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August 2005, VOLUME26 /ISSUE 8

Keeping kids safe in cyberspace

Pediatricians should talk to patients, parents about Internet dangers

  1. Daniel D. Broughton, M.D., FAAP

Children are spending more and more time on the Internet. We worry about the appropriate amount of time spent on this activity and its impact on other activities such as reading, exercising and socializing. Isolation can be a serious risk for some young computer users. However, the biggest concern many parents have is safety.


Dr. Broughton

What are the real risks to children, and what should pediatricians tell parents?

No such thing as privacy

One of the first things to understand is that being online is the same as being in public. While using the Internet at home may feel safe and secure, there are very real privacy issues.

Personal information can be obtained easily when children create“ member profiles” with Internet service providers, on a Web site or in a chat room. “Cookies” allow outside sources to see inside one's home computer. This information can be misused in a variety of ways, including marketing directed at children and by child predators.

Inappropriate sites

Pornography on the Internet is an area of concern for many parents. Kids unexpectedly come across pornography. A recent study showed that 25% of children find unwanted pornography, and about one-quarter of them find it quite distressing (). These sites generally are found while surfing the Web by mistyping addresses, misleading names to Web sites and links from other sites. Pornography also will show up in an individual's e-mail in-box, usually from an unknown or anonymous sender.

In addition to pornography, there are many other inappropriate sites, including those that promote anorexia/bulimia, racism or misinformation on important health issues such as birth control and immunizations. The May AAP News ( reported that 1 million to 2 million teens may have a serious gambling problem. There now are more than 2,000 online casinos.

Online solicitation

Of even greater concern is that child molesters are contacting and luring children and teens with inappropriate intentions. Finkelhor found that one in five children and adolescents has been solicited over the Internet. While three-quarters of them were not upset by the encounters, one-fourth were frightened or quite upset by the episodes.

In 2004, more than 700 kids were abducted by someone they met over the Internet. Those most frequently involved are in the 12- to 17-year-old age group, especially girls. These contacts often are initiated through chat rooms or instant messaging, with contact continuing via e-mail. While the majority of perpetrators were male, women also can be involved. One striking finding is that nearly 50% of those doing the solicitation were under the age of 18.

In talking about Internet use, we need to broaden our advice to “Be careful and behave.”


Another area of considerable concern is bullying.

Kids are using e-mail and instant messages to intimidate or send unflattering messages to individuals or to others about these individuals. Likewise, embarrassing information, photos or stories about someone can be posted on Web sites for others to see. In some cases, Web sites have been created for this purpose.

Another potentially damaging technique is to obtain someone's password and then send inappropriate material to someone else using the victim's e-mail account.

While reliable statistics on Internet bullying are not available, estimates range from 6% of U.S. kids having been bullied in this way in 2000 to as high as 25% more recently in Canada, Great Britain and New Zealand.

Ubiquitous access

When we think of Internet use, we think of computers, namely desk- and lap-top computers. That thinking should be broadened to include hand-held devices, such as iPods, personal digital assistants and, most notably, cellular telephones. Phones already are being used to send text messages, and some have limited connection with the Internet. Shortly, devices will combine all of these activities in a single sophisticated package that is 3.5-by-5-by-1 inch.

When talking about the Internet, we now are talking about everyone, everywhere, any time.

Internet advice

Pediatricians need to be aware of these issues and be prepared to talk to patients and parents about them as part of anticipatory guidance. Pamphlets are available from the Academy and other advocacy organizations. (See resource box.)

While there is obvious need for concern, there also are things families and others can do to help the situation.

Parents need to learn about computers, understanding that their children often know more about them than they do. Children should be supervised whenever using a computer, especially when on the Internet. It is best to keep computers in a public place in the house and never in a child's room where a door can be closed.

The time allowed for Internet use should be included in the two hours daily of screen time recommended by the Academy. Parents also need to know how to trace what Web sites have been visited and should check frequently. Software that enables detailed tracking of these sites is available.

Parents also can consider filtering devices to control computer visits. These products can restrict Internet travels to chosen sites or can be used to block unwanted sites or materials. While they can be helpful, there are some limitations. For example, they block indiscriminately, prohibiting access to appropriate sites that contain a blocked word, such as Klan on a civil rights site or breast on a health site. Also, they are not good teaching tools and do not replace parental involvement.

Older children and teens are likely to use computers outside home or even cell phones to connect to the Internet. Parents need to be sure their kids understand the possible dangers and practice the following basic safety rules:

  • Keep identity private, don't share personal information.

  • Never get together with someone you “meet” online.

  • Talk to a parent or trusted adult if uncomfortable or frightened.

  • If uncomfortable, don't respond.

  • Never send any message you would not want to say face-to-face.

Dr. Broughton is a member of the AAP Committee on Communications.

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