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Prevalence, correlates, and trajectory of television viewing among infants and toddlers.

OBJECTIVES: Recognizing the negative effects of television on children, the American Academy of Pediatrics (AAP) recommends that children 2 years and older watch <2 hours of television per day and that children younger than 2 years watch no television. However, relatively little is known about the amount of television viewed by infants and toddlers. The objective of this study was to describe the prevalence and correlates of television viewing that exceeds the AAP guidelines for 0- to 35-month-olds and to examine the trajectory of a child's viewing over time. METHODS: Data from the National Longitudinal Survey of Youth, 1990 to 1998, were used to analyze reported television viewing at 0 to 35 months of age and to follow the trajectory of a child's viewing from infancy through age 6. Logistic regression models were used to determine risk factors associated with greater television viewing at 0 to 35 months and the association of early viewing habits with school-age viewing. RESULTS: Seventeen percent of 0- to 11-month-olds, 48% of 12- to 23-month-olds, and 41% of 24- to 35-month-olds were reported to watch more television than the AAP recommends. Compared with college graduates, less-educated women were more likely to report that their children watched more television than recommended. Children who watched >2 hours per day at age 2 were more likely to watch >2 hours per day at age 6 (odds ratio: 2.7; 95% confidence interval: 1.8-3.9), controlling for maternal education, race, marital status and employment, household income, and birth order. CONCLUSIONS: A substantial number of children begin watching television at an earlier age and in greater amounts than the AAP recommends. Furthermore, these early viewing patterns persist into childhood. Preventive intervention research on television viewing should consider targeting infants and toddlers and their families.

Black or African American↗

Unsafe and violent behavior in commercials aired during televised major sporting events.

