Ask the Mediatrician

Do you have any last-minute tips for holiday shopping?

Q: I'm doing last-minute holiday shopping, and I still don't know what to give! How do I know what to choose for the children in my life? The choices are overwhelming!
-Holiday harried, in Medford, MA

A: Dear Holiday harried,

Never fear! Even as time grows short, you still have time to take a breath and think about what to give the children on your list this holiday season--whether you're giving media or non-media gifts. No matter what you choose, remember to keep the CHILD first:

• Creativity: Think creatively about who the child is & customize your gift.
• Homework: Do your homework to make sure the gift matches the child.
• Imagination: Stimulate their imagination with gifts they can use creatively.
• Learning: Encourage learning with gifts that peak their curiosity.
• Donate: Teach about giving by helping a child make a donation.

Take a look at our media shopping gift guide if you're considering giving media gifts. If you're looking for non-media gifts, check out our non-media gift ideas. And remember, some of the most meaningful gifts are free.

Enjoy your media and use them wisely,
The Mediatrician® 

My teen daughter's addiction to technology is ruining our family life--what should I do?

Q: I am the mother of three daughters (15, 13, and 11). Although I try to set limits, technology is ruining my family life. My oldest daughter in particular is addicted to Facebook, Skype, texting, etc.—whenever I try to reduce or eliminate her access, she finds a way to be in touch with her friends. Plus, when she does interact with friends via technology, she gets anxious, which leads to increased use. What do you suggest?
-Anxious about Addiction, Metro West suburb, MA 

A: Dear Anxious,

As a teenager, your daughter is pursuing key developmental tasks through her media use—seeking experience, establishing individual identity, and connecting with peers. But the amount of time she is devoting to it, the exclusion of family, and the anxiety she is experiencing when interacting via technology—and the fact that she responds to it by increasing her use—are cause for concern and could be symptoms of addictive behavior. Although the formal diagnosis has not been established in this country, Internet Addiction Disorder is a recognized and serious problem in parts of Asia and Europe, and it is causing real problems for American adolescents and their families.

Address this issue quickly, directly, and with compassion. First, at a time when things are good and you are not in open conflict about your daughter’s media use, sit down and have a conversation with her. Ask how she feels about her media use. Listen to her. She may be unhappy or uncomfortable and may say so if she doesn’t feel criticized or attacked. Then, when the opportunity presents, tell her that she seems anxious when she communicates online, and that you are concerned for her. Ask her what she thinks might help.

It’s possible that she’s feeling lots of pressure to be constantly available. If she acknowledges that that’s the case, enlist her help in finding peace for herself and your family, but be prepared to help her with concrete guidance and boundaries. Offer to take the blame if her friends criticize her for not being available at all times—she can complain that mom takes the phone away to charge it between 9 pm to 6 am, or for even longer if she uses it too much. This way, she can save face while reducing her anxiety, as well as learning to manage her media use in the context of everything else she needs to do in a day.

It is possible, though, that she will resist any and all of your attempts to address the situation with her. If nothing you try works—if she really can’t stop and it continues to wreak havoc for her and your family—you may need to seek professional help.

Enjoy your media and use them wisely,
The Mediatrician®

Can I protect my kids’ media use at school? On the bus?

Q: How do I protect my children against what I consider to be harmful media when they are at school or on the bus? Older boys are sharing content that we disapprove of (like Star Wars, Spongebob, etc.) with my 6 year old on their MP3 and portable video players. As you know, these devices are capable of downloading very ugly content—including pornography and sadistic M-rated video games—even on the way to class. No one seems to care about this. What should I do?
- Concerned About School Commutes in Lincoln, NE

A: Dear Concerned:

If this is a concern to you, it’s likely that lots of other families feel similarly helpless. Even if these older boys aren’t friends with your child, I would start by asking your child’s friends’ parents about their feelings about media use on the way to school, whether this problem is arising for them, and how they’re attempting to curtail their kids’ exposure to violent or sexual content. This can help you get a sense of the scale of this issue.

If you know which kids are responsible and are able to contact their families, ask what kind of personal media devices their kids carry and how they regulate what goes on those devices. It’s possible that they don’t know what their kids have downloaded and are sharing with younger kids and that they would be willing to intervene. They may even be willing to keep an ongoing dialog with you about how your kids interact with each other.

