From the category archives:

Ask the Mediatrician

What are the best Facebook privacy settings for my child?

by Michael Rich MD MPH on September 30, 2013

Michael Rich, MD, MPH, is Boston Children’s Hospital’s media expert and director of Boston Children’s Center on Media and Child Health. Send him a media-related parenting question via and follow him on Twitter @CMCH_Boston.

Michael Rich, MD, MPH

Q: I was on Facebook the other day and noticed that my friend’s teens had Facebook profiles. I could see the entire profile of one (pictures, information, posts, etc.), while I only had limited access to the other (basically just her name and one picture). This made me wonder, what are the privacy options on Facebook? And what privacy settings do you suggest teens use? My teen has a Facebook profile, and I want to make sure her information is only visible to her real-life friends and that her privacy is protected.

~ Perplexed about privacy, Los Altos, CA

A: Dear Perplexed,

As a parent in the digital domain, you are on the right track by looking into what online platforms your child is using and the safety issues surrounding those platforms. Just because a child has turned 13 and is legally able to have her own social media site does not mean that she has the knowledge or skills to function on that site in ways that are safe, healthy, and consistent with good citizenship. Full story »

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Should my 5-year-old be watching educational TV?

by Guest Blogger on August 17, 2012

Michael Rich, MD, MPH, is Boston Children’s Hospital’s media expert and director of Boston Children’s Center on Media and Child Health. Take a look at his blog archive or follow him on Twitter @CMCH_Boston

Michael Rich, MD, MPH

Q:So far I’ve only allowed my 5-year-old to watch DVDs that I’ve selected. Should I introduce some quality educational TV programs, or should I stick to my guns and keep her away from TV—and the commercials that come with it—for as long as I can?

-Tepid about TV, USA

A: Dear Tepid,

Your question raises some good points. First, there’s no reason your child has to watch TV. There are many different ways she can learn the same lessons…like books, creative play, and time outside in nature.

If and when you do decide to incorporate TV into her media diet, there are a few things to consider. First, choose the programs carefully. There are high-quality educational TV shows that she could really enjoy (in limited quantities). Which ones work best for her depends on both who she is as an individual and her developmental stage. Refer to child-friendly reviews of children’s TV to help you decide whether the content is developmentally appropriate for her.  Full story »

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Michael Rich, MD, MPH

Michael Rich, MD, MPH, is Children’s Hospital Boston’s media expert and director of Children’s Center on Media and Child Health. Take a look at his blog archive or follow him on Twitter @CMCH_Boston

Q:We have stopped our 17-year-old daughter from using Facebook a number of times due to angry and inappropriate postings. We put unrecognizable passwords in, but she keeps creating or restarting Facebook pages. I believe she has one now, and I can’t find it. She has probably blocked me. Is there any way of totally blocking Facebook from our home? She is unable to control her reactions and what she says. We are at a loss.

-          Facebook Frazzled in Acton, MA

A: Dear Frazzled,

Frankly, it is difficult, if not impossible, to block Facebook from her (remember, in the days of smartphones and free wifi sites, blocking from your home is not enough). However, it sounds as if keeping your daughter off of Facebook—even if you did manage it—wouldn’t solve the problem. Her angry posts probably reflect what she’s feeling in real life, and it sounds like she’s looking for an outlet for those feelings.

It is important to remember where your daughter is developmentally as a teenager. At this stage, it is normal for your daughter to be exercising her independence and expressing how she feels. Social media sites serve these developmental needs well because they can be crafted by each user. The best way to address your daughter’s postings is by opening the doors of communication and engaging her in a conversation about them. Full story »

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Do toddlers and iPads mix?

by Tripp Underwood on May 24, 2012

Children are using iPads earlier and earlier. Is it affecting development? flickr/remcovandermeer

Apple’s iPhone and iPad technology has revolutionized communication. The way millions of Americans interact with media, personal contacts and the Internet is now largely funneled through an Apple shaped logo. But are these machines so influential they could shape the mental and emotional development of young users?

Because these devices are so new, there’s not enough hard scientific data to know for sure. But the fact that more than half of the young children in the United States now have access to an iPad, iPhone or similar touch-screen device means the time to ask these questions is now.

