Ask the Mediatrician

Meet the Mediatrician!

Hello readers! I'd like to introduce myself; I am Dr. Michael Rich, the Director of the Center on Media and Child Health at Children's Hospital Boston, Harvard Medical School and Harvard School of Public Health. But more importantly, I am a parent, just like many of you. As a former Hollywood filmmaker, I am a lover of media.  But as a pediatrician, I see that media have both positive and negative effects on children's health. See intro video

I'm here as The Mediatrician^SM to answer your questions about media and health.  It is my goal to provide you with science-based answers and practical solutions that can help the children in your life use media in ways that can enrich their development.  What's YOUR question about media? Go ahead and ask!

My son gets really angry when I ask him to stop playing video games, what can I do?

Q: A father of three asked a question on JustAsk about his youngest child, who is 14 and addicted to video games. He explained that his son used to be involved in athletics but now plays video games 4 hours a day, studies only 2 hours a day, goes to bed around midnight, and falls asleep in class. When confronted about these issues, his son gets very angry and threatens violence with a stick or a knife. The father wants to know what he should do.
-Carlo on www.education.com/answers

A: Dear Carlo,

The situation you describe is very serious and concerning. If your son physically threatens you, others, or himself with a stick or a knife or anything else that can be used as a weapon, then he needs immediate professional care. I would advise you to reach out to his physician right away and discuss the situation. The doctor will likely recommend and refer your son to psychiatric treatment. If you’re not sure where to go, a school psychiatrist or school counselor can provide guidance as well.

It does sound like your son’s behavior with regard to video games is addictive, and that would be concerning even without the aggression he is threatening you with. Signs of addictive behavior include excessive use, choosing games over all other activities, and withdrawal—in this case, getting very angry when you ask him to stop. On top of that, your son is willing to accept all kinds of other negative consequences in order to continue playing these games, from doing poorly in school to not getting enough sleep. You'll want to mention these things when you talk to his doctor.

Video games aren’t inherently harmful—in fact, they are incredibly powerful teaching tools. Research suggests that playing certain kinds of games for limited amounts of time can help improve skills, like hand-eye coordination and arithmetic. But there is also evidence that violent content teaches a set of attitudes that may be harmful. And even the most positive games can become problematic when played for too many hours.

Therefore, to use video games in ways that are healthy for your children's development, pay attention to what the games they play are teaching, who they’re geared toward, and how long they are using them. In the case of your son, you will likely want to talk with his physician to determine whether your son should continue playing the games at all and, if so, how to establish a healthy, safe balance of gaming with other activities in his life.

Enjoy your media and use them wisely,
The Mediatrician

Could speech delays be related to TV watching?

Q: I am a speech therapist, and a large percentage of the children with speech delays whom I treat are allowed to “graze” on TV all day. Are there any studies showing a relationship between TV watching and speech and communication delays in the preschool population?
-Serious about Speech in Atlanta, GA

A: Dear Serious, 

We are not aware of many studies related specifically to speech delays, except for one study that suggests that “children with frequent television viewing…would have delayed development of meaningful word speech.” However, most of the media effects literature does not make a distinction between language delays and speech delays. 

So if we look at the research that refers to language development but not specifically to speech, we can find more information that might also be related.  For example, babies seem to develop language far more effectively from people in real life than from people on screen. In one study, American children between ages of 6 and 12 months were exposed to native Chinese speakers in person and to the same native Chinese speakers on video. The infants who had real people interacting with them recognized and responded to specific phonemes, and those exposed to the video did not. What this seems to show is that human interaction appears to be critical in the complex process of language development.

But when the TV is on, parents tend not to talk as much to their children. And given that babies learn language from live people—particularly their parents!—having the TV on could be detrimental to that process. And although some research found no difference in word learning between babies who did and did not watch baby videos, it also found that the strongest predictor of number of words learned was the number of hours a baby was read to.

As a speech therapist, you likely already provide parents with specific guidelines on how to help their children. Though the media effects research specifically on speech is not an often-researched area, from these others studies I described, it seems like adding media recommendations could be helpful anyway.  Perhaps you could recommend that parents decrease or eliminate TV watching and increase interactions around books.  Or you could suggest that when their kids do watch TV, parents should watch with them and look to the TV program content for new topics to talk about with their kids.  By giving them activities that include speaking to, reading with, and interacting with the child, you can help families experience the difference between learning from a person and learning from a screen.

Enjoy your media and use them wisely,
The Mediatrician ®

Do violent video games affect my 18-month-old son?

Q: I am concerned about the negative impact that violent video games may be having on my 18-month-old son. He is at a babysitter’s, where there are shooter-type video games being played often! Should I remove my son from this environment, before any harm is done?
-Curious about Childcare in Prince Albert, SK, Canada

A: Dear Curious,

First, I commend you for being aware that what’s in your son’s environment will affect him. It is important to speak with your babysitter to understand who is playing the games, and when and where they are doing so. Research has shown that even children as young as your son may be affected by what they are exposed to on a TV screen. 

Some of the effects are indirect. For example, from birth to age two, one of the things kids most need is face-to-face interaction with other people. An adult who is distracted by, say, playing video games or watching TV cannot also give a child the kind of focused attention he needs.

In addition to distracting the babysitter, research has also shown that the video games are probably also distracting your son, even if he does not appear to be paying attention to the screen. Research shows that young children who play in a room where a TV is on in the background do not stay focused on their own play as well as they do when there is no TV--and at this age, learning to maintain attention is some of his most important developmental work.

In terms of the violence in the video games, research is not clear on how much an 18-month-old can interpret from a screen. However, there is evidence that babies respond to tone, even if they don’t understand content, and that they are attuned to the feelings of their caregivers. So even if your son doesn’t understand the violence, he may feel anxiety based on the images and sounds that are in this environment.

Given the potential effects, it might be worth asking your sitter to change this part of the environment. Just as you might ask whether your babysitter knows First Aid or how they choose to address bad behavior, you can ask how he or she will use media around your child. It would be ideal if the sitter would agree to eliminate the videogames when your child is around.  However, if that is not possible, perhaps you could suggest that the games be played in a room where a door can be closed and your son will be taken elsewhere to play.

>>See related question: How can I get my husband to stop playing violent video games around our toddler?

Enjoy your media and use them wisely,
The Mediatrician®