television watching in children

Glued to the Tube

Dr Hirsch is a fellow at Nemours Center for Children's Health Media in Wilmington, Del, and an associate at Jefferson Faculty Pediatrics at Jefferson Medical College in Philadelphia. She is also a medical editor for Dr Pohl is professor of pediatrics and associate dean of student affairs and career counseling at Jefferson Medical College.

Glued to the Tube
Are Parents Following AAP Recommendations to Limit Screen Time?

According to the American Academy of Pediatrics (AAP), the average child watches 4 hours of television per day.1 By the time a child finishes elementary school, he or she will have seen 8000 murders on TV.1 By high school graduation, that child will have spent more time in front of the TV than in school.2

Multiple studies have shown the impact that media can have on children--specifically on their developing views of violence, alcohol( use, body image, and sexual activity. For these reasons (among other concerns about media's effects on developing brains), the AAP recommends:

•No television viewing for children younger than 2 years.

•No television in a child's bedroom.

•Limited screen time for older children to 1 to 2 hours per day of educational, nonviolent programming.

How often do parents of young children follow these guidelines? To answer this question, Vandewater and colleagues3 looked at media access and use in children between the ages of 6 months and 6 years. Their study was recently published in Pediatrics.3 Data were collected from 1045 parents in 2005 by telephone interviews conducted by the Kaiser Family Foundation. Interviewers asked to speak to the parent who spent the most time with the child, 81% of whom were mothers. Parents were asked about the presence of televisions, cable or satellite service, DVD players, VCRs, video game players (handheld or consoles), computers, or Internet access in the home and in the child's bedroom. Parents were also asked about their child's typical use of media, including watching television, playing video games, and watching DVDs or videos.

The authors found that almost every parent interviewed had at least 1 television in the home; the average home had between 2 and 3. Approximately 80% of the households had computers, and about half had video game systems. Many children had a television in their bedroom, ranging from 18% of children younger than 2 years to 43% of 3- to 4-year-olds. Satellite or cable channels were available to half of the children with a television in their bedroom. On a typical day, children younger than 6 years watched an average of 1 hour and 19 minutes of television. While few children in this age group played video games, about a third watched DVDs or videos for over an hour on average.

In another recent study, Zimmerman and colleagues4 found that by the time children are 3 months old, approximately 40% are watching television, DVDs, or videos on a regular basis. By the time they are 24 months old, 90% are regularly exposed to media.4

Vandewater and colleagues also examined which children did not follow the AAP recommendations. They found that children younger than 2 years who had a television in their bedroom were more than 4 times more likely to fall outside of other viewing guidelines. The AAP recommendations were also less likely to be followed by older children--particularly those with a TV in their bedroom--whose parents believed that television helps with learning and who had fewer rules pertaining to the content viewed.

However, 85% of the parents stated that they had never discussed media use with their child's pediatrician. Most parents are unaware that the AAP hasguidelines for media use. If we are not discussing this issue with the parents of our patients, we cannot be surprised when children do not follow the recommendations.

While the Vandewater study is limited by factors such as reporting bias and media use outside of parental presence, we need to recognize media as an important influence on our patients. By inquiring about media use and appropriately educating parents and children about its impact, we have the potential to affect the prevalence of violence, substance abuse, and teen pregnancy in our society as these children grow into young adults. *