Council on Communications and Media Blog

School Starts for Children & Moms

2011-11-08T17:41:00.001-05:00

Nancy M. Silva, MD, FAAP

Our son just started kindergarten. It was really exciting! I didn’t cry, but was amazed by the flashbacks of when I waslittle girl in school. I loved tolearn. It was great to be withother kids. Kindergarten was filled with playtime.

Kindergarten sure isn’t playtime anymore. And, everyone doesn’t have the sameexperience anymore either. Before,regulated day care & pre-K classes didn’t exist. As for my son, he has been in day care since he was 3 monthsold. You’d think he’d beprepared. But, it’s just as hardfor him as the other kids who have stay-at-home mommies. He had to say good-bye to his oldroutine, his old friends, his old teachers, basically to the life he knew forover 5 years. Now, playtime isover; it’s learning time with a little bit of playtime. After school, there’s the bus ride today care too. He has a longday. That’s hard on anybody.

Did I mention it’s hard on us too? No one likes change. And this was a lot of change. This house wakes up earlier. He has to eat breakfast within a certain time frame. Lunch bags need to be prepared. How is a 5 year-old going to carry abackpack, a lunch bag & a snack bag? How is he going to put it all up, repack stuff, coordinate all thoselittle things? I don’t know; butothers have done it for years. It’s just our turn this time.

Technology has changed in schools as well. My son’s teacher has his homeworkschedule on her blog, which is very convenient. She also offers communication via email. Remember when it used to only be notesand/or phone calls? Even the PTAis modernized. The PTA has its ownwebsite with many helpful links. They even have a Facebook page. If we want to know what the PTA school functions are, we must refer tothe website and Facebook. Forexample, the PTA ran Family Bingo Night. There was no note in his folder, like there would have been in the past;instead, all the details were on the website. By relying on technology, a lot can be accomplished. I must say, I’m amazed that this schoolis using technology as a part of communication, not a replacement for it. It’s a public school that has family atits heart.

Despite all the changes, there is one thing that doesn’tchange … the human experience. Letting go isn’t easy. Trusting others to teach your kids & care for them isn’t easyeither.

Yet, somehow, we are surviving. He’s starting to make friends, but it’s not as easy as inday care. And he feels it. Positive affirmations and pep talks aregiven. Reviewing the day,homework, and coaching are done. Clearly, our roles have expanded. I must admit I’m feeling more tired than before. The great news is that he isexcited. In the end, that’s allthat matters.

So, this pediatrician, this mommy, is going through growingpains along with my patients’ moms. It’s nice to bond with families at this special time in our children’slives. It’s nice to share in thedifficult times and the joyous ones as well. After all, being a parent is the toughest and most rewardingjob of all.

The Verdict Is In

2011-10-26T00:11:00.001-04:00

DonShifrin, MD, FAAP

InJune’s United States’ Supreme Court decision in Brown (Governor of California)versus the Entertainment Merchants Association, the “nine” (actually 7-2) votedto reject a California law prohibiting the sale or rental of violent M-ratedgames to minors under 18. (According tothe Entertainment Software Rating Board, “Titles rated M (Mature) have content that may be suitable for those ages 17and older. Titles in this category may contain intense violence, blood andgore, sexual content and/or strong language.”)

Apparently,there was a “lack of credible evidence” that created enough of a “reasonabledoubt” to convince a majority of the justices that viewing or playing violentvideo games would not influence young minds and imaginations in morallyperverse ways. Therefore, First Amendment freedoms could not be marginalized. Caseclosed.

True,the California law was vague and would have been difficult to enforce. But childhoodadvocates and most (unfortunately not all) researchers agree that viewingviolence can influence behaviors, desensitize emotions to real life aggression,and produce a perspective that the real world has a violent landscape.

Buthere’s the thing -- the court established decades ago that laws could protectchildren from sex and pornography in the media. Albeit, apparently just notviolent pornography against prostitutes as in Grand Theft Auto: Liberty CityStories.In all honesty, a large majority of programming in cable, movies, games, andthe Internet breach those laws daily.

Thegaming industry, as well as TV, movies, and the music industry, proudly defendtheir individual rating systems, and device features, as evidence that parentscan control exactly what their kids view or play.

Inthe “life imitating art” lesson here, I participated in an Israeli Armytraining session 3 years ago.At an Army training center, we weregiven M-16 rifles with laser sights and then watched a video on a room-sizedscreen where various terrorist scenarios were played as live situations.Shooters (of laser bullets) were graded on reaction time, terrorists killed orwounded, and civilians spared, or not. This video exercise has been in placefor years to train soldiers to instinctively recognize, react, and respondappropriately with lethal force. I could say, in all honesty, that I wascertainly desensitized to real life violence after multiple encounters. Andthat was after only 30 minutes of “playing time.” The true point of theexercise? Get used to assessingand shooting quickly and efficiently. The exercise is about desensitization.Appropriate for people going to war, not to school.

Trainingsoldiers to react, shoot, and kill produces shooters like Michael Carneal. AtHeath High School in Paducah Kentucky on Dec. 1, 1997, Michael, an expert gamerwho had never fired a real gun, took a pistol to school, pulled it out in thehall and fired eight shots in succession. All eight hit students; five werehead shots. (Something even law officers cannot accomplish most of the time.)He was heard to reply after he dropped the gun, “Kill me please; I can’tbelieve I did that.”

In1999, the parents of three victims filed a $33 million lawsuit against twoInternet pornography sites, several computer game companies, and makers anddistributors of the films Natural Born Killers and The Basketball Diaries. Theyclaimed that media violence inspired Michael and should be held responsible.The 6th U.S. Circuit Court of Appeals ruled it was “simply too far a leap fromshooting characters on a video screen to shooting people in a classroom.” Both the parents’ attorney and the 79thU.S. Attorney General, John Ashcroft, went on record as stating that Michael’sproficient marksmanship was due to practice in violent video games.

Nosmall wonder Lt. David Grossman, author of the book “Stop Teaching Our Kids toKill,” calls these games “murder simulators”. We should not be surprised then when kids and teens enteremergency rooms after being shot with real bullets and they exclaim, “I didn’tknow it could hurt this much.” Certainly it is a fact that pain or negativeconsequences of violent acts are rarely seen on screens. Research from the landmark three-yearNational Cable Television Violence Study in 1997 demonstrated that conclusively.

Forevery Cheryl Olson (former Harvard psychiatry professor), who maintains thereis no “credible evidence” that violent games cause children psychological orneurological harm, or make them more aggressive and likely to harm others, theevidence is slowly but surely going to cast “a reasonable doubt” on theirassumptions. Many think ampleevidence exists to support that connection already.

Sofar, we do not know which children are most at risk or when; what kind ofcontent in these games could cause psychological changes; and how much exposureit takes.

Wedo know, based on sex and pornography, that books are different from videos. So comparing violence in a book to avideo, done by one Supreme Court justice, seems simplistic at best. And, to lump in that consideration thatviolent games have benefits, causes most researchers to reach for theirantacids.

Withthis affirmation of free speech, the two dissenting justices did reaffirm therightful job of mothers, fathers, grandparents, and caregivers to filter,monitor, and regulate children’s exposure. You and I both know that withdevices galore and connections aplenty, that is now a seemingly endless task.

Notehere that the Entertainment Software Ratings Board (ESRB) rated around 1,600games in 2010. That job was doneby humans watching a DVD submitted by the game’s publisher, which includes theworst violence, language, and sexual scenes. Evidently, they do not “play” the game. But at least humans are involved -- fornow. The ESRB will now have computers rate online consolegames for Xbox, Wii, and PlayStation based on extensive ‘questionnaires’submitted by the publishers. Humans will not see or review the online games until it is on the Web. As for the increasing number of apps,social, and mobile games, Apple and Zynga/Facebook have taken no actionconcerning any ratings system to date.

Everthe pragmatist, Michael Gallagher, President and CEO of the EntertainmentSoftware Association, called the Brown decision, “An overwhelming endorsementof the first amendment: the right to free expression.” Additionally, “It’s also a great victoryfor parents and the rights of parents.”

ReallyMr. Gallagher? I am sure if youput your ear to the rail you will hear a different kind of rhetoric fromparents and the public.

Thegreat Harlem Baptist preacher Calvin Butts once declared, “Violence is anAmerican tradition.” It’s also bigbusiness now left virtually unfettered. And, at least in the court of this pediatrician’s opinion,money may not be all it is generating.

Opportunity, Means, And Motive

2011-10-11T18:35:00.000-04:00

David Hill MD, FAAP

“So, Doctor, what are some things people can do about this problem?” If you’ve ever faced a reporter then you’ve probably answered some version of this question. If you had adequate time to prepare, you may have even emailed your advice in advance to provide bullet points for the graphic. This is, after all, “news you can use!” (What would they call it if “news” and “use” didn’t rhyme?)

But do you ever wonder how many people actually do the stuff you recommend? I imagine it depends in part on the nature of the advice. “Keep your children indoors while these wildfires rage,” probably sees a lot of takers. “Be sure and get your child’s flu vaccine this season,” wins some, if not as many as we’d like. “Don’t let your child have a television in his bedroom,” gets...(crickets).

What do we hope to accomplish as pediatricians by engaging the media, aside of course from the fame, fortune, and autograph-seekers we so enjoy? Personally, I hope to extend my mission beyond the exam room into people’s living rooms, where my advice can help children live healthier lives. But if that’s our goal, how can we be best accomplish it?

In the clinic, I know the answer. My career has spanned the transition from a paternalistic model of behavior change (“Of course you’ll do what I say; can’t you see how crisply pressed my white coat is?”) to the awkwardly named transtheoretical model (“So is it okay if we talk for a moment about your habit of sharing cigarettes with your child?”). This transition has given birth to motivational interviewing, a technique that pretty much blows everything else out of the water when it comes to helping people embrace healthier behaviors.

Motivational interviewing is far too involved to fully explain in this space, but the four core concepts are pithy enough to hit. The first idea, “express empathy,” suggests we start by listening to where our patients are coming from and trying to connect, i.e., “I can see how smoking with your child gives you two a chance to bond.”

Second comes, “develop discrepancy,” meaning to help patients see how their current behaviors might lead to outcomes they don’t desire, as in, “You’ve said you wished you could quit smoking. How do you feel about your child smoking?” Third, and most alliterative, is, “roll with resistance,” meaning we must accept that patients’ reluctance to change is a normal part of human nature and not a moral failure, like, “It sounds as though you feel the time you share smoking with your child is strengthening your relationship. I see why you might not want to give that up.”

This leads to the final step, “support self-efficacy,” a toughie; both because it’s nearly impossible to say three times fast and because it doesn’t just mean being supportive when patients do what we suggest. It means being equally supportive when they don’t, as in, “I’ve enjoyed our conversation today. If we can talk about this smoking thing again some time, please let me know!”

Motivational interviewing isn’t magic, but when practiced one-on-one it has posted impressive results for changing behaviors ranging from overeating to alcohol abuse. The question I struggle with is how to make this face-to-face intervention work when addressing a whole population, as we do in the media. Can we ask what people’s most common reasons are for, say, not vaccinating their kids? (It turns out more parents are worried about pain and fever than about autism.) Can we show empathy for those in our audience who may resist change, citing those reasons? Can we avoid moralistic language when talking about people whose decisions we think are unwise?

I don’t pretend to have mastered the art of translating motivational interviewing techniques to a sound bite that may last well under a minute. I do think, however, that those of us who can pull off that trick will be the most effective medical communicators ever. As for myself, I can live without autograph-seekers. I wouldn’t want them to wrinkle my white coat.

Teens, Multi-Tasking and Attention Span: The New Normal

2011-08-02T15:34:00.000-04:00

Susan Buttross, MD, FAAP
Professor of Pediatrics
Developmental and Behavioral Pediatrics
University of Mississippi Medical Center

Have you ever thought about what’s really happening when teens are watching television, waiting for an appointment in an exam room, sitting in a classroom or talking to you? Most likely, it’s not just that one thing. Look carefully and you’ll see that our preteens and teens are absolute masters at multi-tasking.

Watching television exclusively rarely happens, nor does talking to you directly. Typically, while watching a movie on the TV (which by the way is becoming almost extinct for many) that same guy may be on his laptop or iPad and also texting or checking texts. Just when you think there is no way that the teen can be listening to you, he proves you wrong by answering a question that you didn’t think he heard, right? Amazing how they possess the ability to move back and forth from one type of task to another. Seems great; but, many of us, who did not grow up in the tech era, have distinct difficulty wrapping our heads around what is really happening and what possible ripple effects this may have on our previously accepted behavioral and societal norms.

