Ask the Mediatrician

My daughter is upset by Justin Bieber’s behavior, how can I help her cope?

Q: My 12-year-old daughter is devastated by what has been happening with Justin Bieber. She has been a fan of the pop star “forever” and she and her friends fervently follow his career and personal life. I originally supported my daughter’s obsession (allowing her to buy his music, hang posters in her bedroom, attend a concert, etc.), because I thought he was a good role model. But now I am at a loss. My daughter cried over his break up with Selena and was confused, disbelieving and hurt by his recent assault and battery charges, seemingly poor choice of friends, and insensitive statements about Anne Frank.  I’m afraid Bieber is going to become the next Brittany Spears and that his breakdown may adversely affect my daughter—any help you can offer will be appreciated!

~ Bemoaning Bieber, Boston, MA

A: Dear Bemoaning,

We have to remember that the word fan was derived from fanatic. Many tweens fall hard for celebrities because these fantasy relationships are rehearsals for romantic and friend relationships that they aspire toward having in real life. For your daughter, Justin Bieber may have become kind of a surrogate boyfriend— idealized as “perfect in every way,” talented, romantic, kind, and completely focused on her.

Bieber’s recent behavior challenges your daughter’s fantasy, because it is clear that he is not perfect. And although that may seem silly to adults, the disappointment is very real for her. But this disappointment, like the infatuation, can be an experience that teaches her about human relationships – to realize that no one is perfect and to recognize both the ‘good’ and the ‘bad’ qualities in potential partners.

There are several ways you can help your daughter cope and grow from this experience:

1) Acknowledge her feelings, and let her know that it’s okay to feel them. Her ideal of Justin Beiber was really important to her--her loss of it is real, and her sadness is valid.

2) Talk with her about differences between how media portray a person and who that person really is. Ask her to think of times when she’s seen a picture or heard a story about someone she knows that she thinks doesn’t match what she knows of them. Then explore with her the images, videos, and stories of Bieber not as accurate representations of a 19-year-old boy, but as products manufactured by producers and publicists to be sold to her and to people like her.

3) Talk about the price of celebrity. Justin Bieber is still a teenager, but as a public figure and the center of a multi-million dollar enterprise, he is under an enormous amount of scrutiny and pressure. Rather than condemning his poor behavior and bad break-up, talk about these incidents with your daughter in light of the amount of responsibility he has. Everybody makes mistakes; instead of focusing on his wrongdoings, talk about how he can recover from them.

4) Help her think about how this lesson can be applied to other real-world experiences. Tweens and teens often spend hours honing their profiles, pictures, and messages to present themselves in the most attractive ways possible. Your daughter’s ability to see through the “positioning”, photoshopping, and editing of Bieber can help her look beyond the carefully created photos and profiles of her peers, making it possible to get to know who they really are.

Above all, you can help this situation be a positive learning experience for your daughter. Leave her space to grieve her idea of who he is (acknowledging that she never did and still doesn’t really know), and help her gain a more nuanced and realistic understanding of how real human beings behave and what healthy, human relationships are like.

For additional insight see:

• Why do adolescent girls idolize male celebrities?
• The role of media figures in adolescent development
• Attribution style, self-esteem, and celebrity worship

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®

Should we keep kids away from media after the Boston Marathon bombings?

Dear Readers,

Our hearts hurt after Monday's explosions at the Boston Marathon. The pain and shock in our community is palpable, and it’s hard to know where to go from here.

But there is also a remarkable upsurge of help and love that sprang out of the shadow of this event. The Center on Media and Child Health is at Boston Children's Hospital, one of the many area hospitals that leapt to care for those who were injured in this attack. In situations as horrifying as this, Fred Rogers say “Look for the helpers”. Well, we are looking—and we see them everywhere. 

There are many wonderful resources to help guide you in talking with kids about this event (like Helping Kids Cope with Tragedy, How to Talk with Children about Boston Marathon Bombs, Helping Children Process the Boston Marathon Bombings). In addition to making space to talk with children and process their feelings about what’s happened, think about how to use media in ways that offer support:

• Limit exposure to the news for children of all ages. Think about who is in the room before turning on the news and when deciding how long to leave it on: 
  • Babies and toddlers: Even very young children who don’t understand what they’re seeing can sense and respond to fear in the adults around them.
  • Preschoolers and school-age kids: For those old enough to make sense of images on the screen, seeing them even once can really make an impact—and seeing them replayed over and over again can escalate feelings of fear. Younger children may even think that the explosions are happening again each time they are shown on TV.
  • Tweens and teens: Older children, too, need space from the images. They are more likely to understand that the images are real and so may feel a greater sense of threat, and that can compound when they hear the reports repeatedly.
• When they do see media images, look for the “helpers.” Ask kids to point out the people they see helping. Everyone from EMTs to policemen to people simply standing on the sidelines or actually running jumped forward to help those who were injured. Looking for the stories of bravery and selflessness can help kids feel hope.
• Look for messages of support, which can bring comfort. It may help kids—especially older kids—to feel a sense of unity and community when they see messages of support from people around the U.S. and around the world. Take a look at images of people in Kabul holding up signs expressing support, or messages of love projected onto the sides of buildings in New York.
• Connect with far-away family and friends. Mobile phones and streaming video can let kids see the faces and hear the voices of loved ones, which may help reassure and comfort them.   
• Listen to favorite songs and read favorite books. Media like these can be particularly comforting in times of great stress.  

