psychological Science 2010;21:1570-1574
16. Baby Media Parents overestimate what their infants are learning from media. It is easy for parents to misattribute their children’s linguistic advances to recent video exposure when there is a developmental “word spurt” during the second year of life.
17. PBS Literacy based programs such as Martha Speaks have the intent to increase literacy skills. There is a lot of research that goes into creating educational shows – for example, Sesame Street. There is research showing the effectiveness of database instruction in the classroom. Learning modules give a basic introduction to a concept and are more of an active learning process verses passive learning environments.
18. Psychological Increased psychological distress associated with low physical activity and greater amount of television and other screen entertainment time. TV/computer watching > 2 hours/day associated with increased risk of psychological difficulties. Violent TV program viewing before age 5 years is associated with antisocial behavior 5 years later in boys.
19. Sex More than 50% of teens consider television an important source of information about birth control and contraception. Media (TV, movies, music videos and computer games) can teach harmful attitudes about sexual activity. The internet has also become an important source of information about sexual health. Websites and chat rooms are putting them at risk for cyber-seduction and online solicitation.
20. Sleep Violent content and evening media use associated with increased risk of sleep problems among children aged 3-5 years (average daily screen time 72.9 minutes in this study) Healthy media use intervention may decrease sleep problems in children aged 3-5 years.
21. Obesity Mean hours of television viewing significantly associated with BMI and prevalence of overweight (followed from birth to 15 years of age). Having a television in a child’s bedroom is a predictor of obesity in childhood. In part from sedentary activity but also from advertising encouraging children to drink sugared soda and eat high-calorie snack foods.
22. Obesity Research has shown that children who watch more TV snack more often. Children, especially under 8 years of age are unable to understand the intent of commercials and advertising.
23. What about video games? Problematic gaming associated with increased violence, smoking and depression in adolescents. Only half of the participants in the study reported >1 hour per week. Increased risk for serious fights, increased aggressiveness and carrying a weapon. Boys likely to have symptoms than girls.
24. Energy expended Playing active video games (Dance Dance Revolution and Nintendo Wii Sports) reported to be similar to moderate-intensity walking in children. Small study that showed energy expended increased 2-3 fold with gaming or walking on treadmill vs. watching TV.
25. Suggestions for TV viewing Advise parents to review the content of the program the child is watching and watch it with the child. Avoid placing television sets in the child’s bedroom. 68% of children 8-18 years have TVs in their bedroom. Be aware of their own media use (adult programs that are on while the child is in the room can be distracting).
26. Healthy Media Healthy media intervention encouraged families to replace violent or age-inappropriate media content with quality educational and prosocial content. Educational television was not significantly associated with subsequent attention problems. Encourage safe media use by screening what the child will watch, listen to, play and visit on the internet.
27. Pros of Television Viewing Positive outcomes, such as civil participation, positive social behavior, tolerance, school readiness, knowledge acquisition, and positive self-image. For any given child, which effects occur depends largely on the media’s content, the child’s age, the context in which the child uses media, the amount of media the child uses, and whether that use is active and critical.
28. Need a babysitter? Avoid using the screen media as an “electronic babysitter.” If you need quiet time, encourage the children to read, play a game, complete a puzzle, draw or build something. Positively reinforce their efforts.
29. Pediatrician Waiting Rooms At check-ins, give the parents Media History forms to complete. Model safe and healthy media use in waiting rooms by providing book and magazine selections without unhealthy advertisements. TV should be off or displaying only health education content.
30. During Office Visits Assess total screen time. Ask about content and if the patient has a television in their room. Be aware of the signs of media overuse including social withdrawal, anxiety, sleep disturbances, disordered eating, violent outbursts, risky sexual behavior, obesity, tobacco, alcohol or other drug use and intervene by reducing media exposure and help to develop responsible media use.
31. During Office Visits Relate specific behavioral factors. Example: a parent is concerned about their 3 year old daughter hitting and biting her friends during play. Pediatricians should correlate TV shows the child may be watching or that are playing in the background with the child’s behavior and suggest changes. Discuss media use with families. Choose quality age-appropriate and educational programming. Do not allow the TV to stay on if nobody is watching. Instead, listen to music, sing songs, read, play games or just have the room quiet. Do not use media during meals. Talk to each other. Family communication should be the norm.
32. Encouragement Encourage families to set limits and create balance at an early age. Encourage families to read to the child to foster cognitive and language development.
33. Pediatricians - Recap Explain to parents the importance of unstructured, unplugged play to stimulate problem solving, thinking innovatively and developing reasoning skills. We are the child’s advocate and role-models. Make healthy media habits in the practice setting. Educate families on AAP recommendations. Know resources available.
34. Resources for Pediatricians AAP at www.aap.org Center on Media and Child Health at www.cmch.TV Center for Media Literacy at www.medialit.org New Mexico Media Literacy Project at www.nmmlp.org Brochure “Media Education in the Practice Setting” at www.aap.org/advocacy/mmguide.pdf CDC at www.cdc.gov
35. References http://legacy.kctcs.edu/newspublications/stylebook/mediatypes.htm www.cdc.gov/obesity/childhood Deloache, J et al. “Do Babies Learn from Baby Media?” Psychological Science. 21.11. (2010). 1570-1574. Schmidt, M and Rich, M. “Media and Child Health: Pediatric Care and Anticipatory Guidance for the Information Age.” Pediatrics in Review. 27.8. (2006). 289-298.
36. References www.aap.org www.cmch.TV web.ebscohost.com.innopac.library.unr.edu/dynamed www.uptodate.com www.mdconsult.com www.medialit.org www.aap.org/advocacy/mmguide.pdf