1. + Teens & Technology Dr Amy Robinson Adolescent Health Specialist Children’s Hospital of Eastern Ontario Assistant Professor, University of Ottawa

2. + Objectives Recognize how the internet can promote healthy youth development Discuss the aspects of online activity and social networking that may result in potentially adverse developmental outcomes Outline recommendations aimed at promoting safe use of internet-based communication applications Identify harm reduction strategies concerning internet situations involving risk

3. + Disclosure You may only access and use this PowerPoint presentation for educational purposes. You may not post this presentation online or distribute it without the permission of the author.

4. + Canadian data MediaSmarts is a Canadian not-for-profit charitable organization for digital and media literacy Survey that was administered in 2013 to 5,436 Canadian students in grades 4 through 11 The purpose of the survey was to explore the benefits and challenges children experience when they use networked devices such as computers, tablets, cell phones and iPods

5. + Internet access Internet access is universal, with 99% of students able to access the Internet outside of school, from a variety of (mostly portable) platforms and devices

6. + Cell phones Cell/Smart phone access

7. + Online activities What are students doing online?

8. + Online activities Finding information online

9. + Online accounts

10. + Unplugging Almost all (96%) students report that they have chosen to unplug in order to enjoy other aspects of their lives

11. + Sleeping with cell phone

12. + American data Kaiser Family Foundation is a non-profit organization focusing on national health issues, as well as the U.S. role in global health policy Large-scale, national survey in US about young people’s media use Subset of respondents also completed seven-day media use diaries

13. + Media consumption  Over the past five years, amount of time spent consuming media increased by an hour and seventeen minutes daily, from 6:21 to 7:38 (which translates into 10+ h media content daily due to multitasking)

14. + Media consumption Teen use of every type of media has increased over the past 10 years, with the exception of reading.

15. + Home internet access

16. + Cell phone ownership

17. + Cell phone usage Teen texting between friends has now overtaken cell phone communications - and every other common form of interaction Pew Research Centre. Teens and mobile phones, 2010.

18. + Media & young adults Understanding the role of media in young people’s lives is essential for those concerned about promoting the healthy development of children and adolescents

19. + Objectives Recognize how the internet can promote healthy youth development Discuss the aspects of online activity and social networking that may result in potentially adverse developmental outcomes Outline recommendations aimed at promoting safe use of internet-based communication applications Identify harm reduction strategies concerning internet situations involving risk

20. + Adolescent development Transitions characterized by: Biological changes Psychological changes Social changes

21. + Promotion of healthy development Socialization & Communication O’Keefe GS et all. Clinical report – The impact of social media on children, adolescents, and families.Pediatrics, 2011.

22. + Promotion of healthy development Socialization & Communication O’Keefe GS et all. Clinical report – The impact of social media on children, adolescents, and families.Pediatrics, 2011. Multiple daily opportunities for connecting with friends, classmates, and people with shared interests Accomplish similar tasks online as do offline: -Stay connected with friends & family -Make new friends -Share pictures -Exchange ideas -Foster individual identity and unique social skills

23. + Promotion of healthy development Socialization & Communication O’Keefe GS et all. Clinical report – The impact of social media on children, adolescents, and families.Pediatrics, 2011. Multiple daily opportunities for connecting with friends, classmates, and people with shared interests Accomplish similar tasks online as do offline: -Stay connected with friends & family -Make new friends -Share pictures -Exchange ideas -Foster individual identity and unique social skills Two key tasks in adolescence are “to stand out – to develop an identity and pursue autonomy… and to fit in – to find comfortable affiliations and gain acceptance from peers” (Brown, 2008)

