No surprise, right?  But it’s not good, and not inevitable!

Here’s the comment I posted about this NY Times article.  (Or see the posting HERE.)

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As a pediatrician, I’m especially alarmed by 2 statistics in this article:

1.  Kids under 2 spend twice as much time being read to as they do watching TV.
2.  6 of 7 parents said that their doctor had never discussed “media”.

Where’s the anticipatory guidance from the pediatrician?

Pediatricians and other health professionals should be discussing regularly both reading and TV with patients.  We have overwhelming evidence that school performance, weight issues, attention problems, and interpersonal skills are all affected.  The issue is at least as important as issues like sugar intake and exercise, which doctors are expected to discuss routinely.

There are loads of well-funded programs (ReadAloud.org, ReachOutAndRead.org, etc.) which can assist doctors in encouraging their patients to choose books over TV (or cell phone apps).  There are many recommendations over 15 years, from respected medical organizations such as the AAP, encouraging doctors to discuss TV and media use by children.

But many doctors are slow to incorporate these resources and recommendations.  They may discuss reading and TV only as an afterthought, if at all.  They may even have TV or DVD’s playing continuously in their waiting room!

Why is this?  Are doctors dubious about the data? Are we worried about a backlash or resistance from their patients?  Or perhaps, are we reluctant to examine their own personal viewing habits?

In my practice, at every checkup starting from birth, I ask parents how much TV the kids are exposed to.  I also encourage reading, and I suggest specific books just to get started.  I also pay attention to our role modeling:  there is no TV in our office, but we have many children’s books available.  In my practice, parents accept these suggestions with gratitude, and they generally follow the advice – often changing their own TV viewing habits in the process.

Doctors should counsel parents, early and often, to avoid TV, and encourage reading.

–  David Epstein, MD

Next week (Sept. 19-25, 2010) is “National Turn Off the TV week.”  The idea is to unplug all the TV’s in your house for 7 days.  Check out the AAP’s website, or the Center for Screen-Time Awareness, to learn more.

Several families in my practice have tried this in the past few years.  The first couple of days sometimes are difficult.  “Where’s my show?” ask the kids.  “What about the big game, and my news?” complain the adults.  But after a few days, everyone adjusts, and finds other outlets.  Parents say, “I have my family back!”  By the end of the week, many families aren’t sure that they want the TV plugged in again.

Instead of screen time, you might try:

• reading a book out loud together (or a play, for older kids)
• visit a park
• have a drawing contest (“who can draw the ugliest dog?”)
• play hide-and-seek with the neighbors – parents too!
• draw on the driveway with chalk

You get the picture.

If you really want to wage guerrilla warfare on the TV, try this:  for $20, you can buy a legal gadget that turns off all the public TV’s within several yards.  I love the idea!  Check it out here.

–  David Epstein MD

Children and teens copy the behaviors they see in the movies and on TV, according to research.

Cigarettes:  If the characters in a show are smoking, kids who see the show are more likely to smoke.  Research shows this effect, even if it’s the “bad guys” who are smoking.  What’s scary is that over two thirds of shows and movies kids see do include on-screen smoking, even PG-13 movies – and the latest movies are no better than the old ones.  Magazines that kids read have just as much advertising for cigarettes as ever, despite new laws prohibiting it.

Violence:  Research shows that kids who see TV shows that model hitting and fighting, even cartoons, increase their real-life physical violence.  This effect is noticed at very young ages, and persists for years after the TV shows were watched.

Obesity:  Experts say that TV watching, all by itself, is responsible for two thirds of our nation’s pediatric obesity epidemic.  The problem is not just that the kids sit and watch; they’re watching one advertisement after another for junk food!

Alcohol:  Kids watch broadcasts of sports events, often with their families.  But beer manufacturers advertise heavily, despite laws forbidding alcohol ads on shows that kids are likely to watch.  Research links this exposure to a tendency to drink later.

So why can’t something be done?  Hollywood has been resistant to criticism, TV ratings are not well understood (and may not be accurate), the internet cannot be regulated, and devices like Ipods and cell phones will only increase kids’ access.  So what are parents to do?  The best advice is for the parents to watch the shows with kids together, with your finger on the “pause” button, and talk about the implied messages.  Ask: “Is that character making a good choice?  What would you do?”

(Download my handout about TV watching (click here) for specific suggestions.)

A recent commentary in JAMA (June 3, 2009, p. 2265) points out “the extraordinary positive power of the media.  Antiviolence attitudes, empathy, cooperation, tolerance, respect for older people — the media can be powerfully prosocial.”  But we, as the parents, must watch out, every time the kids see a show or movie.  Ask yourself:  “How would I react if a real person were behaving like the characters in this show, in front of my children?”

–  David M. Epstein, MD