OBJECTIVE: Injuries are the leading cause of death in children, and media exposure seems to increase children's risk-taking behavior. Televised sports are commonly viewed by children. The objective of this study was to determine the proportion of commercials that depict violence or other unsafe behavior during major televised sporting events that are aired before 9:00 pm. METHODS: We obtained a list of the 50 sports programs that were most highly rated by Nielsen Media Research and that were televised between September 1, 2001, and September 1, 2002. These 50 programs included Winter Olympics events (n = 15), National Football League (NFL) regular season games (n = 14), NFL playoff games (n = 10), Major League Baseball World Series and playoff games (n = 7), the NFL Super Bowl (n = 1), the National Basketball Association Western Conference Final Game (n = 1), the College Football Rose Bowl (n = 1), and the National Collegiate Athletic Association Basketball Championship game (n = 1). Two other events were reviewed as well: the final round of the Masters Golf Championship, because it was the only sporting event rated in the top 50 of the previous year that was not represented by a similar sporting event in the study year, and the Daytona 500 National Association for Stock Car Auto Racing race, because it was the only event rated among the top 75 of the study year that was not represented by a similar event (ie, there were no other golfing or auto racing events reviewed). These events were included because different sporting events may attract different viewers and different advertisements; thus, their inclusion provides a more comprehensive evaluation of the topic. For sporting events with >3 programs in the top 50 (NFL regular season games, NFL playoff games, Winter Olympic events, and Major League Baseball World Series), representative samples of events were assessed. Surrogate events were analyzed for programs that were aired after 9:00 PM (Eastern Time) to control for the reduced likelihood of viewing by children after 9:00 PM. For example, afternoon telecasts of the National Collegiate Athletic Association Regional Final and National Semifinal games were assessed in place of the Championship game, which started after 9:00 PM. Weekend afternoon telecasts of the Winter Olympics (3 successive weekends) were assessed as surrogates for all Olympics telecasts. For the World Series, the Super Bowl, and the National Basketball Association Conference Championship games, which began before 9:00 PM but ended after that time, we evaluated only commercials that aired before 9:00 PM. All commercials that were aired during these programs were reviewed at standard speed for unsafe behavior or violence. Commercials that were aired during pregame, postgame, or halftime periods were not assessed. Commercials were categorized according to the product being advertised. Unsafe behavior was simply defined as any action that could have harmful consequences or that contravened the injury prevention recommendations of national organizations. Violence was defined as any intentional physical contact by an aggressor that had the potential to inflict injury or harm or the legitimate threat of such action. All commercials were reviewed by at least 2 investigators; when the 2 could not agree on the findings, a third investigator was used to resolve differences. The percentage of commercials and of commercial breaks that portrayed violent or unsafe behavior was determined for each category of event and advertised product. A commercial break was defined as a series of commercials shown during a single break from the sporting event. chi2 analysis was used for all analyses, and relative risks with 95% confidence intervals were determined. The proportion of commercials that depicted unsafe behavior and/or violence during each sporting event was compared with the proportion of such commercials that were observed during the Masters Golf Tournament (which had the lowest proportion of commercials depicting such behavior). The proportion of commercials that contained violent/unsafe behavior for each advertised product was compared with the proportion of such commercials that advertised food or nonalcoholic beverages. Food and nonalcoholic beverage commercials were selected as the reference because they are a well-defined, common category of commercial. RESULTS: Of the 1185 commercials assessed, 14% (n = 165) displayed unsafe behavior and 6% (n = 66) depicted violence. Of the 322 commercial breaks, 158 (49%) contained at least 1 commercial showing unsafe behavior or violence. Sixty-three commercials required review by a third investigator to adjudicate violence or unsafe behavior; 20 of 52 were ultimately judged to portray unsafe behavior, and 4 of 11 were ultimately judged to portray violence. Sporting events differed in the proportion of commercials that showed violence or unsafe behavior. The Super Bowl had the highest proportion of such commercials, and the Masters Golf Tournament had the least (relative risk: 4.3; 95% confidence interval: 1.4-12.5). The Masters Golf Tournament was noteworthy for the complete absence of violent commercials. Only 18% of reviewed commercials advertised movies or television programs, yet these commercials accounted for 86% of all violent commercials. Forty-eight percent of commercials that contained violence were for movies, and an additional 38% were for television programs. Nearly two thirds of all commercials for movies contained violence, whereas 15% of all commercials for television programs contained violence, a rate that increased to 22% when commercials for other sporting events were excluded. Several categories of commercials portrayed unsafe behaviors; commercials for automobiles accounted for the most. In 8 different categories, 10% or more of the commercials depicted unsafe behavior, and 7 were significantly more likely to depict such behavior than a food or beverage commercial. CONCLUSIONS: Children who watch televised sports view a significant amount of violent and unsafe behavior. In accordance with American Academy of Pediatrics recommendations for television viewing, parents should both limit and directly supervise children's viewing of these events. Our findings suggest that parents should remain present during commercials or should consider implementing commercial-skipping technology. In addition, efforts should be made to regulate the content of commercials that promote television programs and movies on the basis of the hour at which the sporting event is aired. Moreover, the sports, movie, and television industries should be encouraged to adopt models of advertising that limit or eliminate such content. These efforts could help to ensure that the viewing of televised sporting events is a safe and positive experience for children.

Advertising↗

Television viewing and its effect on physical health of schoolage children.

Obesity is an increasing health problem all over the world. In addition to genetic and many environmental factors, television is also thought to be a risk factor. This study examined the effects of television viewing on obesity and other physical complaints among Turkish children. From two different socioeconomic class primary schools, 886 second- and third-grade children were visited at their schools, and their weight, height and triceps skin fold thickness (TST) were measured and body mass index (BMI) calculated. Television viewing behavior of the children, parental weight and height, and physical complaints of children were investigated by a questionnaire sent to parents. A subgroup of children was also called to the hospital, and their blood lipid profile and visual acuity were measured. According to the questionnaires, children were found to watch television 2.1 +/- 1.2 hours/day (hr/d) during the weekdays, 3.4 +/- 2.1 hr/d at the weekend and 2.5 +/- 1.3 hr/d generally. Children were also grouped according to the amount of time they watch television. Group 1 (n = 298) children watched television less than 2 hr/d, Group 2 (n = 323) watched 2-4 hr/d, and Group 3 (n = 68) more than 4 hr/d. The prevalence of obesity was 10.9% according to BMI, 11.8% according to TST and 6.4% according to both criteria. Obese girls were found to watch television longer than their peers (2.9 +/- 1.2 hr/d vs 2.3 +/- 1.3 hr/d, respectively, p = 0.034), but no other relation was found between television viewing and obesity. Headache, back pain, eye symptoms and sleep problems were found to be more often among children who watched television longer (p < 0.05). It was concluded that television viewing is related to many physical complaints, which may have lifelong consequences (obesity). Thus, pediatricians should give appropriate guidance to families about television habits and health consequences.

