“My Baby can learn, but not through TV”

By Jeff Hutchinson, MD FAAP

There are two truths that we as pediatricians should accept. The first is that television and video entertainment is here to stay. The second is that parents who use video entertainment don’t want to feel guilty about using it. In October 2009, the Disney Company conceded that the Baby Einstein product line was misrepresented as educational and offered parents a refund. This offer has since expired and the number of parents who took advantage of the refund is difficult to find. I suspect that Disney did not lose much and may have gained supporters by showing honesty and concern.

The American Academy of Pediatrics continues to discourage TV viewing for children under two because developmentally it teaches them only how to watch TV and likely causes harm in language development(Arch Pediatr Adolesc Med. 2009;163(6):554-558). The 2001 AAP policy statement on Children, Adolescents and Television recommends, “Discourage television viewing for children younger than 2 years, and encourage more interactive activities that will promote proper brain development, such as talking, playing, singing, and reading together.” However a 2003 Kaiser Family Foundation survey “Zero to Six” reported 68% of children under two use screen media on a typical day. This demographic of toddler television viewers has inspired the creation of products directed at parents who want educational screen time.

One product , the “Your Baby Can Read” series, claims that these instructional videos will teach your baby to read. Wouldn’t that be a parent’s dream? Plop the kids down in front of the TV and go about your business. When you return, your baby can read.

None of the educational products claim to work that way. They emphasize that the screen is a teaching device for the parent. Calling the products educational tools and comparing the videos to a teaching aid may quiet some critics, but even a die hard videophile knows that interaction is the most important aspect of development. The reality of life is that interaction with a TV screen and child often takes a back seat to laundry, dishes, meals, bills and the thousand other tasks that a parent has to do. A book forces interaction while a screen allows the caregiver to step away.

As pediatricians and parents we have to acknowledge that parents need breaks. Organized and fortunate parents get those breaks during naps. Many parents do not. Just as we talk about second hand smoke and the health benefits of quitting, we should also discuss video exposure and the benefit of stopping exposure under 2 years old. We should discuss it with the same non-judgmental but research proven emphasis we give tobacco exposure, along with the recommendation to limit exposure at all other ages. We as pediatricians can discuss if parents believe that babies and children learn from TV. We should be ready to acknowledge the need for a distraction but discourage the fantasy that TV alone has any place in early development.

Social Media and the Private Practice

By John Moore, MD FAAP

Over the past ten years, Americans’ usage of electronic media has exploded. The Internet has gone from a novelty to an essential part of our personal and professional lives. I check my email and Facebook wall before I finish my first cup of coffee in the morning, and I know I’m not the only one! A recent survey of pediatricians (2009 Periodic Survey of Fellows) found that over 85 percent of us use the internet for news and CME. Over 60 percent of younger pediatricians also use social networking sites like Facebook or Sermo.

A small but growing number of practices are starting to use social networking sites as marketing tools as well, communicating directly with patients and families. As I began to investigate starting our own practice Facebook page, however, I quickly realized this is a very complicated issue with a lot of pros and cons.

There are many positive aspects to social media. It is a free way to communicate directly and instantly with a highly receptive audience. The sites are easy to construct, free to establish, and require minimal time to maintain - all of which are in stark contrast to conventional websites. In addition, the communication between administrator and patients is instant. Finally, you are able to communicate your message directly to patients and families who register with you - targeting the most interested audience. Facebook pages can provide a convenient portal to correspond with patients and families, transmitting not only office information and policies but also overall pediatric news.

However, social networking pages are not without risks for physicians. Pediatricians need to keep some basic rules in mind before opening their pages for business. Patient privacy is a real and major concern. Posts on walls that contain specific identifiers and privileged information may run afoul of federal law and thus may constitute a HIPAA violation.

Pediatricians who maintain a social media presence also need to monitor their pages regularly. Patients may treat those portals as an extension of our offices and expect the same level of communication they receive through more conventional methods. While no legal precedents have been set, it is reasonable to assume that we are as liable for social media communications as we are for all other platforms. Finally, pediatricians need to keep copyright, libel and slander laws in mind - social media are not immune from conventional legal standards and violations are more public and more permanent!

We also need to consider which features make social networking sites effective. Marketing and business leaders have identified several key components of successful platforms. Sites should be interactive, drawing readers in and soliciting their comments. People like to feel included - successful sites encourage interactions between patients and the moderators. The more “viral” the site becomes, the more effective it is. Furthermore, sites should be updated frequently with interesting, entertaining and useful content, practice information and changes, links to pediatric or community-specific events, or even commercially available data (as copyright-applicable!).

The decision to open a practice-specific social networking page is a difficult one. For many of us who are “quick adapters”, these pages are a natural extension of our personalities. We are more than willing to embrace the unknowns in order to engage our patients in conversations. For others, however, the concerns more than outweigh any perceived benefits. Whatever your personal opinion on social networks, however, they are inescapable part of modern life and a growing part of many pediatricians’ daily practice.