So let’s take this a little further. If someone is not looking at us, can they really be paying attention? To learn something, must a child stay on task for 25 minutes at a time? At 5 years, we expect a child’s attention span to be about 10-15 minutes (that’s the basic standard of about 2 to 3 minutes of attention per year of age), by 12 years that length has doubled. For most individuals, there seems to be little real growth in the length after that, even into adulthood. However, with rapidly moving and exciting programs available electronically, the needed attention span may be only a few seconds because of the “machine gun-like” rapid-fire movement of the tasks.

Over the last 20 plus years, Adele Diamond, Russell Barkley, Doug Cantwell and other researchers in attention deficit hyperactivity disorder (ADHD) have spoken about executive function and working memory as the major deficits in the disorder. As Dr. Diamond hypothesizes, individuals with ADHD-I (the inattentive type of ADHD) have sluggish “cognitive tempo.” Thus, they are easily bored. Perhaps, changing the tempo of presentations may prevent that boredom and improve the performance of the child. Something that can keep the adrenaline (or dopamine) going improves the attention span in those with ADHD. Maybe that is true of all children. Perhaps children, in general, are better able to engage when their adrenaline is peaked. This would explain the incredible success and even addiction that many children and adults, for that matter, have for video games. The tempo is rapid fire; risks are there; adrenaline is up and so the hook is there that makes one able to stay with something for hours without boredom.

Sitting, talking and watching TV, individually are typically slow paced tasks. Multi-tasking is a way for someone to stay engaged without boredom. This phenomenon of multi-tasking when faced with conventionally slow placed tasks seems pervasive in much of the teen population and may increase their ability to have sustained attention to the task at hand.

We know in the past the “normal and respectful” way to be was to look a person in the eye and certainly NOT to do something else when you are talking to that person. Fast-forward to now…really fast, and perhaps the norm is changing.

The diagnosis of ADHD is on the rise. There has been an explosion of medication use and alternative therapies created for the treatment of this disorder.

Don’t misconstrue my comments to mean that I don’t agree with using medication for the treatment of ADHD. ADHD is a real disorder and often individuals need medication to help in its treatment. But understand that, with the growing use of technology occupying the majority of our children’s waking lives, if our society continues to try to educate children in the same manner that we have in the past, we may be facing an ever-increasing number of children who meet the criteria for ADHD. Perhaps, we need to consider incorporating learning into different formats and look more closely at how we can really hold the attention span of our children. As we change as a society, we may need to take a hard look at the way we teach and the way we define what is really ADHD.

Oh Mickey You’re So Fine, You’re So Fine You Blow My Mind- Hey Mickey

2011-07-05T23:42:00.000-04:00

Oh Mickey You’re So Fine, You’re So Fine You Blow My Mind - Hey Mickey
Don Shifrin, MD, FAAP

When Disney announced in 2010 that it was buying Playdom, an online social gaming company, for $532 million, it was lauded as part of a long-term strategy to have a more formidable presence in the video game industry. This followed their purchase of Club Penguin in 2007 for $350 million. Seems like Mickey may have had his eye on a lot more than just webpages.

In May Playdom/Disney paid to settle federal charges that it illegally collected and disclosed personal information from hundreds of thousands of children under 13 without parental consent. Talk about success! The Federal Trade Commission (FTC) noted that the ‘settlement’ was the largest civil penalty ever for a violation of the Children’s Online Privacy Protection Act (COPPA). Just to make sure, let me reiterate. Ever.

Does Mouse central consider this a setback, akin to when the FTC investigated whether their Baby Einstein series was marketed falsely as “educational”? Although the complaint was dismissed in 2007, Disney responded in 2009 to the continuing bad publicity by offering a refund to parents who might have purchased DVDs with visions of Harvard on their children’s horizon. Actually, I am not sure what would embarrass Mickey these days. But I digress.

According to the FTC, Playdom operated 20 websites that collected children’s ages and email addresses and allowed children to post names, email addresses, and locations on personal pages and in online forums. Prior to Disney’s purchase in July of 2010, about 400,000 children registered with Playdom sites. An additional 800,000 registered with its Pony Stars site as well. (Pony Stars was purchased by Playdom when they bought Acclaim Games two months before the Disney deal swallowing them both). A July, 2010 Disney release announcing the purchase stated, “By acquiring Playdom, Disney will strengthen its already robust digital gaming portfolio, acquire a first-rate management team and provide consumers new ways to interact with the company on popular social networks like Facebook and MySpace.”

Well, not exactly what Mickey’s shareholders had in mind; last fiscal quarter Disney’s interactive unit lost $155 million -- $100 million more than the previous year. The culprit? Well Playdom came on board for $500+ million. True, most of the blame for the FTC’s ire is on Acclaim. But when you pay over half a billion (plus maybe another $200+ million in incentives), one assumes that due diligence should be a given.

Let’s get back to the FTC. No question that Disney/Playdom/Acclaim violated the COPPA law, which became active April 2000. As of last week, Representative Edward Markey of Massachusetts proposed new COPAA legislation to “extend, enhance, and revise the ability of companies to collect, use, and disperse personal information from minors.”

So after we have a clear FTC violation, what was Disney’s response? Not so coincidentally, the same response has been in the playbook for years by children’s food companies investigated by the FTC for deceptive marketing practices; admit no wrongdoing even though you have been found to be unscrupulous by the FTC. Then declare happily that the infraction is all behind you.

Predictably, Disney’s release reads, “This matter involved a FTC investigation of the practices of Acclaim Games, a company that was acquired by Playdom prior to Disney’s acquisition of Playdom in 2010,” textbook boilerplate language acknowledging no wrongdoing on Disney’s part. Then the happy ending, “Disney is pleased that Playdom and the FTC have now resolved this problem amicably.”

The amicable resolution of the “problem” was a mandate for the largest civil penalty ever. Did I mention ever? Wait for it -- 3 million dollars. For a company whose recent quarterly profit was $942 million, that amount could be found on the mailroom floor. That represents less than 1% of their purchase price for Playdom.

If and when a new COPPA law is instituted, do we really think that companies targeting children will be afraid to play chicken with the FTC? Not at those prices.

Adjusting to the new digital reality: why pediatricians may need to rethink—or at least refine—their messaging.

2011-06-16T13:19:00.001-04:00

Claire McCarthy, MD, FAAP

A couple of weeks ago I went to a Verizon store to upgrade my phone (to an iPhone!). I had my 10-year-old and 5-year-old with me, as my big kids weren’t available for babysitting; this will be quick, I told them.

Of course (in that Murphy’s Law kind of way) it wasn’t quick at all; I had to wait more than twenty minutes for someone to help me. But Natasha and Liam didn’t mind. They went straight to the iPads on display, and navigated them without any help from me. Natasha found a puzzle application and started putting puzzles together. Liam found a drum set application and started making up songs, adding his own lyrics and dance moves.

As I watched them so fully and happily engaged in activities that required concentration and creativity, I thought (as I have so many times): there’s a lot that’s good about digital media.

We pediatricians tend to be very negative about “screens” when we talk with families. We stress the 2-hour limit to help prevent obesity. We warn about Facebook depression, exposure to violence and sex, cyberbullying and online predators. We talk about how texting can keep kids up at night and how video games can contribute to ADHD.

Don’t get me wrong: these are important messages. There are very real risks associated with the Internet and media. We need to keep kids healthy and safe; that’s our job as pediatricians.

But if we are just negative, we miss two important points:
• It’s not all bad. Children these days literally have the world at their fingertips. In our house, questions don’t go unanswered; when something comes up in a conversation, we Google it (often on someone’s smart phone at the dinner table). They have the ability to connect within seconds with people all over the world and to learn about lives that are very different from theirs. There are thousands of websites and applications that can teach them anything and everything, from science to writing to sign language.
• For better or worse, digital media is here to stay. This is the reality of our patients’ lives. Whether we like it or not, they are surfing the web (including for health information), communicating via text and Facebook and Twitter, reading and writing blogs, watching and creating videos. We can’t turn back the clock.

It’s not unlike when cars were invented. We didn’t insist that everyone keep riding horses. Instead, we created seatbelts and car seats and stoplights and traffic laws. And while it’s true, cars still bring risks and pollution they also make our lives better and easier in so many ways. We can’t imagine life without them. Already, it’s hard to imagine life without the Internet and digital media. They have incredible potential to improve our lives, if managed well.

If we are just negative, we may miss the opportunity to inform the discussion. We may miss the opportunity to guide children and families on the best uses of technology. Someone else will step in and do it, someone who doesn’t understand child health and development the way we do.

It’s hard to teach what you don’t know. So explore the Web. See what’s out there. Do the health searches your patients might do—and see what pops up. Find sites and applications that you like and can recommend. Talk to your patients and their families about how they use technology at home—learn from them. Check out Facebook and Twitter and YouTube. Consider using social media yourself.

Really, this is about meeting patients where they are, about being relevant in their changing world. It’s about making a difference in the lives of youth today.

And that is undeniably our job as pediatricians.

Dr. McCarthy is member of the American Academy of Pediatrics’ Council on Communications and Media. For more information regarding social media and its impact, please see The Council on Communications and Media’s full clinical report, “The Impact of Social Media on Children, Adolescents and Families.”

Social Media and Public Health

2011-05-10T18:54:00.000-04:00

Jacqueline R. Dougé, MD, MPH, FAAP

Social media has become an important public health tool. It is inexpensive; it reaches millions, and can positively affect behavioral change. However, for the busy pediatrician it can be hard to stay abreast of all the new and beneficial tools out there. Below are a few that I have found particularly helpful and innovative.

Healthychildren.org is a website developed by the American Academy of Pediatrics to provide health information to parents. Parents can search for pediatric providers, get answers to health questions or look up health topics. It is a great resource to link to your practice’s website and to share with your parents.

Text4Baby recently celebrated its one year anniversary. It is a project of the National Healthy Mothers, Healthy Babies Coalition; the American Academy of Pediatrics is among its many partners. Text4baby provides free health information to pregnant and new mothers via free text messages. The messages coincide with a woman's due date or the baby's date of birth. Moms receive information on topics such as breastfeeding, immunizations, safe sleep, nutrition and smoking cessation. Mothers are also connected to community services. This is a great resource to refer new parents.

The National Association of County and City Health Officials (NACCHO) recently developed a campaign to promote the Vaccine for Children’s Program (VFC). VFC is a federal program that provides free immunizations to millions of children enrolled in Medicaid or who are uninsured. The campaign promotes the program and educates parents as to how they can access vaccinations for their children.

Health and Human Services (HHS) launched a website, InsureKidsNow.gov. This site increases awareness about what programs are available across the country for uninsured children and helps parents enroll their children into affordable health insurance plans.

Lastly, the First Lady’s Let’s Move Campaign uses social media to prevent childhood obesity. The site is bringing together health care providers, parents, children and industry to find ways to promote healthy eating and physical activity.

These social media campaigns not only promote but improve the public’s health. They illustrate how the field of medicine and public health are changing. It is an exciting time to be both a pediatrician and public health professional. Personally, I like to think all pediatricians are also public health professionals and as such it behoves us to familiarize ourselves with the tools and campaigns out there and to share this information with our patients. Social media is a great tool to promote health and improve health behaviors.

To learn more about current social media campaigns and about social media in general, check out the The Centers for Disease Control (CDC) website or the May issue of AAP News.

The Kids Are All Right?

2011-03-23T16:09:00.000-04:00

Don Shifrin, M.D. FAAP

Now that Amy Chua has tacked her parenting mantra to the church door, are we surprised the autobiographical view of raising her two daughters has culminated in her becoming more of a controversial cultural lightning rod than Sarah Palin?

I cannot imagine she would be blind to this, as any description of extremism sets its author up as a target. Thus, I feel marginally forthright in adding my modest commentary of the descriptive paradigms of her tome, which some are referring to as the definitive manual on überparenting. T. Berry Brazelton this isn't.

The book reads as a how-to manual for parents who want to help -- no -- make their kids succeed. At the very least, you have to admire Chua's veracity in penning this exposé. Her "Battle Hymn" reveals in graphic terms how she tirelessly compelled her girls to never be losers. The book's descriptive passages struck me as the parenting equivalent of Vince Lombardi's, “Winning isn't everything. It's the only thing."

She has opened up the floodgates of professional and parental scorn, ridicule, and vitriol. I have always acceded to the notion that the word, parent, is more verb than a noun, connoting what we do, not who we are. But, I would be reluctant to highlight Chua as the parent-model others would want or need to emulate.

A simplistic view of parental responsibility would include physical safety, emotional security, fiscal responsibility, as well as social, cultural, community, religious, academic, political, and moral role modeling. Most would agree to throw in more than a little unconditional love as well.

All parents, myself included, have, on more than one occasion, fallen way short of the mark. Granted, our children are subject to the whim and whimsy of quirky parenting styles. (I will confess to being a stickler for politeness and manners.) As a pediatrician, I have seen many parents step right across the egregious over-parenting line, where, it appears that the "Tiger Mother" has firmly planted herself, at least, until she was forced to realign when her youngest 'rebelled'.

