Limit Setting

My House, My Rules: Parents should control kids' media exposure

by Regina M. Milteer, M.D., FAAP

Children are growing up with personal "electronic gardens" concentrated in their bedrooms. Often nestled in their rooms are a landline telephone, cellular phone, computer, television (usually with cable), VCR, DVD/CD players, MP3 players, video games with handheld devices, and radios.

Information is emerging about the exposure of children younger than 2 years to this electronic bounty. The 2003 Kaiser Family Foundation ( study Zero to Six: Electronic Media in the Lives of Infants, Toddlers and Preschoolers found that 26% of children 2 years and under had televisions in their rooms.

In the 2004 survey Parents, Media and Public Policy by the Kaiser Family Foundation, only 6% of parents of children under 2 years were aware of the AAP recommendation that children under 2 years should not watch television and that all other age groups should be limited to one to two hours of educational screen media per day.

The 2003 study also found that children 2 years and under spend two hours and five minutes in front of a screen daily (59% watching television, 42% watching videos, 5% using a computer and 3% playing a video game). The same report cited that 70% of children 4 to 6 years have used a computer, with 56% having used one without the help of a parent.

This information is alarming as it is well-recognized that screen time in this age group subtracts from time playing, learning social skills, reading and being read to.

Research shows that as children get older, their exposure to electronic media increases as do the associated consequences of prolonged exposure: decreased academic performance, sleep deprivation, obesity, increased sexuality and violence.

Children learn from media. When used in a supervised environment, it can be a source of useful information. For example, media sources can complement school systems' educational programs. In some school systems, students can check and submit assignments online. In addition, assignments may be given to view educational television programs to enhance class discussions.

Parents, however, must remain vigilant and exercise guidance over their children's electronic use even when it is associated with an academic assignment.

Effects of media

School systems across the United States are re-evaluating their morning "start times" for middle, junior high and high schools. Students and parents are complaining that adolescents with early morning classes are being deprived of sleep because extracurricular activities, sports, jobs and homework keep them up late at night.

A Sept. 4 Washington Post article titled "Kids Wired for the Night," written by a 30-year veteran high school teacher, tells a different story. A guidance counselor stated that high school students "stay up until one or two o'clock in the morning instant messaging, talking on their cell phones or surfing the Web" long after their parentshave retired for the night. The counselor went on to say that when students are late for or miss early morning classes, parents claim their child has a sleep disorder. Parents then request prescription sleep aids from their pediatrician instead of limiting access to cell phones, video games and computers.

Kids with access to a plethora ofmedia such as cell phones, computers and televisions in theirbedrooms often suffer sleep deprivation, leading to poor academic performance.

Children do not perform well academically or socially when they are sleep deprived. The National Center on Sleep Disorders Researchat the National Heart, Lung, and Blood Institute has developed a campaign to educate parents about the importance of sleep ( It recommends at least nine hours of sleep each night for children to perform their best.

The prevalence of childhood obesity in the United States also is increasing. As cited in the 2003 AAP policy statement PediatricOverweight and Obesity, the causes of childhood obesity are multifactorial. However, research reveals that many children spend more time watching television and engaging in a less active lifestyle.

The 2004 Kaiser Family Foundation study, Generation M: Media in the Lives of 8- to 18-Year-Olds, reports that children in this age group average six and one half hours daily exposure to recreational media compared to one hour and 25 minutes exercising or participating in sports.

Childhood obesity is associated with hypertension, type 2 diabetes, sleep apnea, asthma, low self-esteem and depression. There also is a statistically significant association between childhood obesity and adult obesity. Thus, early learned behavior of inactivity can lead to future medical problems.

Broadcast and cable television, Internet sites, video games and music lyrics inundate children daily with inappropriate sexuality, and violent and aggressive behavior. Studies have associated continued exposure to media violence and sexuality with increased acceptance. This is troublesome, as young children cannot differentiate fantasy from reality (Pediatrics 2001;107:423-426).

Additionally, unsupervised Internet use can be dangerous as children accidentally or intentionally explore online solicitation sites that have resulted in abduction by someone met online, pornographic sites and gambling sites. A recent study showed that 25% of children found unwanted pornography, and about one-quarter of them found it quite distressing (Finkelhor D, et al. Online Victimization: A Report on the Nation's Youth. Alexandria, Va., National Center for Missing & Exploited Children, June 2000, page ix.)

Helping parents help children

There is no foolproof method to prevent the "wrong" media exposure. Access to electronic media is everywhere — television, computers, cell phones, MP3 players, video games and PDAs. Pediatricians should discuss media exposure with parents beginning with the first-year well-child visits and continue the dialogue at regularly scheduled intervals. The discussions should include the children as soon as they are able to vocalize their electronic media habits.

Parents should be encouraged to provide their children with positive entertainment choices, to teach them to discriminate between good and poor media exposure, and to play video games, view television and listen to music with their children. Parents should not only encourage physical activity but should participate in such activities with their children regularly.

Finally, pediatricians must help parents overcome feelings of  helplessness in weeding out their children's electronic gardens by empowering them to use old-fashioned parental authority to say "No — my house, my rules."

Dr. Milteer is a member of the AAP Committee on Communications.

Article from AAP News, December 2005.


© Rick Voakes 1999, Health-bytes LOGO  by Rie Cramer