428 PEDIATRICS Vol. 62 No. 3 September 1978
does not “a better doctor make,” as Dr. Work
points out so well in his commentary in this issue
(p. 425). But perhaps interest kindled and
knowl-edge transferred will make possible the prepared
mind for the learning of insight skills advocated
by Dr. Work.
TV
update
The public debate over television and its
impact on children is heating up. Two highly
visible skirmishes of 1978 are the investigation
into television advertising to children by the
Federal Trade Commission (FTC) and the trial in
California of a bizarre rape claimed to have been
perpetrated
in imitation of a crime whichappeared on a television drama.
The FTC has scheduled nile-making hearings
in the fall of 1978 to consider whether television
advertising to young children is inherently
“un-fair and deceptive” and whether restrictions
should be placed specifically on the advertising to
children of sugared products. Entering into these
deliberations will be research and anecdotal
evidence and authoritative opinions about the
developmental capacity of children to make
discerning judgments regarding advertising; the
relation between sugar intake and dental caries
and obesity; and the potentially disruptive effects
of TV commercials on family life. These issues are
well summarized in the FTC Staff Report on
TelevLiion Advertising to Children, available on
request. Interested health workers can contribute
to these hearings by writing letters expressing
their views to the Commission. Individuals with
expert knowledge can offer to testify as well.
Health workers can also write to their
congres-sional representatives, urging them to resist the
attempts by agriculture and food processing
inter-ests to block the hearings through the withdrawal
of funding.
The suit of Olivia Nienti, minor, rs. the
Nation-al Broadcasting Company, Inc. (NBC), and Chronicle Publishing Company (the local NBC
affiliate) was brought to trial in the Superior
Court of the State of California in August 1978.
Olivia Niemi was raped with a soda bottle by a
group of children on Baker’s Beach in San
Fran-cisco in direct imitation, according to the charges,
of the rape scene in the program Born Innocent,
which had been broadcast at 8 PM three days
before the crime without advice about “parental
discretion.” In addition to adjudication of the
charge of negligence and of the relevance of the
First Amendment rights of broadcasters, the body
of research into the causal relation between TV
violence and viewer behavior was also on trial.
R.J.H. The possible ramifications are broad.
. Such laying out of issues in the public arena is
but the tip of the iceberg. There are now at least
65 organizations (including the American
Medi-cal Association, the Ambulatory Pediatric
Asso-ciation, the American Academy of Pediatrics, and
the American Academy of Child Psychiatry) with
programs for media reform. The groups deal in a
variety
of ways (education, monitoring ofprograms and feedback, lobbying and legal, and
building bridges with industry) with the issues of
violence, health-related effects, stereotyping and
discrimination offensive to various groups (e.g.,
the elderly, blacks, Hispanics, women, the
handi-capped), commercialism in children’s television,
and the promotion of more discriminating use of
television in home and school. For more
informa-tion, see the Citizen ‘s Media Directory of the
National Citizens Committee for Broadcasting.
While there are many levels on which issues
related to television and children can and should
be addressed, pediatric health workers are in a
unique
position to reach the parents of preschoolchildren. There is good evidence that parents are
an important link in children’s viewing behavior.
One national survey found that only about one
third of parents having children 12 years of age
and younger said that they “often” restricted the
total amount of television viewing. In a sample of
mothers of first-graders in a California suburb,
about 60% said that they never imposed
restric-tions on the amount of viewing. On the other
hand, children’s interpretations of TV
commer-cial messages have been found to be highly
susceptible
to correctives provided by parents and other adults.There are now a number of resources for direct
use or referral by the health worker. The
Ambu-latory Pediatric Association has prepared the
brochure TV and Children, which can serve as the
basis for discussion with parents. The Media
Action Research Center, Inc., offers television
awareness training workshops open to the public
which cover topics such as “Television and
Ster-eotyping,” “Television and Human Sexuality,”
and “Television Advertising and Values.”
Con-sumer Reports Films rents or sells The Six Billion
$$$ Sell (A Child s Guide to TV Commercials). TV Guide does a credible job of covering issues in a
balanced way.