The descriptions of her children's subsequent successes as a result of her parenting should not activate or relieve any of our collective parenting angst. Product development takes longer than 18 years. I would caution us to continuously monitor results, while consciously readjusting our outcome parameters. And, inadvertently, that maybe the best lesson from Ms. Chua's book.
Parenting is a challenge; it is not a war. It's a marathon, not a sprint. Children are human hard drives, with back-up programming that fortunately, or unfortunately, will last a lot longer than their parents.

So, I, for one, welcome her commentary, certainly not for her definition of success, but to motivate all of us to reexamine our parenting roles. Getting past all the obvious data points, the take away message is, perhaps, to redirect in a kinder, gentler way the burning passion all parents share: to balance nature and nurture in creating a childhood -- not an apprenticeship.
So, for all you Tiger Mothers (and Tiger Fathers) out there, a final note. Even with the best of intentions, parents that are rarely satisfied with their children, raise children that are rarely satisfied with themselves.

The Injustice of Immunization Interviews

2011-03-10T17:33:00.001-05:00

Wendy Sue Swanson, MD, MBE, FAAP
Author, Seattle Mama Doc Blog

When Dr. Wakefield interviewed on "Good Morning America" in January, an injustice occurred. It occurred inadvertently, I suspect, yet this injustice happens frequently in the world of pediatric health messaging. The stories the media covers, clearly change how we think and feel in regards to protecting and parenting our children. Their work to inform and educate, just like that of physicians and nurses, can get lost and misconstrued. ABC worked hard to inform us of the accusations against Dr. Andrew Wakefield with a 2-minute introduction by Dr. Richard Besser, a pediatrician and medical editor/correspondent. Yet, when the interview was over, we are left remembering the myth.

Dr. Wakefield interviewed with George Stephanopoulos who later labeled the interview "combative." Mr. Stephanopoulos was given a terribly difficult task. He was interviewing Wakefield on one of the most complex, emotional and loaded quandaries of the last few decades: vaccine-hesitancy and Wakefield's purport linking vaccines to autism. When Wakefield failed to deny any allegations and failed to discuss the significant research refuting his work, Mr. Stephanopoulos had to defend science. Alone. Although Stephanopoulos isn't gaining popularity (read the comments) with the anti-vaccine crowd, the 7-minute interview simply stirs the pot. I trust it had huge viewership. I worry that this is why it was done.

We need to discuss immunizations in the context in which decisions for vaccinating are made. In 2011, interviewing Wakefield alone on national TV doesn’t help. Wakefield’s myth and legacy regain power with each second he's on the news. We need to acknowledge the fear that has arrived on parents' doorsteps because of Wakefield's work. We needed a general pediatrician, a parent of immunized children, and a vaccine expert in the interview too. We need voices of reason. We need to frame issues surrounding immunizations truthfully. Although Wakefield's original study only applied to the MMR he has fueled millions of parents to distrust all vaccines. Dr. Wakefield claims that he doesn’t want others to stop immunizing against pertussis, but this point is easily lost. Stephanopoulos needed to make that point clear. In the office, when parents who are hesitant about immunizations talk about their worry, they point to Wakefield's claim.

Dr. Besser's introduction included micro-interviews (sound-bites) from Dr. Paul Offit and Seth Mnookin (book author of The Panic Virus). Neither was given the time and exposure Wakefield received. What we learned from Offit and Mnookin about immunizations could easily be forgotten by the time the interview with Wakefield was over.

Interviews, such as this one, leave parents increasingly more confused, not more informed. Although some bloggers are declaring vaccine-hesitancy dead with BMJ’s expose on Wakefield's work, we're far from seeing its end. Distrust in our physicians and nurses only increases when stories and interviews occur in this fashion. I suspect I will be helping families concerned about immunizations for the rest of my clinical career.

It can take only seconds to create a myth. It can take decades to rebuild the truth.

The editorials in The BMJ uncomfortably put Wakefield back into the spotlight. His message, although rebuked, regains momentum. Regardless of the scientific findings that vaccines have not been found to cause autism, Wakefield "won" the January interview.

Seven minutes alone in front of millions is power.

Viewership is the economy of television. If you want to get people to watch, putting Dr. Wakefield in the hot seat is a great way to start. And that’s where the injustice occurs.

Physically Isolated, Electronically Connected:

2011-01-13T02:14:00.000-05:00

By Elizabeth Murray, MD

My family has recently been dealing with the terminal illness of my father-in-law. Unlike me, he has never been a TV watcher or a strong computer user. Therefore, it was quite an adjustment when he was placed in isolation in the ICU, effectively cutting him off from his friends, and most importantly, his grandchildren. It was then that he was introduced to Skype. Being able to reconnect to his family was the highlight of his day.

My father-in-law's experience is not unique. Work being done at the University of Rochester has shown that teens with cancer suffer not only the side effects of the cancer but significant social isolation due to missing out on the normal activities of teenage life. The effects of this social isolation can linger even after they have beaten the disease. Yet, studies now show that the use of new media and social networking sites are allowing teens to remain connected to their peers and teenage life even when physically separated. Studies like these have the potential to impact how patients are treated in the hospital regarding cell phones and computer usage. These forms of connection to the outside world may be more than merely ways to pass the time, but rather, ways to reduce some of the emotional effects hospitalization has on an individual. As pediatricians, we need to remain open to the fact that, although we often regard increased screen time as something to avoid, allowing a child or teen, in the appropriate setting, to have increased access to computers and cell phones may be beneficial.

As I watch my 15-month-old daughter figure out how to play movies on my iPhone all by herself, I am struck at how intertwined our lives have become with new media and technology. I realize how different my daughter's and father-in-law's lives will be because of the flood of technological advances and new media that has entered our lives. But as she smiles at videos of herself with her great-grandfather, I am thankful for video conferencing and cell phones that can record memories at the push of a button. New technology and increased screen time are here to stay. Yet, if used appropriately, they may actually have positive impacts on our patients and their families.

Mirror, Mirror on the Wall, Which Friday is Blackest of Them All?

2010-11-16T13:14:00.000-05:00

By Vandana Bhide MD, FAAP

I’m in a panic because it is November and I have already missed the “first” Black Friday and now am about to miss the “second” Black Friday of the holiday season. I am fascinated by the marketing phenomenon of this year’s “early” Black Friday. “Traditional” Black Friday (I am waiting for the greeting card industry to get in on this one so I have yet another card I have to send during the year) is, of course, as every smart American shopper knows, the day after Thanksgiving. (Another requirement for a greeting card, I rest my case.)

Last year, a few “genius” manufacturers decided to advertise an “early” Black Friday and they scored a home run in sales. In response, this year, many retailers, desperate for business in difficult economic times, started “early” Black Friday advertising (AKA “sales” and “deep discounts”) as early as July.

No wonder parents feel like a pawn in the endless sea of toy and electronic gadget advertising, aimlessly trying to determine which toys will be “the IT toy” of the holiday season. (Hint: Cabbage patch dolls ARE NOT hot this year!). Not necessarily the most fun toy, but the item that one “must have.” Kids are still determining which toys they “must have” from Santa this year while manufacturers jockey for position to be the “ultimate number one” toy to have in 2010. (Ta Da!)

I am embarrassed to say that as a pediatrician and a parent, I too have succumbed to the pressure of finding the “IT” toy before the item “runs out” and I have to buy it online for ten times the suggested retail price. Of course, suggested retail price is a relative term, determined primarily by the phenomenon of the “sale” price. I’d rather spend $30 on a toy that is “slashed” from the suggested retail price of $60 than actually buy an item that costs the suggested retail price of $30. And if I can find a coupon for $5 off, well, I am in parents’ retail heaven.

Whew, I am sweating at the mere thought of not being able to get the “right toy” so that my child is not an outcast at school for getting that “educational” holiday present (AKA books or “reading material”). Parents (AKA “consumers”) are now used to the annual ritual of fighting for a small supply of the most popular toys (which will surely be determined by a multitude of manufacturing experts writing online articles now that the first two “early” Black Fridays are over so that one may prepare for the “original” Black Friday, followed by the “late” Black Fridays of the holiday season.) Parents are forced by manufacturers to believe that a toy can’t be valuable unless it is in short supply. The aura of a holiday present is not quite the same unless your Santa gets it when other kids’ Santas were unable to find it in time for the holidays! (Of course finding a coupon and a “drastic reduction” in price helps. None of us wants to admit going overboard on holiday presents!).

Of course the unknown deciding factors this year are the holiday movies geared toward children and teenagers. Can one really accurately determine the “best toys of 2010” until after the movies have come out? (Surely they will be released on what will be known as the third and fourth “early” Black Fridays of this year.) That’s a lot for parents to think about (along with internet safety, bullying and underage drinking)!

How is a parent to deal with all of this? Well go on the Internet of course! Right after each Black Friday, there will be plenty of retail “experts” writing Internet articles telling us which items are the “official” “must have” items for 2010. I have already read ten “Top Ten Toys of 2010” lists online in the time it took me to write this blog post!

For a second there, I toyed with the idea of dawdling enough to get presents at the “the last and final early Black Friday” of 2010, also known as the “day after Christmas sale,” which I now believe will be called “the first earliest Black Friday of 2011.” Nah…

Hats off to the Professor

2010-10-08T19:31:00.000-04:00

By Don Shifrin, MD FAAP

It wasn’t so long ago that Robert Preston played the legendary flim-flam man, Professor Harold Hill in the 1962 movie, The Music Man. In it he envisions a way to profit from the paranoia he creates by sensationalizing the threat to River City’s youth from the local pool hall. In the movie’s seminal scene he sings to the parents of the ‘troubles’ hanging around the pool hall will cause:

“Well, either you're closing your eyes
to a situation you do not wish to acknowledge
or you are not aware of the caliber of disaster indicated
by the presence of a pool table in your community.
Ya got trouble, my friend, right here,
I say, trouble right here in River City.

Now, I know all you folks are the right kinda parents.
I'm gonna be perfectly frank."

Flash forward 48 years to the concept that the newest “threat” to our youth might be media overexposure. Could it be real, or as exaggerated as the Professor’s theory regarding pool halls?

The list of negative outcomes from media overexposure grows longer each day: from early sexuality, smoking, poor nutritional choices, sleep problems, attention issues, cyber-bullying, violence, decreased family time, and potential academic underachievement.

I accede to the positive aspects of media for children and teens to connect, form peer-related communities, heighten political awareness, and hyper-accelerate learning.

I am not looking for profit, like Professor Hill, but note that in respect to learning. Michael Kirst, an emeritus education professor at Stanford, estimates that 60 percent of incoming community college students and 30 percent of incoming freshman at 4 year schools need remedial reading and math courses. ( Newsweek 9/13/2010)

While elementary schools are making progress academically, high schools have stagnated. Is it the teachers, courses, rigor, or failure to engage academic curiosity? Or is it media time, content and depth, or constant multitasking that is one of the biggest factors in disincentivizing students to “not like school”?

The US high school drop out rate is now 1 student every 26 seconds (7000/day). There are nearly 2000 high schools in the US where 60% of the students entering do not graduate. I can guarantee you, however, that those who drop out are all very media aware across a multitude of electronic devices.

Is there a carry-forward? I suspect strongly that tweens and teens are “tuning in, turning on”, and possibly then ‘dropping out” of the traditional educational process. (Apologies to Timothy Leary circa 1965 urging people to embrace change by using LSD to remove their cultural and conventional norms.)

Can we not say that media is now the primary peer of our digital generation and cajoles them in similar ways: incessantly glamorizing, sensationalizing, and normalizing behaviors for them to emulate?
I want to bring us back to the reality of digital immersion: it is not going to vanish, unlike an obsession with billiards. Sixty-four percent of adults in 2004 thought that owning a TV was ‘necessary’. In 2010, that number dropped to 42% indicating that other devices are supplanting TV as a primary media source.

So the digital footprint moves quickly. This Professor thinks that the greatest risk for our children would be NOT to grant them access. And the second greatest risk would be to grant them unlimited access without guidance.

In my view their social, cultural, academic and economic future will be digitally integrated. Tools are being developed to change the school paradigm from classical appointment education in a classroom, to anytime, anywhere digital learning.
Soon tablets, interactive textbooks, super fast anywhere download speeds, educational games, voice processing, and Avatar model learning systems will come online.

Who will mentor children in this brave new world? Through multiple media outlets children are repeatedly exposed to questionable ethical behavior and morals. If left to sift through the world of reality TV, talk shows, political pundits, etc. without supervision, can we expect them to emulate the values we intend them to have?

Therefore, like Professor Harold Hill I now urge parents to “Heed the warning before it's too late!
Watch for the tell-tale sign of corruption!”
That may be a little too bombastic for this topic, but parent’s need to “turn on” and tune in” to the fact that the daily media exposures of 7+ hours (Kaiser Family Foundation Jan.2010) has essentially “dropped them out” of their role as the family’s primary value filter and educator.

