Ask the Mediatrician

How can I stop my kids from being 'catfished'?

Q:The Manti Te’o “catfish” story makes me wonder how I can best prepare my teens for future online friendships. My teens say that kids meet through friends-of-friends online and off, but online they just lie about personal information. I’ve always thought that practicing strong communication skills, honesty, integrity, and trust would help my kids grow up to be emotionally healthy adults, but can these traits fully develop if they don’t practice or value them online? How can I help my kids avoid catfish schemes without becoming bottom dwellers themselves? 
-Swimming in murky waters, Chicago, IL

A: Dear Swimming,

To answer your questions about how your teens present themselves online—and how they can avoid catfish schemes—let’s first talk about what’s going on with them developmentally:

1) Adolescents are right in the middle of developing self-awareness and individual identities. Because they are figuring out who they are, they may experiment with different behaviors and personalities—both online and off. Sometimes it seems as if they change personalities as often as they change their clothes.

2) Because their identities are still fluid and forming, adolescents often present, in person or through social media, a mix of who they are and who they aspire to be. So a shy girl may post a picture of herself in a bikini or a boy who doesn’t drink alcohol, but wants to be included in the party crowd, will post a story about getting drunk.

So your adolescents’ online portrayals of themselves do appear dishonest, but it is usually experimental and aspirational - who they think they are or want to be right now - rather than deceitful on their part. “Catfishing”, such as what occurred in Manti Te’o’s case, is more intentional, a deliberate effort to deceive. It may be the work of a shy or insecure person who feels inadequate trying to attract someone they like, so they create a fake online persona. This fictional character can be completely different than the actual person,  and may even use someone elses’ photos, life story and gender (as in Manti Te’o’s case) in hopes of attracting attention. Other  “catfishing” schemes are scams, that try to draw vulnerable people into “relationships” in order to get them to send them money.

It is important that your kids use social media to connect with people they already know, whether through school, the community or through trusted friends and family. They shouldn’t send money or locating information to people whom they do not know – and they shouldn’t arrange to meet those people in person, unless they are in a safe public place and are accompanied by friends or family.

Perhaps the most effective and developmentally optimal way to approach this is not solely as a social media or internet issue, but about how an honest portrayal of themselves can help your kids connect with others in real and substantial ways. Encourage them to think about how they would respond to discoveries that their friends or romantic interests were not who they represented themselves to be. Good relationships are built on honesty and trust. Social media is a great way to connect with people of like interests and a useful venue in which to explore how to communicate and build relationships. Done with foresight and care, it can provide a good foundation for lasting friendships.

Enjoy your media and use them wisely,
The Mediatrician®

My 10-year-old-daughter was frightened by a pornographic video, what do I do now?

Q: My 10-year-old daughter had a sleepover with 3 friends. It turns out that one of the girls brought a smartphone and pulled up some porn. My daughter is still quite traumatized by what she saw, and my husband and I are trying to figure out how to counsel her. The girls saw three explicitly pornographic videos, which she described to me in detail. What can do to support her? What implications might these images have on our young daughter’s developing views of sexuality?
-Culture Shocked in New Delhi, India

 A: Dear Culture Shocked,

It’s tricky when kids who are forming their sense of themselves as sexual beings are exposed to portrayals of sex in the media, which are often unrealistic and dehumanizing. It can certainly affect their understanding of how sex and relationships work. To address that challenge, first help your daughter make sense of what she saw. Nurture her and share her discomfort, asking empathetically about her feelings, and, most importantly, listen to her without judgment. Let her talk as long as she needs to, and ask questions when it feels right.

Then take some time to put what she saw in context. Explain that, just like her favorite movies, pornography is a manufactured fiction that exaggerates, sensationalizes, and makes superficial something that can be a very special experience of intimacy and trust. What she saw was made-up stories and the people in them are actors who were paid for what they did. Talk with her about what I call “the five C’s” of healthy sexual behavior:

• Closeness
• Commitment
• Consent
• Contraception
• Consequences

These are rarely present in media portrayals of sex but are extremely important in real life. Spend some time with her looking for positive representations of relationships and intimacy that include those 5 C’s. Direct her to resources you trust for healthful, accurate, age-appropriate information on sex and sexuality.

