Video Games: Practical Approaches
by David Perlmutter, MD, FACN

Video games are usually played on video game consoles (such as XBox, Playstation, or Nintendo) and require a gamepad (formerly called a joystick) to maneuver through the game, but they can also be played on computers with the appropriate hardware or with hand held devices.

Video games have been around for more than three decades, yet they seem to become more controversial with each passing year. When it comes to video games, there is no shortage of critics who say that these games are corrupting our youth - it's harder to find someone who has anything positive to say about them. Video games are an easy target. For one thing, many of the most popular games are incredibly violent and contain sexual content that is definitely not for children, although the games may fall into their hands. There are hundreds of games that are not violent and are age appropriate but they don't get the same kind of publicity. Perhaps because it is a newer medium, there are far fewer studies exploring the impact of video games on children than that of television, and the few studies that have been done show a link between aggressive behavior and playing video games with violent content.

Parents are understandably concerned about the long term impact of video games on their kids. Like television, video games are seductive to young minds because they are also very stimulating to the sensory portions of the brain. If given a choice, many kids, especially boys, would spend every free moment gaming.

According to the National Institute on Family and Media, the average child plays video games around nine hours a week, and that's not counting the twenty-five or so hours spent watching TV, or time on the computer.

Video games appear to have a greater allure for males than females about 70 percent of the players of the most popular console-type games are male, but that could be due to the fact that the games are typically very male oriented.

Furthermore, many parents of school-age children tell me that when their children play video games, they undergo a personality transformation and appear to be in an almost trancelike state. When the parent tries to get her child to stop playing, she hears the universal cry, "Just let me get to the next level," and the child will keep going unless the game pad is physically taken away from him, This poses a real problem for parents who find that video games are sapping the time their child should be devoting to homework or other activities. As a result, grades often suffer.


Why would I allow children to play video games at all? There are positive aspects to playing video games that their critics don't mention.

First, video games are a user-friendly introduction to electronic media and can help demystify technology for children. A child growing up today is going to be interacting with electronic equipment - from ATMs to PDAs to computers - for the rest of his life. It's important to feel comfortable and not intimidated by technology (which is also why I feel it's absolutely essential for every child over 3 to develop computer skills.)

Second, video games may help develop hand-eye coordination, which is useful for playing ball, using a computer mouse, driving, and other activities. I use the word may because although one would expect video games to improve hand-eye coordination, simply because of how the games are played, there have not been any studies to indicate that this is true. Nevertheless, it takes a certain amount of skill to manipulate a game controller, and I would bet that many of today's pilots, engineers, and surgeons played video games as kids.

Third, video games can enhance mathematical skills. In a typical game, you reach a certain number and you move on to the next level. Even the most math-resistant kid will eagerly count up his points so he can move ahead in the game.

Finally, if a child plays the game with a partner, he learns to be a team player, another valuable skill. For boys in particular, video games provide a way of social bonding, and the kid who doesn't play is going to be the odd boy out.


Set Strict Age Limits

Video games are not appropriate for children under the age of 3. First, they don't have the manual dexterity to manipulate a game pad. Second, they should be doing other things with their time. Third, they can hurt themselves. Their hands and arms are not developed enough to sustain the strain of video game playing.

The repetitive motion of manipulating the game pad can damage tendons in the arm and hand. Even older children need to be careful about developing repetitive stress syndrome from overplaying video games, but younger children are especially vulnerable.

Choose Age Appropriate Games
By around age 3, some children may be ready to play age appropriate games, preferably ones that are designed for a preschool-aged child and are not violent. If you have older children at home, be vigilant that younger children do not use their games. Games designed for schoolaged children can be surprisingly violent. Some manufacturers of educational toys offer interactive products that resemble video games, but unlike standard action video games, these games promote reading and math skills. These include products produced by Leap Frog, Fisher-Price, and the V.Smile TV learning system. Children seem to enjoy them, but it's a rare child who will be happy to play these games exclusively once he sees the real thing.

Set Strict Time Limits

As with TV, excess playing of video games can prevent a child from getting enough physical activity, which can lead to obesity. Moreover, if children play video games by themselves for hours on end, they may not learn appropriate social skills necessary for success in school and in life. Don't allow your child to play video games for more than thirty minutes daily. Period.

The two real problems with video games are: (1) time spent playing them and (2) content. Parents have control over both of these factors.


Children who spend the most amount of time in front of an electronic screen may also be at risk for premature sex development. Even if not actually entering puberty, they mature sexually at early ages than peers who don't watch much TV. This relationship is stronger for girls than for boys. The average age of puberty, or first menstruation, is around 12.8 years for Caucasian girls and up to a year younger for African American . Many girls these days are showing signs precocious sexual development, including well-developed breasts and pubic growth, well before these ages. Eraly physical development can be especially devastating for girls; it is linked to academic performance, low self esteem depression, and even substance abuse.

Although no one knows for sure why watching TV would cause premature sexual development, there are several possible explanations. First, as discussed earlier, excess TV viewing is associated with childhood obesity, which can boost levels of the female hormone estrogen which, in turn, can hasten sexual development. Second, TV viewing (as well as prolonged exposure to artificial light) suppresses the production of a hormone called melatonin that helps regulate sexual development in both boys and girls. As children enter early adolescence, melatonin levels fall naturally, signaling the start of bodily changes that culminate in puberty. Artificially suppressing melatonin, however, could cause a child to start puberty prematurely.

In a recent study conducted at the University of Florence, researchers studied 74 children between the ages of 6 and 12 years old who normally watched around three hours of television every evening. For a seven day period, the children were not allowed to watch any TV or to use sources of artificial light such as computers or video games. At the end of the week, the children's melatonin levels had risen by an average of 30 percent, with the youngest children showing the greatest increase. Excess TV watching is disrupting normal hormone cycling in children, which, at least indirectly, can affect both their health and academic performance.
The intense sexual content of many television programs could rev up hormone production in children who are not meant to be exposed to this type of stimulation at so young an age. Adults often forget that even though very young children can't talk, they can listen and observe. Their brains soak up everything in their environment. You may think that a 1 or 2-year-old is not observing the sexy soap opera scenes or the casual sex on a sitcom, but she is. And by the time a child is 4 or 5 and beginning to develop a sense of her sexual self, she is definitely picking up the suggestive themes on TV. It's very important for parents and care givers to keep kids away from shows that are not appropriate for their age.

Copyright 2006 by David Perlmutter, MD, FACN and Carol Colman, from Raise a Smarter Child by Kindergarten by David Perlmutter, MD, FACN and Carol Colman, published by Broadway Books, a division of Random House, Inc.

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