Without sensationalizing the topic any further please encourage your parents to answer two questions:

1) Does your child have unsupervised and unlimited electronic access on his/her various devices, especially in the bedroom?
2) Has your child’s use of media changed his or her behavior(s), academic or social, or sleep habits, or his/her connection with your family?

If their answers are inconclusive, perhaps a song from the Professor might be appropriate.

Turnoff Week - September 19th-25th

2010-09-17T22:25:00.001-04:00

By Corinn Cross, MD FAAP

Next week, September 19-25th, is National Turnoff Week. Parents are encouraged to use this upcoming week as a seven-day hiatus from televisions, video games, web surfing etc. Instead, families are encouraged to spend a screen-free week together.

Turnoff Week is supported by the American Academy of Pediatrics and the Council on Communications and Media. The most recent statistics show that the average American child spends over 1000 hours a year watching TV and playing video games. To put that in perspective, they only spend 900 hours a year in school. Television, video games, computers and now cell phones are becoming an increasing part of everyday life for the American child. Although there may be many advantages of living in such a technological era, there are well-documented detriments as well.

America is quickly becoming a nation of overweight individuals, and obesity is highly correlated with increased screen-time. Studies have shown that children who spend 4-6 hours a day in front of screens have a higher risk of being obese. All this screen-time is at the expense of less time spent playing sports, doing outdoor activities, reading and having family time.

Pediatricians can help parents by encouraging families to take part in Turnoff Week. As pediatricians, we can discuss the challenges of implementing a screen-free week and provide families with tools to help make the week successful.

1. Have a plan for each day in order to help keep children occupied.
2. Encourage outdoor play.
3. Schedule a family game night.
4. Involve children in dinner. Allow them to create a menu and help with the cooking.
5. Go on a family outing. Fall is a great time to go apple picking or to a pumpkin patch.
6. Plan a trip to the library.

These are just a few ideas of ways to pass seven days without a television. As the Turnoff slogan goes, "Turn off TV. Turn on life."

“My Baby can learn, but not through TV”

2010-07-20T14:34:00.001-04:00

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

2010-07-20T14:34:00.000-04:00

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.

The Perfect Pitch:

2010-06-03T13:19:00.000-04:00

By Alanna Levine, MD FAAP
Developing a pitch for a television segment is not an easy task. You have one chance to pitch the segment to a producer, so it pays to make it a strong one. Producers scan through hundreds of emails every day-some they read and some they don’t even open. How do you make your pitch stand out, get read, and ultimately get picked up?

I have been pitching stories to the media for three years. I have developed relationships with many producers and have been lucky enough to get feedback from them on my pitches. The following are tips I have picked up along the way that help maximize the chance that my pitch will become a segment.

1. Develop a one line ‘tease’: Try to create the headline for the show in the pitch. What would the hosts say is coming up after the commercial break to keep people interested and prevent them from turning the channel? For example, “Spring Break Safety Tips: 5 things every parent should know to keep their teens safe while away on Spring Break” or “Is your baby safe in the car? A new study shows that only 20% of babies are buckled in properly. Find out how to make sure your baby is protected”
2. Be succinct: Producers don’t have that much time to spend on any one pitch. Put the most important points in the first lines of the pitch. Limit the pitch to one paragraph or a few bullet points. If they are interested, you can always provide more information later.
3. Give the story a hook: Why should it be in today’s news? Relate it to something that happened recently. For example, the week Michelle Obama launched the “Let’s Move” campaign was a great time to pitch a story about the importance of diet and exercise in kids’ lives. If a child was recently injured in a sledding accident, pitch a story about guidelines parents should follow to make sure their kids are protected.
4. Make sure the segment is timely: Pitch backpack segments just before back to school time; pitch segments about the importance of flu vaccines in the fall when they hit doctors offices; pitch fireworks safety just before July 4th.
5. Pitch when the pitch will be best received: Do not send your pitch to a producer while the show is live on the air, or during the hour it tapes-it will only get buried in his/her inbox. Try to find out the producer’s schedule. For example, the CBS Saturday Early Show's medical producer is off Mondays. Each week early Tuesday morning, I scan the health news headlines and send him a pitch before 10 am. He usually emails back feedback within the hour. Catching a producer at the right time can make all of the difference.

And lastly, don't be shy about pitching. Remember, producers cannot come up with all of the segments on their own. They rely on experts to present them with great ideas.

Violence In The Media - A Topic To Include in The Well-Child-Care Visit?

2010-05-02T22:45:00.001-04:00

By Corinn Cross MD, FAAP

In the new movie Kick-Ass, the 11 year-old heroine both doles out and is the recipient of heinous acts of violence. This violent comic book inspired movie comes on the heels of two horrendous incidences of real violence meted out on children by children. There was the shocking story of Michael Brewer burned alive by his classmates and now of middle schooler Josie Lou Ratley who was kicked repeatedly in the head by a boy wearing a steeled-toe boot.

Media, through TV, movies, music, video games and the Internet, is having an increasingly larger impact on children, while at the same time, society's standards as to what is appropriate for mainstream marketing both toward children and adults seems to be becoming more and more lenient. One has to wonder with the release of increasingly violent video games and movies along with a relaxation of television standards, "Are our children becoming immune to violence and what are the consequences?"

Twenty years ago, it was fairly easy for parents to limit exposure to violence. There was no Internet, TV sitcoms were held to a much more stringent standard, and video games consisted of Pac-Man, Donkey Kong and Super Mario Brothers. Duck Hunt was as violent as it got.

But the children of that generation are now parents in a media laden world. The parenting techniques and guidelines they were subject to as youngsters are insufficient for raising their own children in this media saturated society. Today's parents have no past experience or tried and true advice to draw upon in these rapidly changing times.

As pediatricians, we are the champions of preventative guidance and parental education. Assessing the level of violence our patients are exposed to and its effect on them as well as helping parents set appropriate limits, is a useful service that we can and should provide at our well-child-care visits.

The best way to approach this topic may be to start when children are very young before media influence has even become an issue. We often discuss limiting young children's exposure to television with our patient's parents. In these early conversations, we can start to convey the message that the content of the television that a child watches is just as important as the amount of television.

For school age children, we already discuss Internet use. We advise parents to move computers to common rooms of the home and monitor their children's use of them. This conversation can also include touching base with parents about age appropriate media exposure.

For the middle schoolers, we start to discuss sex education, bullying, and Internet dangers. Again, this is a very easy segue into sex and violence exposure through all media venues.

For teenagers, a formal HEADSS exam should be done at every well-child-care visit. The HEADSS exam can seamlessly incorporate questions on exposure to violence through media.

With older children, it is also important to assess what effect exposure to media violence may be having on them. This can be evaluated with questions directed at what types of behavior the patient feels is appropriate when he or she is angry.

For most pediatricians, the framework for these conversations already exists within the well-child-care visit. It is simply a matter of becoming aware that this is an increasingly important issue in our patient population and incorporating an age-appropriate discussion consisting of questions, advice and parental resources into these visits.

When Can a Child Use Facebook?

2010-04-03T03:33:00.001-04:00

By Bryan Vartabedian, MD FAAP
Assistant Professor of Pediatrics at Texas Children's Hospital/Baylor College of Medicine

This is a question parents are beginning to ask. If they don’t ask their pediatrician, it’s a question they will inevitably ask themselves and their friends. As the prevalence of social media increases, the issue of social media use by teens has become a legitimate concern and one that may not be on the radar of most practicing pediatricians.

Social networking is evolving at an extremely rapid pace. What’s popular today may not be in a year or two. As parents and pediatricians, we need to be less concerned with the particular method of communication and instead focus on instilling basic core values of privacy and personal boundaries in our children and patients. These same values will apply whether a child is using MySpace, Facebook or Twitter, whether they are texting or uploading photos of themselves.

Here are a few things to consider in our dialog with parents surrounding teen social media use:

A parent’s capacity to protect is limited
There are two basic truths that parents and pediatricians need to accept in this new digital age:
• Online social activity is inevitable.
• A parent’s ability to control what teens say and do is limited.

It’s important to recognize that as children get older, our ability to protect them, online or off, is greatly reduced. Digital socialization is not a fad or a gimmick. It represents a generational shift in how we engage one another. To suggest that our patients will grow and develop socially exactly as we did is fantasy. Digital culture is changing that.

Instead of trying to create an environment where online activity can be avoided, we need to help children develop a construct, or framework, for appropriate engagement in this new digital world.

Parents set an example
Perhaps the greatest framework for a child is the behavior of his or her parent. What parents do and how seriously they take their online engagement is noted and potentially adopted by tweens and teens. Modeling may be an important first-step in helping children identify what’s healthy and what isn’t.

Teens are digital and invincible
The trademark of teens is their ability to detach themselves from situations with the belief that they can’t get hurt. This narcissistic grandiosity affects the way teens evaluate risk and makes them more likely to engage in risky behavior. Unfortunately, just as what happens at a party or behind the wheel of a car can cause lasting damage, so too can online behavior.

Online engagement creates a trail that we call one’s digital footprint. This trail can follow teens into the college admission process and even into the workforce influencing how potential employers view them in their quest for jobs.

Parental monitoring of a child’s public ‘brand’ is evolving as a new responsibility in 2010. Parents can begin by impressing upon their children the emphasis that a digital footprint can have on their future. Although teens do view themselves as invincible, starting around 16 years of age they are also very concerned with the concept of a reputation and personal image. Once teens become aware of how online behavior can affect that image for years to come, they may be more apt to protect their online reputation.

The responsibility of pediatricians
If as pediatricians we don’t advise parents, they will turn to their own devices and their own networks for advice. Personal networks are part of parenting, but we should not surrender our role as child health advocates in the sphere of social engagement.

Helping parents navigate the territory of online socialization should fall under the responsibility of the pediatrician. Just as parents have to rethink the way they raise children, pediatricians collectively need to rethink anticipatory guidance. Our worldview of how we advise parents needs to evolve.

The Children's Television Act: An Update

2010-01-27T13:38:00.000-05:00

By Vandana Y. Bhide, MD, FAAP, FACP

The Children's Television Act (CTA) was passed by Congress in 1990 with the goal of providing educational programming to children that "furthers the positive development of the child in any respect, including the child's cognitive/intellectual or emotional/social needs¹."

Subsequent modifications of the Children’s Television Act required that:

1. Television stations provide a minimum of three hours per week of educational and informational shows targeted to children under the age of 16 during their prime viewing hours of 7 AM to 10 PM. Commercials were limited to 10 minutes an hour on weekends and 12.5 minutes an hour on weekdays.

2. Educational/informational children's shows had to show the "E/I" label on the television screen the entire length of the show.

3. As television transitioned from analog to digital, broadcasters, who can have up to six channels of programming in digital instead of one channel in analog, were required to provide the commensurate amount of children's educational/informational programming.

The FCC is also required to consider whether a television station has served children’s educational needs during the station’s license renewal process. In return for providing such educational programming, broadcast stations were given free access to public airwaves.

So twenty years after the Children’s Television Act was first passed, has it achieved its mission of promoting educational programming for children? Unfortunately, the answer is no.

For example, broadcasters once labeled the The Jetsons educational because it dealt with the futue and The Flintstones informational because it dealt with history. Although the show GI Joe had violent content, it was described by television stations as educational due to its pro-social themes. Networks also labeled Leave it to Beaver as educational because it had pro-social messages.

Children Now, a nonpartisan children’s research and advocacy organization, evaluated educational shows broadcast by the four major networks from 1997-2008. Children’s Now determined that in 2007-2008, only 13 % of programming described by networks as educational and informational was determined to be of high educational quality. 63 % of shows were found to have moderate quality and 23 % minimal quality.

Health and nutrition messages, especially those that addressed childhood obesity prevention, were "extremely rare." ² The report concluded that current television programming does not meet the original intentions of the Children's Television Act.

The Senate Commerce, Science and Transportation Committee concurs. On July 22, 2009, Senator Jay Rockefeller, D-W.Va., Chairman of the committee, convened a hearing called "Rethinking the Children's Television Act for a Digital Media Age." The Senator said he planned to introduce legislation to regulate children's media content, citing his "grave concerns about violence and indecency in the media."

Clearly the Children’s Television Act has failed to increase educational children’s programming in a meaningful way. Even more discouraging is the fact that there have been a number of lawsuits filed by broadcasters in federal courts as well as before the FCC in an attempt to avoid their obligations to provide educational programming as stations convert from analog to digital.

What can pediatricians do to help parents when typically only three hours per week of television programming on a particular station is educational?

First, we can talk to our patients and parents about the educational programming requirements of the act, and what the “E/I” symbol means. Encourage parents to watch programs with their children to evaluate the educational value. Parents and pediatricians can notify the FCC about programming that lacks educational quality.