To help her manage future situations like this, let her know that she doesn’t have to stay in a situation that makes her uncomfortable. Encourage her to say that she doesn’t want to watch those videos, or if she doesn’t feel comfortable doing that, to make up a reason to leave the room. Let her know she can always call you to come pick her up, and that she can always talk to you.  

Finally, use this as an opportunity to discuss internet safety more broadly. Let your daughter know that while the internet can be a wonderful tool, you can’t take everything you find at face value—there are people who are trying to sell items or ideas, and they don’t always have your daughter’s best interests at heart. Giving your daughter the skills to navigate the internet and offering yourself as a resource when she needs help will equip her to trust her own instincts in the future if she is exposed to something she finds confusing or upsetting.  

Enjoy your media and use them wisely,
The Mediatrician®

If TV contributes to obesity, should I limit my kids' screen time to video games and computers?

Q: I just saw that you published a study about childhood obesity and watching TV. From the article I read, it sounds like kids who watch TV and commercials for high-calorie foods are more likely to be obese—but that playing video games and using the computer aren’t a problem. Does this mean I should limit my kids’ screen time to only video games and the computer?
-Confused about consumption, in MA

A: Dear Confused,

Good question! Our study compared how middle school students use media to their body mass index (BMI), a measure which relates how heavy they are to how tall they are. We found that among those who watch TV, use computers, and play videogames, those who spent a higher percentage of their time paying attention to TV had higher BMIs.  There are a few possible explanations for this finding:

• Kids see commercials for snacks, fast food, soda, and other high-calorie, nutritionally questionable foods on TV.
• You use your hands to play video games or use a computer, but your hands are free when you watch TV. Kids often snack while watching TV, frequently on the kids of foods they see advertised.
• When kids are paying attention to the TV, they are too distracted by what they are seeing and hearing to realize that their stomachs are actually full.

Our takeaway messages, then, are for kids to skip commercials or watch commercial-free programming and to avoid eating in front of the TV.

Even though we didn’t find an association between higher BMI and video games and computers, though, it’s still possible that their use is related to obesity as well (in addition to a host of other outcomes of concern, from social isolation to aggression to addictive behavior). Our study just found that attention to TV carries the greatest risk. More research using larger groups of kids is necessary before we can draw any final conclusions about the relative effects of video game and computer use.

Our study also didn’t find that watching TV makes kids overweight—we just found that it’s one of the factors that can increase risk, just as smoking cigarettes increases risk for lung cancer but doesn’t automatically mean you’ll get it. Benefits and risks exist with all media, and we hope that by knowing the risk factors associated with how we use certain media, people will chose media mindfully, reducing risk and making their media use as positive as possible for children and for themselves.

Enjoy your media and use them wisely,
The Mediatrician®

Am I limiting my child’s chances of success in today’s economy by trying to limit his screen time?

Q: My 11-year-old son spends every free minute in front of his computer—doing homework (he really does, thank goodness), social networking, playing games, and now creating his own games. Concerned that, one by one, he has dropped sports, playing with friends, getting outdoors, and, frankly, spending time with the family, I have struggled (and been stalemated) for years trying to get him out from behind the screen. He came home from school with a news article provided by his teacher about a 17-year-old boy in England who just sold an app he developed for $30 million. Now I am wondering—are my efforts to get him away from the computer not only futile, but limiting his chances for success in today’s economy? 

Apprehensive about Apps, Ontario, Canada

A: Many parents already believe that their children need media early and often so that they will be prepared to compete in the adult world. That means parents are putting kids in front of screens from an early age, having toddlers and babies use lapware, tablet apps, smartphone games, and other forms of screen-based “edutainment” that often have little real educational value and, in some cases, may be developmentally detrimental.

