Wednesday, October 14, 2009

Television – not in front of the children?

Television – not in front of the children?

Get out of our living rooms. This country is in danger of becoming a politically controlled nation closer to communist China. That's all very well if you have three hours to wash the dishes, but some of us need to get things done. Gee, these toddlers are up to no good. What are they up to? Wait for it – they're watching television!

The outrage that has greeted reports that the Australian government is to issue cautious guidelines advising parents and carers to prevent children under two from watching television seems remarkably acerbic. Across the world, however, the same debates flare up every time it is tentatively suggested that the electronic screens we began by placing in one room at home and now carry everywhere in our pockets may not be good for the development of children's brains.

Television is no longer merely the drug of the nation, it is the pacifier, babysitter, wallpaper and teacher for our children. Increasingly it intrudes on the very first months of their lives. In Australia, young children spend more time watching television than any other activity. The average four-month-old gazes at the box for 44 minutes every day. In the United States, under twos watch 1.2 hours a day on average. In Britain, older children have been calculated to spend five hours and 18 minutes watching TV, playing computer games or online each day, just over an hour less than the US average.

Behind the fury about strictures suggesting television is bad for our children is guilt. Parents are uneasy about the effects television has on their children and are quick to get defensive about switching it on. "Whether it is the slack-jawed look their children have when they put them in front of the television or the tantrum when they turn it off, most parents have this unease about it but it's a battle they choose not to fight. They have enough battles getting them to eat the right food," says Dr Michael Rich, director of the influential Center on Media and Child Health at Boston Children's Hospital.

We may now be highly tuned to what we feed our children's bodies but we are less careful about what we feed their minds. Academics researching the impact of television on the very young compare debates over its adverse effects with those over smoking a generation a half ago, or seat belts and cycle helmets more recently.

A draft of the Australian government's guidelines says that screen time for young children "may reduce the amount of time they have for active play, social contact with others and chances for language development", and may also "affect the development of a full range of eye movement [and] . . . reduce the length of time they can stay focused". Jo Salmon, associate professor of epidemiology at Deakin University, was one of the researchers who informed the Australian government's draft guidelines. "Children aged six to 30 months who are watching television have less developed vocabulary, display more aggressive behaviour and have poor attention spans," she says. "Parents and childcare centres are not justified in encouraging children, under the age of two, to watch television." While there is no evidence that so-called educational programming is harmful, she would discourage under twos from watching it. "I really would not put my young one under two in front of a television. Generally, the evidence that's out there says it could be detrimental," she says.

We may sense TV is bad for young children but what evidence is there really? There is a booming market in educational computer games and DVDs, such as the Baby Einstein range, and if our modern multitasking lives are saturated in electronic screens, isn't sitting children in front of them at least good training for the modern world?

Rich worked in the film industry before having a "midlife crisis" and retraining as a paediatrician. He is not evangelical about governments enforcing how television is used in homes but barred his own two young children from television and computer games before they were 30 months old. While there is good television that children can consciously learn from at a later age, he says scientific studies show young children are not able to consciously learn from television.

As Rich explains, humans have the most sophisticated brain on the planet because it is relatively unformed when we are born. Our brains triple in volume in the first 24 months. We build our brains ourselves, by responding to the environment around us. The biggest part of this is a process called pruning, says Rich, whereby we learn what is significant – our mother's voice, for instance – and what is not. "TV killing off neurons and the synaptic connections that are made in order to discriminate signals from 'noise'," he says.

Experts in child development have found that three things optimise brain development: face-to-face interaction with parents or carers; learning to interact with or manipulate the physical world; and creative problem-solving play. Electronic screens do not provide any of this. At the most basic level, then, time spent watching TV has a displacement effect and stops children spending time on other, more valuable brain-building activities.

Scientists concede that they do not yet know precisely how TV affects the cognitive development, not just in terms of understanding the inner workings of the brain but because the way we use television and other electronic screens is changing so rapidly that we do not know how it will affect people by the time their brains stop developing in their mid-20s. But the weight of evidence about the deleterious impact of TV on child's ability to learn is alarming – to say nothing of its impact on children's sexual activity.

The Australian government's advice is supported by the recommendation of the American Academy of Pediatrics that under-twos are not exposed to any television time. Dr Dimitri Christakis at Seattle Children's Research Institute found that for every extra hour watching DVDs, 8- to 16-month-olds learned six to eight fewer words than children who spent no time in front of the screen. Marie Evans Schmidt at the Centre for Media and Child Health found that even just having television on in the background while under threes play with their toys disrupted their attention span even when they appeared to pay little attention to it.

While there is a paucity of evidence that television is beneficial to early cognitive development, there are studies that show it is not as influential as the educational status and income of parents. Schmidt found that an apparently negative relationship between TV viewing and cognitive development disappeared when she factored in the mother's educational status and household income – parents' education and finances mattered more. "TV viewing is an outgrowth of other characteristics of the home environment that lead to lower test scores," said Schmidt. Other research suggests these include less mother-and-baby interaction and less reading to children.

Unlike the Australians, the British government does not offer any guidance on how much television toddlers should be allowed to watch. It has introduced an "Early Years Foundation Stage" for 0-5s which implies that television should be part of children's learning. Carers, the guidance states, should help children become familiar with "everyday technology" and use it to support their learning. Only the French government has been brave enough to ban stations from showing programmes targeted at under-threes. Last year it also insisted that overseas cable channels must incorporate a tobacco-style warning: "Watching television can slow the development of children under three, even when it involves channels aimed specifically at them."

