Most kids plug into the world of television long before they enter school. According to the Kaiser Family Foundation (KFF):

• two-thirds of infants and toddlers watch a screen an average of 2 hours a day
• kids under age 6 watch an average of about 2 hours of screen media a day, primarily TV and videos or DVDs
• kids and teens 8 to 18 years spend nearly 4 hours a day in front of a TV screen and almost 2 additional hours on the computer (outside of schoolwork) and playing video games

The American Academy of Pediatrics (AAP) recommends that kids under 2 years old not watch any TV and that those older than 2 watch no more than 1 to 2 hours a day of quality programming.

The first 2 years of life are considered a critical time for brain development. TV and other electronic media can get in the way of exploring, playing, and interacting with parents and others, which encourages learning and healthy physical and social development.

As kids get older, too much screen time can interfere with activities such as being physically active, reading, doing homework, playing with friends, and spending time with family.

Of course, TV in moderation can be a good thing: Preschoolers can get help learning the alphabet on public television, grade schoolers can learn about wildlife on nature shows, and parents can keep up with current events on the evening news. No doubt about it — TV can be an excellent educator and entertainer.

But despite its advantages, too much television can be detrimental:

• Children who consistently spend more than 4 hours per day watching TV are more likely to be overweight.
• Kids who view violent acts are more likely to show aggressive behavior but also fear that the world is scary and that something bad will happen to them.
• TV characters often depict risky behaviors, such as smoking and drinking, and also reinforce gender-role and racial stereotypes.

Children's advocates are divided when it comes to solutions. Although many urge for more hours per week of educational programming, others assert that zero TV is the best solution. And some say it's better for parents to control the use of TV and to teach kids that it's for occasional entertainment, not for constant escapism.

That's why it's so important for you to monitor the content of TV programming and set viewing limits to ensure that your kids don't spend too much time parked in front of the TV.

Violence

To give you perspective on just how much violence kids see on TV, consider this: The average American child will witness 200,000 violent acts on television by age 18. Kids may become desensitized to violence and more aggressive. TV violence sometimes begs for imitation because violence is often promoted as a fun and effective way to get what you want.

Many violent acts are perpetrated by the "good guys," whom kids have been taught to admire. Even though kids are taught by their parents that it's not right to hit, television says it's OK to bite, hit, or kick if you're the good guy. This can lead to confusion when kids try to understand the difference between right and wrong. And the "bad guys" on TV aren't always held responsible or punished for their actions.

Young kids are particularly frightened by scary and violent images. Simply telling kids that those images aren't real won't console them, because they can't yet distinguish between fantasy and reality. Behavior problems, nightmares, and difficulty sleeping may follow exposure to media violence.

Older kids also can be frightened by violent images, whether they appear on fictional shows, the news, or reality-based shows. Reasoning with kids this age will help them, so it's important to provide reassuring and honest information to help ease fears. However, consider not letting your kids view programs that they may find frightening.

Risky Behaviors

TV is full of programs and commercials that depict risky behaviors (such as drinking alcohol, doing drugs, smoking cigarettes, and having premarital sex) as cool, fun, and exciting. And often, there's no discussion about the consequences of those actions.

For example, studies have shown that teens who watch lots of sexual content on TV are more likely to initiate intercourse or participate in other sexual activities earlier than peers who don't watch sexually explicit shows.

Alcohol ads on TV have actually increased over the last few years and more underage kids are being exposed to them than ever. A recent study by the Center on Alcohol Marketing and Youth (CAMY) found that youth exposure to alcohol ads on TV increased by 30% from 2001 to 2006.

And although they've banned cigarette ads on television, kids and teens can still see plenty of people smoking on programs and movies airing on TV. This kind of "product placement" makes behaviors like smoking and drinking alcohol seem acceptable. In fact, kids who watch 5 or more hours of TV per day are far more likely to begin smoking cigarettes than those who watch less than the recommended 2 hours a day.

Obesity

Health experts have long linked excessive TV-watching to obesity — a significant health problem today. While watching TV, kids are inactive and tend to snack. They're also bombarded with ads that encourage them to eat unhealthy foods like potato chips and empty-calorie soft drinks that often become preferred snack foods.

Studies have shown that decreasing the amount of TV kids watched led to less weight gain and lower body mass index (BMI — a measurement derived from someone's weight and height).

Commercials

According to the AAP, kids in the United States see 40,000 commercials each year. From the junk food and toy advertisements during Saturday morning cartoons to the appealing promos on the backs of cereal boxes, marketing messages inundate kids of all ages. And to them, everything looks ideal — like something they simply have to have. It all sounds so appealing — often, so much better than it really is.

Under the age of 8 years, most kids don't understand that commercials are for selling a product. Children 6 years and under are unable to distinguish program content from commercials, especially if their favorite character is promoting the product. Even older kids may need to be reminded of the purpose of advertising.

Of course, it's nearly impossible to eliminate all exposure to marketing messages. You can certainly turn off the TV or at least limit kids' watching time, but they'll still see and hear advertisements for the latest gizmos and must-haves at every turn.

But what you can do is teach kids to be savvy consumers by talking about the products advertised on TV. Ask thought-provoking questions like, "What do you like about that?," "Do you think it's really as good as it looks in that ad?," and "Do you think that's a healthy choice?"

Explain, when kids ask for products advertised, that commercials and other ads are designed to make people want things they don't necessarily need. And these ads are often meant to make us think that these products will make us happier somehow. Talking to kids about what things are like in reality can help put things into perspective.

