Ask the Mediatrician

Should I use the movie "Bully" to talk about bullying with my 10 year old?

Q: My 10-year-old son will be starting middle school in the fall. So far, he has had a pretty sheltered, drama-free experience at a great elementary school. I want him to be aware that bullying goes on and that he needs to tell someone if anything like that ever happens to him. I have thought about taking him to see the movie “Bully,” but am afraid that it will make him fear going to middle school. What do you think?
-Bothered about bullying, in Minneapolis, MN

A: Dear Bully Bothered,

Your concerns echo those of many parents who have children transitioning from one school to another. You are doing the right thing by trying to start a conversation about bullying with your son. However, your instincts on using “Bully” to introduce the subject are right on track. It may be too intense, since it includes a lot of physical and emotional child-on-child violence, as well as the suicides of bullying victims. Try opening the topic in another way.

One way approach could be to take your son for a drive and start the conversation in the car—that way, you won’t have to face each other as you talk, and his attention will be focused on the conversation (provided that he doesn’t have a book, DVD player, radio, or cell phone). Chances are your son isn’t so sheltered that he hasn’t heard about bullying, and he probably has some concerns of his own. Begin the conversation by allowing him to vocalize his thoughts:

1. Start with open-ended questions: “How are you feeling about starting middle school? What are you excited about? Worried about?”
2. It may help him talk if you depersonalize the topic, ask: “What worries do your friends have about school?”
3. If bullying hasn’t come up yet, you can present the issue from your own perspective, saying, “One thing I’m worried about is bullying, which we know can be an issue in some schools. Have you heard about that happening?" And "Please talk to me if you see anything that makes you uncomfortable. Together we can figure out a way to deal with it, and you’ll be helping to keep your school safe.”

When children and their schools see bullying as a community issue, they solve the problem by focusing on the needs of the bullies, victims, and the school community to make a positive change. This approach helps heal the community as a whole and is more effective than using a system of punishment, which often doesn’t address the core of the problem. Presenting the issue this way can help give your son a sense of shared responsibility for his school environment and will not only make him aware of bullying, but also empower him and his schoolmates against it.

For more information and resources check out:

• http://www.stopbullying.gov/
• http://www.ncpc.org/topics/bullying/what-parents-can-do

Enjoy your media and use them wisely,
The Mediatrician®

My 17-year-old is having serious anxiety since he started playing Call of Duty--is there a connection?

Q: My 17-year-old son started playing Call of Duty a few months ago. Since that time, he has had more trouble than usual falling asleep and has been waking up in the middle of the night. Last night, he woke me saying he felt like he was having a panic attack—racing heart and hyperventilation. I hadn’t associated it with his Call of Duty play, but when we talked about it last night, I realized that the timing lined up. Is there any evidence of violent video games bringing on stress or anxiety in young players?
     —Shoot or Scare, in Vancouver, British Columbia, Canada

A: Dear Shoot or Scare,

The key question is this: Did your son realize the association between the time when he started playing Call of Duty and his increased general anxiety punctuated by panic attacks?

The research shows that at his level of brain development, your son is more likely than an adult to have increased fear/anxiety after playing violent video games, but less likely to have the insight necessary to make the connections. He will be address this problem more effectively if he “discovers” the relationship himself and devises a solution. If he has not made the association, it will work better if you explore with him what might be stressing him at the moment, gently steering him toward his own observations rather than telling him yours.

The reason that kids get so involved with Call of Duty (the biggest selling video game to date) and other action games is that they are designed to put players on high alert—to get their adrenaline flowing and their hearts racing, ready for unexpected turns of events. Adolescents seek new experiences and sensations—it is an integral developmental task at your son’s age. Video games are one way in which they can vicariously experience fear and mastery of that fear in a situation that is not life-threatening.

Gently encourage your son to stop playing for two weeks or so and see whether his anxiety lessens. If it does, he may want to decide whether playing the game is worth living with the symptoms. If it doesn’t, the adrenaline rush of gaming may have unmasked an underlying anxiety—he may want to take a closer look at what else is happening in his life, and consider seeking help from a talk therapist to develop effective coping strategies. See this related post for more information.

Enjoy your media and use them wisely,
The Mediatrician®

Ratings Reality: Who rates our media and what that means for children

CMCH staff member Kristelle Lavallee contributed the following post to Thriving, Boston Children's Hospital's pediatric health blog.