The Teachers Guides to Tclerision and Prime
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COMMENTARIES 429
Time School TV (PTS-TV) provide study guides to
current programs for parents, teachers, and
chil-dren. The program becomes the jumping-off
point
for further learning. For example, in thePTS-TV curriculum unit Television, Police, and
the Law, children analyze police stories on TV
from the point of view of the validity of
repre-sentation of the activities of law enforcement
agencies: legality or illegality of the procedures
depicted regarding the acquisition of evidence,
use or nonuse of search warrants, informing a
suspect of the right to remain silent, etc. Such
exploration leads logically to a study of the
structure of the legal system, right up to the
Constitution itself. This approach to education is
based on the existing motivation of children to
watch current crime dramas and has the added
major advantage of cultivating a critical
eye-per-haps the most important objective for those
dissatisfied with the way TV is presently used.
A related use of television is the successful and
much-copied Philadelphia Reading Program (c/o
Philadelphia Board of Education) in which
students are provided with the scripts of TV
programs concurrently with their broadcast. The
students are assigned the dual tasks of reading the
script and watching the program. Reading scores
are reported to show a significant increase. There
is little doubt that TV presentations can also lead
children to read the originals of the stories
presented.
Action for Children’s Television (ACT) has
sponsored A Family Guide to Children ‘s
Televi-.iion by Evelyn Kaye (New York, Pantheon Books,
1977) and has produced the poster Treat TV with T.L.C., which offers sound rules for home use such
as parents watching with their children,
discuss-ing programs, planning what to watch, and
turn-ing the set off when the agreed-to program is
over. Similar guidelines are contained in a
“re-minder tag” designed to be attached to the
television set. ACT has also recently issued the
book Promise and Performance: ACT’S Guide to TV Prograniming for Children With Special Needs
(Cambridge, Mass., Ballinger Publishing Co.,
1977). This book features programming for
mentally retarded and perceptually handicapped children, a long-neglected audience.
The National Parent-Teachers Association is
working on a critical viewing skills curriculum for
use in home and school in addition to its more
visible campaign for a reduction in violence in
programming and for a greater involvement of
parents and citizens in a dialogue with local
broadcasters.
The American Medical Association, having
gone on record as strongly opposed to violence on
TV, has developed a cadre of physicians available
to speak to community groups on the general
topic of television and children, with emphasis on
constructive ways of using the media. The
Amer-ican Broadcasting Company (ABC) commissioned
the booklet Watching Television With Your
Chil-dren, which is available through its affiliates. The
Children’s Television Project of the Kaiser
Permanente
Medical Center in Portland, Oregon,is developing a channel of closed-circuit
televi-sion with carefully selected programs for children
hospitalized at the center. This use of the
televi-sion in a children’s hospital could provide a model
for other institutional settings. More information
about all of these resources is available on request from the groups themselves.
The television industry has made some
response to these expressions of concern: violence
is definitely down, although it remains one of the
leading themes. There has been a noticeable
increase, though still not enough to satisfy the
critics, in the involvement of minority groups,
women, and the handicapped. The networks have
made a number of laudable efforts to recognize
the special needs of children. The After School
Speciali introduced by ABC are a good exam-pie.
With
regard to commercialism, the economiclifeline of the industry, there has been relatively
little change as far as children are concerned.
Although the advertising time on Saturday
morn-ings (when special industry self-imposed limits
apply) has been reduced from 12 to 9#{189}minutes
per hour since 1973, the number of ads has
remained pretty much constant. The average
child viewer still sees about 21,000 ads per year.
There has been a small shift toward increased
truth in advertising, e.g., adding the proviso,
“assembly [is] required” for certain toys.
As this article goes to press, the Federal
Communications Commission (FCC), in response
to a petition by ACT, has announced an Inquiry
Into Children’s Television Programming and
Advertising Practices for the fall of 1978. This
inquiry will address a broad range of issues.
Contributions by professionals are eagerly
sought.