If you aren’t able to contact those families or if they are unresponsive to your concerns, consider talking with the school about their policies regarding media usage both in and out of the classroom. What is their policy about personal media on buses? In the hallway? How is it enforced? The conversation about any kind of in-school media use can be tricky, as many districts have signed contracts with companies that provide entertainment and education during and on the way to class. Channel One News, for example, delivers 12 minutes of news—and commercials—to about six million teens in 8,000 middle and high schools daily. Similarly, Bus Radio was a company that played commercial radio broadcasts on the way to school—until parent activists helped shut it down, furious that their children were being marketed to in such a captive, targeted way. If you’re not satisfied with your child’s school’s media policies as they apply to in-class or out-of-class media use, be vocal about it: As the Bus Radio scenario shows us, parents like you can advocate for kids’ media health and safety—and affect positive change.

Finally, and most importantly, don’t leave this issue to be regulated by the bus driver, the other riders, or the school. Make sure that your child, him or herself, is aware of technologies out there and conscious that there can be material on them that might disturb him (not just that “he shouldn’t see it”). Help your son learn to navigate exposure to media that makes him uncomfortable or confused—whether by talking about it with you, by not looking at what other children show him, or by sharing something else when presented with something he doesn’t want to see. Doing this now can empower him to make a lifetime of smart media decisions for himself.

Enjoy your media and use them wisely,
The Mediatrician® 

How do I ensure that my wired kids are being responsible citizens offline?

Q: My kids are attached to their cell phones and laptops, and it worries me that they're not paying as much attention to the world happening around them—just the other day, I heard about how Bill Nye the Science Guy collapsed, and no one came to his aid because they were taking photos of him and tweeting about it! What can I do to ensure my children don’t end up like these onlookers?  
- World-Mindful Mom in Henderson, NV

A: Dear Mom,

Yours is an excellent example of how the way we use media can insulate us from each other and from experiences, rather than encourage us to share our common humanity. If that report is accurate, it sounds like the audience members may have lost awareness of the difference between the constructed, controlled domain of media and the reality in which we live. They also may have gotten caught in the phenomenon of diffusion of responsibility—that is, given that so many people were present, they may have all assumed that someone else would respond to the emergency. So instead of being the reason that they didn’t respond, media may have simply been where they engaged their attention instead.

But that, too, is something to address. And to paraphrase Shakespeare, the fault, dear Brutus, is not in our media, but in ourselves. Media devices are not inherently problematic, and they don’t necessarily separate us from each other: Consider TV programs that research shows can help kids learn to play well with others. Bill Nye himself used television in other positive ways, to explain concepts that could not have been shared as effectively using other means. Rather than lecturing about the lives of bats or how cells divide, for example, he used his program to show us and tell us about science in a fun, fascinating way. 

The best way to make better citizens of ourselves and our children, both on- and off-line, is to be sophisticated and effective users of the media tools that we have at our disposal. This means using—and teaching others to use—all kinds of media in mindful, focused ways: to learn, to connect with each other, to communicate, and to create, and then to turn media off when the tasks we set out to do are complete. Offline, it means being engaged in and ready to react to what happens around us: When someone collapses in front of them, for example, teach them what to do, whether it be to check whether they’re okay or to call 911. And talk with them about how even when there are many people around, they should still take the responsibility of doing something to help. 

Need convincing that new media tools really have been used to connect us in powerful ways? 

• Check out the videos being created for the Playing for Change project, which brings a mobile recording studio around the world to record music and promote peace.
• This viral video, taken over the holidays, is a example of how technology can be used to organize and orchestrate a shared cultural experience—not only for those who happened to be in a food court in Ontario, Canada, on one particular November afternoon, but for the millions who have since viewed it on YouTube: 
  
    

Enjoy your media and use them wisely,
The Mediatrician®

 

The Mediatrician’s New Year’s Resolutions for 2011

Q: This year, I want to start making some better choices about media so I can better connect with my family. I usually hate resolutions—because who ever keeps them, really?—but am wondering what I might consider when deciding what and how to change.
- Determined for 2011 in Eden Prairie, MN

A: Dear Determined,

I’m with you. I don’t usually make New Year’s resolutions—they’re often idealistic and unrealistic and, thus, abandoned by mid-January. But this year, to create some that I could live with, I decided that my resolutions should adhere to three basic criteria: 

1) They cost basically nothing, so that there’s no financial barrier to achieving them.