Child↗

Television and the 3- to 10-year-old child.

A questionnaire on the use of television was administered to the parents of 387 children aged between 3 and 10 years. All families owned at least one television set and 57.6% of families owned two or more sets, with one in the child's bedroom in 10.6% of cases. Television was turned on all day in 16% of cases, mostly in families with low level of parental education (P less than .01). Television was on at mealtime in 54.5% of cases; 45.2% of children were watching television for between 7 to 16 hours per week, and the heavy viewers belonged to families with low levels of maternal education (P less than .05). About one third of children watched television without any interdiction set by their parents. According to age, from 28% to 40% of children watched violence on television. Parents believed that television facilitates learning (65.3%) but were concerned about violence (22.7%) and commercials (7.4%). Finally, 63.3% of parents reported that they would like to obtain more information about television use. According to this survey, many children are watching television without any limits being set by their parents and are witnessing violent scenes at an impressionable and vulnerable age. The pediatrician should include at routine office visits parental guidance on the mediation of television effects through coviewing, content discussion with children, and program selection.

Analysis of Variance↗

Violence in television commercials during nonviolent programming. The 1996 Major League Baseball playoffs.

OBJECTIVE: To identify the frequency of violent television commercials aired during major league baseball playoffs, traditionally thought to be a family-oriented viewing time. DESIGN AND SETTING: All 6 World Series games televised on the Fox Television Network (Fox), all 5 American League Championship Series playoff games televised by the National Broadcasting Company (NBC), and 4 first-round playoff games televised by ESPN Sports Television Network (ESPN) were videotaped in October 1996. RESULTS: During the 15 televised games reviewed, 104 (6.8%) of the 1528 commercials contained violent content. Sixty-one commercials (10 per game) that included violent interactions were noted during the World Series, 30 (6 per game) during the American League Championship Series, and 13 (3 per game) during the 4 first-round playoff games for a total of 104. In these 104 violent commercials, 69 contained at least 1 violent act, 90 contained at least 1 violent threat, and 27 contained evidence of at least 1 violent consequence. Seventy (67.3%) of the violent commercials were promotions for television programs, 7 (6.7%) were cable television program advertisements, and 20 (19.2%) were big-screen movie promotions. Twenty (71.4%) of 28 big-screen movie promotions were violent. Twenty-two (21.2%) of the 104 violent commercials and 7 "nonviolent" commercials contained blood or other graphic content, all of which were televised during the Fox presentation of the World Series. Fox also accounted for all 24 violent commercials that used a knife. Guns were involved in 25 violent commercials on NBC (5.0 per game), in 20 on Fox (3.33 per game), and in 7 on ESPN (1.75 per game). CONCLUSION: Overt violent content in commercials during the 1996 major league playoffs was common and consisted mainly of promotions for television programs and big-screen movies. It is counterintuitive to find such commercials in nonviolent programming and makes it difficult for parents to avoid exposing their children to this form of violence.

Advertising↗

Behavioral correlates of television viewing in primary school children evaluated by the child behavior checklist.

BACKGROUND: Television is a source from which children gain information about life and experience different types of behavior. The Child Behavior Checklist (CBCL) has not been used thoroughly to evaluate the behavioral effects of television viewing on children. OBJECTIVE: To examine the competency and problem behavior correlates of television viewing in school-aged children using the CBCL. DESIGN: Cross-sectional survey. SETTING: Two randomly selected grade schools, one from a high-income district and the other from a low-income district. PARTICIPANTS: Students in grades 2 and 3 and their parents. MAIN OUTCOME MEASURES: A questionnaire on children's time spent watching television and engaging in other daily activities and the CBCL were sent to the parents of 888 second- and third-grade students. RESULTS: Results of the questionnaire reported that the overall mean +/- SD daily television viewing time was 2.5 +/- 1.3 hours. Overall television viewing time had a negative correlation with social and school achievement (r = -0.17, P<.001 and r = 0.11, P =.03, respectively) subscale scores. Withdrawn (r = 0.11, P =.004), social problem (r = 0.14, P =.001), thought problem (r = 0.11, P =.03), attention problem (r = 0.20, P<.001), delinquent behavior (r = 0.12, P<.001), aggressive behavior (r = 0.22, P<.001), and externalization (r = 0.19, P<.001) subscales and total problem (r = 0.15, P<.001) scores were positively correlated with time spent watching television. Stepwise logistic regression analysis revealed that the only significant variables associated with a risk of watching television for more than 2 hours were age, gender, social subscale, and attention problem subscale scores of the CBCL. CONCLUSION: As evaluated by the CBCL, television viewing time is positively associated with social problems, delinquent behavior, aggressive behavior, externalization, and total problem scores. Older age, male gender, and decreasing social subscale and increasing attention problem subscale scores on the CBCL increases the risk of watching television for more than 2 hours.