Remember, too, to make media-free space for processing and healing. Bring kids outside for a walk in nature, which can help with calming and feelings of well-being, and make time to connect and let them know that you love them. 

Peace, health, and freedom from fear to you and your loved ones,
The CMCH Team

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®

 

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®

Is an e-Reader appropriate for a 7-year old?

Q: I am the mother of a 7-year-old girl who is a voracious reader. I have been considering buying her a no-frills e-Reader that doesn’t have games, video, or other features, but just allows you to read books.  We are a minimal electronic media household--we don’t own a TV, and our girls (ages 4 and 7) rarely use electronic devices such as smartphones or tablets. The convenience of an e-Reader, however, has some appeal to me. I’m wondering if there is any research on the effects of screen reading on young children. As someone who has been very deliberate about keeping our home relatively electronic media free, I am conflicted…but my book shelves are awfully crowded! 

 ~ Anxious over e-Readers, USA

A: Dear Anxious,

To date, there is little direct research comparing reading books to reading e-Readers, but in basic ones that don’t have lit screens, the technology itself is remarkably similar to reading words on a printed page. (Research shows ones that do have lit screens, though, can contribute to the same kinds of sleep problems as TVs and computers.)

When e-Readers were first introduced to the public, I resisted the idea because I love the look, feel, and overall experience of reading paper books. However, once I started using an e-Reader, I quickly learned to appreciate it as a flexible and convenient tool for storing a large number of books in an easy-to-read, portable format. My 8-year-old son loves the e-Reader, too.

One lesson he helped me learn, though, is how easy it is to buy books on it. After finishing one book, he was so excited to continue reading that he ordered the rest of the series--placing a $60 order using the e-Reader store application. I was able to cancel the order, but now I only enable the store account when I am using it. That way, my kids can’t run up large bills or buy books that I don’t think they’re ready for.

If you do decide to buy your daughter an e-Reader: 1) Follow the instincts you already have and buy a basic one with an unlit screen and 2) Establish from the beginning how you will purchase books for it together, that way you can control both what she is exposed to and your wallet--and you can model critical thinking in book choice as well.  Then load it up with a book or two you think she’ll enjoy, and get reading! For more ideas on encouraging young readers, see these posts:

• Where can I find books for young advanced readers?
• How can I tell if an e-book is appropriate for my 10-year-old?

Enjoy your media and use them wisely,
The Mediatrician®

The Mediatrician’s tips for choosing family-friendly holiday films

The holiday season is often filled with family traditions that are passed on from generation to generation, year after year. From special foods, activities and decorations, to visiting with family and friends, this is the time of the year when we celebrate traditions and look to share them with our children and the ones we love.

Many of these traditions include media, whether listening to a favorite holiday album, browsing online catalogues for gift ideas, or watching televised specials, media can be a wonderful addition to your holiday traditions. Each year brings new holiday films, and many of us remember movies from our own childhoods that we look forward to watching and sharing with the children in our lives. To help you and your family maximize the enjoyment that movies can bring, here are several tips for helping you choose holiday movies wisely: 

1. Choose the movie based on the age of the youngest child in the group. This will help ensure that the content will be appropriate for everyone watching, and not just for the older children and adults.
2. Consider each child individually.In addition to accounting for each child’s age, pay attention to who they are and where they are developmentally as well as their personality.  Choosing a movie with individual temperaments in mind will help everyone avoid feeling confused, anxious, fearful, or even bored during the movie.
3. Start smart family media traditions early. Start smart family traditions while kids are young. Getting teens to enjoy time-honored holiday movies rather than the latest blockbuster –“that everybody else is watching”- has a better chance of succeeding if you start the tradition at a young age. Your enthusiasm and presence can have more influence than hundreds of commercials and marketing ploys.
4. Research the movie before you share. Even if a holiday movie seems light-hearted and fun, it might contain a scary or inappropriate scene, if you haven’t watched the movie yourself or are not sure if a movie’s storyline or message is appropriate, ask trusted friends who have seen the movie for their opinions. Also check out review sources such as Common Sense Media and Movie Review Intelligence. Remember that a movie’s MPAA rating is not based on what is developmentally appropriate for children, so be sure to use additional sources before you make your decision.

Remember to watch the movie together as a family or group, use the pause or fast-forward buttons as needed (for questions, conversation, or to skip scary parts), and talk about what you watched. Hopefully, you will find a film that you and your loved ones can enjoy as a holiday tradition year after year.

Happy Holidays!

The Mediatrician®