Social media discussion needed during teen checkups

Physicians who are not talking to young patients about texting or Facebook should work social media into the conversation, a clinical report suggests.

Pediatricians are in a unique position to help families understand the benefits and pitfalls of social networking sites such as Twitter, gaming sites and video sites such as YouTube, according to the American Academy of Pediatrics report published in the April issue of Pediatrics.

"The goal of the clinical report is awareness," said report co-author and pediatrician Gwenn O'Keeffe, MD. "A large part of this generation's social and emotional development is occurring while on the Internet and the cellphone." The study was published online March 28 (link).

One in five young patients logs onto a social media site more than 10 times daily, according to a recent poll by Common Sense Media, a nonprofit that provides information to help parents navigate media for their children. More than half log on more than once a day. A study in the Journal of School Violence in 2007 showed that three in four teens own a cellphone, with more than half using it to text.

Doctors can ask young patients how much technology they use in a day, Dr. O'Keeffe said. Evidence of a cellphone can be an opportunity to ask about the topic.

With physicians already trying to cover many topics during an office visit, social media questions can be part of a questionnaire filled out in the waiting room, or nurses can ask during their screening, said Dr. O'Keeffe, who wrote the book CyberSafe.

She said social media do more good than bad for teens. The AAP report found that social media allow children to stay connected with friends and relatives, give them access to health information and enhance learning by letting them connect with others about homework and group projects.

But there are risks. Adolescents are susceptible to cyberbullying and online harassment. There is also the issue of "sexting," which the report defines as "sending, receiving or forwarding sexually explicit messages, photographs or images via cellphone, computer or other digital devices." The report said a recent survey showed 20% of teens have sent or posted nude or seminude photos or videos of themselves.

Another concern is so-called Facebook depression, which develops when preteens and teens spend a great deal of time on social media sites and begin to exhibit classic depression symptoms. Also, teens may not understand that inappropriate messages, pictures or videos posted online stay there and could hurt future job opportunities and college acceptance.

If physicians aren't familiar with some of the technologies, they can start texting with a child or sign up for a social network site, Dr. O'Keeffe said. If a doctor isn't comfortable signing up for Facebook, he or she can join a physician social network site, she suggested.

Dr. O'Keeffe said it would help physicians to think about what children's lives are like today -- often overextended and with a high exposure to technology -- rather than the Norman Rockwellian child portrayed when some of them were trained.

"If they do that, it becomes easier to figure out what to ask," she said.