Analysis of Variance↗

When children eat what they watch: impact of television viewing on dietary intake in youth.

OBJECTIVES: To test whether increased television viewing is associated with increased total energy intake and with increased consumption of foods commonly advertised on television, and to test whether increased consumption of these foods mediates the relationship between television viewing and total energy intake. DESIGN: Prospective observational study with baseline (fall 1995) and follow-up (spring 1997) measures of youth diet, physical activity, and television viewing. We used food advertising data to identify 6 food groups for study (sweet baked snacks, candy, fried potatoes, main courses commonly served as fast food, salty snacks, and sugar-sweetened beverages). SETTING AND PARTICIPANTS: Five public schools in 4 communities near Boston. The sample included 548 students (mean age at baseline, 11.70 years; 48.4% female; and 63.5% white). MAIN OUTCOME MEASURES: Change in total energy intake and intake of foods commonly advertised on television from baseline to follow-up. RESULTS: After adjusting for baseline covariates, each hour increase in television viewing was associated with an additional 167 kcal/d (95% confidence interval, 136-198 kcal/d; P<.001) and with increases in the consumption of foods commonly advertised on television. Including changes in intakes of these foods in regression models provided evidence of their mediating role, diminishing or rendering nonsignificant the associations between change in television viewing and change in total energy intake. CONCLUSIONS: Increases in television viewing are associated with increased calorie intake among youth. This association is mediated by increasing consumption of calorie-dense low-nutrient foods frequently advertised on television.

Advertising↗

Primary care interventions to reduce television viewing in African-American children.

BACKGROUND: Data are lacking on primary care interventions to reduce children's television viewing. Low-income African-American children watch greater amounts of television than their peers. DESIGN/METHODS: A randomized controlled pilot and feasibility trial was conducted. Twenty-eight families with 7- to 12-year-old African-American children receiving primary care at an urban community clinic serving a low-income population were randomized to receive counseling alone or counseling plus a behavioral intervention that included an electronic television time manager. The main outcome was hours of children's television, videotape, and video game use. Parents/guardians and children completed baseline and 4-week follow-up self-report surveys. Additional outcomes included overall household television use, time spent in organized physical activity and playing outside, and meals eaten by the child while watching television. RESULTS: Both intervention groups reported similar decreases in children's television, videotape, and video game use (mean changes of -13.7, SD=26.1 and -14.1, SD=16.8 hours per week). The behavioral intervention group reported significantly greater increases in organized physical activity (changes of +2.5, SD=5.9 and -3.6, SD=4.7 hours per week; p =0.004) and nearly significant greater increases in playing outside (changes of 1.0, SD=5.9 and -4.7, SD=9.4 hours per week; p <0.06). Changes in overall household television use and meals eaten while watching television also appeared to favor the behavioral intervention, with small to medium effect sizes, but differences were not statistically significant. CONCLUSIONS: This small pilot and feasibility study evaluated two promising primary care-based interventions to reduce television, videotape, and video game use among low-income African-American children. The effects on physical activity suggest that the behavioral intervention may be more effective.

Black or African American↗

Role of television in childhood obesity prevention.

