TV content affects children's behavior over time

Reviewing the studies by Dr. Christakis and Ms. Robertson, Dr. Claire McCarthy couldn’t help thinking about Albert Einstein’s famous definition of insanity: doing the same thing over and over again and expecting a different result. Physicians have been advocating for years that children not watch TV more than 2 hours per day, yet U.S. children still watch 3-4 hours per day, on average. The message from physicians, however, largely hasn’t changed: "Turn it off."

"In the face of overwhelming evidence that the behavior is not changing, I am pretty sure that qualifies as insane," Dr. McCarthy wrote. "It is time to change our approach."

She lauded Dr. Christakis’s study as an example of how parental guidance could change. Physicians should switch the emphasis in their messages away from screen time and toward the effects of TV content "because it is the outcomes that matter," she said.

You don’t need to imply that watching TV all day is okay. Keep encouraging parents to shut off the TV and get children outside and playing. "But this cannot be all we do," she stressed. Physicians could find ways to help TV and video program creators add prosocial and other helpful content, not unlike efforts to get them to decrease cigarette smoking in movies.

"It is a variation on the ‘if you can’t beat ’em, join ’em’ idea," Dr. McCarthy wrote. "If the screens are going to be on, let’s concentrate on the content, and how we can make it work for children."

Dr. McCarthy is a pediatrician at Boston Children’s Hospital and is with Harvard Medical School, Boston. These comments were excerpted from her editorial published in the same issue as the two studies (Pediatrics 2013;131:589-90). She reported having no relevant financial disclosures.