Ask the Mediatrician

How can I tell if an e-book is appropriate for my 10-year-old?

Q: With the purchase of a couple of e-book tablets for our home, how can we know if the books our 10-year-old triplets will be reading on them are age appropriate? My daughter read a book she heard about in her 4^th grade class during a book report, and it ended up having significant sexual content and very questionable language. If it were a movie, it would have been rated R!
—Troubled Tablet times 3, Kinnelon, NJ

 A: Dear Troubled Tablet times 3,

It can be a difficult task trying to figure out if a book is developmentally suitable for your child. The old adage “you can’t judge a book by its cover” still holds true, even in the age of e-books. Fortunately, there are several ways to make an informed decision about whether it will be a healthy read for your child. If there is a particular book your daughter is interested in reading, like the one she heard about in her book report, review the content in one of these ways:

• Read the book yourself. As a parent, you know your child better than almost anyone else. If you are able to read the book before she does, you can see whether its content is optimal for her and can direct her to other books if you decide it isn’t.
• Sample the story. Even though one small section of the book may not accurately reflect the whole story, a chapter or two can give you a taste of the book’s content (and its level of difficulty). You can go to a library or bookstore, or you can preview chapter or two for free wherever you buy e-books.
• Start a book club. By reading and discussing the book with your daughter—and possibly with other mother/daughter pairs—you can help her process the content and her feelings about it. That may allow her to engage in more challenging material in a supportive environment.
• Check out an expert resource. Since you won’t be able to read everything that your child wants to read, look for reviews from resources you trust (try this one or this one).

When you do find books that meet your daughter’s needs, be sure to share them with others—in your book club, at your child’s school, or even by adding them to a trusted resource list.

Enjoy your media and use them wisely,
The Mediatrician®

How can I block sexual content in Web searches from my 15-year-old's iPad?

Q: What is the best way I can block websites with sexual content that appear through Web searches on my 15 year old’s iPad and still let him use the Internet for safe sites? The built-in controls are a blunt instrument and block too much or all content.
-Seeking Better Blocking, in Nashville, TN

A: Dear Seeking,

As you’re finding, software controls aren’t very effective at blocking sexual content. They may allow sites that are creatively named while blocking innocuous sites on, say, breast cancer awareness. Also, if your son wants to get around them, he will. That’s why the best software for protecting your son is the knowledge in his head.

First, know that it’s natural and healthy for him to be curious about sex. But as you imply, the world of sex online is a minefield: The images he sees there are likely to be unrealistic, dehumanizing, and treating sex as a commodity—as something to buy and sell rather than an intimate expression of love and trust. That can affect his understanding of sex.

That’s where you come in. As a parent, you can direct him toward online information that will support him in developing positive sexuality (take a look at Scarleteen and GoAskAlice). You can also help him interpret the negative portrayals he sees online by having a candid conversation with him. Ask questions like, “What is really going on there?”, “How do you think that makes her feel?” and “Is that the kind of relationship you want to have?”

The more that his sexual education can occur out in the open and in contact with you, the less of an impact the schoolyard or Internet “sex ed” will have.

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® 

Is my daughter's Halloween costume too sexy?

Q: My pre-teen daughter is dying to go as a sexy vampire for Halloween (she's a big Twilight fan) but I just don't feel comfortable with her running around the neighborhood in a short skirt, tight top, and lots of makeup, costume or not. What can I say to her without making this such a big deal?
-Bella’s Nemesis in Belchertown, MA

A: Dear Nemesis,

Halloween is a day to have fun being someone different—but that certainly has consequences, so it should also come with limits. There’s a reason that every October, little boys want to be Superman or star troopers: It shows their aspirations for being mature and powerful. When teens (or adults for that matter) choose costumes that emphasize their sexuality, they are publicizing their desire to be noticed for their bodies. 

So it doesn’t necessarily matter how she dresses or who she presents herself as during the rest of the year: Going out in this costume tells the world something about her.

It’s likely you’ll get “But it’s just a book, Mom. She’s just a character.” You can respond by talking with her seriously: What is it about this costume that she likes? Does she realize how people will respond to her in it, and if so, is that what she’s looking for?  Be frank: Is she ready to be sexually objectified? Will she be uncomfortable in this costume in front of her peers, older teens, or even people her dad’s age?