OBJECTIVE: To assess the role of television as tool for childhood obesity prevention. METHOD: Review of the available literature about the relationship between television and childhood obesity, eating habits and body shape perception. RESULTS: The reviewed studies showed the following: television watching replaces more vigorous activities; there is a positive correlation between time spent watching television and being overweight or obese on populations of different age; obesity prevalence has increased as well as the number of hours that TV networks dedicate to children; during the last 30 y, the rate of children watching television for more than 4 h per day seems to have increased; children are exposed to a large number of important unhealthy stimulations in terms of food intake when watching television; over the last few years, the number of television food commercials targeting children have increased especially when it comes to junk food in all of its forms; the present use of food in movies, shows and cartoons may lead to a misconception of the notion of healthy nutrition and stimulate an excessive intake of poor nutritional food; and obese subjects shown in television programmes are in a much lower percentage than in real life and are depicted as being unattractive, unsuccessful and ridiculous or with other negative traits and this is likely to result in a worsening of the isolation in which obese subjects are often forced. The different European countries have different TV legislations. CONCLUSION: The usual depiction of food and obesity in television has many documented negative consequences on food habits and patterns. The different national regulations on programs and advertising directed to children could have a role in the different prevalence of childhood obesity in different European countries. Television could be a convenient tool to spread correct information on good nutrition and obesity prevention.

Advertising↗

The effect of television frame rate on EEG abnormalities in photosensitive and pattern-sensitive epilepsy.

PURPOSE: Seizures provoked by television viewing may be triggered by patterns in the television image or by flicker from the display itself. We examined the incidence of EEG abnormalities elicited by patterns displayed on television sets with two different frame rates to evaluate the likely contribution of photosensitive and pattern-sensitive mechanisms to television- and video-game epilepsy. METHODS: Televisions with frame rates of 50 and 100 Hz were used to present 35 patients who were photosensitive or pattern-sensitive with grating patterns. These patterns comprised vertical square-wave and sine-wave gratings of 90% contrast, and the spatial frequency was varied between 0.25-7 cycles/degree. EEGs were analysed for laboratory sensitivity to patterned and unpatterned intermittent photic stimulation (IPS). RESULTS: Significantly fewer EEG abnormalities were elicited by patterns displayed on the 100 Hz frame-rate television than on the 50-Hz frame-rate television. No abnormalities were observed in response to the blank screens of either television. Thirty-three patients showed abnormalities in response to patterned IPS but only 15 in response to diffuse flash. Two patients showed no laboratory evidence of photosensitivity. Patients who were sensitive to patterned IPS at 50 Hz were significantly more likely to demonstrate abnormalities to patterns displayed on the 100-Hz frame-rate television than were patients who were not sensitive to 50-Hz patterned IPS. CONCLUSIONS: We suggest that for many patients, the combination of high-contrast patterns and screen flicker may elicit the observed EEG abnormalities. For patients with sensitivity to screen flicker, the use of a high frame-rate television may be beneficial in reducing the risk of seizures.

Adolescent↗

Household television access: associations with screen time, reading, and homework among youth.

OBJECTIVE: We examined how household factors that mediate television access are associated with screen time (television, videos, movies, and computer and video games), reading, and homework. METHODS: We conducted a self-report survey among 1197 sixth and seventh graders in 10 middle schools in 4 Boston-area communities in 1995. To assess independent associations, SUDAAN linear regressions were calculated to control for respondent characteristics and household access and to account for clustered sampling in the school-based design. RESULTS: Total viewing (television, videos, movies, and computer and video games) averaged 3.35 plus minus 2.2 hours per day. In multivariate regressions, independent direct associations with total viewing were observed for the following categories: youth has a television in the bedroom: 0.64 hours per day (P <.001), never/seldom has family dinners: 0.55 hours (P <.01); no parental limits on television time: 0.48 hours (P <.01); and each additional television outside the youth's bedroom, 0.12 hours (P <.05). Similar results held when television/video/movie use was examined separately from computer/video game use. Youth reported an average of 1.6 plus minus 1.1 hours of reading and homework per day. Parental limits on television time were associated with 0.21 hours more reading per day (P <.01), whereas a television in the bedroom was associated with 0.18 hours less (P <.01). CONCLUSIONS: Reducing intrahousehold television access may enhance clinical, school, and community strategies to reduce youth television viewing and other screen time.

Adolescent↗

Early childhood television viewing and adolescent behavior: the recontact study.