Are you looking to take the family to a movie but aren’t sure whether your child should see The Hunger Games (PG-13) or Bully (unrated)? If you base the decision on the Motion Picture Association of American (MPAA) ratings, the answer seems pretty cut and dry—“maybe” to Hunger Games, and “no” to Bully. But are the movie ratings the best guide to making healthy media choices for your children?

Based on the best-selling novel, The Hunger Games is a fantasy story where teenagers are pitted against each other in a battle to the death broadcast on live TV. In contrast, Bully is a “slice of life” documentary about peer-on-peer bullying in American schools.

Both movies center on children and teenagers, but the fictional Hunger Games, portraying “intense violent thematic material and disturbing images” (MPAA’s description) was given a PG-13 rating, while the documentary Bully with “some language” (MPAA again) was rated R. The producers of Bully knew that accepting an R rating would greatly limit the film’s impact as an educational tool for young viewers, so they chose to release it unrated. But when a film is released without an MPAA rating, it comes at a price: Fewer theaters are willing to show it, and those that do will treat it the same way they treat films unrated for extreme violence or sex. Continue reading here.

Am I overreacting if I don't want my husband to play games like Grand Theft Auto with our 5-year-old?

Q: My husband plays X-box games rated for those over 16 or over 18, like Call of Duty, Grand Theft Auto, and Modern Warfare. He allows our 5-year-old son to play these games with him. I do not know anything about X-box, but I feel they are not suitable for a child that is so young. Am I over-reacting like my husband suggests? 
-Fear of Gaming, in Ireland

A: Dear Fear,

Trust your parenting instincts on this—you know your child better than anyone. Your concerns are not an over-reaction, but are supported by scientific research.

In video games, players gain or lose points for behaving in certain ways. They practice those activities over and over again, getting better and better at these “behavioral scripts.” While your husband’s adult brain can tell what’s fantasy and what’s reality, your son’s can’t—and won’t be able to for at least 3 more years. Instead, he will use these experiences to build his understanding of what the world is like and how people behave in it.

Using virtual violence as entertainment makes children of all ages less sensitive to the real-life suffering of others. It makes world seem more violent, which leads to anxiety—especially among the youngest users. And although they are unlikely to go out and do the things in real life that they do in video games, some users will think and behave more aggressively. If your son is having trouble with nightmares or aggression toward other kids, it could be related to playing these games.

Even if he isn’t visibly experiencing these kinds of problems, though, talk with your husband about what you’d like your son to learn and what kind of person you want him to become. Then brainstorm fun activities they can do together to accomplish those goals. And remind him that your son’s childhood is fleeting—their time together will build both memories and the person your son will be, so choose them mindfully.

Enjoy your media and use them wisely,
The Mediatrician®

Is The Hunger Games movie too scary for younger fans of the book?

CMCH staff contributed to the following post on Thriving, Children's Hospital Boston's pediatric health blog, about the movie The Hunger Games. The post is written by Thriving blogger Tripp Underwood.

The movie The Hunger Games opens today, and record tickets sales are expected to make the grisly, post-apocalyptic, survival tale one of the spring’s biggest blockbusters. Like the Harry Potter and Twilight series before it, The Hunger Games film is based on a book written for young adults that has captured the imaginations of readers of all ages.

Considering the ultraviolent nature of The Hunger Games’ plot line—24 teenage protagonists are pitted against each other in a fight to the death—is all this hype a good thing for young, would-be fans? The intended age for young adult novels is 12 to 17, but the books’ popularity has piqued the interest of much younger readers. Not wanting to sully their younger children’s budding interest in reading, many parents across the country have allowed them to read the story.

But just because your child has read The Hunger Game books, does that mean she’s ready to watch it’s bloody action unfold on the big screen? The answer will vary from child to child, but it’s a question parents of younger Hunger Game fans need to ask.

“[Reading about violence] is a gut experience as opposed to a head experience,’’ said Michael Rich, MD, MPH, director of Children’s Hospital Boston’s Center on Media and Child Health, in a recent Boston Globe story. “A movie is very direct. You are seeing it, you are hearing it, as compared with translating it from black ink on a page into something in your own mind.’’ Continue reading here.

My 5 year old is afraid of TV—what do I do?

