Victor Strasburger, MD's, 1985 article, "When parents ask about...the influence of TV on their kids," was a balanced summation of a growing body of literature on the risks and potential benefits of television exposure on children. This well-written article highlighted television exposure trends among the pediatric age group in 1985. Children ages 2 to 12 years watched an average of 25 hours of television per week, viewing peaked in the pre-school period and again in the preteen years, and children from lower-income homes tended to watch more television than peers in higher-income homes. Strasburger pointed out that television in the US was distinct in both its lack of formal children's programming, and the paucity of child-specific programming during times in which children would reasonably have access to them.

In addition, Strasburger identified six areas of concern regarding television exposure that remain of concern today:

• Violence
• School performance
• Obesity
• Promotion of an unreal world
• Sex and drugs
• Disruption of family life

Since 1985, children's opportunities for media exposure have broadened greatly to include computers, video games, phone texting, and downloads, among others. A report of the Kaiser Family Foundation of children 8 to 18 years showed an increase in total exposure to media (television, movies, computers, video games, audio, and print media) from 7:29 hours/day in 1999 to 8:33 hours/day in 2004.¹ This increase in media exposure primarily reflects increases in the proportion of time children spend with computer and video game media.

The American Academy of Pediatrics (AAP) Policy on Children, Adolescents, and Television provides guidance on how to mitigate the effects of television on youth at the clinical encounter, through community advocacy, by active participation in relevant AAP committees, and through legislative changes.¹⁷ These recommendations bear great resemblance to the recommendations in Strasburger's 1985 article, which could be a source of frustration to the pediatric provider—much has been added to the body of evidence of the negative impact of media exposure on youth, yet little progress has been made in mitigating that effect.

As opportunities for youth to be exposed to media increase, so too do the potential opportunities for positive intervention. Demonization of television and other forms of media is not useful or appropriate; rather equipping ourselves to be responsible users of media allows us to model "healthy" media behaviors. Pediatric providers who are knowledgeable about the effects of media on youth, who take the time to screen for media exposure and its effects, and who become "media literate" can serve as tremendous resources to their patients and families in how to responsibly utilize media in the years to come.

WHERE ARE THEY NOW?

DR. GUNN is Chief Medical Officer, Tennessee Department of Health, and Assistant Professor of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tenn. The author has nothing to disclose in regard to affiliations with, or financial interest in, any organization that may have an interest in any part of this article.