It is important to remember that the reason a 17-year-old boy developing an app and selling it to a prominent company is news is because it is such a rare event. We need to understand that while there are kids with brilliant ideas and skills, these children have often spent many hours honing and developing these skills, sacrificing other activities in the process. While some may look at this early dedication as a career route, it is similar to becoming a professional athlete or musician: It requires a strict focus, innate skills, hours of practice, and sacrifice of other activities (primarily social). And after all of that, for every child who is able to successfully achieve professional status, there are thousands who will not.

My advice is for you to continue what you are doing—in addition to having some time when he’s on the computer, provide a rich and diverse experiential landscape for your son where he has the choice of many different activities (not just on a computer). Limit his screen time and give him options for other activities. If he isn’t into sports, maybe a book club, art classes, or free time outdoors will interest him. Many children join clubs, sports teams, and other organized activities for the social exposure, not necessarily for the activity itself.

Remember that children are natural generalists, not specialists. It is important for them to be able to sample a broad menu of life and to follow their hearts and minds to find what they are most passionate about. Providing your son with a landscape of diverse experiences and opportunities and seeing where he naturally gravitates will help you raise a child who is as happy, social, and productive as possible—it would be a shame to create a rich but unhappy coder at the cost of losing a brilliant and happy person because he focused his energy so narrowly so early.

Enjoy your media and use them wisely,
The Mediatrician®

 

How can I monitor my 12-year-old daughter's use of Instagram?

Q: I am trying to monitor my 12-year-old daughter’s use of Instagram and am wondering if there is a way to find any ‘secret storage’ spaces on her smartphone. I am not too concerned right now, but in the future I would like to know how to access it. Instagram is the only social media platform I allow her to use at this point, but I am concerned that it is just as bad as Facebook. I am considering banning her from using it based on what I have seen other kids post.
-Iffy about Instagram, Rockport, MA

A: First, it is important for parents to be aware that social media are restricted by law to children 13 and older, because these sites target their users for marketing—and kids haven't fully developed the cognitive ability to understand that the personalized messages they receive are selling them a product or idea. Most importantly, however, on Instagram your daughter is sending and receiving images over the World Wide Web, where they travel quickly, spread broadly, and are "sticky"--they will exist essentially forever on hard drives somewhere in the world.

There are a number of apps available that allow users like your daughter to hide images and messages, and these apps are constantly changing. So instead of focusing your efforts on finding your daughter’s secret Instagram stash, adjust your focus. Share and teach media use with your daughter, just as you will sit in the front seat of the car when she learns to drive. The privacy and secrecy with which young people use media is not an inherent right; it has evolved because many parents have defaulted their parenting role in the digital domain. Help your daughter make decisions about photo sharing—and all social media activities—in ways that are effective, safe, and respect themselves and others. To do that, establish an ‘open-screen policy’ that includes you in her social media exchanges:

• Cyber space is not private space. sure your daughter understands that her on-line life is not separate from her ‘real’ life, and that you are her parent both on- and off-line. Children need guidance when using internet because they don’t yet fully understand or value privacy the way they will when they mature, they don't know how to protect their reputations, and they can't foresee the future repercussions that may occur.
• Educate yourself. Be sure that you know how to use the applications, sites, and accounts you allow your daughter to use. Familiarizing yourself with on-line content prior to giving your daughter permission to engage with it will ensure that it is developmentally optimal, and will give you a better understanding of her internet and social media activities.
• Be a co-member on all media accounts. Unless you are completely comfortable allowing your daughter to go to an unchaperoned party, sign up for on-line activities with her, using a username and password you both can access. This way she knows that you will have the ability to check in on her activity at random intervals, and that you are maintaining an open dialogue about her on-line activity, available to mentor and support her should an issue arise.

A large part of parenting in the digital domain is taking your everyday parenting know-how and applying it to the digital environment in which your children are growing up. You are more prepared and qualified than you think--human development has not changed, the environment has. You can learn it from and with your daughter, turning a source of worry into an opportunity for bonding.