2) They are worth keeping for their own sake, and because the process of keeping them is worthwhile. Perfection is not the goal—tweaking your family’s media use and enjoy the resulting time together is.

3) They’re fun!

The following are resolutions that I can and will try to follow throughout the year, and I welcome you to join me: 

Share media you love with your kids
What movies, songs, and books did you love at your child’s age? Share and talk about them with your kids. Then ask your kids to share their favorite media with you. Whether they teach you to play a video game or make a Facebook page, they’ll love getting to show their mastery, and you’ll get a window into their media worlds. Enjoying these shared experiences is also a fun way to bring media use into the realm of positive (as opposed to policing) parenting.

Make mindful choices
How many times do you find yourself or your kids turning on the TV, computer, or video game console out of habit? Or because you or they can’t think of anything else to do? As a New Year’s Resolution, transform media use into a purposeful choice. Watch a certain show or play a certain game, and then switch to another activity you enjoy. This will help your family use technology as the powerful tool it can be for learning, connecting, and entertaining rather than simply as a diversion.

Move screens into common rooms
When media use is confined to a shared space, it becomes a social rather than a solo act and must compete with the other demands of family life. This makes it easier to engage with media only when there is a focused reason to do so. It also gives parents greater access to what children are doing with media, and it gives children a way to understand (and accept) their parents’ responsibilities in overseeing their media use.

Create media together
Shoot video of your family, edit it, upload it to YouTube, and share the link with friends and family. Or build a website or blog about a favorite cause. Such activities emphasize that kids can not only receive but also create media. They also model how media can be used in public dialogue and true participatory democracy—concepts that kids may not understand now but can learn about over time. Instead of worrying that media are making us less individually and socially responsible, model ways in which media can make us more involved in life, each other, and our society.

Upgrade your interactions with others
Social media can be a wonderful addition to the host of ways you connect with people who live far away or with whom you’ve lost touch. They can help you locate folks and provide a way to connect as frequently as you’d like at your convenience (e.g., if you’re around the world from each other, you can be in regular communication despite the time difference). However, if communication with a given person remains exclusively virtual, you miss out on nuance and warmth that a voice provides. To regain some of these other aspects of human connection between in-person visits (or when visiting isn’t feasible), call a faraway friend on the phone. Or use email or texting as ways of arranging in-person gatherings. In this way, media can serve as tools for developing and nurturing true relationships. 

Share media-free family meals
Research shows that sitting down and sharing food protects kids against becoming overweight, as well as from a host of health risk behaviors, from anxiety and depression to early sexual activity to violence. The mealtime opportunity to share experiences and thoughts with those you love and trust is powerful prevention. But remember to keep the tube off: Having the TV on during that meal distracts you from each other and from your body’s signals of hunger and satiety, thus neutralizing the potential positive effects

Touch nature and let it touch you
Research shows that spending time with nature reduces anxiety, improves attention deficits, and contributes to free play and imagination. So turn off the TV, computer, and video games and take a family walk. Or grow a plant from a seed, and let everyone get dirt under their fingernails. Just be together, outside and unwired.

Unplug to bring back daydreaming
We parents so often focus on giving our children the best advantages we can: schools, lessons, sports, and media, all intended to help them learn and expand their minds. But no directed activity can take the place of daydreaming, free play, and even boredom, which is when we can let our thoughts wander and then be regrouped in new and unexpected configurations. This is when kids engage their creativity, develop a sense of self, and learn to reflect on what is important to them. All the knowledge in the world cannot compare with the ability to think deeply about it, and then imagine and create something better. Let’s give kids this crucial space.

Enjoy your media and use them wisely—and happy new year!
The Mediatrician®

Do you have any tips on good gifts for kids?

Q: Help! I’m shopping for kids of all ages this year for the holidays, and don’t know where to begin. What are your thoughts about the kinds of toys that are good for kids?
- Wrapped Up in Gifts in Ames, IA

 

A: Dear Wrapped Up,

Become your gift recipients’ holiday hero by keeping this word in mind: CHILD.

Creative: Think creatively about who the child is and what makes him or her truly happy. 