Violence has moved over to let sex in. While
there is little organized information about the
impact of the usual sexual portrayals on viewers,
there is almost nothing positive that I can say
about the TV treatment of this topic. It is little
more than stereotyped drivel. For example, in the
popular Starsky and Hutch, the heroes are a pair
of single macho cops whose primary emotional
allegiance is to each other. They work and play
together and act like a homosexual pair, although
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430 TV UPDATE
their affection is never made explicit-they never
touch each other. Occasionally, they are
portrayed with “girlfriends” or “fiancees” whose
sole function is to be assaulted or abducted by
criminals and ultimately rescued by Starsky and
Hutch. This is at least a cut above Baretta or
Kojak-male loners who lack close friendships
entirely, even though they work with other men
and enjoy impersonal hit-and-run sex with
deco-rative females. These characters seem to be
tell-ing the men in the audience to “hang loose, trust
no one (maybe some men, but never any women),
and don’t get emotionally involved.”
Women on TV are reduced to even more
extreme stereotypes than are men. Sexy young
females are acceptable as audience bait, provided
they are beautiful fashion model-types and act
dumb. The best current examples are Charlie’s
Angels. These three women are investigative
undercover detectives under the remote control
of Charlie, a paternalistic boss who is never seen
hut who directs his “girls’ “ every move. The
“Angels” catch their malefactors through sexual
enticement. In a typical episode, one of the
“Angels” posed as a “bunny” in a private men’s
club, and her sidekick as a singer, in order to trap
a sex murderer. Stripped as bare as prime time
will allow, the “Angels” ply their trade in bikinis
and low-cut gowns. But, true to their name, they
are totally pure. They promise a lot and deliver
nothing. Their message for men is obvious. Their
message for women seems to be “If you were born
with good hones, defer to your male boss, dress
and undress with style, then you will have a
glamorous although sometimes dangerous life,
boast
an enormous wardrobe, and tease as manymen as
you
wish.”With sex as with violence, prime-time TV
seems
to have an uncanny knack for coming downon the wrong side of an issue. For example, at a
time when teen-age pregnancy is almost epidemic
in our society, the loud and clear message should
be “Don’t!” or, at the very least, “Be careful!” Yet
one installment of James at 15 featured James for
the first time “making it” with a Swedish
exchange student at his high school. The author,
Dan Wakefield, resigned in protest over the
refusal of the producers to allow even the
mention of contraception.
A final point about sex on TV is that the Project
on Human Sexual Development is working with
the TV industry in a nonadversary format to begin
to examine some of the issues raised in my brief
critical foray.
What about the state of research? The weight
of evidence still suggests that violence stimulates
aggressive, antisocial behavior, at least in this
country.
That it leads to criminal acts isunprov-en. An interesting cross-cultural observation is
that Japanese TV, which is even more violent
than ours, is associated with one of the lowest
crime rates in any industrialized country. It is also
clear in more limited studies (primarily of Mister
Roger’s Neighborhood) that TV can promote
posi-tive social behavior. With regard to this research
on TV effects, it concerns me that I have yet to
see stated the biases of the social scientists who
have conducted the studies. Having met a number
of them, I am struck with the degree to which
their results seem to confirm and reinforce their
prior points of view.
Turning to educational TV, there is some
evidence, by no means conclusive, that programs
like Sesame Street and Electric Company can
teach cognitive skills, particularly when a parent
or teacher provides reinforcement. The
impor-tance
of parental encouragement in producingthe educational effect probably accounts for the
fact that the gap in performance between
middle-class and disadvantaged children widens
in response to these programs. My admittedly
iconoclastic opinion on these teaching
produc-tions
is
that they are considerably overrated (I stillfail to see the point in learning the alphabet
early), that they are on the air primarily because
they are watched just as are commercial
programs, and that parents rationalize their major
use which is really that of social control (as a
babysitter) in terms of their alleged educational
value.
For the reader interested in a concise review
of TV research, there is the Impact of
Teleri-sion on Children and lout/i
by
Stein and Freid-rich.Closely related to “How to use TV?” is “What
to do when not viewing TV?,” a reasonable
question to ask when the startling amount of time
spent by children in viewing is comprehended.