Enjoy your media and use them wisely,
The Mediatrician®

Is it ok to let my kids play with the iPad when I need a break?

I have two kids, ages 7 and 2. My eldest is given access to the iPad on car trips and once in a while at home. My younger son likes to sit by his brother while he plays and of late, has been pointing to it and asking for it. There are some days when I have given in, especially during fussy mealtimes or when I need to work and keep him occupied. My question is, will allowing him to play on the iPad once in a while adversely affect his development? Is it a terrible idea to let him use it sometimes just to give Mommy a break?

 - iConcerned, USA

Dear iConcerned,

There’s nothing inherently harmful about using tablets for either of your kids, and it may have some benefits. Tablets require that kids interact with the device both mentally and physically, with their fingers and hands not just watching. Particular kinds of learning can happen when a child sees that his action (like touching an image of a cow) makes something else happen (like a “moo” sound), and tablets can offer that kind of engagement in unique ways.

To keep it positive, pay attention to how long they’re using the iPad – your 2-year-old has a significantly shorter attention span than your 7-year-old. Observe him using it once or twice and you will see that after 15-20 minutes, he will probably look up for something else to do. When this occurs, direct him to another sort of play, with blocks, imaginary play, or going outdoors. This way the iPad becomes part of a rich and diverse menu of experience rather than drawing him back in for another cycle.

 The content each child is using should be developmentally optimal for each child—and that means having different content for each. Here are some tips to manage time and content:

• Choose content with each child in mind. You can use parent reviews from Common Sense Media to decide which apps, books, and games to try out, choosing a variety of activities such as finger painting, making music, and, for your 7-year-old, activities and games with reading, math, and science. Observe closely how each child responds and interacts with the content he is being exposed to, then help each of them choose content that will both interest and challenge them.
• Use it with them sometimes. The way that kids best use technology to learn and grow is with adult interaction and guidance, bonding with them and “scaffolding” their explorations.
• Use the tablet as part of their rich experience, rather than a babysitter. Continue to foster the same expectations for tablet time with your 2-year-old as you have done with your 7-year-old. While it is okay employ the tablet to smooth car rides or even to grab a few moments to work, I would recommend against using it at mealtimes for a host of physical and mental health reasons. It is important that the iPad doesn’t become an expected (or demanded) part of the daily routine and remains a special, once-in-a-while activity.

Enjoy your media and use them wisely,
The Mediatrician®

How important is outdoor recess for children in elementary school?

Q: Hi, I am a parent of a first grader who attends public elementary school. Her school offers the option of having an outdoor recess period after lunch or an indoor free-time in the school’s media center (essentially an extension of the library, featuring several computers, tablets, and eReaders). When I first heard about this option, I thought it was great and could potentially sharpen her tech skills. However, it seems that she chooses the media lab more often than outdoor recess (she says she likes the ‘games’), and I worry that she isn’t socializing with her peers enough and participating in enough physical activities (even though she has gym three times a week and is in good shape). Any advice you can offer will be appreciated—thanks!
-Ruminating over recess, in NH

 A: Dear Ruminating,

You have reason for concern about your daughter missing out on outdoor recess. In addition to being a great way to get exercise, recess has many cognitive, social, emotional, and physical benefits for children (see the recent American Academy of Pediatrics policy statement here).

Outdoor recess offers a break from the normal pressures of the school day and provides an opportunity to experience nature, not just physical activity. Nature has rhythms and rules of its own, that software can’t duplicate. Watching a robin feed its young or ants carrying food can be a wonderful way to learn about these rhythms and can also help calm and center oneself.

In addition, unlike solo media center play, outdoor recess is communal. That means it’s great for social development, which is a key task of elementary education. Having a safe, supervised time for free play allows kids to play games, create imaginary worlds, and develop a social structure where they learn to confront challenges and resolve conflicts. While computer games and videos can introduce content from reading to science, and can even help socialize kids with anxiety or who are on the autism spectrum, they are much simpler than the endless complexity of nature and face-to-face interaction with peers.