The FCC is generally responsive to parents who object to programming. For example, in 2007, the FCC entered into a consent decree with Univision to resolve petitions by children's and media organizations to deny the broadcaster's license renewal applications. It was alleged that Univision's children's programming did not comply with the educational requirements of the CTA. Univision voluntarily paid $24 million and developed a plan to comply with the rules of the Children's Television Act.

It is clear that most broadcasters adhere only to the minimum educational programming requirements of the Children’s Television Act. Therefore, the only way to encourage more educational television programming is to encourage the FCC and Senator Rockefeller’s committee to increase E/I programming requirements that stations must provide in order to continue to access the public airwaves for free.

References:

1. "Policies and Rules Concerning Children's Television Programming Memorandum Opinion and Order," Federal Communications Commission Record 6,(1991): p.2114.

2. Executive Summary: Educationally/Insufficient? An Analysis of the Availability & Educational Quality of Children's E/I Programming. Children Now. Htttp://www.childrennow.org/eireport.

Why Pediatricians Need to Discuss Texting and Driving In Our Offices

2010-01-27T13:27:00.003-05:00

By John Moore, MD, FAAP

As part of my daily commute from my home to my office and back, I spend about thirty minutes per day driving on Interstate 81 through central Virginia. That commute has allowed me the fascinating and frightening opportunity to observe first-hand the recklessness and aggression of the modern American driver. Over the last seven years, I have seen drivers of cars, trucks, motorcycles, and vans doing almost everything imaginable except paying attention to the road. I have witnessed people been drinking coffee, scolding their children, applying makeup, and even flossing their teeth.

While hard data on the numbers of drivers texting or surfing while driving are not available, anecdotal and observational studies are very concerning. A recent survey by Nationwide Insurance estimated that twenty percent of drivers either send or receive text messages while driving. That number of people who drive while texting reaches a staggering sixty-six percent when limited to 18-24 year-olds.

The exact impact of texting on automobile safety is impossible to gauge. No reliable data exists to associate texting, distracted driving and accidents. However, anecdotal data continued to accumulate and the potential impact may be staggering. Several recent, dramatic deadly crashes in New York and Florida have been associated with drivers sending and receiving text messages.

Fourteen states, including Virginia, New Jersey, and Washington DC, have taken action to address that issue. In July of this year, police in Virginia began fining drivers caught texting while driving. The penalty for those caught is only $20-$50, but the psychological impact may be more profound. Hopefully, the new legislation in Virginia and other states will make motorists think about their messages and exactly how important that text really is.

As pediatricians, we are faced with the task of helping our patients navigate the complex path from childhood to adulthood as smoothly as possible. We know that teens are at significantly increased risk of automobile accidents. In addition, teens are the quickest adaptors of new, exciting, and dangerous technology. In the case of texting and driving, that combination has proven to be deadly in several well-documented cases. If we can get one teen to ignore their phone and concentrate on the road a little closer, we have made immeasurable difference in their lives. In my opinion, the ability to make huge differences in lives is why we all became pediatricians in the first place.

When Patients Google for Medical Advice

2010-01-27T13:25:00.001-05:00

By Jennifer Shu, MD FAAP

If you’ve been practicing in the 21^st century, I’m willing to bet you’ve had patients come into your office armed with the latest “research” they’ve found on the Internet about condition X and either want to know what you think or demand the treatment recommended on the Web. I can’t say that I blame them for trying—after all, the Internet is open 24/7 and is often easier to access than the doctor’s office or nurse advice line. Since the Internet is here to stay, I believe physicians would do well to embrace this relatively new influence on our patients’ health literacy and channel our energy into helping them find the most accurate and reliable information out there.

I had the opportunity to present my views on finding credible healthcare information online at the BlogHer 2009 conference, a meeting of women (and some men) bloggers all over the country who make a living or hobby out of sharing their thoughts with online readers. As a member of a panel of experts moderated by our own Dr. Gwenn O’Keeffe, we had an audience outside of the usual realm of conferences geared toward medical professionals. I hope that by providing Googling-guidance to bloggers seeking health information, this information will then trickle down to their readers, who likely include healthcare consumers such as our patients’ parents.

I’m including some of the tips we provided and hope you’ll share your ideas too:

Look for .gov sites. Governmental sources are credible and reliable. Some great resources are http://medlineplus.gov and http://www.cdc.gov.

Visit medical organization pages. Professional associations such as the American Academy of Pediatrics www.aap.org offer accurate information. Also, consider www.medem.com (which contains a collection of information from multiple medical societies). The American Medical Association www.ama-assn.org and your state or local medical society may also provide helpful resources.

Check into a hospital site. One site with extensive information is http://www.mayoclinic.com/ but many hospitals offer credible web resources. You may wish to check out a local medical center’s site first.

See sites devoted to health information. Some examples are http://kidshealth.org/ (which has information targeted to kids and teens as well as to parents) and www.uptodate.com.

Strength in numbers. If several web sites give the same medical information, there’s an increased chance that it’s credible. Also check that there are multiple physician reviewers and that the information has been verified for accuracy recently.

Consider the source. Before getting too concerned about something you read online, consider who authors the site. Some organizations and individuals can look official but may not really provide trustworthy information.

Talk to your doctor. Your doctor should be your sounding board when it comes to making sense of online medical information. If you have questions about something you’ve read, be sure to ask your pediatrician, who can put the information into the context of your own child’s health. Better yet, ask your doctor for recommendations for favorite health web sites so you can go straight to a reliable source.

A Different Take on Social Media: Our patients...Today's YouTube Stars?

2009-07-30T09:17:00.003-04:00

“Did you see, I made the news”, said my teenage patient a few hours after being shot twice in the legs.

“No”, I said, “I’ve been busy taking care of the other patients in the ED”.

“Too bad”, he replied. “It was pretty cool”.

I have never thought of having a gunshot wound as pretty cool. However, I am not part of this new generation that expects to be a part of social media, YouTube, Twitter, Facebook, etc.

A moment on the trends I have been seeing….

1. Teens with injuries sustained while doing some activity (likely not a safe or wise activity) that is being taped for production on YouTube. For example, with the warm weather brings the annual “what can we do to make a Slip-and-Slide more dangerous”? The last two teens with splenic lacerations opted to show me the injury as it was happening as depicted by video on YouTube. That is, before coming to the hospital, the patient (or the patient’s friend) took the time to post the video of the injury inducing event to YouTube.

2. Families videotaping injuries instead of helping the child being injured. I recently cared for a young man that was attacked in a local park. When I asked for a description of what happened, his older brother (of adult age) said he could show me the video if I wanted. When I asked why he chose to video the event instead of help his brother, he replied that he thought it would be better for the police and the news to have the video.

3. Victims of violence feeling a sense of accomplishment when their stories are covered on the local news. The gunshot victim provides a classic example.

Perhaps our entrance into social media is not best served by the medical professionals producing their own spots, but instead helping to prevent our young patients (and when necessary, their families) from being the star of these less than endearing media clips.

This is a new health crisis impacting the youth of today. I am at a loss as to the root of the problem. Is it due to the dramatic increase in reality TV? Are kids getting the message that since anyone can post a video on-line they are not worthy unless their video is the most dramatic, dangerous, outlandish, or destructive? What would cause a family member to choose allowing injury to a loved one over stopping an assault? Perhaps in addition to reviewing our patients’ charts prior to a visit, we need to Google them too…then discuss what we find when we see them in our offices!

By Elizabeth Murray DO MBA

Editor's Note:

Dr. Murray has offered us a bird's eye view into the real world of how kids are using social media. Our job is to figure out how to use this information clinically. Perhaps it's as simple as asking "been on YouTube recently?"

R Rated at 40,000 Feet?

2009-07-30T09:00:00.003-04:00

As I make my mental checklist to prepare for family vacations, I instinctively remember the booster seats, Ziploc bags to carry snacks, and card games and books for the long flight. But I’ve been caught short-handed on a few flights with my kids due to unexpected entertainment provided free of charge by my airline “hosts” and without the opportunity of refusal. I am sometimes at a loss when my kids are staring right up at the airline’s offering of a violent R movie on the overhead screens. I took frequent transcontinental flights when my elder son (now 12) was an infant and toddler and learned the hard way that my discerning taste for my child was not shared by the airlines. I actually purchased one of the first laptops with a DVD player just so I could use that in a pinch…and I used it shortly afterwards when my toddler son looked up and saw that Matrix was playing right in his view. The Tigger Movie was my quick replacement!

Federal broadcast laws do not apply to in-flight entertainment, and airlines are not required to adhere to motion picture ratings. The Family Friendly Flights Act was introduced in Congress in September 2007 (the 110th session of Congress) to require separate airplane seating areas for kids and families to protect them from violent inflight entertainment. Although it was referred to committee, it did not get referred back to the House and is not law. However, child advocacy groups and flight attendants have continued to work with the airlines and movie studios to lobby for logical guidelines on the selection of movies for inflight entertainment on overhead screens.

On my most recent flight with my kids, now 7 and 12, we were fortunate. The boys had their portable entertainment available but the overhead fare was reasonable for their eyes. But searching the airline websites for last month’s movies showed me that they might have been faced with Gran Torino, Dark Knight, or Quantum of Solace. US Airways, Delta and countless other airlines assert their prerogative to screen any movie for the enjoyment of all of their passengers and to edit them as they see fit.

So what is a parent to do to protect his child from inappropriate inflight films? While airline spokespersons have suggested that a parent contact a flight attendant who might be able to switch the family to “obstructed view” seats during the flight, we all know that the planes are usually filled to capacity these days. This is a chancy option at best. So here are my tips for a safer flight:

1) Choose an airline that has signed onto the principles of the Family Friendly Flights Act or at least have individual screens for each passenger. This includes Southwest, Virgin Atlantic, and Jet Blue.

2) Check on airline website for the movies that are scheduled for the upcoming month. This may or may not be helpful if you are purchasing ticket months ahead, but it will give you a heads up about the relative risk of your 2 year old watching Gran Torino or Watchmen.

3) Either purchase/borrow a portable DVD player (we bought one for about $60 at Christmas) or consider renting from an airport facility or from the airline itself. Alaska Airlines rents onboard digEplayers (personal entertainment players) to passengers with 24 hours notice. InMotion Entertainment has stores in major airports and will rent you a personal DVD player and DVDs for the flight or the whole trip. In a pinch, as I have done, use the DVD player in your laptop. For those with really good eyes, you may hand over your iPod pre-loaded with an appropriate movie for the little ones! In the case of a VERY curious preschooler, a blanket “tent” might make a fun diversion to keep her eyes on her movie and off the overhead screen.

4) Of course, try to limit your kids’ screen time on the flights. Bring books, music, playing cards and travel games for the whole family. Kids often love the one-on-one time with a parent held captive right next to them for 6 hours straight. Scrabble, Mastermind, and many other classic games come in travel editions. My younger son cajoled my husband into reading a 300 page adventure novel to him on a series of flights when he was four.

5) Provide feedback on inflight entertainment to EVERYONE in the travel industry. I have been receiving more post-flight surveys these days and I make comments on the movie issue even when it is not the topic of the survey. I applaud those flights in which I am not scrambling to “distract” (Horton Hears a Hoo followed Yes Man on our transatlantic flight…good option but the kids were already asleep for the G movie!) and I draw attention to the times that I am not so pleased (The Day the World Stood Still did not make my cut on a recent flight due to apocalyptic scenes).

Letting airlines know that you will be looking elsewhere for your travel needs is the best way to protect all of our children from these films. Airlines are traveling movie theatres but are not members of the MPAA and do not have to follow MPAA rating guidelines. So your efforts to keep your child from a PG-13 or R movie while at home are being undermined by the airlines’ lack of commitment to families. The airline industry needs your dollars and advocacy may start with consumer decisions. Until the friendly skies change, however, travel with kids means travelling prepared. Bon voyage!

By Mary Beth Miotto, MD, FAAP

Editor's Note:

Readers may be interested in checking out www.kidsafefilms.org, an organization dedicated to this very issue.

Sexting: dangerous but is it a crime?

2009-04-30T08:00:00.001-04:00

“Come gather round people wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You’ll be drenched to the bone
Then you better start swimming
Or you’ll sink like a stone
For the times they are a changing”

Bob Dylan’s song of protest (voted #59 of the top 500 songs ever written by Rolling Stone) seems as prescient today as in 1964, especially as COCM members recognize the latest teen-technology on-line behavior:sexting. Research studies reflecting usage reveal that between 20-25% of all teens have sent or posted semi-naked or naked pictures. A higher percentage says that exchanging sexy content makes dating or hooking up more likely.

Teens have been recently charged with disseminating child pornography in 9 states, many have to then register as sex offenders. Meanwhile,the media (as usual) has sensationalized the issue by the way it has covered the topic, often confusing parents, teens and even pediatricians.