There appears to be a pressing need to encourage
alternatives to TV use lest this medium choke off
other important human concerns. We are party
today to a widespread cynical retreat into
self-centeredness and loss of concern for public needs.
While the relationship of these trends to
televi-sion is beyond the scope of this discussion, I wish
simply to emphasize that TV is a powerful
competitor for people’s attention, energy which
might be better spent from the point of view of
society’s interests. Families may be losing the
capacity to use their time actively and may need
support in rediscovering and learning the skills of
doing things on their own. Thinking about issues
related to TV from this perspective could open up
many opportunities for action.
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PEDIATRICS Vol. 62 No. 3 September 1978 431
The pediatric health worker who decides to
take action can become acquainted with the
programs which children watch (keeping in mind
in defining a “children’s program” that over a
million children are still viewing at midnight!)
and with the issues, research, and resources
avail-able. He or she will then be able to take an
intelligent television history (a revealing window
on a family’s life) and to offer guidelines on
tele-vision use to interested parents. Those with a more
activist bent will find many outlets in the public
arena for their energies. With the two major
regulatory
agencies
holding hearings this fall, thetime to speak imp has never been more ripe.
RICHARD I. FEINBLOOM, M.D.
Family Practice Group and
the Family Health Care Program,
Harvard Medical School
2464 Massachusetts Atenue Cambridge, MA 02140
Addresses
Presiding Officer
Children’s Advertising Rulemaking Federal Trade Commission Washington, DC 20580
National Citizens Committee for Broadcasting 1028 Connecticut Avenue NW.
Suite 402
Washington, DC 20036
Send $5.00 check or money order for the Citizen ‘s Media Directory.
Ambulatory Pediatrics Association
Office of the Executive Secretary
4525 East San Francisco Street
Tuscon, AZ 85712
Send $1 .00 check or money order for brochure TV and Children.
Send $2.95 check or money order for A Family Guide to Children ‘s Television. Information available on the FTC and FCC hearings.
National PTA TV Action Center
700 North Rush Street Chicago, IL 60611
American Medical Association Committee on Television 535 North Dearborn Street Chicago, IL 60610 ATFN: Suellen Muldoon
Children’s Television Project A’VFN: Herman Frankel, M.D. The Permanente Clinic 5055 North Greeley Avenue
Portland, OR 97217
Susan Greene
Ghildren’s Television Task Force Federal Communications Commission
Room 837
Washington, DG 20554
Project on Human Sexual Development 305 Longfellow Hall
13 Appian Way Cambridge, MA 02138
The Impact of Television on Children and Youth,
by Aletha Stein and Lynette Freidrich. Send $2.50 check or money order to University of Chicago Press
5801 South Ellis Street Chicago, IL 60637 ATTN: Vertell Kanyama
TV Guide
Box 400
Badnor, PA 19088
Media Action Research Center 475 Riverside Drive
Suite 1370
New York, NY 10027
Consumer Reports Films Box XA-35
256 Washington Street Mount Vernon, NY 10550
Prime Time School TV
120 South LaSalle Street Chicago, IL 60602
Teachers Guides to Television 699 Madison Avenue New York, NY 10021
Action for Children’s Television 46 Austin Street
Newtonville, MA 02160
Accident
prevention
and health
education:
Back to the drawing
board?
Some ancient Japanese ivory carvings consist of
an intricate, often two-faced exterior shell within
which a second or even a third, equally complex,
figure is embedded. In like fashion, two of the
most important questions confronting pediatrics
today
are closely related and contain within themseveral other equally profound puzzles. The first
is how to prevent accidents-the leading killer of
children in our time. The other is how to change
health behavior, not only to reduce accidents or
their consequences, but also in hope of promoting
life-styles that will lead to positive health in other
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1978;62;428
Pediatrics
Richard I. Feinbloom
TV update
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1978;62;428
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Richard I. Feinbloom
TV update
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