May 2, 2010

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

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.