My recommendations:

• Talk to your daughter about her recess choices. Acknowledge and discuss how gender may play a role in her choice of media. Explain to her the benefits of being outdoors, and share with her some of your favorite childhood experiences of playing outside or on a playground with friends.
• Encourage her to balance her playtime, and suggest trying to go outside at least twice a week to start. Once she chooses to go outside, talk to her regularly about her experiences in a way that lets her reflect on the good and access your help addressing the more difficult. Compliment her on her successes and encourage her to increase the frequency of her outdoor play as the school year progresses.
• Communicate your concern and your plan with your daughter’s teachers so that they are aware of the situation. They can help encourage your daughter to choose outdoor recess, help her habituate to the playground dynamic, and let you know how she is doing. 

Although this is less likely the cause, make sure that her choice of media center over playground is not social avoidance because she feels ostracized or bullied (in which case, make sure to address that issue with both her and the school). If she is choosing the media center because she enjoys it more, your job is to help her recognize the unique pleasures of hanging with her friends and exploring the world.

Enjoy your media and use them wisely,
The Mediatrician®

How can I ensure social media safety for students with special needs?

Q: At the therapeutic day school where I work, we’ve been encountering a number of internet and social media issues with our students (all kids with emotional/behavioral special needs). I would love to get your thoughts and ideas on how to best educate our kids and their parents on how to understand and appropriately use media.In particular, we’re struggling to balance the kids’ appropriate desires to connect and be curious with their clinical needs and vulnerabilities. Taking a “just say no” approach doesn’t seem sufficient.

- Seeking social media stability for students, in Boston, MA

 A: Dear Seeking,

Think of social media as tools that amplify social interactions. They are fast and “sticky”—that is, information spreads quickly and never really goes away. That can create real challenges, especially for students who have trouble with checking their impulses or managing their emotions.

For those reasons, teach your students, teachers, and parents to treat online interactions as seriously as in-person ones—and to manage them in similar ways:

• Keep your messages simple. One parent I know helps her son remember who it’s okay to connect with on Facebook by remembering “the 2 F’s for Facebook”: friends and family.  This is the kind of message that is easy to repeat and remember. Another effective one is the grandma test—asking kids, “Would you be okay with your grandma seeing what you want to post? If not, then don’t post it!”
• Focus on ways of managing their emotions before they go online. If you teach them to take 10 deep breaths before saying anything when they’re upset, teach them to take 10 deep breaths before they post anything online—and then to walk away from the computer until they're calm and thinking clearly. To help them build empathy, ask them to look at anything they're about to post as if they were on the receiving end of it, and then make a decision about whether to actually post it. 
• Supervise students as they go online until they show that they can manage themselves well there. A child who wouldn’t be left unsupervised in person shouldn’t be left unsupervised online. Make sure that when she goes online, there is an adult present with her. As she learns to use positive strategies for deciding when and what to post, you can gradually allow her to have more freedom.

It may be helpful to communicate about internet safety concerns with parents as well. Consider hosting an afterschool lecture or workshop about how to support students in using the internet and social media in positive ways.

Enjoy your media and use them wisely,
The Mediatrician®

My 18-year-old son is addicted to video games, what can I do?

Q: Our 18-year-old son started playing video games at age 9 and became addicted gradually. We struggled with him over the years to limit the time he was online. It became the center of his world, especially when he hit puberty and was dealing with insecurity, anxiety, and depression. The games became more and more violent. He withdrew socially and just recently dropped out of college in the first month of his freshman year. He denies having an addiction but has ceased to do anything but play the games all night and sleep all day. His only friends are those who play games with him online. We are trying to get him into a Video Game Addiction Detox program, if there is such a thing, but he is 18 and refuses to go. What do we do?