In this Monograph, we report the follow-up of 570 adolescents who had been studied as preschoolers in one of two separate investigations of television use. The primary goal of the study was to determine the long-term relations between preschool television viewing and adolescent achievement, behavior, and attitudes. Using a telephone interview and high school transcripts, we assessed adolescent media use; grades in English, science, and math; leisure reading; creativity; aggression; participation in extracurricular activities; use of alcohol and cigarettes; and self-image. In each domain, we tested theories emphasizing the causal role of television content (e.g., social learning, information processing) as contrasted with those theories positing effects of television as a medium, irrespective of content (e.g., time displacement, pacing, interference with language). The results provided much stronger support for content-based hypotheses than for theories emphasizing television as a medium; moreover, the patterns differed for boys and girls. Viewing educational programs as preschoolers was associated with higher grades, reading more books, placing more value on achievement, greater creativity, and less aggression. These associations were more consistent for boys than for girls. By contrast, the girls who were more frequent preschool viewers of violent programs had lower grades than those who were infrequent viewers. These associations held true after taking into account family background, other categories of preschool viewing, and adolescent media use. One hypothesis accounting for the sex differences is that early experiences, such as television viewing, have greater effects when they counteract normative developmental trends and predominant sex-typed socialization influences than when they reinforce them. Adolescents in the study used both television and print media to support ongoing interests. Television content (e.g., entertainment, sports, or world events) predicted extracurricular activities, role models, and body image. The only evidence for possible effects of television as a medium was the positive relation of total viewing to obesity for girls. The medium of television is not homogeneous or monolithic, and content viewed is more important than raw amount. The medium is not the message: The message is.

Adolescent↗

Television viewing and childhood obesity.

Children spend a substantial portion of their lives watching television. Investigators have hypothesized that television viewing causes obesity by one or more of three mechanisms: (1) displacement of physical activity, (2) increased calorie consumption while watching or caused by the effects of advertising, and (3) reduced resting metabolism. The relationship between television viewing and obesity has been examined in a relatively large number of cross-sectional epidemiologic studies but few longitudinal studies. Many of these studies have found relatively weak, positive associations, but others have found no associations or mixed results; however, the weak and variable associations found in these studies may be the result of limitations in measurement. Several experimental studies of reducing television viewing recently have been completed. Most of these studies have not tested directly the effects of reducing television viewing behaviors alone, but their results support the suggestion that reducing television viewing may help to reduce the risk for obesity or help promote weight loss in obese children. Finally, one school-based, experimental study was designed specifically to test directly the causal relationship between television viewing behaviors and body fatness. The results of this randomized, controlled trial provide evidence that television viewing is a cause of increased body fatness and that reducing television viewing is a promising strategy for preventing childhood obesity.

Adolescent↗

Saturday-morning television: do sponsors promote high-risk behavior for burn injury?

Television has become an important tool for learning and socialization in children. Although television violence has been associated with adverse effects, data on depiction of fire and burn injury are lacking. We sought to determine whether Saturday-morning television programming, viewed primarily by children, depicts fire and burn injury as safe or without consequence, thus potentially increasing the incidence of burn injury in children. This was a prospective observational study. Saturday-morning children's television programs were videotaped from 7 AM to 11 AM for eight different television networks during a 6-month period. Tapes were scored for scenes depicting fire or smoke by independent observers. Recorded items included show category, scene type, gender target, context of fire, and outcome after exposure to flame. Fire events were documented during programs and their associated commercials. A total of 108 hours of children's programs, 16 hours per network, were recorded. Scenes depicting fire or smoke were identified 1960 times, with 39% of events occurring during the program itself and 61% in commercials. Fire was depicted as either safe or without consequence in 64% of incidents. Action adventure stories accounted for 56% of flame depictions. Overall, one incident involving flame and fire was portrayed for each 3 minutes of television programming. Saturday-morning television programming frequently depicts fire as safe, empowering, or exciting. The incidence of flame use in programming varies between stations but is most prevalent in action/adventure stories. Television commercials, although brief, provide the majority of the misinformation regarding fire. Medical professional societies should alert the public to this potential hazard and recommend responsible portrayal of fire in children's television programming.

Burns↗

Time well spent? Relating television use to children's free-time activities.