So that’s exactly what Wall Street Journal reporter Ben Worthen did. Worthen spoke with many childhood development experts, including Michael Rich, MD, MPH, director of Boston Children’s Center on Media and Child Health, to find out how touch-screen technology is affecting the development of millions of young users. Here’s a brief video describing what he learned.

Until more data is collected, the scientific community remains split on how touch-screen technology affects kids. But there is one thing that they all agree on: parents know their children best and should be the final decision-maker on if and when this type of technology is appropriate in their house.

Does your child use an iPad, iPhone or tablet? If so, are you pleased or worried about her reaction to its interactive nature? Let us know in the comment section or our Facebook wall.

Read the entire Wall Street Journal on toddlers and iPads. Dr. Rich participated a live chat on the topic with parents on The Wall Street Journal’s website. Follow the conversation here: Should Your Toddler Use a Tablet?

You may also enjoy these stories on how touch-screen technology has shaped the lives of some of our patients and their families:

Are kids benefiting from all these electronics?

The new digital reality: why parents and pediatricians may need to rethink their messaging

Can the new iPad take therapy apps to the next level?

Mobile Mamas: Parenting in the smartphone age

Touchscreen technology helps kids with cerebral palsy

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Michael Rich, MD, MPH

Michael Rich, MD, MPH, is Children’s Hospital Boston’s media expert and director of Children’s Center on Media and Child Health. Take a look at his blog archive or follow him on Twitter @CMCH_Boston

Q: My son is 15 and displays symptoms of video game addiction, including lying and sneaking to try to gain access. He has Asperger’s and ADHD, and regardless of what medication regimen we try, the gaming obsession remains. I recently asked the psychiatrist to hospitalize him and treat him as they would other addicts, but they just changed his meds. Anyway, even if he were treated, he needs the computer for school. Do you have any advice for me?
-Dealing with Addiction, Orlando, FL

A: Dear Dealing with Addiction,

Unfortunately, more and more families share your story. Whether through sleep deprivation, anxiety, or social isolation, teens struggling with problematic video game or internet use are suffering, and their families are disrupted. And research shows that young people with ADHD may actually be more susceptible to problematic video game or internet use. Full story »


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

by Boston Children's Hospital staff on April 5, 2012

By Kristelle Lavallee, staff member at Boston Children’s Hospital’s Center on Media and Child Health

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

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

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

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Scene from The Hunger Games movie

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

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

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


Will sitting close to the TV hurt my kids’ eyes?

by Boston Children's Hospital staff on January 26, 2012

Michael Rich, MD, MPH

Michael Rich, MD, MPH, is Children’s Hospital Boston’s media expert and director of Children’s Center on Media and Child Health. Take a look at his blog archive or follow him on Twitter @CMCH_Boston

Q: I have an son who’s 11 and a daughter who’s 9½, and for many years, they have sat close to the TV when watching. I have asked them to sit farther away, and they do move back maybe a foot…but they always go back to viewing the show close up, even if the screen is a 40” color flat screen. Any studies that show why? Any concerns? My wife and I sit 8 to 10 feet from the TV.
-Up Close and Personal, in Rochester Hills, MI

A: Dear Up Close,

Concern about sitting close to TV screens, like concern about reading in low light, is founded more on what our parents told us when we were little than on research. The worries about sitting close dates from the (not so long ago) time when TVs were actually “tubes”—cathode ray tubes, that is—and people were uncertain about how the cathode radiation emitted might affect a viewer’s eyes. Today’s TVs flatscreens only emit the light you see, which removes that concern. And there’s no evidence that sitting close to either kind of screen hurts your eyes.

That said, the fact that your children sit so close to the TV may be a sign that they are near-sighted and that this distance is where they best resolve the pixels of color, light, and darkness into a coherent image. Bring them in for an eye exam to see whether they need glasses.

If their eyes are fine, then they probably sit close because they like having the screen fill their peripheral vision. That shouldn’t cause any problems. Just make sure that they aren’t staring at screens all the time—that can cause eye strain and, of course, will take time away from all of the other activities they need to accomplish in a day to be happy and healthy.

Enjoy your media and use them wisely,
The Mediatrician®