Q: My 5-year-old daughter does not like TV that involves conflict. She has no desire to see a Disney movie and even gets anxious when a kid gets lost on Veggie Tales. She'll watch Blues Clues, Yo Gabba Gabba, and Barney but has no desire to watch the shows for her own age. When a movie is shown in CCD or Kindergarten, she gets anxious and sometimes starts crying. Will her inability to distinguish reality from fantasy resolve with age? Or is she an overly anxious, sensitive child?
-Facing Fear, in Chicago, IL
 
A: Dear Facing Fear,

It’s wonderful that you’re observing so closely how your child responds to the media she’s using. Every child is different. Knowing your daughter and watching her as closely as you do will help you make the best decisions for her.

Because children younger than 7 or 8 can’t reliably tell what’s real and what’s not, things that don’t seem scary to you or to older siblings may terrify them. Even though cartoons are marketed for young children, most aren’t really designed with their developmental stage in mind. Conflict and suspense sell tickets to adults, whose brains understand that it’s not real, but children experience these things in a much more direct and primal way.

Many kids are encouraged or learn to cover the anxiety that these images provoke. Your daughter may simply be more transparent in her responses than others her age, and even if she does seem more sensitive than other children, that can be positive, too.

In any case, it’s likely that her fear will resolve with time, but don’t push her to achieve this developmental milestone earlier than she’s ready. That would simply encourage her pretend she is not feeling what she is feeling, which will make her more anxious in the long run. In the meantime, ask teachers and other caregivers to find alternative activities for her rather than forcing her—and peers who may be better at hiding their anxiety—to view TV or videos that trigger her very normal stress response to anxiety-provoking images.

Enjoy your media and use them wisely,
The Mediatrician®

How can I find educational video games for an 8-year-old boy who likes war stuff?

Q: Do you have suggestions for how to find appropriate media, such as educational video games, for different ages, such as an 8-year-old boy who likes war stuff? I’d like to help direct him to more creative sites. 
-Seeking solutions, in Burlington, VT

A: Dear Seeking,

It’s not always easy to know which video games will be exciting and engaging for a child and will teach him things you’d like him to learn. And you’re right: he will learn from whatever he plays, so your impulse to direct him toward games that teach positive lessons is a good one.

Remember that many boys of this age are interested in “war stuff,” and it’s actually developmentally appropriate for them to sort out how to resolve conflicts and master the complexities of winning and losing at this point in their lives. This often why they might like books about war and war-based games, like football and chess.

That said, there is a distinct difference between playing first-person shooter video games and reading war stories or playing chess, where the images of conflict are created in the player’s imagination. Video games are created by adult imaginations, informed by greater life experience and psychological defenses—and the best-selling games, which generate the greatest marketing “buzz”, are increasingly graphic and realistic. Because the player is not creating the images from his own experience bank, he may have difficulty handling or even forgetting these intense and scary virtual experiences.

The trick is to understand with him what he likes about war games—whether it’s that they allow him to role-play, that he likes being part of a developing storyline, or that they challenge him to strategize or solve problems—and then to look with him for games that present these challenges but that set game conditions and teach skills you want him to experience.

To do that, when he mentions a specific game, ask, in a non-judgmental way, “What do you like about this game?” Then, take a look at some parent-oriented reviews, many of which will give you more information about the game than the marketing or even the ESRB rating. You can take many games out of your library or demo them at a game store or on a website. If you think the game is a good match for him, great! If not, use the parent reviews to look for another that he’ll like and that educate him in the ways you’d like to educate him.

Enjoy your media and use them wisely,
The Mediatrician®

How can I get my 2½ year old's dad to stop showing her movies that scare her?

Q: I am a single mom of a fun-loving 2½ year old who watches about one hour of TV per day. She spends Saturdays with her dad, and she comes home telling me about Scooby Doo, Sponge Bob Square Pants, Happy Feet, Dumbo, and Finding Nemo. I am concerned about the age appropriateness of these selections. She has had nightmares after watching  Dumbo, and I have watched Finding Nemo and Happy Feet with her and seen her cower behind her hands in certain places. I’ve spoken to her father, and he sees no issue with her watching such TV and will not accommodate my wishes for the TV to be more educational than entertainment. Do you have any data or advice on the damage these media may have on my child?
-Concerned, in Chicago

A: Dear Concerned,

Scary media content can certainly have immediate and lasting effects on kids. Think about how clearly you remember the movies that scared you as a child. For me, the flying monkeys in Wizard of Oz sent me cowering behind the couch, and some college students report that after seeing Jaws as children, they stopped swimming entirely, even in lakes. Long-lived fear reactions like these can happen after just one viewing.

