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uthor Affiliations aDepartment of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico; bAnnenberg Public Policy Center, University of Pennsylvania, Philadelphia, Pennsylvania; and cDepartment of Communications, College of Social and Behavioral Sciences, University of Arizona, Tucson, Arizona

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reducing the negative effects can be implemented.

otential for media to play a beneficial role

Health Effects of Media on Children and Adolescents

Health Effects of Media on Children and Adolescents

Limit the number of TV-watching hours: Stock the room in which you have your TV with plenty of other non-screen entertainment (books, kids' magazines, toys, puzzles, board games, etc.) to encourage kids to do something other than watch the tube. Keep TVs and internet connections out of bedrooms. Turn the TV off during meals. Don't allow kids to watch TV while doing homework. Treat TV as a privilege to be earned — not a right. Establish and enforce family TV viewing rules, such as TV is allowed only after chores and homework are completed.

TV and other electronic media can get in the way of exploring, playing, and interacting with parents and others, which encourages learning and healthy physical and social development.

Have your kids watch public television stations (some programs are sponsored — or "brought to you" — by various companies, although the products they sell are rarely shown). Record programs — without the commercials. Buy or rent children's videos or DVDs.

TV is full of programs and commercials that depict risky behaviors (such as drinking alcohol, doing drugs, smoking cigarettes, and having premarital sex) as cool, fun, and exciting. And often, there's no discussion about the consequences of those actions.

But despite its advantages, too much television can be detrimental: Children who consistently spend more than 4 hours per day watching TV are more likely to be overweight. Kids who view violent acts are more likely to show aggressive behavior but also fear that the world is scary and that something bad will happen to them. TV characters often depict risky behaviors, such as smoking and drinking, and also reinforce gender-role and racial stereotypes.

And although they've banned cigarette ads on television, kids and teens can still see plenty of people smoking on programs and movies airing on TV. This kind of "product placement" makes behaviors like smoking and drinking alcohol seem acceptable. In fact, kids who watch 5 or more hours of TV per day are far more likely to begin smoking cigarettes than those who watch less than the recommended 2 hours a day.

The first 2 years of life are considered a critical time for brain development

Television viewing frequently limits children’s time for vital activities such as playing, reading, learning to talk, spending time with peers and family, storytelling, participating in regular exercise, and developing other necessary physical, mental and social skills

Television can be a powerful teacher

In some disadvantaged settings, healthy television habits may actually be a beneficial teaching tool (

The average child sees 12,000 violent acts on television annually, including many depictions of murder and rape.

Television viewing makes a substantial contribution to obesity because prime time commercials promote unhealthy dietary practices

Commercials for healthy food make up only 4% of the food advertisements shown during children’s viewing time

Television can also contribute to eating disorders in teenage girls, who may emulate the thin role models seen on television (8). Eating meals while watching television should be discouraged because it may lead to less meaningful communication and, arguably, poorer eating habits

Television exposes children to adult sexual behaviours in ways that portray these actions as normal and risk-free, sending the message that because these behaviours are frequent, ‘everybody does it’. Sex between unmarried partners is shown 24 times more often than sex between spouses (32–35), while sexually transmitted infections and unwanted pregnancy are rarely mentioned.

On an annual basis, teenagers see between 1000 and 2000 beer commercials carrying the message that ‘real’ men drink beer.

One-half of the G-rated animated feature films available on videocassette, as well as many music videos, show alcohol and tobacco use as normative behaviour without conveying the long term consequences of this use

tend to believe what they are told and may even assume that they are deprived if they do not have advertised products.

A number of studies have documented that children under the age of eight years are developmentally unable to understand the difference between advertising and regular programming

The average child sees more than 20,000 commercials each year (12). More than 60% of commercials promote sugared cereals, candy, fatty foods and toys

If children are allowed to be exposed to these media without adult supervision, they may have the same deleterious effects as television.

Studies show that parents play an important role in their children’s social learning (44), but if a parent’s views are not discussed explicitly with children, the medium may teach and influence by default.

Music videos may reinforce false stereotypes.

Parents may feel outsmarted or overwhelmed by their children’s computer and Internet abilities, or they may not appreciate that the ‘new medium’ is an essential component of the new literacy, something in which their children need to be fluent.

Music lyrics have become increasingly explicit, particularly with references to sex, drugs and violence.

Some video games may help the development of fine motor skills and coordination, but many of the concerns about the negative effects of television (eg, inactivity, asocial behaviour and violence) also apply to excessive exposure to video games.

The effect of violent video games on children has been a public health concern for many years.

Up to 75% of videos contain sexually explicit material (45), and more than half contain violence that is often committed against women. Women are portrayed frequently in a condescending manner that affects children’s attitudes about sex roles.

The Internet has a significant potential for providing children and youth with access to educational information, and can be compared with a huge home library. However, the lack of editorial standards limits the Internet’s credibility as a source of information.

The amount of time spent watching television and sitting in front of computers can affect a child’s postural development

Parents can use technology that blocks access to pornography and sex talk on the Internet, but must be aware that this technology does not replace their supervision or guidance.

2003 May-Jun

Correspondence: Canadian Paediatric Society

it is important for physicians to discuss with parents their child’s exposure to media and to provide guidance on age-appropriate use of all media, including television, radio, music, video games and the Internet.

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The objectives of this statement are to explore the beneficial and harmful effects of media on children’s mental and physical health, and to identify how physicians can counsel patients and their families and promote the healthy use of the media in their communities.

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