Children's exposure to sexual images in the media, and how to help protect your patients

DR. LEDER is associate professor of clinical pediatrics at Children’sHospital/The Ohio State University, Center for Child and FamilyAdvocacy, Columbus, Ohio.DR. FRENCH is associate professor of clinical pediatrics, KapiolaniMedical Center for Women and Children, Honolulu, Hawaii.They have nothing to disclose in regard to affiliations with, or financialinterests in, any organization that may have an interest in any part ofthis article.

More than $12 billion is spent in marketing and advertising to children annually, with "brand loyalty" and "cradle-to-grave marketing" guiding the trend.¹ Companies that sell products for children, such as clothes, electronic devices, and toys, have grown more sophisticated in recent years in their efforts to reach your patients-in particular, "tweens," or 10- to 13-year olds-at the same time that advertisements for their products have grown more explicit, including the use of sexualized images of children. Media outlets such as Cartoon Network and Teen People exist specifically to increase children's exposure-with minimal parental oversight-to these advertisements.

The scope of the problem

Further evidence suggests the way in which television viewing influences children's behavior: One study demonstrated that food commercials embedded in cartoons influence children's food choices; ³ a study of third- and fourth-grade students found that decreased television viewing is associated with fewer requests for toys;⁴ and a third study found decreased prosocial behavior and increased aggressive affect in children who play violent video games.⁵

Further evidence suggests that media have the ability to promote adult behaviors in children, including tobacco and alcohol use and sexual activity. In particular, researchers found a twofold increase in the rate of sexual intercourse in adolescents who had what was considered a high level of exposure to sexual content on television.⁶ This finding is more worrisome in light of an additional finding that 83% of television programs directed at adolescents include sexual content.⁷ A detailed discussion of the impact of media on children and adolescents is beyond the scope of this article; excellent reviews of the subject are available elsewhere.^8,9

Processing media messages

Not until adolescence is a person able to judge what is probable, to think abstractly, and to thereby understand the meaning behind a media message. But because an adolescent lacks life experience and knowledge, he may be particularly vulnerable to unrealistic media messages. As he develops the ability to think in the abstract, and as his self-concept grows more clearly defined, he is growing more independent and, perhaps, engaging in experimentation and risky behavior (recall that approximately half of high school students have had sexual intercourse).¹² Although parents can help a child identify those messages that promote unhealthy behaviors, the percentage of waking hours that a child spends with his family falls from 35% to 14% between fifth and 12th grade.^13,14