Homework: Do your homework on the nature, content, and age-appropriateness of gifts, especially media products, before buying.

Imagination: Provide a child’s growing mind with gifts to stimulate her imagination, creative growth, and development.

Learning: Look for gifts that encourage problem-solving, creativity, and positive social interaction.

Donate: Give the gift of giving.

(Read all of our tips on choosing great holiday gifts!)

Did the kids in your life provide wishlists? Check out our recent science-based advice on the following toys, games, and media. 

Does your recipient want…

A cell phone?

• Should I give my 11 year old the cell phone she's asking for?
• How much texting is too much?
• Do cell phones affect kids’ sleep?
  More cell phone Q&As >>

Video games?

• How does Call of Duty impact teen boys?
• My whole family enjoys Guitar Hero, but I’m concerned about the lyrics!
• Which computer games are good for my 2 year old?
  More video game Q&As >> 

Questionable toys?

• My kids are asking for toy weapons; what should I do?
• How can I ask my family to forgo character toys?
• Are American Girl dolls a better choice for my niece than the more sexualized Barbies or Bratz?
  More toy Q&As related to gender and violence >>

Laptops, MP3 players, etc?

• Should I encourage my preschooler to use the computer?
• Are kids benefiting from all these electronics?
• Is there anything wrong with cutting out electronic media completely?
  More computers & electronics Q&As >>

Books or magazines?

• Are audiobooks a good use of kids' time?
• Could vampire fiction be contributing to my daughter's anxiety?
• Do models in ads affect how girls feel about their own bodies?
  More book & magazine Q&As >> 

Movies or videos?

• Which kids’ movies will my 5 year old enjoy?
• What goes on in the brain during a 3D film?
• Can toddlers learn sign language by watching DVDs?
  More TV, movie, & video Q&As >>

New tunes?

• Help! We don’t approve of the music our child wants to listen to!
• Does playing the blues cause the blues?
• How should I explain that my kid’s favorite pop star is having emotional issues?
  More music Q&As >>

Enjoy your media and use them wisely,
The Mediatrician® 

Do cell phones affect kids' sleep?

Q: Maybe I'm jumping to conclusions, but my middle-schooler honestly seems like a zombie during the day since we agreed to let her have a cell phone. She's grumpy and sleepy, though she doesn't seem to be having trouble with friends or school. I have noticed that she’s constantly checking the phone—even bringing it to the dinner table—but when I mention it, she snaps at me. What's going on here?
Phone-miffed Mom in Glen Arm, MD

A: Dear Mom,

It’s likely that what your daughter is doing with her cell phone is affecting her behavior, not the phone itself. Like most tweens and teens, your daughter probably uses her phone primarly as a platform for texting--thus, she may sleep with it on a nightstand or even under her pillow, just in case she receives middle-of-the-night messages. When a text does arrive, her sleep is interrupted and she never makes it to stage 4 REM sleep. This stage is when the dreamwork necessary for resting and repairing brain circuits and moving experiences from short- to long-term memory takes place. Not a good stage to skip since adolescence is the period of greatest physical and intellectual development since infancy!

So it’s little surprise that recent studies suggest that kids who use electronic media before bed—or after they’ve supposedly hit the hay—have a greater incidence of sleep disorders that lead to the sort of prickly behavior you’re describing, in addition to learning problems, mood swings, anxiety, and depression. Lots of parents believe that their teens’ cell phone usage is none of their business, but I would argue that it is as much your business—and just as important—as ensuring that they buckle their seatbelts.  Parents are in charge of setting boundaries to keep kids healthy, and you can do so here.  Discuss with her some reasonable rules about when she needs to turn her phone over to you at night before bed. A previous Q&A addresses how parents can set and enforce cell phone limits; our CMCH website offers more tips on curtailing use.

A final consideration, given your daughter’s dinnertime reaction: Could her grumpiness be on account of what she’s seeing when she receives a text? Kids who are cyberbullied can become hypervigilant about the messages on their phones. They’re often fearful, anxious, or sad because of how they’re being harassed but are embarrassed and therefore reluctant to share what’s happening. Before you delicately broach this topic with your child, take a look at some of these cyberbullying resources that can help steer your conversation.

Enjoy your media and use them wisely,
The Mediatrician®

How can I keep my teen from texting while driving?