- Desperate for Detox, in Miami, FL

A: Dear Desperate,

Your story is heartbreaking and, unfortunately, not unique. Without more information and getting to talk to your son directly, I can’t offer anything that can be construed as medical advice. What I can offer is observations on what you have shared and some thoughts about choices you might make. For a definitive plan, seek out the professional advice of someone who knows your son well, a primary care doctor, psychologist, even a former college advisor or school guidance counselor.

You are absolutely right that your son is legally an adult and thus must seek professional help himself. However, as with those addicted to alcohol or other substances, you son may be oblivious to the harm and disability that is obvious to those around him. It’s likely that your son may have begun using video games to distract himself, to “self-medicate” his anxiety and depression. Video games allow users to master environments and can give players a sense of control and self-confidence within these virtual worlds that they may not experience outside of the game. What makes your son’s gaming problematic is that it is consuming his efforts in a way that prevents him from achieving larger life goals. Since your son can’t be admitted to therapeutic care without his consent, the best solution may be to stage an intervention—just as you might if he were addicted to alcohol or drugs.

First, educate and empower yourself with strategies and resources for interventions.  There are professional interventionists who can help you through the process if you decide that’s the best route to take. It sounds as if your goal is for your son to agree to entering treatment, so part of your preparation will be to identify a specialist and/or facility where he can receive treatment for anxiety, depression, self-harming behaviors, and video game addiction. You will need to be prepared to admit your son into care immediately following the intervention, as that is when he will be most willing to go.

The intervention will likely involve gathering some close, trusted family members and friends (maybe even some gaming friends) who care about him and whom he trusts, and then confronting him about the issue in a way that is clear, and, most importantly, from a place of love and concern. Tell him that you all have noticed that his video game play has hurt his physical and mental health and that all of you want him to seek out treatment so that he will be happier, healthier, and more able to pursue his life goals. Please keep me updated about how it goes, I am certain that other parents will benefit from your experience.

Enjoy your media and use them wisely,

The Mediatrician®

 

Will my young kids be 'missing out' without a smartphone?

Q: I am mom to a 3-year-old and a newborn. I’m careful about the amount and content of my kids’ screen time. I occasionally try to find simple computer games for my toddler to develop keyboard and mouse skills, but I wonder if these skills will be relevant for her in the future. I’m starting to see more and more coverage about kids’ overuse of apps and wonder if my kids will miss out by having zero smartphone exposure.
—App Anxious, Belmont, MA

A: Dear Anxious,

There is a significant amount of research on children and TV viewing, but we are still learning about the effects of tablet, smartphone, computer, and other interactive technology use on their health and development.

It sounds as if you have two questions:

• What is my child learning at this age? Babies and toddlers are learning how to connect with others, how to creatively solve open-ended problems, and how cause and effect work, particularly in their interactions with the physical world. If the app or device you are considering will support one or more of those key tasks, then it may be worthwhile. But remember that an app or device can never replace you as a parent. Continue to prioritize personal interaction, play, or even using an app together.
• How will this help my child in the future? Given how quickly technology changes, the mouse-clicking and finger-swiping skills that your child is learning now probably won't be useful by the time she’s in high school. Think about how dramatically iPads have changed they way we use computers in the past 2 years. Who knows what the technology will be in the next 5, 10, or 20 years? On the other hand, when your daughter experiences cause and effect through direct experience—like building a tower of blocks and knocking it over, or smiling at you and seeing you melt—she develops basic awareness and skills that she will need to navigate the world of the future. Focus on building those skills.

As long as children are given exposure to loving care-takers and an environment where they are able to complete their age-appropriate developmental tasks, they won’t ‘miss out’ by not using apps. Remember is that apps are tools and should be evaluated by how well they will help your child learn now and develop skills for the future. If you choose to bring apps into your kids’ lives, pick apps that you will use with them and that teach real-world skills that they can build upon as they develop.

Please see the below to help you choose developmentally conscious apps:

• PBS Parents
• Common Sense Media

Enjoy your media and use them wisely,
The Mediatrician®