But the real question here is this: should laws made to protect children be used to prosecute them? I believe that misses the point. Pediatricians and parents should look beyond the headlines to the convergence of adolescence and these electronic devices that allow instant communication decisions from immature teen brains.

These kids are not threats to society.They’re reckless hormonal narcissists who are tasked with growing up in a sexualized society. Their previously private thoughts are now revealed all too publically. They often are the real victims here: assaulted by a desire and opportunity to get older-younger.

Parents need to become aware that the media has ensured that adolescence occurs well before Tanner stage II. The media has framed the issue, but not focused on real solutions. That's where we can help enormously with our pediatric knowledge and media skills!

So what is the Pediatrician’s role when it seems that teens are more connected to their devices, and each other, but disconnected from their parents? It doesn’t have to be complicated.

1) Don’t wait until a health maintenance appointment to frame the issue of texting/sexting. Rarely does a teen or tween appear in the office without a cell phone. (Or receive a call during the appointment).

2) Remind them that a text or sext, once sent, is out of their control permanently. Examples abound from the pictures of Vanessa Hudgins (HSM 1,2,3-oh google her) or Michael Phelps and his famous bong picture.

3) Ask about whether parent is concerned about texting as nauseum. Most will agree
about the numbers, but will be clueless as to potential solutions.

4) Advise visiting ThatsNotCool.com (go there yourself). A great site with tools and guidance, prime parenting directives actually, to buffer cyber-stalking and cyber-pressures. The site also has great posts that could be taken from the site to stimulate a discussion in your examination rooms, newsletters, websites.

Note that as the January archives article revealed, uncovering the problem does not imply you have to solve it. Expressing awareness and concern, could, hopefully, motivate parents to seek opportunities to learn and engage in collaborative conversations that would lead to constructive solutions.

“Come Mothers and fathers throughout the land
And don’t criticize what you don’t understand
Your sons and your daughters are beyond your command
Your old record is rapidly aging
Please get a new one
If you can’t lend a hand
For the times they are a changing”

By Don Shifrin, MD, FAAP

What if every pediatrician was on twitter?

2009-04-28T08:00:00.001-04:00

Is the absence of pediatricians on social media platforms a public health issue for children? It might be. Misinformation predisposes children to risk. We all can identify instances where poor decisions for a child were made on corrupt information obtained online.

And as doctors we complain. We see ourselves as victims. Our patients are reading someone else’s information and opinion. And most of us handle matters by taking precious time to get the facts straight. Time that could be better spent on anticipatory guidance or counseling in other areas.

But to some extent the issue of bad information is our responsibility.

As pediatricians our response to online misinformation tends to be reactive. For some reason we never think that we should be the ones generating the information and dialogue. As the group charged with the well-being of the next generation we need to be proactive. We have a commitment to see to it that we are visible and vocal online.

So what can you as a fellow of the AAP do?

Contribute to a blog. It doesn’t have to be your own blog. There are many that would be happy to host you as a guest author. Offer practical input on the issues that you see creating confusion in your parent base. If every fellow of the AAP posted one blog post annually on the absent association between vaccines and autism, for example, there would be 60,000 online entries which would likely dominate search engines.

Comment regularly on news sites, blogs or anywhere there’s dialog on children’s health. With no input from those of us with the facts, discussion will be dominated by a vocal minority, many of whom have an agenda not representing the interests of the parental reader.

Begin a Twitter account. Just a few minutes a day cultivating relationships with peers, patients and ‘followers’, AAP fellows have the potential to change minds and influence thinking. Twitter is a platform for the dissemination of ideas, thoughts and information in ‘tweets’ of 140 characters. Assuming just 250 followers (I have 1,000), the news of a measles outbreak associated with undervaccination, for example, could instantly reach 15 million individuals with a single tweet from AAP members.

The battle for the health of our children and the sanity of our parents is now fought online. A commitment to online literacy through active involvement by AAP Fellows in social media should be seen as a critical advocacy role.

By Bryan Vartbedian, MD, FAAP

Being A TV Medical Expert: Tips to get asked back

2009-04-21T10:23:00.001-04:00

Being asked to appear as a guest medical expert for the first time is an exciting experience. How do you ensure you will be asked to come back on the show again? The following are a few tips I have picked up along the way:

1) Arrive early. The last thing the producer wants to do is worry about whether you are going to make it to a live appearance. It's better for you stroll around the neighborhood and collect your thoughts on the topic for a few minutes, rather than run the risk of receiving panicked phone calls from a producer.

2) Be courteous from the moment you enter the building. Smile at the security guard, be friendly to the intern or page who escorts you in the building, and make small talk with the people in the green room. Not only will it make good impressions, but you will appear relaxed and confident. Often times, the make-up artist or others in the green room will ask what you are about to talk about…it's great practice to speak your thoughts aloud, so be sure to use the opportunity. Just remember that what's spoken in the green room may be repeated in public.

3) Ask ahead of time if you need to arrive camera-ready. Some shows will have a stylist on set to do hair and make-up, others will expect you to arrive camera-ready, and some will have someone ready to touch up what you have applied ahead of time. It pays to ask before you arrive. Additionally, I recommend that the ladies always carry some make-up and hairspray, in case you get stuck in traffic and don't have time for the full stylist treatment. Gentlemen, I encourage you to accept the offer of face powder. Distracting shine can take attention away from your good messages.

4) Discuss the segment with the producer ahead of time. Some producers will want to pre-interview you on the telephone, while others will want you to email 'talking points' in advance of the show. Either way, make sure you have some contact with the producer ahead of time, so you know what to expect and aren’t faced with any surprises on camera.

The producer will ask you about the topic you will be discussing so before you speak with the producer take a few minutes to do a quick internet search, even if you are well-versed on the topic. One great resource is the AAP "children's health topics" page on your topic at www.aap.org. A small bit of mental organization goes a long way in making you sound like an expert who can convey a lot of valuable information in a short period of time.

While on the phone, ask the producer if he or she would like you to email formal ‘talking points’ for the show. If so, send these in Q&A form. Even if the producer does not desire ‘talking points’ from you, creating some for your own personal use is a fantastic way to prepare for the segment.

Issues to ask the producer about include duration of the segment, who will be interviewing you, what to expect when you arrive at the studio, and whether hair and make up touch up are provided.

5) Be flexible. Things frequently change in the broadcast world, and they can change last minute. I have had a topic change upon arrival at the studio, leaving me only 10 minutes to review the topic on my i-phone. Though this would fluster almost anyone, try not to let the producers know you are uncomfortable about a last minute switch. The more easygoing you are, the more likely they are to have you back. And, unfortunately, we all get cancelled. Sometimes it's the day before, sometimes it's the morning of, and sometimes it's even after sitting on the set. I personally have been sitting next to the interviewer with my microphone on, only to have my medical segment bumped by someone talking about vegetarian turkeys for Thanksgiving! But don't give away your annoyance, even if you (ahem) changed around your whole schedule, only to have the segment be canceled at the last second.

6) Be reachable. Immediate access to email is a must. Often you will receive an appearance request in the form of an email. If your response time isn't quick enough, you risk losing the opportunity. A blackberry or i-phone really comes in handy if you plan to appear on air often.

7) Send a quick thank you email. It's always nice to send a brief "thank you for having me" email, and it gives you an opportunity to say that you would love to come on again if the need should arise. Many times this has opened the door for me to send pitches back to the producer.

By: Alanna Levine, MD, FAAP

Discussing On-Line Profiles - A New Addition To The Well-Child Exam

2009-03-02T07:00:00.000-05:00

Through social networking sites, teens can now hangout with their friends without leaving their homes. But unlike sitting in a friend's basement, you're not always sure who else is there. There are unseen risks involved with virtual communities. Depending on the settings of one's web profile, personal information, photos, etc. may be open to anyone who wants to see them. Teens may be more lax about what they share on-line. They may say and do things on-line that they would shy away from in person. Teens may also feel pressured by their virtual community to post comments or pictures that may be inappropriate or illicit unwanted attention.

With how common these sites have become in everyday adolescent life, it would be wise for us as pediatricians to begin to include them in the teenage well-child exam. On-line activity and its risks can easily be worked into the "activities" part of a HEADSS exam. Incorporating it into the HEADSS exam can open the door to discussing the risks involved with putting personal information on-line as well as how to protect one's self and maintain one's privacy.

A recent study published in January's Archives of Adolescent and Pediatric Medicine has shown that adolescents may be open to advice regarding how and what they display about themselves on-line. In this study, a physician using MySpace sent an email to 18- to-20 year olds who displayed risky behavior in their on-line profiles. She informed them that the information they were sharing was open for anyone to see and advised that they take steps to maintain their privacy. 42% of the interventional group versus about 30% of the control group (P=0.7) made some sort of protective change whether it was reducing references to sex and substance use or changing their web profile setting to private.

These results were based on an unsolicited email from an unknown physician. It is likely that advise from one's own pediatrician with whom they have had a relationship for many years would be much more influential. Although there are many things to cover at the teenage well-child visit, given how much time teenagers spend on-line and in these virtual communities it is incumbent upon us to find the time and make the effort to discuss the risks involved.

By
Corinn Cross, MD, FAAP
COCM Website and Blog Editorial Advisory Group Member

The Nation's Doctor

2009-02-27T07:50:00.002-05:00

As Surgeon General, from 1998-2002, Dr. David Satcher described his role as the “Nation’s Doctor”. In 2007, he testified before Congress stating in part, “I believe that it is the responsibility of the Surgeon General to communicate directly with the American people….” (Committee on Oversight and Government Reform The Surgeon General’s Vital Mission: Challenges for the Future Testimony by David Satcher, M.D., Ph.D. July 10, 2007.) Surgeon General nominee, Sanjay Gupta has already proven that he can communicate with the American people. The prevailing argument however, is that it takes more than a reporter to be the Surgeon General. His first challenge will be Congressional approval. After approval, Dr. Gupta will likely spend the majority of his time winning the support of those who believe he is not qualified.

Only two of the last eleven Surgeon Generals are easily remembered: C. Everett Koop and Joycelyn Elders. C. Everett Koop was Surgeon General from 1982-1989. He is a Pediatric Surgeon and continues to make television appearances. He was very public during his service and fit the stereotype of what most Americans associate with wisdom and experience. The Surgeon General warning labels and C. Everett Koop are synonymous in the minds of Americans who witnessed the obscure office become a very public platform. The second memorable Surgeon General is Jocelyn Elders who was Surgeon General from 1993-1994. She is a Pediatric Endocrinologist and created a media firestorm with comments about masturbation. Her firing began a rift in the perception of what the Surgeon General should promote. Public health advocates and political conservatives do not always agree on what message the Country should hear.

These two examples demonstrate contrasting communication styles and media experience. Media knowledge is a vital skill for an effective Surgeon General. It is this role as the “Nation’s Doctor” and his ability to communicate that illuminates the choice of Dr. Gupta for Surgeon General. Dr. Gupta is a neurosurgeon who has already become a trusted source of information for millions. However, he may not have the support of many in the scientific community or the Public Health Corps, which he would oversee. As with many institutions, experience is the currency that pays the dues. Other physicians also look at the choice as a threat to public health and primary care because he is a sub-specialist without a Public Health degree. The past eleven Surgeon Generals have had specialties to include neonatology, family medicine, nephrology and veterinarian medicine. The current acting Surgeon General Dr. Steven Galson specializes in Preventative Medicine and Occupational Health. Dr. Gupta’s credentials as an expert in neurosurgery confirm his ability to practice medicine. His success in public health would depend on taking full advantage of the vast resources at his disposal. If Dr. Gupta utilizes the scientific and medical advise of experts to analyze the evidence and then, uses his skills as a communicator to direct the National health goals he has the potential to be one of the best remembered Surgeon Generals in a generation. Imagine 15 year-olds talking at lunch, “Dr. Gupta said, ‘Ephedra can kill you.”

The Office of the Surgeon General may be poised for the spotlight and focus America’s medical needs toward the best care practices. Or it may become another distraction from important issues. We may see how ready for change everyone is and how an effective communicator can make a difference.

by
Jeff Hutchinson, MD, FAAP, FSAM
COCM Website and Blog Editorial Advisory Committee Member

Social Media Sites and Inauguration Coverage: A Glimpse Into Communication of Today and The Future

2009-01-22T16:09:00.003-05:00

This week's Inauguration will not easily be forgotten. From the earliest moments to the First Couple's First Dance, it was a day filled with hope, memorable "tissue" moments, though-provoking music and words, and images of a gracious passing of the Presidential torch of power that will be carried with all of us for a very long time.