How you address your daughter’s fear reactions should depend on her age. Until she is 7 or 8, her brain won’t really understand the difference between fantasy and reality, so explaining that something isn’t real won’t help her feel better. Therefore, when you see her cowering behind her hands, turn it off, comfort her, and switch activities. If she wants to discuss it, emphasize that she is safe, and that the things she saw won’t happen to her (or to you—many animated films involve parents dying or being separated from their children).

When it comes to discussing this issue with the child’s father, of course, matters can become more complicated. He may see your request as a criticism of his parenting. To sidestep that issue, approach this as a conversation about your mutual efforts to ensure your daughter’s health and well-being, not about whether his media choices are educational.

For example, you can say, “Is she having nightmares at your house? She wakes up crying at mine, and I’m really worried. I think she’s afraid of things she sees on TV and in movies.” Talk with him about what he thinks scares her and how you might work together to create a safer-feeling environment for her. And don’t forget to share what makes her happy in everything she does, including TV and movies. 

Enjoy your media and use them wisely,
The Mediatrician®

How do I get my 4 year old’s grandpa not to play violent video games with him?

Q: My father-in-law bonds with my 4-year-old son by playing video games. Recently, he bought a LEGO pirates game, rated for 10 year olds, and the two play it for about an hour every time they see each other. I love that they spend time together, but since they started playing this game, my son has become more violent. My father-in-law doesn’t see the problem, even though I’ve tried talking with him about it. Is there research that might help convince him to choose other bonding activities? 

-Baffled over bonding in Palo Alto, CA

A: Dear Baffled,

You know your child better than anyone else, so you are most sensitive to a change in his behavior—and you are in the best position to guide him toward the person you want him to become.

Research agrees with your observations, showing that video games are excellent tools for teaching whatever they focus on. They can teach players to build a city—or to see violent acts as okay, as may be true in your son’s case. The fact that these games are such good teachers might help explain why research has linked playing violent ones with increased aggressive behavior, increased attention problems, and decreased helping behaviors.

Thus, there are good reasons to help your father-in-law shift how he connects with your son. First, point out the important role he plays in your son’s life—because he is a trusted and loved role model, your son will see anything he brings as something he endorses. So if he wants to connect through video games, encourage him to choose games that offer information and skills that he wants his grandson to have. And don’t rely on the age recommendations on the labels—research shows that games are often rated by the industry ratings as less violent than they actually are. Instead, look at parent-oriented reviews  for ideas.

Finally, encourage your father-in-law to connect with his grandson through creative, hands-on activities like playing with real building blocks and developing stories about them together. Such imaginative, open-ended play is a great way to build your 4 year old’s brain, and it’s a great way for him to connect with his grandfather.

Enjoy your media and use them wisely,
The Mediatrician®

How might kids experience the final Potter film?

CMCH staff contributed the following post to Thriving, Children's Hospital Boston's pediatric health blog, about the final installment of Harry Potter. 

Last night at midnight, the final installment of the Harry Potter movies opened in theaters, creating exhilaration and, maybe, a sense of loss for those who have grown up with Hogwarts on the brain and magic in the air.

Since his first appearance in 1997, Harry has cast a spell on the hearts of Muggle children, teens and adults everywhere. The stories have been credited with engaging tentative readers, and with getting them to read longer books than many adults thought they were ready for. But that level of engagement isn’t all magic. It’s believed that Harry’s adventures may be organized in such a way as to better connect with readers on a personal level as they age. With each book, Harry is another year older, the story is longer, and the intensity is greater. Because of this gradual maturation, legions of Potter-ites say they felt like they’ve grown up with Harry.

It’s an interesting story-telling technique, but it could present a problem for some families with young readers who are just discovering the series. When Harry’s adventures were originally released, kids had no choice but to wait the few years in between books; by the time the next one was published, they were usually ready for its content. But now the books are all readily available, so asking a young reader to wait a year or two in between installments could be met with a lot of resistance. What’s more, few parents want to discourage their children’s budding enthusiasm for reading and will allow their children to read the later Potter stories earlier than the author may have intended. (It’s suggested that his youngest readers should be about Harry’s age in any given book.) Continue reading here.