Frame your conversation around the ideas of self-awareness and self-respect, and focus on how your daughter wants to be viewed as a whole person. Who knows, maybe there are creative ways you can modify the costume that would allow her to express her love for Twilight but in a less objectifying way. Hopefully, she’ll see the long-term effects of this decision in the larger scheme of choices she needs to make about how she is seen by others—and see you as someone helping her become the person she wants to be.

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 does pornography impact boys' ideas about women and relationships?

Q: Recently my daughter shared with me that the boys in her 8th grade class were looking at pornographic images on one of their phones during lunch. With so much online pornography being directed at our tween/teen boys, has there been any research done in this area, or will we not know the effects of such imagery on these boys’ brains/relationships for some time? I am wondering what impact this will have not only on our boys’ health and well-being but also on their relationships with the girls who date and marry them.
-Serious About Sex in Solana Beach, CA

A: Dear Serious,
Whether we like it or not, this scenario is neither rare nor one of “bad kids doing bad things.” Pornography is not being directed just at tween/teen boys but at all of us. It is a multibillion-dollar economic engine of the Internet, and it is easily accessible with any Web-capable device. Combine that with the rapidly increasing ownership of and facility with cell phones by school-aged children, and you have the situation you describe.

There are two issues here. The first is the effects of viewing pornography on anyone, and the second, and more important one in this age group, is its effects on youth who are forming their ideas and attitudes about sex. Research with older adolescents and young adult males has shown that exposure to pornography results in objectification of, desensitization to, and reduced empathy for women. It also shows that men who view sexually explicit films degrading to women are more dominant in their subsequent interactions with women.

Media-effects research, which addresses outcomes from violence to nutrition, has consistently shown that young people learn about the world and how to behave in it from the media they use. Research from the Netherlands found that the more exposure a young person has to pornography, the more realistic they think it is, which influences expectations for their own sexual behavior. Another study by the same researchers suggests that seeing sexually explicit material was associated with thinking of women as sex objects. Eighth graders are sexually curious and experientially naïve. Pornography and mainstream media representations of sex as a desirable commodity with no commitment, connection, or consequences may be their first, most powerful impressions of sex. “Friends with benefits” and other potentially unhealthy sexual attitudes and behaviors can result if these media messages are not countered.

Parents, teachers, and other adults can help reduce the potential unhealthy effects of exposure to sexual media by talking with kids about sex in a way that is clear, matter-of-fact, and without shame. Make it safe and comfortable to come to you for information. That way, if and when they encounter sexually explicit media, what they see becomes just one part of their larger understanding of sex, human relationships, and how they work in the real world. It can be difficult to know how to start these conversations, but there is advice out there that can help you figure out what to say and how to say it. Media portrayals of sexual situations can actually make these conversations easier and more effective, as research around a Friends episode dealing with condom failure demonstrated. Although unquestioned and undiscussed exposure to sexually explicit material has been associated with negative effects of children’s sexual health, you can address your child's curiosity about sex in ways that supports healthy development and the kind of understanding of sex and relationships you’d like them to have.

Enjoy your media and use them wisely,
The Mediatrician®

What are kids learning from Lady Gaga's music videos?

Q: I recently saw the music video for the song “Telephone,” by Lady Gaga and Beyoncé. It is full of sexualized violence. I can’t imagine what kids are learning from this. I know my son loves listening to Beyoncé, and I’m sure he has seen or will see this video. How can I talk to him about what he’s seeing in videos like this?
-Vexed by Videos

A: Dear Vexed,

Music videos, like all media, provide an educational experience -- a chance for kids to learn something about the world. Music videos are especially powerful because they combine music with images to capture attention and make us feel excited as we watch them. They can provide entertainment, titillation, social commentary, or artistry; they can be fun or frightening, relaxing or infuriating. But whatever their goals, the mood and atmosphere they create do not often reflect reality.

Research shows, for example, that music videos disproportionately portray white women as victims of violence and black men as both perpetrators and victims. These representations matter because kids are in the process of forming their understanding of the world and how it works. Anything they’re exposed to, whether realistic or not, becomes part of that understanding.