To limit kids' exposure to TV commercials, the AAP recommends that you:

• Have your kids watch public television stations (some programs are sponsored — or "brought to you" — by various companies, although the products they sell are rarely shown).
  
  
• Record programs — without the commercials.
  
  
• Buy or rent children's videos or DVDs.

Understanding TV Ratings and the V-Chip

Two ways you can help monitor what your kids watch are:

1. TV Parental Guidelines. Modeled after the movie rating system, this is an age-group rating system developed for TV programs. These ratings are listed in television guides, TV listings in your local newspaper, and on the screen in your cable program guide. They also appear in the upper left-hand corner of the screen during the first 15 seconds of TV programs. But not all channels offer the rating system. For those that do, the ratings are:
   
   • TV-Y: suitable for all children
     
   • TV-Y7: directed toward kids 7 years and older (kids who are able to distinguish between make-believe and reality); may contain "mild fantasy violence or comedic violence" that may scare younger kids
     
   • TV-Y7-FV: fantasy violence may be more intense in these programs than others in the TV-Y7 rating
     
   • TV-G: suitable for a general audience; not directed specifically toward kids, but contains little to no violence, sexual dialogue or content, or strong language
     
   • TV-PG: parental guidance suggested; may contain an inappropriate theme for younger kids and contains one or more of the following: moderate violence (V), some sexual situations (S), occasional strong language (L), and some suggestive dialogue (D)
     
   • TV-14: parents strongly cautioned — suitable for only kids over the age of 14; contains one or more of the following: intense violence (V), intense sexual situations (S), strong language (L), and intensely suggestive dialogue
     
   • TV-MA: designed for adults and may be unsuitable for kids under 17; contains one or more of the following: graphic violence (V), strong sexual activity (S), and/or crude language (L)
     
2. V-chip (V is for "violence"). This technology lets you block TV programs and movies you don't want your kids to see. All new TV sets that have screens of 13" or more now have internal V-chips, and set-top boxes are available for TVs made before 2000. The V-chip allows you to program your TV to display only appropriately rated shows — blocking out other, more mature shows.
   The Federal Communications Commission (FCC) requires that V-chips in new TVs recognize the TV Parental Guidelines and the age-group rating system and block those programs that don't adhere to these standards.

For many, the rating system and V-chip may be valuable tools. But there is some concern that the system may be worse than no system at all. For example, research shows that preteen and teen boys are more likely to want to see a program if it's rated MA (mature audience) than if it's PG (parental guidance suggested). And parents may rely too heavily on these tools and stop monitoring what their kids are watching.

Also, broadcast news, sports, and commercials aren't rated, although they often present depictions of violence and sexuality. The rating system also doesn't satisfy some family advocates who complain that they fail to give enough information about a program's content to allow parents to make informed decisions about whether a show is appropriate for their kids.

So even if you've used the V-chip to program your TV or a show features the age-group ratings, it's still important to preview shows to determine whether they're appropriate for your kids and turn off the TV if they're not.

Teaching Good TV Habits

Here are some practical ways to make TV-viewing more productive in your home:

• Limit the number of TV-watching hours:
  
  • Stock the room in which you have your TV with plenty of other non-screen entertainment (books, kids' magazines, toys, puzzles, board games, etc.) to encourage kids to do something other than watch the tube.
  • Keep TVs and internet connections out of bedrooms.
  • Turn the TV off during meals.
  • Don't allow kids to watch TV while doing homework.
  • Treat TV as a privilege to be earned — not a right. Establish and enforce family TV viewing rules, such as TV is allowed only after chores and homework are completed.
• Try a weekday ban. Schoolwork, sports activities, and job responsibilities make it tough to find extra family time during the week. Record weekday shows or save TV time for weekends and you'll have more family togetherness time to spend on meals, games, physical activity, and reading during the week.
  
• Set a good example by limiting your own TV viewing.
  
• Check the TV listings and program reviews ahead of time for programs your family can watch together (i.e., developmentally appropriate and nonviolent programs that reinforce your family's values). Choose shows that foster interest and learning in hobbies and education (reading, science, etc.).
  
• Preview programs before your kids watch them.
  
• Come up with a family TV schedule that you all agree upon each week. Then, post the schedule in a visible area (e.g., on the refrigerator) so that everyone knows which programs are OK to watch and when. And make sure to turn off the TV when the "scheduled" program is over instead of channel surfing.
  
• Watch TV together. If you can't sit through the whole program, at least watch the first few minutes to assess the tone and appropriateness, then check in throughout the show.
  
• Talk to kids about what they see on TV and share your own beliefs and values. If something you don't approve of appears on the screen, you can turn off the TV, then use the opportunity to ask thought-provoking questions such as, "Do you think it was OK when those men got in that fight? What else could they have done? What would you have done?" Or, "What do you think about how those teenagers were acting at that party? Do you think what they were doing was wrong?" If certain people or characters are mistreated or discriminated against, talk about why it's important to treat everyone fairly, despite their differences. You can use TV to explain confusing situations and express your feelings about difficult topics (sex, love, drugs, alcohol, smoking, work, behavior, family life).
• Talk to other parents, your doctor, and teachers about their TV-watching policies and kid-friendly programs they'd recommend.
  
• Offer fun alternatives to television. If your kids want to watch TV but you want to turn off the tube, suggest that you all play a board game, start a game of hide and seek, play outside, read, work on crafts or hobbies, or listen and dance to music. The possibilities for fun without the tube are endless — so turn off the TV and enjoy the quality time together.

Reviewed by: Steven Dowshen, MD
Date reviewed: October 2011