Aric Sigman, a UK psychologist and author of The Spoilt Generation, a broadside against permissive parenting, says while governments are happy to offer advice on suncream and portions of fruit and vegetables, they are less willing to provide guidelines about TV. "Of course they don't want to because it is a vote-loser," he says. "It is society's favourite pastime and it makes parents feel guilty. The convenience of us parents is seen as paramount as opposed to the wellbeing of our children. When it comes to our childrens' wellbeing, our guilt as parents has to come second."

Part of the problem, argues Sigman, is we have a nostalgic view of our own experience of television when we were young. "We say, 'I watched Blue Peter and I'm OK'," says Sigman. "But the editing speeds and the colours and the number of hours spent watching TV and the age at which TV watching starts are a whole different thing now. We can't compare now with before."

Rich agrees. Television is so different now that the "it didn't harm me" argument is irrelevant, he says. Instead, frustratingly, he finds the debate around young children watching TV is played out as part of the culture wars in which the educated, ruling classes of academia and, when they dare, politicians, are perceived as self-righteously restricting the freedom of expression of ordinary people. Rich instead hopes the debate could be examined more neutrally – and scientifically – as an issue of "health and development". He accepts that TV is not like smoking: it is not simply bad for your health. He would like a return to a "respect" for TV and other electronic screens so they are treated like a trip to the theatre or a novel, as something to be consciously watched in moderation. This may sound like another culture wars value judgment but, as he argues, it is not about good or bad TV but about the good and bad ways in which we consume it.

Swine flu jab 'is safe in pregnancy'

Swine flu jab 'is safe in pregnancy'

The vaccine against swine flu is completely safe for pregnant women and could also help to protect their unborn child, the government's chief adviser on immunisation said yesterday.

Pregnant women have been identified as being particularly vulnerable to complications from the virus, but a poll last month said that almost half of expectant mothers could refuse a vaccination over fears about its safety.

Professor David Salisbury, director of immunisation at the Department of Health, said that such worries were "theoretical, with no evidence".

"The evidence is cumulating that it is worthwhile vaccinating pregnant women and that there is a benefit both to them and to their infant," he told a seminar of health professionals at the Royal College of Obstetricians and Gynaecologists.

A government leaflet giving advice to pregnant women who are considering the vaccine has been drawn up, he added.

The government's chief medical officer, Sir Liam Donaldson, told the seminar that, in contrast, the risks of contracting the swine flu virus were very real: "We know that pregnant women are at a higher risk of miscarriage and they are at higher risk of stillbirth and they are at higher risk of serious illness themselves. The problem is that we haven't really got enough data to be able to put numbers on it. We can't say to somebody what their risk is."

Having a vaccine in the midst of a major outbreak was a unique opportunity, Donaldson said. "In all previous pandemics we've been chasing after the virus and it's been almost too late to give a vaccine. This is the first time ever that it has been possible to have a vaccine in place close to the main peak of the pandemic."

Senate finance committee votes to pass healthcare reform bill

Senate finance committee votes to pass healthcare reform bill


The US Senate finance committee today voted 14-9 to pass a bill to extend health insurance to tens of millions of Americans, boosting President Barack Obama's hopes of securing the elusive goal of universal care.

Although the debate will continue in Congress for several more months, the Senate finance bill is significant, suggesting the argument has moved beyond whether Obama will get legislation passed to what will be in it.

The bill offers a basic framework for eventual legislation, the closest glimpse yet into what reform might look like.

Obama has managed to go further towards securing universal healthcare than any of his predecessors, who have been struggling since Theodore Roosevelt's presidency in 1912 to introduce it.

Senator Max Baucus, chairman of the finance committee, had made a last-minute plea to Republican senators to vote for the bill, saying: "This is our opportunity to make history."

The Democrats enjoy a 13-10 majority on the committee.

Most Republicans were opposed to the reform bill, expressing concern about the estimated $829bn (£520bn) cost. Charles Grassley, one of the most senior Republicans on the committee, described the bill as a "march leftward".

The most anticipated vote was that of Olympia Snowe, a Republican from Maine, and the only member of her party on the committee who voted for the bill.

Snowe had previously hinted at her support when she said: "Is this bill all that I would want? Far from it. But when history calls, history calls and I happen to think that the consequences of inaction dictate the urgency of Congress to demonstrate its capacity to solve the monumental issues of our time."

The Senate finance committee bill follows one passed in July by the Senate health committee, and three from House committees. But the finance committee is the one that has attracted the most interest, in part because it was the only one where a serious effort was made by the Democrats to win over Republican support. Democratic senators are now set to sit down to resolve differences between the health and finance committee bills before putting a compromise bill on the floor of the Senate possibly later this month for further debate.

Discussions between the Democrats and Republicans on reform began last November.

The finance committee bill would extend health insurance coverage to an estimated 30 million Americans and would for the first time in US history come close to providing health coverage for all. Excluded would be an estimated 20 million illegal immigrants, even though they form an integral part of the US economy.

The bill will disappoint liberals because it does not contain a public health option offering a government alternative to private health insurance. It proposes instead individuals gathering in cooperatives to use their muscle to negotiate lower prices from insurance companies.

The Senate and House disagree on how to pay for the reform. Democratic senators favour a tax on high-value health insurance policies to raise revenue. The House wants to charge millionaires.

The vote was the focus of a last-minute onslaught from the US health insurance industry. Yesterday a report by America's Health Insurance Plans, an industry trade group, claimed that proposals in the bill would see the average cost of health insurance policies for families rise from $12,300 to $25,900 by 2019.

John Kerry, the former Democratic presidential candidate and a member of the finance committee, described the report as a disgrace, coming as it did at the last minute with claims that did not stand up to scrutiny.

Snowe echoed this, saying: "I don't think it was based on any valid assumptions."

Jay Rockefeller, a Democrat from West Virginia, said: "The misleading, and to me, harmful claims made over the weekend by the profit-driven health insurance companies are politicking for corporate gain at its worst."