When it comes to music videos like “Telephone,” adults’ concerns often focus on the amount of skin showing, and the implied (or even quite explicit) sexual behavior. But it’s not so much the simple fact of skin exposure that’s potentially harmful for kids; rather, it’s the nature of the way sex is portrayed that is potentially damaging. In music videos like this one, sex is shown in a way that has nothing to do with intimacy or relationships. It is instead used as a way to exploit others and is tied to violence and death. While this edgy approach is great for attracting attention and for selling CDs or downloads, the music video audience tends to be teens or pre-teens who are just starting to think about their sexuality. Thus, anything they see will become part of their growing body of knowledge about sex.

It makes sense that you wouldn’t want your son to see this video, but also know that it can present a great opportunity for discussion. First, ask whether he’s seen the video (or any other Beyoncé or Lady Gaga videos) in a non-judgmental, open way. Then ask what he thinks of it—what does he think the video is about? What does he like about it, and what does he find disturbing? Does he think it’s realistic? If not, then why does he think these artists made this video? What are they trying to say? Genuinely listen to his responses, and encourage his thinking with questions. You can also take this opportunity to compare what happens in this video to what happens in real life, to help keep his understanding of the world realistic and healthy.

Enjoy your media and use them wisely,
The Mediatrician®

My daughter feels left out because she doesn't use the media her friends use--what do I do?

Q: My children know it is not right to watch, play, or listen to things that are not for their ages, and they understand why, as we have explained to them. But their friends tend to walk away from them because of this. For instance, my 12-year-old daughter was asked by her friends to dance to a Lady Gaga song for a show at school. I watched the music video so I could talk to my daughter about it; of course, I said that it was inappropriate for her to dance on it. Her friends told her she was chicken; I told her not to care, and that she would be the one to go really far in life. I would like to know your thoughts on this, as my children’s self-esteem tends to suffer because of the power of the media on children. How do we improve their circle of friends?
-Peer Pressured, in London, UK

A: Dear Peer Pressured,

First of all, I also want to commend you for actually listening to the Lady Gaga song that your daughter’s friends asked her to dance to. Many parents don’t engage with their kids’ media because they feel like they can’t relate to it in any way, but by listening to the song yourself, you invite discussion with your daughter. This gives you a chance to learn what she thinks about it, to share what you think about it, and to keep the conversation open between you.

The main issue here, though, relates the difference between how your daughter uses media and how her friends use media. Part of the challenge is that entertainment media create a common experience that young people can share, whether they’re discussing what happened on The Simpsons or what happened in a basketball game. If a young person doesn’t share in this common experience, she is likely to feel left out. This is especially challenging during the pre-teen years, when social validation begins to come from peers instead of from family.

It sounds like your daughter feels very alone, in part because she’s having trouble finding like-minded peers at school. But there are many young people who are in the same boat as she is—it’s just a matter of finding them. In the Media Age, a great way to do that is through online social networking.

Youth use social networking sites to build communities around everything from shared hobbies to shared chronic illnesses, especially when such communities don’t exist in their immediate environments. For your daughter, finding youth who share other interests of hers might help address this challenge—whether the relationships occur offline or online. For example, one parent I met recently told me that her 12-year-old daughter loves New Moon, an ad-free, adult-moderated site where she has open, honest discussions with other girls. Encourage your daughter to see what’s out there, and take a look for yourself. Although challenges with school friends will still arise, other forums for connection can help her find the social approval she’s looking for without feeling like she has to change herself.

Enjoy your media and use them wisely,
The Mediatrician®

Are kids benefiting from all these electronics?

Q: I keep hearing how younger and younger children are being exposed to electronics -- that there are computers in preschool classrooms, that kids are using smart phones to learn the alphabet, and that a children's version of the iPad is in the works at Fisher Price.  This exposure to electronics at such an early age certainly has an effect on children’s social and family life, the way they play, and their academics. My question is whether these effects are positive or negative -- is the next generation benefiting from these electronics?
Interested in the iGeneration, in Boston, MA

A: Dear Interested,

This is an important question, and unfortunately, we only have limited data to help us answer it. We do know that computers and other interactive media have immense teaching potential. They respond to the user’s actions (at least in a basic kind of way,) so for skills and drills learning (for example, memorizing the alphabet, learning numbers, practicing arithmetic), they can be a great supplement to what a teacher or parent can offer for instruction.

