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Am Fam Physician. 2003;67(3):593-594

Children learn and develop skills by observing and experiencing the world around them. In the United States, the average child watches about three hours of television per day. Children have difficulty separating reality from fantasy when watching television. In addition, television provides children with a distorted image of the world. Multiple studies have evaluated the impact of television viewing on the behavior of children. However, none of the studies has involved the use of the Child Behavior Checklist. Özmert and colleagues used the Child Behavior Checklist to determine the impact of television viewing on competency and problem behavior in school-aged children.

The study was performed at two primary schools that were randomly selected from a city school system. One school was in a low-income district and the other was in a high-income district. The subjects were second-and third-grade students enrolled in these schools. The subjects' parents were asked to complete a questionnaire and the Child Behavior Checklist. The questionnaire sought information about the time the child spent watching television versus the time spent engaging in other daily activities. To evaluate the accuracy of parent-reported television viewing time, 10 percent of the group were randomly selected, and the parents were asked to complete a seven-day diary of television viewing. The results were compared with the parents' reports. The participants were divided into three groups based on television viewing time: group 1 watched television for two hours or less per day; group 2, for two to four hours per day; and group 3, for more than four hours per day.

The results of the questionnaire showed a mean daily television viewing time of 2.5 hours. Overall viewing time had a negative relationship with social and school achievement scores. Other scores that were negatively affected by increased television viewing time included withdrawal, social problems, thought problems, attention problems, delinquent behavior, aggressive behavior, and externalization. The total problem scores on the Child Behavior Checklist were higher in group 3, indicating more problems in this group than in children who watched less television per day.

The authors conclude that the more time children spend watching television per day, the more likely they are to have behavior problems, according to the Child Behavior Checklist. This negative effect on behavior occurs regardless of program content. The authors reinforce the American Academy of Pediatrics' recommendation that parents limit their children's television viewing time to two hours or less per day.

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