24. + Promotion of healthy development Socialization & Communication O’Keefe GS et all. Clinical report – The impact of social media on children, adolescents, and families.Pediatrics, 2011. Multiple daily opportunities for connecting with friends, classmates, and people with shared interests Accomplish similar tasks online as do offline: -Stay connected with friends & family -Make new friends -Share pictures -Exchange ideas -Foster individual identity and unique social skills Two key tasks in adolescence are “to stand out – to develop an identity and pursue autonomy… and to fit in – to find comfortable affiliations and gain acceptance from peers” (Brown, 2008) Social networking sites can help accomplish this

25. + Promotion of healthy development Socialization & Communication Enhanced learning opportunities O’Keefe GS et all. Clinical report – The impact of social media on children, adolescents, and families.Pediatrics, 2011. Social media programs allow students to gather outside of class to collaborate and exchange ideas about assignments Blogs as teaching tools has the benefit of reinforcing skills in English, written expression, and creativity

26. + Promotion of healthy development Socialization & Communication Enhanced learning opportunities Accessing health information O’Keefe GS et all. Clinical report – The impact of social media on children, adolescents, and families.Pediatrics, 2011. People coping with rare disease have turned to the Internet as a means of information-gathering and support Eight in ten internet users have looked online for health information Access online information about health concerns easily and anonymously Mobile technologies (i.e. cell phones/texting) can produce improvements in health care, such as increased medication adherence, better disease understanding and fewer missed appointments

27. + Objectives Recognize how the internet can promote healthy youth development Discuss the aspects of online activity and social networking that may result in potentially adverse developmental outcomes Outline recommendations aimed at promoting safe use of internet-based communication applications Identify harm reduction strategies concerning internet situations involving risk

28. + Privacy Risks from each other – cyberbullying Risks of improper use of technology - sexting Lack of privacy – digital footprint Sharing too much information – online victimization O’Keefe GS et all. Clinical report – The impact of social media on children, adolescents, and families.Pediatrics, 2011.

29. + Cyberbullying Cyberbullying is deliberately using digital media to communicate false, embarrassing, or hostile information about another person. It is the most common online risk for all teens and is a peer-to- peer risk 34 % of students in Grades 7 to 11 report being bullied 74 % were bullied at school and 27 % over the Internet Moreno MA. Cyberbullying. JAMA Pediatrics, 2014.

30. + Cyberbullying Additional risks of cyberbullying compared to traditional bullying Anonymity: Victims often do not know who the bully is or why they are being targeted No reprieve: Hurtful actions of a cyberbully can reach the teen anytime he or she uses a telephone or computer Potential for wider scope: Bullying messages can spread virally through the Internet to many other people at school or in the community, making this type of bullying potentially very embarrassing and lasting Moreno MA. Cyberbullying. JAMA Pediatrics, 2014.

31. + Cyberbullying Depression Social anxiety, loneliness, isolation Stress related health problems (e.g., headaches, stomach aches) Low self esteem School absenteeism and academic problems Aggressive behaviours Contemplating, attempting, or committing suicide Not knowing the difference between right and wrong Delinquency and substance use Academic problems and increased school dropout rate Aggression Sexual harassment and dating aggression Gang involvement and criminal adulthood Difficulties in their relationships with others Being bullied at the hands of others ‘Bullying and Cyberbullying’, http://www.rcmp-grc.gc.ca/cycp-cpcj/bull-inti/index-eng.htm. Dangers for Victims Dangers for Bullies

32. + Amanda Todd’s story

33. + Bill C-13 Protecting Canadians from Online Crime Act 162.1 (1) Everyone who knowingly publishes, distributes, transmits, sells, makes available or advertises an intimate image of a person knowing that the person depicted in the image did not give their consent to that conduct, or being reckless as to whether or not that person gave their consent to that conduct, is guilty Known as “Anti-Cyberbullying” law: Supporters: Combat online harassment by making it illegal to distribute intimate images of a person without their consent Critics: Could violate citizens’ privacy because it also gives authorities more powers to investigate what Canadians are doing online

34. + Sexting Pew Research Centre. Teens and sexting, 2009. Sexting - sending and receiving of sexually explicit images or messages via mobile phones

35. + Sexting Pew Research Centre. Teens and sexting, 2009. 30 % of cell-owning 17- year-olds who say they have received sexually suggestive images of someone they know via text messaging.