Electronics are not, however, good at teaching children how to think or that they should ask questions, or use creativity—all of which are critical parts of the learning process. These skills are what help young kids learn to love learning itself, which is one of the most important academic skills to gain. For that, in-person interaction is essential. A recent study, for example, helped demonstrate the difference between being read to in-person versus being read to through a screen: When the reader was physically present, there was greater activation of the child’s frontal lobe (the part of the brain associated with reasoning, emotions, and problem solving) than when the reader was on a screen.

In addition to these limitations, there is real concern that increased screen time contributes to kids being less connected to their family, friends, and others. A recent study from New Zealand showed that both today and 20 years ago, increased screen time was associated consistently with poorer attachment to parents and peers. Other issues connected with more screen time include social isolation, obesity, and increased risk of exposure to violent and sexual content. 

If electronic media are used in thoughtful, focused, and limited ways, however, they can be a boon to your kids. You can help ensure that this happens by paying attention to what kinds of electronic media they are using and how much time they spend using them. Help them learn to watch a specific show, play a certain game, or talk to a certain person, then to shut them off rather than surfing without direction.  And, as always, a good rule of thumb is to make sure that media are used after all the important tasks of life--like sleeping enough, eating good meals, getting exercise, and spending time with family--are complete.

Enjoy your media and use them wisely,
The Mediatrician®

Are parents legally responsible when their teens engage in sexting?

Q: I just recently found some sexual pictures in my son’s phone and I am totally shocked and scared. I do not know what to do and if I should tell his girlfriend’s parents or not. Is this a crime punishable to the parents of these “sexting” teens?
-Asked by Trish on Education.com's JustAsk forum, after reading the article Is Your Child Sexting? What Parents Need to Know

A: Dear Trish,

When you think about it, sexting (sexual content + text messaging) is the perfect storm for teens: Start with the fact that they’re at the peak of sexual urges and curiosity, then combine it with their tremendous love of media and ease with technology. If that weren’t enough, you can add parents who are often uninterested in how media work, plus the fact that teens have not fully developed the area of the brain that lets them think through future consequences.

From a developmental perspective, exploring sexual expression is normal behavior for teens, regardless of whether adults approve of how, when, and where they choose to do so. However, the Digital Age has raised new concerns about these expressions. In the past, a printed photograph could be given to a love interest in relative privacy. Even if the photograph was passed around between friends, the print could eventually be destroyed. With today’s digital pictures and messaging, however, sexual photos and texts can spread to many more people much more rapidly, and since each person owns a copy of the file after they receive it, there is no good way to make sure that all copies are destroyed.

This has unexpected legal (and social) implications. Most of the laws about child pornography were established before the Internet became widely used, and certainly before sexting existed. In many states, your son, the girl in question, and anyone else connected to those images could be subject to prosecution under child porn charges, which could mean ending up as registered sex offenders—which sticks for a long time. Ironically, the laws that were created to protect children from being victimized by pornography are being used to convict children, who, in many ways, are doing what kids have always done.

Given all of these factors, do everything in your power to keep this out of the legal system and within the context of your family and the family of the girl in question. First, talk to your son. Avoid making this a moral question—this is not about whether he’s a good kid or not. You could say, for example, “We can deal with the issues of whether this was a good decision later, but right now, we need to talk about how to clean this up.” Then you should think about talking to the young woman and her parents, stressing that your concern is for her safety. Then, if necessary, consult an attorney about how the laws work where you live.

Ideally, prevention is the most effective approach. I encourage parents to really think through the implications of giving a child a cell phone, just as they would think through the implications of letting a child drive: he first needs to learn to use the tool safely. And that’s probably why you got him a phone in the first place—to keep him safe. To maintain that safety, start having clear, open discussions about what the phone will be used for as you move forward, who pays for it, and when and if you as a parent will have access to it. This is not to check up on him but rather to make the point that what’s on that phone is not, as he has now discovered, truly private.

See below for an MTV presentation on the consequences of sexting:

Enjoy your media and use them wisely,
The Mediatrician®