Television: realities, risks and recommendations


Questions fielded by a doctor and a mother By Dr. Alyna Chien :::::::::::::::::::::::::::::::::

photos by Josh Hawkins Hayley Yussman, 8, of River Forest.

Perhaps it was just luck that we could not afford cable when our children were babies. I was in medical school at that time, and we lived in a place with extremely poor television reception-seriously, two or three fuzzy broadcast channels at best. As a result, no one watched much TV and our kids spent a lot of time going for stroller rides, looking at board books and playing with ordinary household objects. When they became toddlers, we deliberated about which videotapes to provide for entertainment. We started with the vintage "Sesame Street" series mainly because my husband and I both remembered and trusted the show. We watched Grover go "under" and "through" a gazillion times before we expanded our collection to include "Thomas the Tank Engine," the Eric Carle series and "Horses A to Z."

Our children didn't watch broadcast TV until they were 4 and 5 years old, when we moved after I finished medical school. I remember how indignantly they hollered when that first TV commercial interrupted their show. My kids held commercials in contempt at that point-an unplanned benefit.

Few parents ask me about television when I'm in my office, but I get a lot of questions on the playground. What should my child watch? Most parents have a sense that certain images are inappropriate for children. For example, a recent study reports that 70 percent of the time parents limit television due to sexual content and because of violence 50 percent of the time.

For the past 30 years, researchers have analyzed television for how it makes children feel, as well as for what it makes children do. Excessive and inappropriate television viewing has been linked with a variety of societal and health concerns: smoking, drinking and overeating as well as poor body image and sexual activity. Amid this myriad of findings, many people have forgotten the most important findings from this body of research: First, television violence begets real-world violence, and second, parents remain the most powerful influence with respect to how television affects their child.

A better understanding of child development and its interplay with television usually helps parents develop their own TV limiting strategies.

Younger children struggle with understanding what is real and what is not. As a result, they tend to fear that what they see on television may happen to them or their loved ones. In the same way children believe in Santa Claus, they can believe that a character such as Valdimort could suck the blood out of them just like he did from the unicorn in the first Harry Potter movie. This inability to separate fantasy from reality often leads children to worry about some rendition of "the bogeyman" well into junior high. In fact, parents themselves often report that their children suffer from bad dreams or nightmares as a result of certain kinds of television programs. Parents can prevent this trauma by not allowing their children to watch scary shows-the age at which children can tolerate violent images and suggestions varies, but it is always safe to bet that less is best. If it makes you or your child cringe, hide or jump, then it is absolutely inappropriate for your child.

Older children and teenagers struggle with immature judgment skills-this is why they seem to do things without thinking. Their behavior may be due in part to hormones, but it is also likely to be due to brain immaturity. The last part of the brain to develop is the part in charge of judgment-the prefrontal cortex; this final step in brain development is thought to occur during the late teen years and early 20s. Until then adolescents have difficulty realizing the true consequences of their own behavior, let alone those associated with behaviors on television.

Because older children are competent in so many ways, parents need to remind themselves that they still require protection, even from television. The best way to provide this protection is to help your child select his or her television programs, to watch the programs together, and to discuss how what is depicted matches-or doesn't match-what you value in your home.

How much is too much? Many parents of 9- to 12-month-old babies tell me they've noticed their child enjoys watching television. What they don't realize is that this apparent interest in television coincides with their child developing better distance and color vision. Parents often seem taken back when I advise eliminating this apparently pleasing and potentially educational activity. Children under age 2 should not watch any television and children 2 years and older should watch television for less than two hours per day. The recommendation is based on the observation that too much television too early deprives children of opportunities to learn basic lessons from the world itself.

From birth onward, children learn by connecting what they smell, taste and touch with what they hear and see in the world. Television is a poor substitute for more complex forms of learning, such as being held and sung to, naming people and objects or even playing with sand and water. For example, television can provide music, but it cannot provide the smells and touch of the person they will grow to recognize as a favorite relative.

Television may display words and letters on a screen, but it cannot figure out what your child is trying to say when he or she repetitively points at something in the room. Television can show children water is clear and sand is brown, but it does not teach them that lake water smells differently from tap water and that sand feels soft or gritty depending on how wet it is. All these seemingly simple activities are important experiences.

If it seems that you are not the only parent who lets your child watch more television than is recommended, your impression is correct. Nearly one-quarter of children 2 to 4 years have televisions in their bedrooms, and this proportion rose to 65 percent for children aged 8 to 18 years. Nielsen Media Research recently reported only 50 percent of our children watch the recommended limits of television. Other studies show the average child watches more than 21 hours of broadcast television in a single week, and these figures did not include time spent watching movies, playing video or computer games, or surfing the Internet for recreational purposes. Since television watching is so common, parents need to be proactive to appropriately limit television viewing for their child.

By luck or by design, my children don't watch much television even though our reception is considerably better where we live now. Many days will go by when they don't watch any television at all-they are simply more interested in other things. Other days I find myself enforcing the few rules we do have:

• No TV before school or during meals and

•"TV time" is earned based on having played outside and finished homework.

I continue to struggle with what I think is appropriate for my children, but somehow my kids' sensibilities match mine. They turn off shows with too much violence, humiliation or disrespect, and they take commercials with a grain of salt. My kids had a simple answer when I asked them how they knew this. They said, "We know because you told us." It sounds corny when people say that parents are the most powerful influence in a child's life, but it's true.

Parents who would like more information on this complicated topic can find useful articles in the Parent Corner of the American Academy of Pediatrics Web site,

Alyna Chien is the mother of two, a pediatrician and a Robert Wood Johnson Clinical Scholar at the University of Chicago's Department of Pediatrics.


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