36. + Digital footprint “Collective, ongoing record of one’s Web activity” Adolescents who lack awareness of privacy issues often post inappropriate messages, pictures and videos without understanding that ‘what goes online stays online’ Consequences: Future reputation Employment College acceptance O’Keefe GS et all. Clinical report – The impact of social media on children, adolescents, and families. Pediatrics, 2011.

37. + Online victimization In 2005, the Second Youth Internet Safety Survey (YISS-2) found that 1 in 7 youth Internet users received an unwanted sexual solicitation during the year prior 6/7 of these propositions came from individuals known ONLY online. Most adult offenders are up front in their online communications about their interest in a sexual encounter Only 5% passed themselves off as adolescents Majority of deceptions were promises of love and romance to vulnerable adolescents “The factors that make youth vulnerable to seduction by online molesters are complex and related to immaturity, inexperience, and the impulsiveness with which some youths respond to and explore normal sexual urges.” Crimes against Children Research Center. YISS-2, 2005.

38. + Cybertip.ca

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40. + Objectives Recognize how the internet can promote healthy youth development Discuss the aspects of online activity and social networking that may result in potentially adverse developmental outcomes Outline recommendations aimed at promoting safe use of internet-based communication applications Identify harm reduction strategies concerning internet situations involving risk

41. + Recommendations Canadian Pediatric Society (from Healthy Active Living/Physical activity guidelines): For children <2 years, screen time (eg, TV, computer, electronic games) is not recommended For children 2-4 years, screen time should be limited to <1 h/day; less is better Children (5-11 yrs) and youth (12-17 yrs) should minimize the time they spend being sedentary each day by: Limiting recreational screen time to no more than 2 h/day – lower levels are associated with additional health benefits. Canadian Pediatric Society. Healthy active living: Physical activity guidelines for children and adolescents, 2012.

42. + Recommendations American Academy of Pediatrics: Ask two media questions and provide age-appropriate counseling for families: How much recreational screen time does your child or teenager consume daily? Is there a TV set or Internet-connected electronic device (computer, iPad, cell phone) in the child’s or teenager’s bedroom? American Academy of Pediatrics. Children, Adolescents, and the Media. Pediatrics, 2013.

43. + Recommendations American Academy of Pediatrics: Pediatricians should recommend the following to parents: Limit the amount of total entertainment screen time to <1 to 2 hours per day Discourage screen media exposure for children <2 years of age Keep the TV set and Internet-connected electronic devices out of the child’s bedroom Monitor what media their children are using and accessing, including any Web sites they are visiting and social media sites they may be using. Coview TV, movies, and videos with children and teenagers, and use this as a way of discussing important family values Model active parenting byestablishing a family home use plan for all media. As part of the plan, enforce a mealtime and bedtime “curfew” for media devices, including cell phones. Establish reasonable but firm rules about cell phones, texting, Internet, and social media use. American Academy of Pediatrics. Children, Adolescents, and the Media. Pediatrics, 2013.

44. + Norris, ML. HEADSS Up: Adolescents and the Internet. Paediatrics & Child Health, 2007.

45. + Objectives Recognize how the internet can promote healthy youth development Discuss the aspects of online activity and social networking that may result in potentially adverse developmental outcomes Outline recommendations aimed at promoting safe use of internet-based communication applications Identify harm reduction strategies concerning internet situations involving risk

46. + Norris, ML. HEADSS Up: Adolescents and the Internet. Paediatrics & Child Health, 2007.

48. + Summary The Internet represents both risks and opportunities for adolescents and young adults Awareness of the range of applications and information available online will facilitate the health care provider’s ability to counsel youth and parents regarding appropriate Internet use

49. + Questions? Comments?