OBJECTIVES: This study assessed the claim that children's television use interferes with time spent in more developmentally appropriate activities. METHODS: Data came from the first wave of the Child Development Supplement, a nationally representative sample of children aged 0 to 12 in 1997 (N = 1712). Twenty-four-hour time-use diaries from 1 randomly chosen weekday and 1 randomly chosen weekend day were used to assess children's time spent watching television, time spent with parents, time spent with siblings, time spent reading (or being read to), time spent doing homework, time spent in creative play, and time spent in active play. Ordinary least squares multiple regression was used to assess the relationship between children's television use and time spent pursuing other activities. RESULTS: Results indicated that time spent watching television both with and without parents or siblings was negatively related to time spent with parents or siblings, respectively, in other activities. Television viewing also was negatively related to time spent doing homework for 7- to 12-year-olds and negatively related to creative play, especially among very young children (younger than 5 years). There was no relationship between time spent watching television and time spent reading (or being read to) or to time spent in active play. CONCLUSIONS: The results of this study are among the first to provide empirical support for the assumptions made by the American Academy of Pediatrics in their screen time recommendations. Time spent viewing television both with and without parents and siblings present was strongly negatively related to time spent interacting with parents or siblings. Television viewing was associated with decreased homework time and decreased time in creative play. Conversely, there was no support for the widespread belief that television interferes with time spent reading or in active play.

Child↗

[Endoscopy by color television--a new technique? (author's transl)].

The routine endoscopic examination by color television is possible be new technical developments. For routine color television - endoscopy an efficient three-tube-camera should be used, directly attached to the endoscope. For demonstration purposes or to control technical proceedings in the field of operative endoscopy the one-tube-color television camera can be sufficient, even if there are difficulties also for the experienced examiner to read findings from the television screen. This difficulty do not exist with the three-tube-camera. The resolution power of the endoscope in comparison to the television picture of the endoscopic color television picture is not different. The resolution power is limited by the endoscopes. An enlargement of the endoscopic picture by changing the focus of the objective gives no improvement. We have excellent experiences with the routine color television-endoscopy during colonoscopy. With a three-tube-camera the total examination can be controlled while the one-tube-camera is only valid to insert the coloscope. The color television endoscopy enables to produce a large archive of endoscopic findings for teaching purposes without secondary cost and with a description during the active examination. Our experiences with routine endoscopy with color television proves that this technique is an improvement.

Colonoscopes↗

Association between television viewing and sleep problems during adolescence and early adulthood.

BACKGROUND: Although research has suggested that extensive television viewing may be associated with sleep problems, the direction of this association has not yet been determined. OBJECTIVE: To investigate directional hypotheses regarding the association between television viewing and sleep problems during adolescence and early adulthood. DESIGN: The Children in the Community Study, a prospective longitudinal investigation. PARTICIPANTS AND SETTING: A community-based sample of 759 mothers from upstate New York and their offspring were interviewed during the early adolescence (mean age, 14 years), middle adolescence (mean age, 16 years), and early adulthood of the offspring (mean age, 22 years). MAIN OUTCOME MEASURES: Television viewing and sleep problems during adolescence and early adulthood measured using the Disorganizing Poverty Interview and the age-appropriate versions of the Diagnostic Interview Schedule for Children. RESULTS: Adolescents who watched 3 or more hours of television per day during adolescence were at a significantly elevated risk for frequent sleep problems by early adulthood. This elevation in risk remained significant after offspring age, sex, previous sleep problems, offspring psychiatric disorders, offspring neglect, parental educational level, parental annual income, and parental psychiatric symptoms were controlled statistically. Adolescents who reduced their television viewing from 1 hour or longer to less than 1 hour per day experienced a significant reduction in risk for subsequent sleep problems. Sleep problems during adolescence were not independently associated with subsequent television viewing when prior television viewing was controlled. CONCLUSION: Extensive television viewing during adolescence may contribute to the development of sleep problems by early adulthood.

Adolescent↗

Children's television-viewing habits and the family environment.

Pediatricians are encouraged to modify the impact of television on children, based on the assumption that parents mediate children's viewing habits through the home environment. Sixty-six parents of children aged 3 to 8 years responded to an interviewer-administered questionnaire. Responses to questions on family environment were compared with reported childhood viewing of educational programming (Public Broadcasting Service) and the child's television-viewing hours. Most homes surveyed had a videocassette recorder, cable television, and more than one television set. Frequent parental discussion of program content with children was reported by 38% of respondents. Availability of television and parent-child discussion of content were not correlated with viewing hours or viewing Public Broadcasting Service. Frequent use of television as a distraction for the child correlated positively with viewing hours. Viewing Public Broadcasting Service correlated negatively with parent-child coviewing and with use of television as a form of entertainment. Children's own television viewing content correlated positively with viewing Public Broadcasting Service. Of all measured factors in the home environment, parental attitudes were most closely associated with children's viewing habits.

Attitude↗