RAY AND JAT
ELECTRONIC MEDIA AND CHILDREN
have the time or the inclination to address such
matters in office visits because their time is limited
and they believe that their efforts in this realm would
be futile.
profiles of at-risk adolescents. There is a need to
decide, how to cover a tragedy in a way that will
communicate the necessary information and
minimize the detrimental effects on the developing
brains(46). Thus, we need to find ways to optimize
the role of media in our society, taking advantage of
their positive attributes and minimizing their
negative ones. Media should deliver positive
messages e.g. program to address childhood obesity,
to encourage parents to talk to their pre-adolescent
and adolescent children “early and often” about
delaying the onset of sexual activity, anti tobacco
message etc. Indian literature also states that with
media’s cooperation, it is possible to take important
health messages to the community and to screen out
images that legitimize practices harmful to child
health(47).
Funding must be made available, and efforts must
b e undertaken to create targeted campaigns that both
raise parental awareness and provide simple
strategies for reducing media time and limiting
exposure to negative content. These are noncomplex, salable actions that can be implemented by
most parents or caregivers and reinforced by
pediatricians. Because the topography of media
exposure has evolved from 10 feet (TV) to 2 feet
(computers) to 10 inches (cellular telephones), these
actions (with the exception of being a good role
model) are important but may only achieve shortterm interventions. Technology will continue to
present new media opportunities to all children.
Finally, a better evidence base is needed. In India,
there are limited studies on effect of media, especially
newer media items, on child health and about
interventions to improve role of media in child health.
Robust, prospective, experimental, population-based
effectiveness trials are needed. Better studies of how
they watch and how viewing habits can be improved
are necessary. Such solution-oriented research is the
key to advancing public health.
The American Academy of Pediatrics (AAP) has
recommended guidelines, which has been revised
recently, for use of media in children(50): 1) not
allowing the bedroom to be a media center with TV,
video games, and Internet access; 2) limiting media
time to 1 to 2 hours of quality programming; 3)
discouraging TV viewing for children younger than
2 years ; 4) viewing and discussing content together;
5) turning off the TV when no one is watching and
during meals; and 6) being a good media role model.
Pediatricians must become cognizant of the
pervasive influence that the wide and expanding
variety of entertainment media has on the physical
and mental health of children and adolescents. The
AAP also makes recommendations to the
entertainment industry to avoid violent content.
Pediatricians should advocate for a simplified,
universal, content-based media-rating system to help
parents guide their children to make healthy media
choices. Just as it is important that parents know the
ingredients in food they may feed to their children,
they should be fully informed about the content of
the media their children may use.
We should focus attention on a strategy that uses
media, sometimes in sophisticated ways, to help
young people avoid behaviors that reduce their wellbeing and increase behaviors that promote it. Parents
may play a vital role on impact of children’s
television viewing(48). Abrol, et al.(48) from India
showed that a co-viewing adult (parents) can make
television viewing an active process and can facilitate
learning from it. Anuradha, et al.(49) reported
significant difference in children’s amount of TV
watching depending on the type of negative
reinforcement and consequences exercised by the
parents. The study also showed that parental disciplinary practices significantly affected children’s
academic achievement. So, parents need to be
educated about the negative effects of media, but it is
not clear how to target messages in such a way that
parents will feel that they have the power to make
changes within the home. Pediatricians should
encourage the development of media literacy, but
studies indicate that few primary care physicians
INDIAN PEDIATRICS
No such guidelines exist in India. The Indian
Academy of Pediatrics should take the lead in
formulating and implementing the guidelines to help
parents and children to develop healthy media using
habits.
565
VOLUME 47__JULY 17, 2010