In addition to the usual TV coverage, a surprising twist to my day was how much more enhanced the experience became for me due to the power of my social media involvement on Twitter and Facebook. As the Inaugural events were unfolding, simultaneously, my virtual community of friends and colleagues were posting their impressions and images real-time from all 4 corners the United States. We even shared what we were snacking on! No longer sitting alone with our thoughts, we became a rich community of voices sharing our thoughts and impressions real-time.In the blink of an eye, a virtual living room of spectators for the biggest historical moment in most of our lives emerged.

And, we were not alone! JuJu Chang from ABC News had a flipcamera and her iPhone at the Inauguration. She not only posted videos on her ABC News blog but updated to Twitter and Facebook throughout the day. It was a cool way to give views another way to experience the Inauguration besides the more traditional TV coverage ABC was also doing, which was excellent.

We have yet to really tap into the full power of these communication tools but if Tuesday was any indication, a door has been opened that we have only just begun to walk through. It will be interesting to see how we all end up using social media in our media and communication lives and to learn from each other's experiences. We are likely to find we will only be bound by the limits of our own individual creativeness.

There was a true sense of unity and community this week that was visible and palpable on the Mall, parade route, the many evening balls, and in all our communities on and off line. While I had a bit of Inaugural media coverage brain burnout the following day, I woke up that morning hopeful about the future and looking forward to exploring more the power of the world of social networking.

Image: First Dance (FoxNews)

Republished with permission from Dr. Gwenn Is In

Question Of The Month: Getting Ideas for Media Work

2008-08-14T16:45:00.002-04:00

Media Question #2:

If you do media work such as write a column, article, blog, do TV or radio show, where to you get your headlines or ideas?

A: Headlines: national or local

B: current AAP journal articles and themes

C: the producers or editors give them to me

D: what I see in my practice

E: other – please specify

Here are this month's responses:

"Most of my topics for articles either come from the AAP / journal searches that I find interesting or from the reporters themselves. While I find the stories that I do from the articles I find to be more interesting and satisfying, I don't have a lot of time to pitch story ideas. Thus, I also respond to reporter's ideas more often than I would like."

"A and D: I get my headlines from the NY Times or Chicago Tribune. Patients are the best source of questions and usually answers. It adds the personal touch to the discussion."

"As my blog is for Residents and our local EMS providers, I tend to stick with topics related to what we are seeing in the ED. The saying about things "happening in 3's" is very true where I work! I often incorporate hot topics or seasonal items into the discussion."

"I do a local cable TV interview show called "School Health news' I get my ideas from my knowledge of school Health' and Current AAP Policies."

"All of the above. I read other blogs, columns; listen to talk radio. Then I research and write my editorials or columns. My essays are from my practice."

If you'd like to contribute your answer to this question, email me!! gsokeeffe@aap.net or cocmeditor@pediatricsnow.com

GENERATIONAL GAP OR INFORMATIONAL GAP?

2008-08-14T16:26:00.004-04:00

Today's blog is by COCM member Mark Rosenberg M.D., F.A.A.P., from Children's HealthCare Associates in Chicago, Illinois, who writes:

"As recently as two generations ago, when a new parent needed advice on the care and raising of their newborn, the trusted source of information was a grandparent or other close relative. Now the ‘trusted’ source of information is the internet and the various information services available on line. While we owe a great deal to the information revolution on the internet including rapid access to information including libraries of journals that would have required a trip to the university library, there is much to be wary of. Information may be posted by literally anyone, who then becomes an instant expert.

A case in point of the information revolution is recent access to information on vaccines; particularly the celebrity endorsed alternative approaches to immunizing infants. Despite numerous medical studies and epidemiologic research in the safety of vaccines, as well as a track record of reduction in vaccine preventable disease, members of the public have chosen to accept anecdotal stories of alleged harm caused by vaccines. The result has been lower rates of immunization in many areas of the country and the potential for susceptibility to diseases that most pediatricians and emergency departments rarely see including invasive pneumococcal disease and Haemophilus meningitis.

On line parent groups provide another source of information to parents, not unlike the backyard fence that my parents used to chat with neighbors, except that the sources of information are unseen and anonymous. These groups have become sources of health information as well as information about specific physicians. Once one of the physicians in my group acceded to parents’ requests to provide an alternative immunization schedule, she was subsequently identified as the physician to go to, despite not seeking out that role. Word of mouth[on line version] has changed her image and practice. A similar source of information is the blog, an online discussion group frequently within a media source web site. This use of the parent to parent information exchange may have the perception of official sanction when conducted by an ‘official’ media source, such as a newspaper or magazine.

For pediatricians, the challenge is to adapt to the new informational age by convincing families to use validated sources of information and rebuild the confidence in physicians as reliable health care providers. Beyond accurate information medical groups must maintain credibility without conflicts of interest in our relationships with the pharmaceutical industry and vaccine manufacturers. Grandparents play a role in discussing their past experience with vaccine preventable disease. Families need to hear our strong voices as advocates for the health of their children."

Do you have a blog post you want to share with COCM members on media issues? Email me at gsokeeffe@aap.net.

Preparing For A Media Appearance

2008-07-28T09:00:00.003-04:00

When you get a call from the media for an interview, how do you prepare? What goes through your mind?

COCM member Dr. Vandana Bhide, an internist and pediatrician in solo practice in St. Augustine, Florida, was called by the media recently about a situation in her community and shared with us her media lessons learned. She writes:

"Recently, I was interviewed by the CBS affiliate in Jacksonville, Florida to on a story about a local 14-year old girl who almost died of alcohol intoxication after attending an underage party. Here are some things I learned from my media experience:

1) Research, Research, Research. Even though I have spoken at town hall meetings and other forums for the public regarding the medical effects of alcohol on children (I am on the board of a local substance abuse counseling center which also runs a number of in-school alcohol and other drug abuse prevention and intervention programs), I felt so much more confident and calm when I had some time (OK, 30 minutes, tops, but better than no time at all) reviewing the important points I wanted to make about the topic. Even though only 10 seconds of it got on the air, it made for a more interesting 10 seconds!

2) Expect the Unexpected. When the reporter called me to meet for the interview, she asked me to meet her at the “Real Jail” (as opposed to the pretend jail???) After unsuccessful attempts at trying to find “Real Jail” under the “Points of Interest” section of my GPS and then also failing to find this location on Mapquest, I finally resorted to the old-fashioned technique of asking a policeman for directions. I finally figured out that the reporter was referring to the adult jail, not the juvenile detention center. When I saw the segment air, I realized that the reason the team was reporting at the jail was that three people had been arrested in conjunction with the underage party.

3) Be Humble. I gave the interview at 5 PM on a Saturday, and the segment was scheduled to air on the 6 o’clock news. I was told that the piece would probably be bumped off the 10 o’ clock news because of the approaching thunderstorm. You may think that your “expert” opinion is important, but maybe it isn’t in the big scheme of television news. Lesson learned: Weather is Important. Especially on the Atlantic Coast of Florida. Especially during hurricane season. Especially during a perfect golf weekend. I guess there wasn’t any breaking weather news because the segment did indeed air again on the 10 o’ clock news.

4) Generate interesting questions and answers. The only question the reporter asked me was, “Should parents speak to their children about alcohol?” The answer seems obvious, and yet studies show that the vast majority of parents don’t speak to their kids about the importance of refraining from alcohol and drugs. So I tried to avoid answering with a brief yes/no question and instead explored what are the barriers to parents and kids having this discussion.

5) Speak in English. Seems obvious, doesn’t it? But how many of us have been guilty at some time or the other of speaking in medicalese? Do television viewers understand that “the toxic effects of alcohol include bradycardia and other arrythmias, respiratory depression, hypotension and death by aspiration?” If the explanation is not easily understood, you may find your segment on the cutting room floor!"

COCM Members In The News

2008-07-22T08:53:00.005-04:00

Here's some of the latest media appearances of COCM members:

Ari Brown (Star Ledger: Autism)

Deborah Mulligan (Star Ledger: Dry Drowning)

Deborah Mulligan (Washington Post: Dry Drowning)

Linda Reid Chassiakos (Editorial Daily News)

Linda Reid Chassiakos (Editorial Daily News)

Gwenn O'Keeffe, MD: Dr. Anonymous Radio Show

Gwenn O'Keeffe, MD: Vicky and Jen's Radio Show

Jo Ann Rohyans, MD was on CBS affiliate Ohio (WBNS-TV) on Tuesday, July 8 discussing HPV

Robert Mendelson, MD discussed HPV for "Scribe" a monthly publication for the Medical Society of Metropolitan Portland in early July

Richard Baltz, MD, Newborn Colic, Newsweek

Thad Woodward, MD hosts for Line One - Your Health Connection, KSKA, Anchorage, Alaska

Question of The Month: Preparing For Media Calls

2008-07-08T16:45:00.000-04:00

Media Question #1:

When the media calls you for an interview on a child health issue or a breaking headline, what do you do to prepare for the interview? Do you

A. A. Consult the AAP

B. B. Consult medical colleagues

C. C. Do a web search for information

D. D. Just do the interview cold because you know the material so well

E. E. Other: please specify!

Here are some of the answers I received from COCM members:

"When the media (TV, radio or print) calls, I usually put together my thoughts and then check the AAP website and links to verify facts/add statistics to my presentation."
"I do A, B and C"
One COCM member who does a great deal of media wrote:

"A. Consult the AAP--I call Susan Martin or Debbie Linchesky in the AAP Media Relations office if I'm not sure of the AAP's position or a certain angle to take with a topic

B. Consult medical colleagues--I often talk to pediatricians in my office and other AAP media spokespeople just to get a reality check and see if there's something I haven't thought of yet.

C. Do a web search for information--I check the AAP web site for policy information as well as parent guides (these make good links for reporters/consumers). I also like medlineplus.gov and emedicine.com for general medical information.

D. Just do the interview cold because you know the material so well--almost never; even if I know the material like the back of my hand and have done an interview topic many times before, I like to refresh my memory, even if it's just a little bit.

E. Other: please specify! If there's time I try to get a little background information about the reporter or publication/web site/TV station etc. to search for other common ground. (For example, I might be able to say "I really like that story you did on pool safety" and comment that the AAP has new information out about summer safety in the Press Room part of the web site or mention a foundation I've heard of that teaches swimming and drowning prevention to low-income African American kids.) I also figure out what kind of stories they do and then pitch them an idea or two for future topics. This can help keep you relevant as a source."

If you have opinions on this question, let me know and I'll add your answers to the mix! You can email me at cocmeditor@pediatricsnow.com

AAP Summer Safety Tip Time - and Tips to Get the Tips to Your Families!

2008-06-30T08:55:00.000-04:00

With summer in full swing and the 4th of July around the corner, we have a lot of advice to give out to our families in the short amount of time our office visits allow. The AAP has some great tips on all the important summer issues, including fireworks, that will help make your job a great deal easier -and more efficient:

1. Fireworks Safety

According to the National Fire Protection Association,

"In 2006, U.S. hospital emergency rooms treated an estimated 9,200 people for fireworks related injuries. 49% of the injuries were to the extremities and 46% were to the head. 55% of the 2006 fireworks injuries were burns, while 30% were contusions and lacerations.
The risk of fireworks injury was two-and-a-half times as high for children ages 10-14 as for the general population."

2. Summer Safety Tips Part I
Sun, Heat Stress, Pool Safety, Bugs, Playgrounds, Bikes and Lawnmowers

3. Summer Safety Tips Part II
Fireworks, Boating and ATVs

So, now that you have the links and highlights, there are some easy ways you can help your families remember the information:

1. Give out a cheat sheet in your office with these links.
2. Include these links in your email newsletter or have the local hospital do it for you. Likely your families receive some sort of seasonal bulletin from your community hospital and most are happy to include information you provide.
3. Post these links on your own blog or website.
4. Write a small article for a local newspaper or blog on summer safety and include these links. Not sure where to start, how about whatever paper you read in your own community!

If you have other ideas for how to share these great AAP tips with families, let me know and I'll share the ideas in a follow-up post: cocmeditor@pediatricsnow.com

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AAP Questions DC Handgun Ban Court Decision

2008-06-26T12:36:00.003-04:00

Released June 26, 2008 by the American Academy of Pediatrics and Society for Adolescent Medicine:

AMERICAN ACADEMY OF PEDIATRICS AND SOCIETY FOR ADOLESCENT MEDICINE STATEMENT ON U.S. SUPREME COURT DECISION ON THE D.C. HANDGUN BAN

WASHINGTON, D.C.—The American Academy of Pediatrics and the Society for Adolescent Medicine criticized today’s Supreme Court decision to overturn the District of Columbia’s handgun ban, saying it undermines efforts to protect children and adolescents from preventable injuries and death.

“As pediatricians, too often we see the terrible toll gun violence takes on its youngest victims,” said AAP President Renée R. Jenkins, MD, FAAP. “Today’s Supreme Court decision is a tragedy for children, taking away a critical law needed to fight a public health threat that needlessly claims as many as eight young lives a day in America. We can’t afford to lose any of the tools that can help keep guns out of the reach of children.”

