The exposure of American children and adolescents to television continues to exceed the time they spend in the classroom: 15 000 hours versus 12 000 hours by the time they graduate.1 According to recent Nielsen data, the average child and/or adolescent watches an average of nearly three hours of television per day.2These numbers have not decreased significantly over the past 10 years.3 By the time a child finishes high school, almost three years will have been spent watching television.1This figure does not include time spent watching video tapes or playing video games.4

Based on surveys of what children watch, the average child annually sees about 12 000 violent acts,5 14 000 sexual references and innuendos,6 and 20 000 advertisements.7 Children and adolescents are especially vulnerable to the messages communicated through television which influence their perceptions and behaviours.8 Many younger children cannot discriminate between what they see and what is real. Although there have been studies documenting some prosocial and educational benefits from television viewing,9 ,10significant research has shown that there are negative health effects resulting from television exposure in areas such as: violence and aggressive behaviour; sex and sexuality; nutrition and obesity; and substance use and abuse patterns. To help mitigate these negative health effects, paediatricians need to become familiar with the consequences of television and begin providing anticipatory guidance to their patients and families.10 In addition, paediatricians need to continue their advocacy efforts on behalf of more child appropriate television.

In this review, we will describe the effects of television on children and adolescents. In addition, we will make recommendations for paediatricians and parents to help address this significant issue.