Family Matters

Pediatricians Should Discuss ‘Facebook Depression’ with Kids

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Don’t be surprised if the next time you head to the pediatrician, somewhere between listening to your child’s heart and lungs, the doctor slips in a question or two about Facebook.

In a nod to the ever-increasing role that social media plays in the lives of kids, the American Academy of Pediatrics (AAP) is calling on pediatricians to incorporate questions about social media usage into doctor visits.

In a clinical report released Monday, the Academy offers guidance to doctors — and parents — about how to peek into the online lives of kids without seeming to pry. (More on Young Kids Increasingly Use the Internet Regularly)

The key, it seems, is to glean information without coming across as heavy-handed. So a doctor might casually ask, Do you have a cell phone? A Facebook account? How many friends — virtual ones, not in-the-flesh pals — do you have?

“Is it 20 or 200?” says Gwenn O’Keeffe, co-author of the clinical report and a pediatrician outside Boston who has written Cybersafe, which was published by the AAP in October. “That gives you lot of information right there.”

Experts are worried about overt dangers like sexting and cyberbullying and more overarching ones, such as how childhood has changed now that many kids prefer digital play over the outdoors kind. The shift means that much of children’s social and emotional development is influenced by their activities online; experts suggest it could even lead to “Facebook depression,” in which some children who may be at risk for social isolation or poor self-esteem and spend a significant amount of time on the social-networking site may become depressed. The constant barrage of their peers’ happy status and photo updates and friend connections may present a skewed view of reality that could make at-risk kids feel that they don’t measure up. (More on Why Other People’s Happy Facebook Status Updates Make You Feel Sad)

“With this generation of kids, they kind of emerged online before we taught them the dangers of being online,” says O’Keeffe. “We would never put a kid behind the wheel without driver’s ed. If we take that approach with younger kids who are growing up, those kids will be much better off.”

More than half of teenagers visit their favorite social media site more than once a day, and nearly a quarter log on more than 10 times a day, according to a 2009 poll by Common Sense Media. Seventy-five percent of teens have cell phones, which they use to access social media and especially for texting. (More on Study: ‘Hyper-Texting’ Teens More Likely to Have Had Sex, Tried Drugs)

But pediatricians, as a group, have yet to adapt accordingly.

“In general, the pediatric training model is still an old-fashioned, very Norman Rockwellian model, where everyone is unplugged and running outside,” says O’Keeffe. “That’s not today’s child. Once I point that out to parents and pediatricians, this huge light bulb goes off and they say, No wonder we don’t get it.”

Some doctors are concerned that they barely have enough time as it is to cover everything they want to during the course of a brief visit; they’re leery of adding another bullet point to the checklist. But the new policy suggests treating the issue of online use as a screening question that could be raised by the nurse taking vital signs or on an intake questionnaire. “We’re not telling people to reinvent the wheel,” she says.

The new policy recommends pediatricians advise parents to bring up digital issues including cyberbullying, sexting and the uncanny way the Internet proves a persistent obstacle to successful time management. Parents should regularly oversee what their kids are doing online and should consider implementing a “family online-use plan” that lays out a set of family rules for online behavior. Some examples: Nobody uses tech at the table. Kids go online only once they finish their homework. Parents — and this is a tough one — can’t  tap away at smartphones when they’re out with their children. (More on Dealing with Cyberbullying: 5 Essential Parenting Tips)

Doctors should also encourage parents to sharpen their tech skills; if your child’s got a Facebook account, well, Mom, you need one too. And what about the modern parenting dilemma — to friend or not to friend your kid? Says O’Keeffe: “Definitely friend your child.”