Earlier this year, AAP and SAM, along with three other organizations dedicated to protecting the health and safety of children, filed a friend-of-the-court brief in support of the District’s handgun law.

“The Society for Adolescent Medicine believes that firearm violence is one of the most serious threats to the health of adolescents in the United States,” said SAM President Richard E. Kreipe, MD. “For that reason, the Society supports laws to reduce the availability of handguns, the primary source of firearm injuries among adolescents.”

The ban, one of the strictest in the nation, made it illegal to own handguns in the District. It also required shotgun and rifle owners to unload and disassemble them, or use a trigger lock, if the weapons were kept at home. A lower court overturned the ban in March 2007, prompting the Supreme Court challenge.

In the wake of today’s decision, AAP and SAM urged parents across the United States to take steps to protect their children from firearm violence, including locking up weapons stored at home. “The best way to truly protect children from firearm injuries is to get guns out of their homes, their neighborhoods and where they play,” Jenkins said. “If we don’t, too many children will continue to be hurt or die needlessly.”

June 25 Webinar on the "M" Generation

2008-06-24T09:21:00.003-04:00

Just Kid Inc is holding a webinar tomorrow on the "M" Generation, or "Millenials", at 11:30 EST. Here's the link if you are interested.

According to the Webinar info flier, the goals of this 30 minute presentation are to:

"focus on the “hot buttons” of this important generations:
o How the “m generation” thinks, communicates, and BUYS
o How their attitudes differ from prior generations
o How to market and message to this powerful consumer group
o With the opportunity to “ask the experts” via online q-and-a"

BTW, what's a Millenial? They are the target population of Just Kids. According to Just Kids, the M's are:

"o More numerous
o More affluent
o More educated
o More “connected”
…compared to any prior generation."

Basically, the M's are the parents of the kids we care for!

Should be an interesting 30 minutes so I wanted to pass it along.

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How Addicting Are Cell Phones?

2008-06-13T08:31:00.001-04:00

This you have to read! A 12 and 13 year old were both admitted by their parents to a psychiatric hospital in Spain for "cell phone addiction". According to the BBC article,

"They were doing badly at school and lying to relatives in order to get money to spend on their phones. They were not just doing "badly" in school, by the way, they were actually failing.

They have been learning to cope without their phones for three months."

Heavy stuff - the lying to get money and the very long duration of the admission.

Dr Jose Martinez-Raga, an addiction medicine specialist, advised looking for similar symptoms as with video game addiction:

irritability
anti-social, or withdrawn behavior
poor school performance

We don't usually ask about cell phone use in our office visits but we often see the evidence in hand. Perhaps that is our foot in the door. Perhaps all it takes is asking the kid "do you use a cell phone?" and then asking the parent "So, how are things in school and home?" and going from there. Simple questions that may not add much more time to our plate if we do it right.

I don't know what the right answer is or the right approach but I do think this story is an eye opener.

What would you do to dig into this deeper?

COCM on the Blogsphere: Miami Dr. Deb on Miami Herald

2008-06-06T06:56:00.000-04:00

Being involved with blogs and blog writing can have many levels of involvement. For some of us, developing and maintaining a blog is fun. For others, just writing is the goal. The blogsphere offers both opportunities.

Writing for a blog has a number of perks:
1. writing experience
2. media exposure
3. exposure for your group
4. health education for the readers of the blog

Dr. Deborah Mulligan, a COCM member from Florida, recently became involved with a new blog for the Miami Herald called MomsMiami. I asked Dr. Deb about what made her decide to get involved with this blog at this time. She told me by email:

"With a market in Florida and International communities the Miami Herald website affords me the opportunity as a pediatrician to reach thousands of mothers with information that will better the lives of their children and families. Discussing burning pediatric issues will help families make informed decisions to ensure that their kids are healthy and safe."

MomsMiami has really taken off. The blog's creator told Dr. Deb: "We launched about two months ago and are getting about 70,000+ views a month so far. We have over 2,000 registered users and growing every day." Not surprising given the circulation of the Miami Herald is 4.2 million readers a year - that amounts to about 600,000 readers a day during the week and over 800,000 readers on Sundays!

You can read Dr. Deb's first post here.

How can you get involved in blogs in your area? Check out your local newspapers. You can start small with your local neighborhood and community papers or go larger to your regional or state newspapers. If they don't have a blog, suggest one. Often you'll find the editors are contemplating one! BTW, this is how my foray into the blogsphere started.

If you ever have questions about blogging, email me or drop a line to all of us on the COCM list-serve and those of us blogging will be happy to share our experiences and get you going.

Do you have a blog story to share? Are you involved with your local newspaper blog? I'd love to know! Email me at cocmeditor@pediatricsnow.com.

And, if you ever have questions about blogging or are not sure where to begin your hunt to join the ranks of pediatricians like Dr. Deb who are reaching out to families through the blogsphere, drop a line through the list-serve. Those of us doing things you want to do are always happy to help and share!

Japanese Government Takes a Stand on Cell-Phones

2008-06-05T08:45:00.004-04:00

Did you see this headline? Very interesting read. Turns out Japanese children are becoming very addicted to the Internet at very young ages due to their cell phones. These phones have a technology called "3G" or third generation which has very high-speed Internet access. Examples you may be familiar with are Smartphones like the Treo or Blackberry.

The Catch-22 here is that with the long commutes many of these kids face heading to schools, parents rely on cell phones to be able to communicate with their kids and have their kids call them or for help if needed.

A huge amount of Japanese kids have these cell phones. According to CNN, 1/3 of 6th graders and 60% of 9th graders. Two solutions the Japanese Government is exploring to make cell phone use more appropriate for their children include:

1. better filtering programs for the Internet to protect kids for inappropriate access
2. development of cell phones with only talk-only and GPS features

How do you advise your families about cell phones? Do you think we need similar restrictions in the USA? I'd love to know! Email me at cocmeditor@pediatricsnow.com.

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Tips For Helping Parents Manage Media

2008-06-02T12:15:00.010-04:00

Today we welcome Guest Blogger Brandy King, librarian at the Center on Media and Child Health (CMCH) at Children's Hospital Boston.

Though you may have considered the health effects of media use from a clinical or research standpoint, do you ever wonder how real-life parents navigate today's media world with their families? If you are a already parent yourself, you may be curious to see how other parents handle this aspect of life in their own homes.

Each month, the CMCH e-newsletter features one parent's story about media, which have covered topics such as video game addiction, using a DVR to manage media use, and even taking action on what movies are shown on airplanes. For example, this past month, Callie in Michigan wrote:

"When I get home from a long day, all I want to do is put on the TV and be entertained for a little while. It helps me relax and get my mind off the whirlwind of the past few hours. I know that my kids are no different in this respect; when they get home from school, they need a break. Though I always encourage them to pursue non-media activities, I know that this is one part of their day when they just need to relax. However, I have always been cautious of what it is they see and hear during this time, preferring that the programs are somewhat educational.

A few months ago, I decided to subscribe to a Digital Video Recording (DVR) service because I found myself constantly missing shows I enjoyed. I never expected that the DVR would become such a useful tool for my kids' viewing as well!...."

Callie goes on to talk about the many benefits of the DVR she didn't expect with tips that will surprise you. In addition to learning from other parents experiences, our site has other tip guides to pass on to your families. In this case, we have a DVR/VHS guide.

Check out the complete list of Parent Perspectives, and if you're interested, contact us about writing your own!

Lawn Mower Safety Awareness Starts Today

2008-06-02T12:04:00.004-04:00

Did you know that "nearly 210,000 people – approximately 16,200 of them children under age 19 – were treated in doctors’ offices, clinics and emergency rooms for lawn mower-related injuries in 2007"? I learned this today from an AAP press release reminding us about lawn mower safety.

With June being National Safety month, lawn mower safety has been chosen as one of the key safety issues to promote.The American Society for Reconstructive Microsurgery (ASRM), the American Academy of Orthopaedic Surgeons (AAOS), the American Society of Plastic Surgeons (ASPS) and the American Academy of Pediatrics (AAP) have united together to encourage us to educate families on the dangers of lawn mowers by reviewing the following tips:

"Children should be at least 12 years old before they operate any lawn mower, and at least 16 years old for a ride-on mower.
Children should never be passengers on ride-on mowers.
Always wear sturdy shoes while mowing – not sandals.
Young children should be at a safe distance from the area you are mowing.
Before mowing, pick up stones, toys and debris from the lawn to prevent injuries from flying objects.
Always wear eye and hearing protection.
Use a mower with a control that stops it from moving forward if the handle is released.
Never pull backward or mow in reverse unless absolutely necessary – carefully look for others behind you when you do.
Start and refuel mowers outdoors – not in a garage. Refuel with the motor turned off and cool.
Blade settings should be set by an adult only.
Wait for blades to stop completely before removing the grass catcher, unclogging the discharge chute, or crossing gravel roads."

Here's a link to the AAP technical report on lawn more safety.

You can find more information on the lawn mower safety campaign here.

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Can video games be good?

2008-05-31T11:00:00.005-04:00

The Robert Wood Johnson Foundation announced last week that they are funding research to answer an interesting question: can video games be positive for the health and well being of adults and kids?

According to AOL News, some of the research being funded includes:

a Cornell University study on "how a mobile phone game rewarding healthy eating and exercise will influence children's behavior"
a University of Florida study to look at "how playing Playstation 2's "Crazy Taxi" affects perception in the elderly"
a University of South Carolina study "to investigate the potential for using video games such as Wii and EyeToy to help people recover their motor skills after experiencing a stroke"

As Debra Lieberman, a researcher from UC Santa Barbara, said in the article: "A good game, or a game where you could actually learn some skills or develop some self-confidence could displace some of the more time-wasting video games that are out there. That could be a win-win in many ways."

While video games do get a bad rap in the health care world, I'm of the opinion we have to admit there are here to stay and find a way to include them in a healthy life style. If these studies help us advice people to do that better, how can we argue otherwise? What do you think? Email me at cocmeditor@pediatricsnow.com and let me know.

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Tomorrow Is World No Tobacco Day

2008-05-30T12:49:00.003-04:00

Tomorrow's World No Tobacco Day has a media theme: Tobacco-Free Youth: Break the Tobacco Marketing Net.

According to the AAP website,

"The tobacco industry spends billions of dollars worldwide on advertising, promotion, and sponsorship. Recent data from the Global Youth Tobacco Survey indicate an increase in tobacco use among adolescent girls in many countries. Much of this increase has been attributed to aggressive marketing by the tobacco industry, which encourages potential users, especially adolescents, to try tobacco and become long-term consumers.
Evidence-based tobacco-control strategies that are comprehensive, sustained, and support nonsmoking behaviors have been shown to prevent and reduce tobacco use. The World Health Organization Framework Convention on Tobacco Control calls on countries to implement scientifically proven measures to reduce tobacco use and its impact. Additional information on World No Tobacco Day 2008 activities is available at http://www.who.int/tobacco/wntd/2008/en/index.html."

The WHO interactive World No Tobacco Day website is worth exploring. Shaped like a web, it has buttons for each media industry that will take you to a page that then explains how that industry markets tobacco to youth. TV, movies, billboards, cultural events, sporting events, are among the many media venues listed in this web.

The AAP press release on World No Tobacco Day is worth reading, too. You'll find some interesting stats as well as ways the AAP has already worked with media groups to decrease the exposure of youth to tobacco.

Image: WHO Website

Welcome To Our Child Health Media Blog!

2008-05-28T11:20:00.007-04:00

Welcome to the American Academy of Pediatrics Council on Communications and Media blog! This blog is for you - COCM pediatricians who are already interested in media issues impacting the lives of today's children and families.

In this space, we will develop together an amazing array or resources to help each other become better communicators with our patient's and their parents about media issues and better advocates in the community about the importance of media issues on the lives of kids and families.

The list of potential topics is endless but some that jump to mind include:

current media studies
announcements about media-related conferences and meetings
ideas for talks and lectures on media issues
social media tips and nuts and bolts: including how to blog!
media tips to help each other interface with the media better in print, online, radio and TV
our work in action: ways we, COCM pediatricians, have done what we can to use the media to improve the health and well being of children whether it be to talk to a local reporter in our home town or to work nationally on an AAP campaign.

Some rules for the road. I'll be doing all the posting but welcome guest posts often. I can post daily, once a week or once a month. It all depends on what is happening in the media world and what you send me. So, feel free to get as involved as you'd like with this blog. I welcome you all to become my assistant editors in this amazing journey.

Don't forget to check out our regular COCM website once in a while. And, if you have an idea for a blog post, drop me an email at cocmeditor@pediatricsnow.com.

Cheers!

Dr. Gwenn
Editor-In-Chief
AAP COCM Web Site and Blog

Image: AAP COCM website