Q: What can be done to stop teens from texting while driving? Laws forbidding this practice seem not to be working.
No Drive-Dialing in Los Altos, CA

A. Dear No Drive-Dialing,

You’re absolutely right: We need to put an end to “driving while intexticated.”  Research shows that using a phone while behind the wheel increases a driver’s risk of getting into an accident by four times (that’s about the same risk as driving drunk) and that drivers who text can be up to 23 times more likely to crash.

These are terrifying odds, and as you said, we as parents can’t and shouldn’t leave this issue up to the law to handle. In Massachusetts, for example, recent legislation made texting by drivers of any age illegal, and teens are now prohibited from using cell phones in the car (see list of all state laws). But officers are already having trouble enforcing it.  The solution to the texting while driving problem starts with all of us taking personal responsibility and encouraging our children to do the same.  Here are some tips:

Set cell phone expectations—and consequences—up front. Likely, you’re both buying your teen’s cell phone and paying for her monthly contract, so you certainly get to help set the rules on using it for calls and texts. Also, you know by now that you’ll have much less leverage to change the rules once your teen actually has the phone. Before you even agree to look at models with her, discuss how your child intends to use it:

• Will she be allowed to text at all? Discuss when and where that is appropriate.
• What are the phone rules while driving? (I recommend parents require cell phones to stay in the trunk while the car is in motion.)
• What are the after-hours phone rules? Many teens sleep with their phones under their pillows which leads to interrupted shut-eye when the phone rings or vibrates. A tired driver is an unsafe driver: Consider having your child turn in the phone to you for charging in your bedroom at the end of the night.
• Will she contribute payments ever? Under what circumstances?
• What are the consequences for breaking a rule? Are there exceptions you two agree on?

Address slip-ups fairly. If the phone rules are made with your teen’s input, he’s more likely to come clean about breaking them. When your child does admit his mistake, don’t overreact or incriminate him: Simply follow through with the consequences you agreed upon. You want to stress that while you understand that accidents happen, they still have repercussions.

Model positive cell phone behavior. It goes without saying, but show your child you value the contract you’ve made about cell phone rules by sticking to them yourself.

For more information about this issue, see this video from The Today Show specifically about teens and texting:

Enjoy your media and use them wisely,
The Mediatrician®

Is sexting a sign of early sexual activity?

Q: I thought I had a handle on my 15 year old’s texting habits, but I recently found some sexually explicit texts between him and a 12 year-old friend—I was extremely shocked! Although the friend’s mother wondered if the conversation had been hacked, my son admitted his part. Now I’m worried: Are my son and his friend more likely to jump into sexual activity, since they have been so daring in their texts?
-Troubled by Texting, Lebanon, OH

A: Dear Troubled,

A report from the National Campaign to Prevent Teen Pregnancy shows that 40% of all teen boys report having sent a sexually suggestive text, so your son and you are part of a growing proportion of families confronting this issue. Much discussion of sexting (sexual content + text messaging) tends to focus on how to address its immediate effects, from exposure to embarrassment to legal trouble. Your question, however, focuses on how sexting might affect your son developmentally—and the answer to that question is even more important in the long term.

Researchers have not yet investigated whether sexting increases the likelihood that kids will become sexually active earlier. However, research has found that exposure to sexual media content in entertainment media is associated with earlier sexual activity and earlier sexual intercourse. These trends may occur because media help shape kids’ expectations of the world—in this case, contributing to their belief everyone is “doing it.” In fact, teens’ perceptions of whether their friends are having sex are an important predictor for how soon they will decide to do the same.

Sexting may reinforce or reflect the presence of those perceptions, and that is a good reason to discuss this with your son. The issue is not so much that sexting will make him more curious about sex or more likely to engage in certain behaviors—much curiosity and experimentation are natural parts of adolescence. The issue, rather, is that sexting can remove sex from the healthy contexts of human relationship, intimacy, and trust. By talking about this issue with him, you can influence his understanding of sex—when it occurs, in what kind of relationships, and under what circumstances—instead of leaving it up to media and friends to encourage. To start this kind of conversation, try the following:

• Ask your son what he thinks about people sending and receiving these kinds of messages. What does he think these interactions are about? Be genuinely open to hearing his responses, and don’t judge or shame him for them. If you don’t talk much about sex with him, it might help to acknowledge the awkwardness, saying, “I know we don’t usually talk about this stuff, but I’d love to know how you feel about what’s going on in your world.”
• Don’t make assumptions about what your son brings to the table. Ask open-ended questions about how he understands sex as part of a healthy, fulfilled life, and have a conversation about what he believes. This is a time to learn about his perspective, not to force your own on him. Just hearing the questions you ask will help him think critically about his perceptions.
• Acknowledge that, while you may understand why and how the sexting started, it needs to stop now—if for no other reason (though there are plenty of other reasons, including the fact that although you understand that he’s experimenting as teens do, the legal system doesn’t) than what he sends is less private than he thinks. If you saw them, for example, imagine who else might.

Then, together with your son, develop rules around cell phone use. Check in about how he’s using his mobile communications on a regular basis, and continue asking what’s going on in his world.  In many ways that you may not expect, that will open communication and make you a safe, nurturing source of information and support as he navigates adolescence.

Enjoy your media and use them wisely,
The Mediatrician®

How much texting is too much?

Q: My daughter is 13 years old, and we have set times during the day that her phone is disabled. It is not available for texting during school hours, and during the week it is set to turn off at her bedtime. My question is about the rest of the time. How much texting is too much? I realize it is the main form of communication for teenagers, but my husband and I find ourselves wondering if she is texting too much. Last night, my husband counted 600 messages back and forth for the day.
-Too much texting?, in Irvine, CA

A: Dear Texting,

First of all, kudos to you for setting up structures that support your daughter in using text messages healthfully. By outlining your expectations (and hers) up front, you have paved the way for discussing any issues that arise. Your "gut feeling" is correct -- 600 texts in a day (or 300 if she sent half and received half of what you counted) is on the high end. To put your daughter’s usage in perspective, the latest numbers from the Pew Internet & American Life Project show that, on average, teens text at a rate of 50 messages per day. Fifteen percent of teens are considered “heavy texters”, sending 200 messages per day.

My first question about your daughter’s use is whether this amount of texting in a day is typical for her. If it isn’t, then take this opportunity to ask your daughter what is going on in her life—is there something major happening that you aren’t aware of? If her use is typical, then we might be dealing with addictive behavior, which would require a different approach. Problematic use of interactive media such as video games or Internet is treated as a clinical problem by health professionals in China, Korea, and some European countries.  The U.S. is somewhat behind in this area, partly because our population seems to be less addicted, and party because we are not clear on how to assess or treat this kind of addiction. So when does heavy use cross over into addiction?  If your child is texting that much regularly, is increasing in her texting, is irritable when not texting, and is disrupting social activities, academic performance, or relationships with family and friends to text, you should seek clinical help for her.

If, however, your daughter is a heavy, but not "out of control" texter, you now need to consider whether there’s enough time left for the other critical activities in her day-to-day life—like completing her homework, engaging in physical activity, and sharing family meals—to occur. To answer this question, engage your daughter in an open, non-blaming conversation about cell phone use. You can say that with school starting again, you’re curious about how she thinks it’s going. What role does texting play in her life? Does she feel like she has enough time to do everything she needs to do? In a previous answer, I referred to a video interview on extreme texting where the teens claimed it was not the texting itself they were addicted to, but rather the need to be in constant connection with their friends.  It’s possible that she hasn’t thought about how so much texting affects her life. Your questions can help her learn to reflect on the nature of connections with others via text vs. in real life, and make active choices about how she spends her time and what sorts of relationships she wants.

If your daughter seems to think everything is fine, you might wish to express your concern about the 600 texts—not as an accusation, but as a statement of concern. Perhaps use the Pew data cited above - many kids take part in certain behaviors because they think that "everybody's doing it", so a reality check often works very well. You can offer to support her by creating a weekly check-in about how things are going with her texting, and offer, rather than threaten, to add external limitations if those would help her restructure her lifestyle. By giving her the excuse that "my parents made me do it", you allow her to explain to her friends why she is texting less without being criticized for not communicating with them as often as she used to. Ultimately, the goal is for her to take over the responsibility of monitoring her own use of her cell phone. Make that clear to her and offer to support her in that process.

Enjoy your media and use them wisely,
The Mediatrician®